bookpower Chapter 281
Chapter 281
"It didn't happen before, did it?"
Lin Feng lowered the old man's pulled eyelids and asked.
Old woman: "No, it used to be okay." "
Lin Feng nodded.
This drooping eyelid may be congenital, and most are acquired.
The reasons for the day after tomorrow are as follows:
Lesions of the eye itself (eye surgery, trauma, contact lenses, infection, tumor), etc...
There is a tumor in the brain that compresses the intracranial nerves...
・Myasthenia gravis...
Lin Feng thought about it,
Tests for myasthenia gravis are the fastest.
That is - electromyography.
Among them, "single-fiber electromyography" is the most sensitive and accurate.
(Last time patients with myasthenia gravis also used this way.) ）
soon
Send the person to the test.
10 minutes,
Check the results out:
Diagnosis: Myasthenia gravis!
In other words, the structure that connects nerves and muscles is called the neuromuscular junction, and there is a disorder of receiving information.
"So easy to come out?"
The old woman was surprised.
They also thought it was a complicated disease that required various tests.
As a result, Dr. Lin did an examination and it was confirmed.
"Dr. Lin, you don't need to save us money, you can do the examination." The old woman said a little proudly.
Lin Feng smiled and said, "I don't need to use other checks... It is definitely "myasthenia gravis"..."
"By the way, out of the head, will the whole body be weak?"
"Okay..."
Lin Feng nodded.
"That's not serious, wait a minute, I'll prescribe a medicine for you."
Lin Feng's prescription medicine is "pyridoximine bromide".
This drug, along with the famous dichlorvos, can increase acetylcholine, but one is a poison and the other is a life-saving drug.
"Acetylcholine": When the body's acetylcholine cannot bind to receptors, it will not be able to produce contractile movements, which will lead to myasthenia gravis.
Therefore, increasing acetylcholine can treat myasthenia gravis.
prescribing,
To the single old woman...
"Thank you doctor ~~~~"
The old woman and the old man prepared to leave.
Suddenly!
"Wait..."
Lin Feng shouted.
One thing came to mind.
Myasthenia gravis, which may be accompanied by another disease, "thymoma", is statistically 10% probable.
If it were an ordinary patient, Lin Feng would not have such a mouthful.
But just now the old woman said that there is no need to save money,
And this old man is not young, and suddenly has myasthenia gravis, and the possibility of having a tumor is quite large.
"What's wrong? Dr. Lam? "
"That's right, I want to give the old man a check..."
The old man sat down again.
Lin Fengshou began to examine the old man's body.
Generally, thymoma has benign tumors and malignant tumors, benign thymomas have no obvious tissue when they are relatively small, and relatively large thymomas can cause chest pain, chest tightness, cough, chest discomfort... And so on and so forth.
Auscultation.
Heh, it does sound weird...
Because thymoma is located between the heart and the sternum, if there is a change, it can affect the stethoscope sound of the heart.
"Auntie, how about I open a CT order and go for a check-up?"
"Doctor, how?"
"I just suspect that there may be something strange and will know when the CT results come out..."
The old woman listened and nodded.
"Okay, I'm Shin Dr. Lin, now go for a check-up."
"Thank you for understanding!"
Lin Feng is very happy, his favorite is this kind of patient who supports the doctor.
......
An hour later,
The CT results were returned to Lin Feng.
There is a 3.6 cm diameter mass in the chest cavity, suspected to be thymoma.
Lin Feng told the two old men about this result.
The old lady and the old man were in disbelief.
With a slight indignation:
"We just look at the eyes, why do we have an extra tumor in our chest?"
Lin Feng patiently explained: "Auntie, this is so, according to statistics, about 10% of myasthenia gravis are combined with thymoma... That's why I suddenly wanted to check my chest CT... Of course, at present, it is only suspected thymoma, which does not mean that it is really thymoma..."
The old lady and old man quickly calmed down.
After all, they still trusted the doctor, and they also trusted Lin Feng.
"Doctor Lin, what do you say you want to do?"
"Do a more accurate examination, such as contrast-enhanced CT, or MRI..."
"Okay, check!"
The old woman continued to pull the old man to go for an examination...
This drag,
It's the afternoon!
In the afternoon,
Review Enhanced Ct results are out:
Confirmed: Thymoma (Stage III)!
At this time, the two old people panicked, checked their eyes, and found tumors!
I don't know whether to thank Lin Feng's medical skills for being too good, or to scold Lin Feng's medical skills for being too good!
"Dr. Lin, are you going to have surgery?"
Lin Feng shook his head: "I can't operate now, because many "Medical Guidelines" make it clear: patients with muscle weakness symptoms, try not to do surgery, it is very dangerous." "
Old woman: "No, isn't my old man okay now?" The eyes are wide open. "
At this point,
After the old man took Lin Feng's medicine, (morning to afternoon), the effect of the medicine came into play.
The eyes are wide open!
Lin Feng shook his head: "This is only temporary, it is not certain... In half a month, come back for a review and see if you consider surgery..."
"Thank you, Dr. Lin!"
The two old people are grateful.
Turn around and leave.
Lin Feng continued to the next patient...
Suddenly!!
Walk to the old man at the door,
Whoops~~~
Jerk one down!
Lin Feng was taken aback, and quickly ran over to help him up.
"Abel, what's wrong?"
"I... It doesn't seem to have much power..." said the old man tremblingly.
Powerless?
Lin Feng was taken aback.
Not good!
The condition has worsened!
Lao Li was previously an eye muscle type muscle weakness, only manifested as eyelid weakness, and now unconsciously fell forward, indicating that muscle weakness developed to the whole body, resulting in physical weakness and becoming generalized myasthenia gravis.
But
It's already been administered!
How could it be aggravated?
Lin Feng's heart was anxious, and he thought of the problem of myasthenia gravis all over the body:
Weakness of breathing... Suffocate...... Shock......
(Patients with previous muscle weakness)
。