"Boss Zheng, I was thinking of asking you to take a look a few days ago," Zhang Weiyu said. "But Chief Wei said that we should talk about it after the examination is done. Otherwise, it will take up too much of your time."
"Okay." Zheng Ren nodded. Chief Wei was right.
"The patient is a young waiter at my Guanyang Shop. It's quite far away in Feng County."
"Huh? Main store? Isn't this the main store? "Su Yun was surprised.
Usually, the main store was set up in super first-tier cities like the Imperial Capital and Sorcery Capital. It was a normal business model to have branches all over the country.
However, this Guanyang Shop's main store was in Feng County.
Since ancient times, Xuzhou was one of the nine states in the world. Feng County was also an ancient city with many historical legends.
"It's an old shop passed down in my family. My father refused to move the shop to the Imperial Capital no matter what," Zhang Weiyu said. "The old man valued the century-old plaque in the house more than his life. I said it twice and was almost kicked out of the house. "
That was conceivable. Zheng Ren nodded. That was the so-called tradition.
"A distant relative of my family had a cerebral hemorrhage last autumn. He recovered well after the surgery but the child didn't want to go to school, so he went to work in the shop," Zhang Weiyu said. "After the surgery, he took medicine to control his blood pressure. It was fine at first but after a few months, his blood pressure got higher and higher."
The patient was an 18-year-old boy. Half a year ago, he suddenly had a headache and confusion. At the local hospital, a head CT scan revealed a paraventricular cerebral hemorrhage in the left basal ganglia area.
When he was admitted, his blood pressure was 220/110.
Considering intracranial hypertension, an intracranial hematoma resection was performed immediately.
After the surgery, he took 10 mg of enalapril maleate orally once a day.
At first, he took oral antihypertensive drugs and carried out antihypertensive treatment. His blood pressure was controlled at 110-120/70-80.
MmHg, the situation was considered good. However, as time passed, his blood pressure got higher and higher.
However, he was still a young man after all. He did not pay enough attention to his body. It was already good enough that he could take his medicine on time every day. As for taking his blood pressure every day, he only persisted for about a month before he stopped caring.
A few days ago, he felt uncomfortable again and took his blood pressure. 180/120.
mmHg。 As for the process, the patient himself could not describe it clearly.
This scared him out of his wits. He hurriedly looked around and even found Zhang Weiyu in the imperial capital.
That was the whole story from beginning to end.
The patient's medical history was not complicated. The patient's family had a history of high blood pressure, but the others had taken an oral antihypertensive drug, and their blood pressure was well controlled.
There is no such thing as stubborn, uncontrollable blood pressure.
Due to his family history, Zheng Ren ruled out many hereditary diseases.
"Director Wei took me to Director Zhang. At that time, Director Zhang suspected that there was a problem with the adrenal glands and did the relevant tests," Zhang Weiyu said.
Department Chief Zhang Lin said, "Later, the patient changed his dressing and increased his dosage. He took Amlodipine Benzenesulfonate, 5mg twice a day, and Terazosin Hydrochloride, 4mg every night. His blood pressure was controlled for a few days before he went back to normal."
"I think it's because of the adrenal glands, but they did an MRI scan of the adrenal glands and a renal angiography. They're all fine."
This examination was very detailed. It almost ruled out the possibility of nephrogenic hypertension.
There were two main types of hypertension, primary and secondary. Each type had many branches. Chief Zhang Lin's considerations were very thorough, and her inclination was also relatively clear. Her consideration was secondary hypertension.
The most common secondary hypertension was nephrogenic hypertension, endocrine hypertension, and some other rare predisposing factors.
"How tall and heavy is the patient?" Zheng Ren asked.
"1.8 meters, more than 230 pounds," Zhang Weiyu said.
He was a little fat. Zheng Ren thought for a moment and asked, "Is his snoring that bad?"
"Yes, I don't even dare to sleep with him. It feels like the bed is shaking when he snores." Zhang Weiyu laughed. "When he was in the hospital, he was in a single room and everyone in the room was scared away by his snoring."
"You suspect obstructive sleep apnea hypopnea syndrome?" Su Yun asked.
"Stubborn hypertension. We can consider this problem," Zheng Ren said.
"Yes, I also suspect obstructive sleep apnea hypopnea syndrome," Chief Zhang Lin said. "We've already asked the patient to do an enhanced MRI of the kidney, but the hospital there is unfamiliar with OSAHS and doesn't know how to do it."
This was also normal. Obstructive sleep apnea hypopnea syndrome was more common. In daily life, many people would snore all night, like singing an opera.
However, induced high blood pressure could basically be controlled as long as appropriate medication was taken. It was rare for it to be difficult to control.
"Boss Zhang, tell me about his snoring." Zheng Ren was more interested in the patient's snoring.
"Don't mention it, Boss Zheng." Zhang Weiyu sighed and said, "I went home for Chinese New Year and only stayed for two days before running back because of his snoring.
"It was Chinese New Year and business was good, so I kept it open. The neighbors were too lazy to cook, so they came over to treat us. I wanted to have a drink and chat with my family when I went back. But I could hear him snoring through the wall. "
Zheng Ren listened quietly.
"I felt like the wall was shaking when he was snoring," Zhang Weiyu complained. "That's not all. As he snored, it was like he was out of breath. Once, I heard him snoring. There was no sound in between, and it stopped for a full 50 seconds … about a minute or so. "
Zheng Ren had a basic understanding of the patient's condition after listening to Zhang Weiyu's explanation.
"I was afraid that he would have another brain hemorrhage. Others would not even know if they died in bed, so I got up to take a look. When I got to the door, he started snoring again, so I went back to sleep.
"Tell me, snoring is not enough. Who can stand being scared in the middle of the night? I stayed at home for two days during Chinese New Year and ran back. "
Roommates or bedmates who noticed a patient's apnea were often worried that their breathing would not recover and woke the patient up. Apnea usually ended with panting, choking, or loud snoring.
This condition was called apnea, a manifestation of sleep apnea hypopnea syndrome.
Most people could breathe on their own when they snored due to lack of oxygen, but the patient in front of him had held his breath for too long.
Since there was no way to examine him, Zheng Ren could only guess. It was hard to say if he was right.
"Boss Zhang, is the old shop in Feng County still busy at this time?" Su Yun suddenly asked.
"It's a small county town. It closes early, so there's not much nightlife." Zhang Weiyu did not know why the topic had changed, but he still said what he wanted to say.
He could not neglect the young master next to Boss Zheng. If he neglected Boss Zheng, he would be magnanimous and would not be angry. However, this Young Master was hard to please. Who knew what kind of trouble he might stir up.
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