"In the end, Dr. Oakland didn't make much progress," Zheng Ren said.
"That's not right. I remember that she experimented on mice and cut off the nerves on one side. The other side also died a few weeks later," Su Yun retorted.
"I think this is a special case. There is no general significance," Zheng Ren said. Zheng Ren said, "Clinically, a Canadian doctor did a large-scale sample survey on kidney stones and found that mirror image pain exists.
But in terms of probability, I've observed it in Sea City General Hospital. The so-called 0.48% rate seems a little high. "
"Oh?" Su Yun did not expect his boss to have already started to study mirror pain in a place like Sea City.
"The data from Canada is that there were three cases of mirror pain out of more than 600 patients," Zheng Ren said. "The data I observed were more than 400 patients with urinary stones. None of them had mirror pain. Clinically, this patient is the first case I've encountered. "
Clinical research was like this. Whether it was 600 or 400 cases, it was considered a small sample. It was normal for there to be deviation.
However, from Zheng Ren's observation, mirror pain should be considered a very rare disease in China.
"Then admission to the hospital? And then? "Chief Yu was a little confused.
"Admission, gravel. If your chief doesn't recognize mirror pain, you can do an intravenous pyelography. " Zheng Ren's finger pointed at the X-ray film inserted in the radiographic film viewer and said, "This should be some kind of stress change in the body. When the stones are broken and removed from the body, there will be no more pain. This should be better. "
"Chief Zheng, can you explain in more detail?" Chief Yu did not have a good idea. He could not say that when he reported the medical history to the chief.
"Well … Then report it to the chief like this," Zheng Ren said as he looked at the radiographic film. "The right renal collecting duct increased pressure due to hydronephrosis. Then, the lamina propria nerve endings extended, smooth muscle spasms, and contraction, trying to move the stones.
"Lactate production increased, stimulating the mucosa and activating chemoreceptors. After the afferent nerve reached the spinal cord, it connected to the spinal cord at the T11-L1 level and then transmitted to the central nervous system, producing the illusion of pain on the opposite side.
"…" Chief Yu was silent and speechless.
If he told the chief that, he would probably be the chief resident for another year.
However, although Chief Zheng gave a diagnosis, he could not say a particularly convincing point. He could only nod.
"As for the image of the left ureter near the L2-3 vertebra, it can be ruled out by venous pyelography. Whether it's mirror image pain or not, I'll have to deal with the right urinary calculus later. "After Zheng Ren said that, he took off the radiographic films, put them into a bag, and handed them to Chief Yu.
After that, the two chief residents started to get busy.
Convincing patients who previously refused to be hospitalized to be admitted to the hospital for diagnosis and treatment was a relatively large project.
However, the two of them had rich clinical experience, and the patient was in severe pain, so he reluctantly accepted it.
The pain of kidney stones was really painful. It felt like the end of the world. Even if there was a mountain of blades and a sea of flames in front of him, he might as well give it a try.
Su Yun took advantage of this time to order breakfast.
When Zhou Litao finished his work, breakfast had just arrived.
"Boss Zheng, Brother Yun, the patient has been admitted to the hospital," Zhou Litao reported.
"Yes, gravel is fine. If it doesn't break, the Department of Urology has plenty of ways to solve it, "Su Yun said as he ate the bun.
"This is also the first time I've encountered mirror image pain in the urinary system." Zhou Litao was still very interested. "I've encountered a few orthopedic amputees who have pain on the opposite side, but I think it's hysteria."
"It's not hysteria. It's just that the scientific principle hasn't been found yet." Zheng Ren smiled. "Current science doesn't have a clear diagnosis and treatment of many diseases."
"I think we can use central nervous system plasticity to solve this problem," Su Yun said. "Unfortunately, I don't do research in this area, so I don't have any clues for the time being."
"There's no need to do it. When you encounter similar patients, you just have to know that there is such a possibility. It's enough as long as you don't misdiagnose it." Zheng Ren was very accurate about his position. After all, he was a clinician.
Previously, when Dr. Charles had persuaded him to do theoretical research, Zheng Ren had already thought it through the moment he decided to give up.
As the three of them ate breakfast, they chatted about speculations about mirror image pain.
Zhou Litao was a little emotional. No wonder Boss Zheng was doing well. When he was the emergency department's chief resident in Sea City, he already had some understanding of such things.
There really was no such thing as a free lunch in the world.
Zhou Litao had been wrong about Boss Zheng's guess from the beginning.
After Zheng Ren encountered the patient with mirror image pain this morning, he began to reflect and recall similar patients he had encountered in his medical career.
Therefore, the thinking of cheats was different from others. Zhou Litao could only go further and further down the wrong path if he used a normal person's thinking to think about Boss Zheng.
Boss Zheng never … rarely did he make deductions. Every time he knew the answer, he would make deductions in reverse. Reverse deduction was very worry-free, but it was also based on Zheng Ren's strong memory.
"By the way, why hasn't Cui Lao been working recently?" Zheng Ren asked after eating.
Zhou Litao sighed and said, "It's been more than half a month since Cui Lao was sick. He's been getting better and worse, over and over again. He came to the hospital for a checkup, but there's nothing wrong with him. "
Zheng Ren was stunned for a moment. He knew that Cui Lao was old. Some things could not be solved by manpower.
"Where's Cui's hometown? I'll go take a look when I have time, "Zheng Ren said.
"Tomorrow is my day off. I'm going to Cui's hometown to take a look," Zhou Litao said. "Boss Zheng, if you have time, let's go together?"
"Sure, tomorrow … in the afternoon," Zheng Ren said. "I have more things to do in the morning."
Speaking of Cui Lao's illness, the atmosphere in the duty room was a little depressing.
However, he was almost eighty years old after all. It was normal for him to have some minor problems.
Not to mention Cui Lao, who was almost eighty years old, Zheng Ren saw the System panel of every doctor's office. It was more or less red.
This was the law of nature. Zheng Ren wanted to go once. First, he missed Cui Lao. Second, he wanted to take a look at the System panel to see if Cui Lao had other problems and misdiagnosed him.
Although the latter was unlikely, Zheng Ren still felt that it was more appropriate to take a look.
After breakfast, Zheng Ren and Su Yun left the emergency department and returned to the interventional department to prepare for the morning shift.
Lin Yuan was still sitting in front of the computer, busy writing medical records. Chang Yue was chatting with the patient's family in the ward. Everything in the department looked as usual.
It was plain, but rich and colorful.
…
…
Note: When I wrote about mirror image pain, I remembered that there was a patient who had been amputated in the emergency department. He kept saying that the amputation position was the same as the pain on the opposite side. He kept saying that he was pretending to be sick behind his back … He felt a little ashamed. This was the first time he had heard about mirror image pain.
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