My medical skills add experience

Chapter 616 Locking gray matter, the trust of family members is the driving force

Because of the high risk of surgery, as long as the vertebrae are moved, it is equivalent to moving the pillars of a house.Both doctors and patients should be cautious.The effect can refer to the load-bearing wall of the modern decoration moving house.

After Zhou Can found out that the boy's neurological decline mainly started from the medulla oblongata, he quickly recalled the anatomical deconstruction of the nerves in his mind.

Each segment of the spinal cord sends out a pair of spinal nerves, a total of 31 pairs.

8 pairs of spinal nerves.

If you want to check, you only need to check the spinal and cervical nerves.

There is no need to check the remaining 12 pairs of thoracic nerves, 5 pairs of lumbar nerves, 5 pairs of sacral nerves and 1 pair of coccygeal nerves.

Speaking of the coccygeal nerve, there is a particularly interesting phenomenon.

Most people have only one pair of tail nerves, but a few people have two pairs of tail nerves.Such people have a total of 2 pairs of spinal nerves.

Just like some people have only 8 molars, while others have 12.

Although the four extra teeth are called wisdom teeth in medicine, their function is no different from that of molars.With 4 more molars, the chewing function of such people will be more powerful.

Looks like an unassuming chewing enhancement.

It seems that people with 8 molars still eat.

In fact, people with 12 molars can benefit in many ways.First, their teeth were stronger, and they were able to grind more food in the same amount of time.And it will grind the food finer.

This eases the digestive function of the gastrointestinal tract.

In medicine, both Chinese medicine and Western medicine recommend eating slowly, which is to take care of the digestive organs of the human body.

Especially our stomachs.

The stronger the digestive function, the stronger that person's body will theoretically be.At least easier access to nutrition than people with 8 molars.

A person with an extra pair of spinal nerves is not a monster.

Some scientists believe that this is a characteristic of incomplete human evolution.Because the extra pair of tail nerves can also be regarded as used to control the tail.But humans have long lost their tails in the course of evolution.

This will allow people with 32 pairs of spinal nerves to have more flexible and powerful lower limb motor functions.

At least in theory it can be understood this way.

The little boy couldn't speak, he couldn't move his head, and he couldn't move his body either.

If you want to further find out which segment of the spinal and cervical nerves has a problem, it is difficult to accurately find out by checking the EEG and body nerve conduction.

According to the anatomical structure of the spinal cord, the spinal cord includes gray matter, white matter, central spinal canal, anterior and posterior cords, spinal ganglia, spinal nerves, etc.

The gray matter part is the low-level center of the human body's reflex activities.

Including patellar reflex, urination reflex, defecation reflex, sweating reflex, sexual reflex, etc., all need to be conducted through the gray matter of the spinal cord.

Many patients with paralysis of the lower body will suffer from incontinence, which is a problem with the lower nerve center.

Zhou Can performed the knee jerk reflex on the child, and the investigation was on the low-level nerve center.

The knee jerk reflex in the right leg was weak and the reflex in the left leg was normal, which meant that there must be something wrong with the gray matter of the spinal cord.

This is actually a good direction for diagnosis.

He ran to Director Yin for advice, just to use this as a breakthrough point to see if Director Yin could provide him with more diagnostic experience for his reference.

Director Yin did provide a lot of valuable clinical diagnosis experience, but it ran counter to Zhou Can's thinking.

In other words, the two are not compatible.

It's not that Director Yin's diagnostic opinions are useless, but that they didn't point to the idea Zhou Can discovered.

This is also a common problem of old experts.

It is precisely because their clinical experience is too rich, their thinking is relatively fixed, and they are not as flexible as young people.

If I have to describe it, the diagnostic ideas of old experts are more stable, and the diagnostic ideas of young doctors are more advanced. They may be unconstrained and unconstrained, and they may overturn and misdiagnose, but sometimes they can find the right lesion through the unique method of young people.

Occasionally, this phenomenon occurs in large hospitals. The old experts shook their heads and sighed, thinking that this patient could not be cured.

As a result, he was cured by a young doctor.

Of course, when the hospital publicizes, it will protect the face of the old experts. The credit is often given to the chief physician and the young doctor who actually cured the patient.Even just passing it off.

Many young doctors will feel unconvinced and think this is unfair.

But it is acceptable to consider the problem from the perspective of the hospital's interests.

Old experts are the hospital's signature, so they must not be smashed.

And any industry has a fine tradition of respecting the elders.Even in foreign countries, profit is king, and teachers and seniors are respected.

Doctors and nurses in some developed countries abroad are paid according to their age.

No matter how hard young doctors work, their income is not as high as that of older doctors.

The domestic situation is slightly better.

Many large hospitals with advanced management pay more for more work.But it is impossible to pursue absolute fairness.

The qualifications of the old experts are hard-earned, and it is a matter of course that they get more in performance distribution.

It's like a sales manager even if he doesn't work, but the manager can get a part of the sales commission of his salesmen.These are industry rules.

Zhou Can thought to himself, this child has a problem with the gray matter of the spinal cord. If the specific part of the injury is determined, can the location of the damaged spinal cord be determined in one fell swoop?
The little boy was unable to move from the neck down, and the nerve sensory function became weaker as he went down, indicating that the problem must not be limited to the gray matter.

It's like fighting a war. If you catch the opponent's scout, you can basically tell that the enemy is nearby.

The patient had taken X-rays at Imperial Renhe Hospital, and no obvious spinal cord damage was found.

Clinically, X-ray examination of spinal cord injury is a common means.

It can not only detect whether there are fractures and abnormalities in the bones, but also has a good effect on the diagnosis of spinal cord injuries.

It can even accurately check the specific degree of spinal cord injury.

Since the X-rays did not reveal obvious abnormalities in the spinal cord, neither of the last two hospitals applied for an MRI examination for the sick child.

The little boy's condition was serious, and the doctor who received him was at least at the director level.

With doctors of this level, few people worry about food and clothing anymore.

Their medical ethics are often also very high.

The cost of MRI examination is relatively expensive, and it is not a routine examination in clinical practice.Chief physicians will try not to prescribe this examination if they can.

After Zhou Can had a plan for further examination in his mind, he turned to look at the child's mother.

The two looked at each other, and from the eyes of the child's mother, one could see anticipation, deep sorrow, and even a trace of fear and confusion.

In case the child cannot be cured, how will she explain to the child's father?

What about the rest of the child's life?
The rest of her life would be ruined too.

Needing to take care of children for a lifetime, eating and drinking, and paying for expensive long-term treatment will become a heavy burden.

In order to cure her son's illness, the young doctor in front of him kept visiting the ward, and even invited other experts to come for consultation.She sees it all.

Although she had some doubts about Zhou Can's medical skills because Zhou Can was too young, it didn't affect her trust in Zhou Can.

"If you have anything you need to know, just ask, and you can also suggest any treatment options."

She spoke first.

It can be seen that this woman has rich social experience and is even more intelligent in her heart.

From her eyes, she could guess what Zhou Can wanted to ask her.

"Do you usually take the children with you?"

"Yes, since the child was born, I have been with me. When I go to work during the day, I will ask the child's grandma and grandfather to take it."

"Before the child fell, was there any abnormality? For example, whether it is difficult to grasp things after birth, whether it often chokes when drinking milk, etc."

Zhou Can's question would easily arouse the resentment of the family members.

No one wants to admit that their child was born with a problem.

"Uh... There seems to be no problem with his grasping. On the third day after he was born, I felt that his hands are particularly strong in grasping things. But speaking of abnormalities, my son always seems to like to raise his head slightly. I don't know if this is the case. normal?"

As she spoke, she raised her fair and slender neck slightly, imitating how her son raised his head before.

"Then is it normal for him to bow his head?"

"It seems normal. Anyway, it's normal to see him looking down for something."

"Has the child been infected with any serious diseases since birth, including during pregnancy? Colds are not included."

Zhou Can asked again.

Colds are mostly viral infections, and sometimes some serious viruses can cause great harm.It can even easily take a person's life.

However, clinically, when checking the medical history, colds are generally rarely taken seriously by doctors.

Unless it is a repeated cold in a short period of time.

Also, doctors and ordinary people have different understandings of colds.

Ordinary people think that a cold is an illness, a minor illness that can recover by itself.But in the eyes of doctors, a cold is a symptom of a disease, and there are thousands of types of it.

"I have never had a serious illness. When I was pregnant, I was weaker than before, and I had occasional colds. After the baby was born, my body has been very healthy, and it only takes a day or two to recover from occasional colds."

She thought about it and replied seriously.

"Does the child's father, grandparents have any serious medical history?"

"The child's grandfather has heart disease, and the grandmother has diabetes and high blood pressure. I have never heard of other illnesses. The child's father sometimes comes back to visit relatives once or twice a year due to work reasons. It is highly confidential in the work unit. I don't know much about his condition. But I haven't heard of any serious illnesses from him."

Her words made Zhou Can deeply feel her difficulty and greatness.

I can only get together with my husband once or twice a year, which is probably unacceptable for most women.

"Okay, I don't have anything else to know for now. I'm going to apply for a somatosensory evoked potential test for my child. I mainly want to find out where the problem is in the spinal cord. What is certain at the moment is that there should be a problem with the child's spinal cord. , There is an abnormality in the low-level central nervous system test, which is likely to be a problem with the gray matter of the spinal cord. However, it is only a problem with the gray matter, which generally does not cause high paraplegia, and the cause needs to be further investigated. To be on the safe side, I am planning to draw spinal fluid for laboratory testing , to see if there is any bacterial, viral infection or other abnormalities."

When Zhou Can prescribes these non-routine inspections, he usually explains clearly to his family members.

It is also the duty of doctors.

For routine examinations, doctors generally do not explain too much.Because a doctor has to see at least dozens of patients a day, he really doesn't have the time and energy to repeatedly explain why these routine examinations are required.

"No problem, I trust you very much, and I can also feel that you are working overtime to diagnose and save my child. I am really grateful to you." She said, bowing deeply to Zhou Can.

"You're welcome, don't be polite, these are what I should do. As long as your family members are willing to cooperate and trust us, we will do our best to treat the child. No one can guarantee the final result. I can only say that we will try best."

Zhou Can said to her.

Somatosensory evoked potential test, ordinary people have never heard of this test.This detection method has a good effect in diagnosing spinal cord injury, and the accuracy rate is very high. Through this inspection, the specific location of spinal cord injury can also be detected.

At present, the main direction of diagnosis and examination is to first find out which pair of spinal nerves has a problem.

It's also possible that it's just one side that's the problem.

As for taking spinal fluid for laboratory tests, he was inspired when director Yin Hua gave him some guidance.

Sometimes, the answers doctors get when they check medical history with family members are not necessarily accurate.

Some family members may deliberately conceal some medical history, such as travel history.

Some family members have poor memory and have forgotten some medical history.

Therefore, to be on the safe side, it is still necessary to take a spinal fluid test.

Neither of the previous two hospitals did this because the child was a high paraplegia caused by a high fall injury.Those doctors don't even think about it.

……

That night, when Zhou Can was lying on the bed with Su Qianqian in his arms, he was still thinking about the little boy's illness.

He is one of the good doctors who forget to eat and sleep to see patients.

The National Day is coming soon, which makes Zhou Can want to hurry up to find out the cause of the little boy and cure him.

Because the wedding between him and Su Qianqian is in full swing.

This is the big thing in life.

Knowing that Zhou Can was very busy with work, Su Qianqian took the initiative to undertake almost all the preparatory work.

She even jokingly told Zhou Can that it was as if she was marrying herself off.

What is more interesting is the family of Su Qianqian's uncle and aunt.

That night, Zhou Can injured two people before successfully taking Su Qianqian away.It stands to reason that she has completely fallen out with her uncle and aunt's family, and she is definitely the kind who never gets in touch with each other.

But Zhou Can far underestimated the despicableness of human nature.

My aunt actually called Su Qianqian, with snot and tears, begging her for forgiveness.He also said that he knew that he was wrong, scolded himself for not being human, sorry for her before, and so on.

Fortunately, Zhou Can was by his side at that time.

He knew that Su Qianqian was a very kind person who was easy to soften his heart.

He asked for the mobile phone on the spot, and said to the crying old woman on the other end of the phone, "If regret is useful, why do you need the police? If you dare to call to pester me again, your son will definitely be put in prison."

Don't look at Zhou Can kicking and hurting his aunt's son at that time, but at that time the kid shot first, he was just defending himself.

With the support of a professional legal team, Zhou Can was rich and powerful, so he directly sued the other party for wanting to imprison Su Qianqian, wanting to snatch the 30 cash he brought with him.Robbery is a felony, as long as the evidence is convincing, it's no wonder if you don't go to jail.

(End of this chapter)