Doctor: It's reasonable to perform surgery on yourself.

It's too simple, so there's not even a flaw to be found, and there's no clue. How to treat such a disease?

"It's a bit troublesome." Everyone looked embarrassed.

"Is it a mental problem?"

"There is a certain possibility. The patient has been under great mental pressure in recent months. This time the child is finally diagnosed. The pressure is suddenly relieved, and it's easy to have problems."

"I looked at the patient's basic condition. She doesn't have diabetes or high blood pressure. It doesn't look like a regular systemic disease. It may really be a mental factor."

All the people present are emergency doctors, and they don't know much about diseases in the fields of neurology and mental health.

But they also know that there is indeed a type of disease in neuropsychiatry that can cause similar symptoms.

Hysteria!

A more professional name is dissociative conversion disorder.

When the patient's spirit is strongly stimulated, hysteria occurs, and there may be a concentric narrowing of the visual field. In severe cases, it can really lead to sudden blindness.

Combined with Xu Qiu's physical examination of Lu Ruping, it can be determined that there is no physical abnormality. It is hard not to consider mental illness...

"Doctor Xu, what do you think?" Wang Ping spoke.

This case was so strange that even he couldn't help but be curious.

Xu Qiu pondered over Lu Ruping's medical records, shook his head slowly after a moment and said: "Don't consider mental illness for the time being."

He is a clinician with a knife, and has rarely set foot in psychiatry.

Moreover, there are not so many mysterious diseases in the clinic. The seemingly incredible signs are actually just that the pathogenic mechanism has not been sorted out.

Compared with the common manifestations of rare diseases such as dissociative conversion disorder, the rare manifestations of various common diseases are more common.

Therefore, Xu Qiu first considered common diseases.

There must be a common disease that can cause sudden blindness, but it has been ignored because there are too few cases.

Xu Qiu flipped through Lu Ruping's examination results.

Generally speaking, a major symptom, plus other minor manifestations to assist, can make a basic judgment, that is, a preliminary diagnosis.

For example, if blindness is accompanied by ptosis, paralysis of the extraocular muscles, impaired consciousness, movement disorders, etc., it is necessary to consider whether it is a problem with the brain or nerves;

If there is a history of diabetes, accompanied by floaters, and vision loss in a short period of time, it is either a problem with the endocrine system or a problem with the eyes themselves.

But there is only one blindness in Lu Ruping's medical record.

Her blood pressure, blood sugar, and physical examination did not find a second abnormality.

If you have to pick a problem, it is probably that her BMI index is only about 17, which is a thin type.

This morning, the laboratory and ophthalmology departments received Xu Qiu's patients and completed various examinations at the first time.

The first is the slit lamp examination.

This project is mainly to confirm the degree of opacity of the conjunctiva, cornea, anterior chamber, iris, pupil and lens, and can diagnose various abnormalities in the optical pathway of the eye.

However, all parts of Lu Ruping's eyeball are intact.

The second one is the fundus ophthalmoscope.

This examination can detect retinal optic neuropathy in the fundus, and it also has a certain prompt effect on central nervous system diseases.

And coherent optical tomography - it can accurately determine the changes in the various layers of retinal tissue and diagnose various retinal diseases including the macula.

However, after various examinations, no abnormalities were found in the integrity of Lv Ruping's eyeballs and the structure of various tissues!

"There are no problems with blood sugar and glycosylated hemoglobin..." Xu Qiu frowned.

Diabetes is most likely to affect the retina, but Lv Ruping has no underlying diseases.

"Sex hormones have also been measured, and prolactin, growth hormone, adrenocorticotropic hormone, etc. are also normal."

These indicators can rule out common diseases such as pituitary tumors, inflammation and hyperthyroidism.

However, the blood routine test did find a low indicator.

Hemoglobin!

Like her son Xiang Kai, Lv Ruping's hemoglobin is also lower than normal, and she is mildly anemic.

But, in addition to this, items such as erythrocyte sedimentation rate have returned to normal levels, so toxic diseases, giant cell arteritis, etc. can also be ruled out.

Low hemoglobin alone has no guiding value except for diagnosing mild anemia.

"Let's prepare for the ward rounds." Xu Qiu stood up and said.

This sentence also meant the end of the morning handover. Everyone quickly dispersed and went to various wards for ward rounds. Then those who needed surgery went for surgery, and those who needed to go to the outpatient clinic went to the outpatient clinic.

Xu Qiu also arranged surgery this morning.

However, before that, he still came to Lu Ruping's ward.

Although no problems were found in the previous physical examinations, facing the confusing disease, all he could do was to repeat the physical examination and examination process, hoping to encounter some changes that indicate the condition.

However, luck did not favor Xu Qiu.

During this physical examination, he successively conducted motor and sensory nerve examinations, reflex examinations, etc., and tested all the patient's senses except vision. What was helpless was that except for blindness, there was no other abnormality.

"Arrange a head CT." Xu Qiu said.

There was no better way at the moment, so he could only further rule out the problem of the brain.

Although according to his experience, it is almost impossible for a patient who is blind but has no other neurological symptoms to have substantial brain lesions, but when it comes to the patient's life, even the most experienced doctors have to put aside the medical edifice they have built.

If there is an exception, it will only add a regret to the doctor's career, a paper, but for this special patient, the price is life.

"Doctor Xu, I have something to tell you..."

After the rounds, when she was about to leave, Lv Ruping suddenly called Xu Qiu.

The latter paused and looked at Lv Ruping, who was lying on the bed with her eyes closed and a peaceful face.

"What's the matter?"

Lv Ruping paused slightly and said, "I'm on my period."

Although she is already a young woman, she is still a little embarrassed to speak up when facing such things.

But this is not strange to doctors. It's just the periodic shedding of the endometrium, which is no different from losing a few hairs.

"Well, is the amount large?" Xu Qiu asked.

"Very large, the sheets were stained with a large area last night, sorry..." Lv Ruping was a little embarrassed.

Xu Qiu nodded slightly... Did it just happen to be the menstrual period?

In this way, mild anemia may be related to the menstrual period, and it may not necessarily indicate a disease.

Xu Qiu frowned immediately.

Originally, low hemoglobin was the only abnormal indicator, and now it points to excessive menstrual bleeding, and even this possible hint is gone.

Now it really becomes a disease with all normal indicators except blindness...

"Okay, if there are any changes in the condition in the future, please communicate with the medical staff at any time." Xu Qiu had no better way for the time being, and could only wait for the results of the brain CT scan.

"Doctor Xu, don't worry about me for now, my son's surgery is more important..." Lu Ruping's gentle voice suddenly became firm.

Xu Qiu knew that no matter what he said, it would be useless, so he nodded and said, "No problem, his surgery is scheduled for the day after tomorrow, the risk is not high, you just need to rest assured and take care of your illness."