Gou is practicing medicine in the clinic

Chapter 242 Help Master Diagnose, ALS

"Even if the cortex of his side bone is damaged, there is still a missing piece!"

After Li Jingsheng investigated, his tone became more serious.

According to experience, the occurrence of cortical damage is already a big problem.With such a large defect, the osteolysis has been taking place for a long time.

"Look at the marrow cavity!"

Professor Wu is relatively calm. After all, he is a chief physician.

"It's a tumor!"

Although Li Jingsheng had had this premonition for a long time, when he saw the pink-white tumor tissue in the medullary cavity, he couldn't help but shake his head.

After investigation, the pink-white tumor in the medullary cavity was soft in texture and very similar to enchondroma.

Carefully scrape off the tumor tissue until the normal medullary cavity can be seen, and then inactivate it with 95% alcohol.

"Send it to a doctor!"

Professor Wu's tone was indifferent, but his expression was much more relaxed.

The patient himself had distrusted the hospital and was quite complaining.If this surgical exploration yields nothing and the patient takes the opportunity to cause trouble, Professor Wu will be very passive.

Fortunately, now that the tumor has been discovered, there is an explanation to the patient.

It can also prove that the doctor's judgment is very accurate.

In fact, in this case of the patient, an MRI should be done first.

CT, B-ultrasound, and X-ray sometimes have some disadvantages because of the imaging principle.

There may be some discrepancies in the results.

For example, the result of this photo taken for the patient looks like arthritis, but who would have thought that there is a tumor growing in the medullary cavity of the joint?
"Doctor, is the tumor you mentioned a tumor?"

The patient asked Li Jingsheng.

"Yes! But there are also benign tumors, so you don't need to be too nervous until the pathological results come out."

When Li Jingsheng looked at the patient, his eyes were complicated.

No doctor wants patients to grow tumors, but clinical practice is so cruel.Whatever comes out is what it is, and no one can change it.

"How did it grow? I don't smoke, I don't drink alcohol, I don't even eat supper, and I exercise regularly. How did I get a tumor?" The patient only received brachial plexus anesthesia, except for his right hand. activities, the rest are basically unaffected.

It was hard for him to hear that he had a tumor.

There should still be fear in my heart.

"No one can explain this kind of thing clearly. But I personally think it may have something to do with you being injured repeatedly and irritating it. In the future, you just need to learn lessons and pay attention. There is no need to have any psychological burden, let alone be afraid. Now that the problem has been discovered, On the contrary, it is a good thing, when the pathological results come out, we will help you further develop a treatment plan.”

Li Jingsheng comforted the patient while suturing him.

After finishing, the patient was sent back to the inpatient ward.

The patient's heart must have collapsed, and he didn't say a word when he was taken out.

With a serious expression and a preoccupied look.

Many patients diagnosed with serious illnesses have this behavior.

Some of those with fragile hearts even sat on the ground and broke down crying.

After Li Jingsheng came out of the operating room, he hurried to work in the outpatient clinic.

The surgery cost him a huge amount of health, 213 points.But he couldn't be happy in his heart, and he was somewhat worried that the pathology result was a malignant tumor.

Back to the outpatient clinic, patients have long queued up.

The manipulative repositioning clinic of the Second Hospital used to be quite famous when Dr. Xu was the only one attending.

Now the processing ability has been greatly improved, and Li Jingsheng's ability is not weaker than that of Dr. Xu, which makes the second hospital's manipulation and bone setting flourish.

Almost the entire medical circle in Jiangli City knew that the Second Hospital had this special treatment ability.

And it is spreading to surrounding cities and rural areas.

According to incomplete statistics, bone injuries account for less than 2% of all outpatient and emergency cases.

Most injuries occur accidentally.

But after the fame spread and further expanded, the impact was too great.

Patients with orthopedic injuries and bone diseases from all over the world came to seek treatment one after another.

As a result, the manual reduction clinic of the Second Hospital became more busy and crowded.

If this trend increases further, Li Jingsheng and Dr. Xu will definitely be overwhelmed.

The master and apprentice are nothing.

Everyone lives a magical life, never works overtime, and their wages are very high.

Of course, the high wages are due to more work and more pay.

The more work you do, the higher your income, and the higher your wages will naturally be.

Li Jingsheng handled everything in an orderly manner.

Not to mention [-]% satisfaction, at least every patient he treats has done his best.

If there is no way to perform manual reduction and treatment, the only option is to persuade the patient to undergo surgery.

If the patient agrees to be treated at the second hospital, he will write a note to the patient and directly tell the patient which doctor to find.

This can prevent patients from queuing and registering repeatedly.

His current status in the Second Hospital may be mediocre, but in orthopedic surgery, from the director of the department to the resident physician, everyone buys his account.

Orthopedic surgery really needs such a young leader.

Only by enlarging the basic base can everyone live a better life.

"Dr. Li, we have encountered a difficult patient in the first consultation room. Dr. Xu invites you to go and have a look."

A nurse in the nearby consulting room ran over to ask for help.

"Okay, I'll go over as soon as I finish dealing with this patient."

Li Jingsheng felt something strange in his heart.

This was the first time Dr. Xu took the initiative to ask for help.

I don't know what case happened?

"Little friend, how old are you?"

Li Jingsheng asked the little girl with a dislocated left wrist joint with a smile.

"Two years old!"

She timidly replied in a childish voice.

Immediately afterwards, there was an expression of pain and tears on her face, but Li Jingsheng had already taken advantage of this time to heal her wrist.

I kneaded and massaged her wrist for a while, and felt that nothing happened.

Then he got up and went to the consulting room next to him.

"Doctor Chen, hold on for a few minutes, I'll be back soon."

Li Jingsheng felt helpless looking at the long line of patients outside.

Every patient comes to see a doctor with great expectations, and the appeal and pain of every patient cannot be ignored.

When I first started learning bone setting, I thought it was quite strange, and I learned a lot of new knowledge about bone setting and reduction every day.

Now that I have learned the basics of technology, it is more of a repetitive work.

After a whole day, it is actually very boring.

Also very tired.

After all, it is physical work.

Just now I reset the wrist joint of that little girl, it seemed easy, and the reset was successful in two or three seconds.

But to achieve this level, in fact, it takes a lot of energy.

It is equivalent to using a hundred catties of strength, but only ten catties can be applied to the patient's bones.It's a bit like lifting it up high and putting it down gently.

Li Jingsheng himself could find that after working in the Second Hospital for nearly three months, his arms became thicker.

It was hard and firm to pinch, all tight muscle.

These are the muscles that have been trained!

But it's also a good thing, work and exercise are the same.

For example, in the morning, the guy with a height of 1.9 meters [-] was pulled by him.

If it was changed to before, it is very likely that it will not be able to hold back.

Go to the next consultation room 1.

Dr. Xu is treating a patient with a broken leg.

"Let's take a look at that patient. His right arm was dislocated two weeks ago, and I reset it. Now he says that his right arm is still unable to exert strength."

Dr. Xu was never polite when talking to him.

It's all straight forward.

This is also a sign of not treating him as an outsider.

It also has something to do with Dr. Xu's own personality.Dr. Xu never licks even when facing the hospital leaders.

If it weren't for his excellent skills, this kind of personality would actually be at a disadvantage in the workplace.

Li Jingsheng looked at the patient sitting there, a pretty young woman.

The handsome boyfriend is by his side and is taking care of him carefully.

"Did you wear a sling after the right arm was reset?"

"Beat it. We were supposed to hang it for about three weeks, but we took it off in the second week when we felt that nothing was wrong. Her right hand has been unable to exert strength. Could it be that the joint has not been reset?"

The boyfriend asked back.

"Do you want to review the filming?"

"It was taken. This is today, and this was taken when I was injured."

The man handed two information packets to Li Jingsheng.

I took it and looked at it. The first X-ray film clearly showed a dislocation of the right shoulder joint.

Looking at the film taken during the re-examination today, the shoulder joint has been reset, and there is no problem.

"Judging from the re-examination film, the reset is very successful, there is no problem! Let me help you to actually check it!"

Li Jingsheng looked at the female patient.

"sorry to bother you!"

Her voice was soft when she spoke.

"You're welcome. Straighten your two hands first." Li Jingsheng instructed her to straighten her hands, and then stretched out her right hand. "Take my hand with your right hand, and use as much strength as you can."

She complied.

It's just that the girl's hand is as soft as boneless, even if she squeezes his hand hard, it's still like cotton.

"You don't have to worry about my pain, just be stronger."

Li Jingsheng thought the girl was worried, so he asked her to step up her efforts.

"I... have tried my best." She replied a little embarrassed.

"Is it the same strength as usual?"

The strength Li Jingsheng felt was that of a five or six-year-old girl.

She must be 23 years old.

This is incredible.

"I used to be very strong. When I was studying at school, I remember that I had to go to the boiler room downstairs to get hot water. The charging standard was [-] cents for a hot water bottle and [-] yuan for a bucket. No matter how much you pick up, half a bucket or a bucket A full bucket is one yuan. One of my roommates is poor and very small, and she often uses cold water to save money. I offered to carry a full bucket of hot water upstairs and give her half of it.”

She was full of smiles when she talked about interesting things while studying.

Some old memories are really good.

"You are quite kind-hearted! Come on, use your left hand to hold my hand again and use your maximum strength."

Li Jingsheng tested her left hand.

She tightened her grip, much stronger this time.

But it is still weaker than the strength that a 24-year-old young woman should have.

And her body shape is not thin.

She doesn't look like the helpless young lady.

"Since when did your strength decrease? Since your right arm was injured?"

Li Jingsheng was full of doubts.

There are more than 55000 known diseases in the world, and the number is still increasing.

Every year, scientists or doctors discover new types of diseases.

Occasionally encounter various strange diseases clinically.

This is the first time that Li Jingsheng encountered a case where his strength became weaker after the joint was reset.

If the joint reduction is unsuccessful, it is understandable.

The film taken by the patient now shows that the reset was successful, and more than two weeks have passed, so it stands to reason that the recovery is almost complete.

"I don't know about this. It's just that I feel weak these days and get tired easily. The last time I injured my right hand was also due to fatigue. I lost my grip when climbing the ladder to change the light bulb, and then fell."

What the female patient said gave Li Jingsheng a new thought.

"For something as dangerous as changing a light bulb, let your boyfriend do it!"

Li Jingsheng looked at the young man next to him with a smile.

"Don't mention it. I was on a business trip at the time. I heard that she was injured in a fall. I don't know how distressed I was."

The boyfriend hurried to the side to make up for it.

It can be seen that this boyfriend is very handsome, but he gives people a kind of slickness who is good at superficial skills.

These days, boys who are too honest are at a disadvantage in chasing girls.

A stupid mouth can't speak sweet words, and it's easy to lose a wife.

On the contrary, he is a smooth-talking man, even if he is so scumbag that he turns black, there are still female servants who follow him and throw himself into his arms.

"Let me touch the bones for you! If you really can't find the cause, I'm afraid you need to go to the orthopedic department."

"Ok."

The female patient nodded in agreement.

Li Jingsheng first pinched her elbow upwards.

Serious expression.

You must also maintain a serious expression, because the boyfriend is watching, and if there is a misunderstanding, it is really difficult to explain.

Some men saw male doctors groping their girlfriends or wives, and some of them beat up on the spot.

"No wonder the strength of your hand is weak, it feels like there are no muscles in your arm!"

Li Jingsheng quickly discovered the problem after touching it.

There were no obvious problems with her bones, but her arms had no muscles and felt very thin.

"I shouldn't be thin either! It weighs more than 110 catties."

The girl touched her face subconsciously.

"Isn't it normal for girls to have no muscles? If a woman had muscles as developed as a man, that would be terrible." Her boyfriend also said next to her.

"You're right. Let me show you my left hand again."

Li Jingsheng didn't argue with them, but he thought in his heart that the girl's right arm muscles were a bit lacking.

He feels the patient's bones every day and will never feel wrong.

After touching the female patient's left arm, he found that the condition was much better, but the left arm also had less muscle.

"Are you sure you were very strong before?"

"That's for sure! Who's lying about this!"

She nodded earnestly.

Li Jingsheng frowned, thought for a while, but couldn't think of any reason for the time being.

"Can I touch your right arm again? I always feel that your right hand is weak. It doesn't look like a joint problem. It may have something to do with the lack of muscles."

After thinking for a moment and finding no important ideas, he could only ask the female patient for her opinion again.

"Okay, no problem."

The female patient agreed generously.

The boyfriend didn't say anything beside him, but his expression looked a little unhappy.

Li Jingsheng touched her right arm muscles again.

The muscles here are very rich, even if it is a girl, as long as you exercise a little, when you clench your fist hard, there will be 'little mice'.

"You make a fist with your right hand."

"Correct!"

Li Jingsheng instructed the patient to make a fist and then exert force.

At this time, he felt the muscles in the patient's right arm trembling.

As if trembling.

"Okay, relax, relax and stop pushing."

Li Jingsheng said to the patient.

After she released her fist, the muscles in her right arm were still trembling, but slightly.

"Let me feel your left arm again."

Li Jingsheng directly pinched her left arm, and then carefully felt whether the muscles were trembling.

There seems to be a little bit.

Her boyfriend looked even uglier, but didn't speak.Just turned to look at it.

"Is your left hand working hard?"

"No!"

The female patient shook her head in denial.

When she shook her head, Li Jingsheng noticed that her neck seemed not as flexible as a normal person's.

"Do you usually struggle to turn your head?"

Li Jingsheng discovered the second important clue, and immediately prepared to check further.

"It's okay! I feel very strenuous recently. Do you think it might be caused by my last fall?"

She should also have troubles in this area, but she didn't think there was any major problem, so she didn't ask the doctor.

"It's hard to tell. Let me check your neck!"

"Okay! Thank you!"

The girl again readily agreed.

The boyfriend's face was a little green, but he still didn't say anything.

In my heart, I must mind my girlfriend being constantly checked by Li Jingsheng.

"Doctor, check it, check it, have you found any problems?"

When the boyfriend saw Li Jingsheng start touching his girlfriend's neck, he couldn't bear it anymore, and asked Li Jingsheng in a cold tone.

"Please wait!"

Li Jingsheng naturally knew that this man might be a little angry.

Also won't care about with the other side.

In fact, there is really no need to be angry. In the face of diseases, doctors and nurses are fighters against diseases, and it is impossible to have other thoughts.

If this woman had an electrocardiogram, her boyfriend would probably explode with anger.

"Strange, why does your neck have mild neck stiffness? When you fell last time, was your neck injured?"

"No! Only the right hand was injured. At that time, this part was bruised and purple, and the back gradually recovered."

She pointed to the elbow of her right hand.

Fatigue, muscle loss in the right hand, unexplained tremors in the muscles of both arms, and stiffness in the neck... What disease could this be?
After thinking hard, Li Jingsheng couldn't help being startled.

He thought of a very rare disease.

Amyotrophic lateral sclerosis.

The symptoms are very similar to this disease.

Li Jingsheng looked at Doctor Xu.

"Teacher, it seems that her illness is not a joint or bone problem, but a muscle problem. Should I ask her to go to the neurology department for an examination?"

"Do you have a muscle problem?"

Dr. Xu was slightly surprised after hearing this.

He himself is only good at manipulative orthopedic reduction, and he is quite proficient in orthopedic surgery.Not good at diseases in other fields.

This apprentice has a good performance in many fields, and he also runs a clinic, and the cases he usually contacts are very complicated.

It can be said to be well-informed.

Tell him now that the patient probably has a muscle problem, but Dr. Xu doesn't doubt his apprentice's diagnosis.

I just find it very strange, it is obviously just a dislocation of the shoulder joint, how did it become a muscle problem?

The two should not be directly related!
"I suspect that there is something wrong with her muscles. It is likely to be a neurological disease, causing muscle atrophy and loss, and weakness in her right arm."

Li Jingsheng explained in detail.

"Girl, you heard what Dr. Li said, go to the neurology department!"

Dr. Xu is an attending physician at any rate. Hearing what Li Jingsheng said, he immediately thought of amyotrophic lateral sclerosis.

He agrees to advise the patient to have a test.

The doctor's obligation is to find out the cause of the patient as much as possible, and then treat the symptoms.

"You young doctor, are you accurate? My girlfriend's nerves are recovering. What's the problem?"

Boyfriend 180 did not trust Li Jingsheng's test results.

"Neuropathy is difficult to see with the naked eye. We just suggested that she go to the neurology department for further examination. Almost all diseases, the sooner they are discovered and treated, the better."

It is a great kindness for Li Jingsheng to come here for consultation.

This man's family is too small-minded.

Isn't it just touching her girlfriend a few more times during the examination?There is really no need for this.

No wonder the doctors of breast and breast surgery are always terrified when examining female patients.

If it is mammary gland hyperplasia, nodules, ductal fistula, can it be detected without touching it?

An experienced doctor can tell whether it is a malignant tumor and how far it has progressed by just touching it.

"Sun Yang, we must have listened to the doctor. Let's go to the neurology department! Anyway, it's still early."

The female patient persuaded her boyfriend.

"Okay, okay, I'll go with you! You are my baby! Let's go!"

The boyfriend took her hand and walked directly outside.

There is no gratitude to Li Jingsheng, and there is probably a trace of dissatisfaction in his heart.

The female patient is quite polite and a little grateful.

Turning back to Li Jingsheng and Doctor Xu, he said, "Thank you, Doctor!"

"You're welcome, hurry up and get checked! This disease cannot be delayed."

Li Jingsheng was worried that she didn't know how serious the disease was, so he tried to persuade her again.

She was dragged away by her boyfriend.

"Do you suspect that the female patient just now has ALS?"

"It's possible. It's a pity that such a young, beautiful and quiet girl, how could she have this disease? Alas!"

Li Jingsheng shook his head and sighed.

"Teacher, then I'll go back there and get busy."

"Go!"

Doctor Xu nodded, showing a hint of contemplation.

Before calling Li Jingsheng over, he must have also examined the girl.

I haven't really thought about neuropathy.

Dr. Xu didn't even think too deeply into the direction of muscle pathology.

Watching the apprentice come over and directly find out the cause of the disease, although I don't know if it is accurate, Dr. Xu still feels that the apprentice is getting stronger and stronger.

When Li Jingsheng was about to leave work, Dr. Xu came over.

"The girl's cause was diagnosed by a neurologist. Amyotrophic lateral sclerosis is highly suspected. Your diagnosis is correct."

"I didn't expect it to be this sick. I feel so sorry for that girl!"

After hearing this, Li Jingsheng felt that fate was really cruel.

I don't know how to pity the fragrance and cherish the jade at all.

What a beautiful girl, still so young, suffering from this disease.

The key is that there is no specific medicine at all.

At that time, she can only watch the disease erode her body little by little, and gradually lose her ability to move, speak, and even drink water.

"The disease is not the most terrifying thing. I heard Director Luo from the Neurology Department say that after the preliminary diagnosis results came out, after talking to the female patient and her family, the man ran away immediately."

Dr. Xu is not a gossip person.

But the doctors and nurses would still talk about such a cold and heartless thing.

Human nature is much scarier than disease.

At most, the serious disease only takes human life and destroys the patient's body, but the indifference of human nature will bring the most terrible spiritual harm to the patient.

Patients need to suffer from psychological trauma and illness at the same time.

"The female patient must not cry on the spot?"

Li Jingsheng thinks that handsome boyfriend is really nothing.

When I met him just now, I felt that the man's mouth was oily and he liked to make superficial articles.Unexpectedly, when he heard that his girlfriend was suffering from frostbite, he left her on the spot and ran away.

Anyway, just put on a show, wait a few days before running!

There are many people in the face of interests, and it will indeed become very realistic.

Even the hypocrisy is directly saved.

"I didn't cry. The girl only said that she recognized the man. Director Luo was worried that the girl would not be able to bear the blow and commit suicide, so she insisted on asking her to provide the phone numbers of her relatives and called the girl's parents over."

Doctor Xu said.

It is really weird that a female patient has not cried yet after suffering the double blow of being seriously ill and being abandoned by her boyfriend.

Based on the experience of doctors, it is very easy for such women to commit suicide without thinking about it.

Because her heart was filled with despair and she felt that life was meaningless.

"I'm off work. You should call it a day when you're done! The number should be limited, otherwise the patient will have to wait for a long time, and you will be exhausted."

Dr. Xu saw that there were five patients waiting in line outside the clinic.

He reminded Li Jingsheng.

(End of this chapter)