stjorthotic Chapter 389
Chapter 389
Chapter 389
In a flash,
One day passed.
Lin Feng goes to work at 23:00 in the evening.
Chen Yu, patient on rounds.
At this time, the results of the cardiogram came out.
·24 Cardiogram: No obvious abnormalities!
This time,
Lin Feng was finally a little disappointed.
He thought the cardiogram could show…
but,
No problem is found in the 24-hour cardiogram, which does not mean that the patient’s heart is really fine.
Because the patient’s seizures are intermittent, not continuous, if the epilepsy is really caused by a heart problem, then the heart arrhythmia should also be intermittent, not continuous. In this case, it is reasonable that the cardiogram is okay.
matter,
Once again deadlocked!
There are no patients tonight, so Lin Feng is very free.
Leaning on the chair, thinking.
Why?
The last patient who was misdiagnosed as epilepsy was finally found to be hypoglycemia, and then the cause was found to be insulinoma.
If this patient was not epilepsy, what would be the cause?
At this moment,
The intern Chen Qingru walked in with a packing box.
“Dr. Lin, your supper, the fried noodles you ordered 08…”
“Let this…”
Chen Qingru put the fried noodles on the table, then took out a bottle of medicine from his pocket, took one pill, and took it with water.
“What medicine are you taking?”
“Calcium tablets…”
“Why do you take calcium tablets?”
“I feel a little cramping in my legs, and I feel calcium deficient…”
“Oh……”
Lin Feng is just boring, just ask,
Sudden,
Lin Feng’s mind flashed!
Calcium tablets!
calcium!
cramp!
“Fuck! Could it be it!”
“No, you can’t get excited, it doesn’t have to be… first check the patient!”
Lin Feng quickly ordered Chen Qingru:
“You go to the patient, draw a blood, and then send it to the laboratory for an electrolyte test…”
“Oh, good…”
“be quick!”
Lin Feng was extremely happy.
Chen Qingru was puzzled, what did Dr. Lin discover? So excited?
Electrolyte check?
What does it have to do with the patient?
Chen Qingru didn’t want to understand for a while.
With doubts, she hurried to find the patient to draw blood, and then hurriedly sent to the laboratory.
Half an hour later,
The result is out!
Electrolyte check, there are many indicators,
Densely packed…
However, Lin Feng skipped the others and found two indicators at once:
“Calcium ion concentration”, “Calcium ion concentration”!
· Electrolyte check: the calcium ion concentration is only 2.1mmol/L (9-11), and the calcium ion concentration is 3.12mmol/L (1.1-1.3).
The calcium ion concentration is low!
The calcium ion concentration is high!
Lin Feng suddenly became excited.
really!
The same as I thought!
Is not enough calcium ions!
Reason: The skeletal muscle activity of the human body relies on many electrolytes. Calcium ion is one of the key points. Muscle spasms are prone to occur when calcium is deficient, which manifests as convulsions.
Up to this point, the reason for the patient’s loss of consciousness cannot be explained!
Here, we are going to talk about another “high blood phosphorus”!
Low calcium and high phosphorus!
what does this mean?
In textbooks, “low calcium and high phosphorus” is one of the manifestations of “hypoparathyroidism”!
Hypoparathyroidism can cause epileptic seizures! !
Parathyroid gland: It is a small gland next to the thyroid gland!
Parathyroid hormone is responsible for the regulation of calcium ion concentration and phosphorus ion concentration. If the secretion of parathyroid hormone is insufficient, the concentration of calcium particles will decrease and the concentration of phosphorus ions will increase.
When the calcium ion concentration is low to a certain level, hand and foot paresthesia, convulsions, and even epilepsy will occur!
The concentration of phosphorus ions will cause the patient to lack water.
Lin Feng waved his hand and was very excited.
“Go, go see the patient!”
Lin Feng wants to confirm whether it is hypoparathyroidism!
This disease can cause constipation, dry skin, cataracts, cardiac insufficiency, etc…
Lin Feng came to the ward.
Observe the skin of the patient Chen Yun.
“Sure enough, the skin is relatively dry!”
Proof +1! !
Earlier, electrocardiogram·QT wave interval singing, QT interval prolonged, may also be caused by low calcium. Calcium ions are also involved in the electrical activity of the heart muscle. If there is a lack of calcium, the electrical activity will be abnormal, and it is not surprising that the QT interval will be prolonged.
Evidence +2!
“Doctor Lin…”
Chen Yun looked at Lin Feng’s excited expression and was overjoyed. Did she find the cause of her illness?
Lin Feng: “Do you often have constipation?”
Chen Yu was surprised: “Doctor Lin, how did you know?”
Lin Feng laughed.
Evidence, +3! !
Obviously, the 99% probability of the patient is: “Hypoparathyroidism”!
“Xiao Ai, draw her blood to get a level of parathyroid hormone!”
Lin Feng’s voice is full of surprises.
At this time, Chen Yu had already seen that Dr. Lin might have found his cause.
“Doctor Lin, my illness…”
“Don’t worry, wait for half an hour and see the result…”
Lin Feng said lightly.
At this time, Chen Yu and boyfriend smiled on their faces, full of expectation in their hearts.
Half an hour later,
The results of the parathyroid hormone test are out.
·Result: lower than the normal range! !
“call…………”
Lin Feng showed his final smile!
That’s right!
It is definitely “hypoparathyroidism”!
Because of it, the patient Chen Yu’s convulsions were induced!
Not-epilepsy!
“My final diagnosis is this…”
“In the future, you don’t need to take medicine, you just need to supplement calcium and vitamin 067D…”
Lin Feng told the patient Chen Yu in detail about his diagnosis process and results.
After Chen Yu listened,
Covering his face, crying in pain! ! !
“Uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu…
She is so miserable!
2 years,
Has been misdiagnosed as epilepsy and treated like a mad woman!
No one can appreciate the sadness behind a patient with epilepsy.
Fortunately, all this is coming to an end.
“Thank you Doctor Lin!”
“Thank you Doctor Lin!!”
Chen Yu thanked again and again, thank you for more than a dozen sentences!
She is so grateful to Lin Feng,
And at this time,
A patient came to the emergency department. Lin Feng left the ward and went to the clinic.
At this time, Chen Yu felt grateful, painful, and happy, and his heart was surging.
She opened her Zhihu account and wrote an article under her column.
“Thank you Dr. Lin for giving me a new life! ——Thanks from a patient with epilepsy
An article, 6000 words,
Eloquently,
I wrote all my sorrows over the years and the luck that I was finally diagnosed by Lin Feng.
In the second half, I was full of praise and gratitude to Lin Feng.
As soon as the article is posted,
Knowing that there are waves again~~~~
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ps: The three shifts are over. I changed to a new computer. Many symbols have changed and cannot be typed out. The chapter originally used [], but now it can only be changed to “”. .