Rebirth 1977 Great Era

Chapter 626: Yang Jingxiang's foot massage, first encounter with an eye disease patient (Happy New Year!)
The next thing was easy, and Fangyan began to arrange treatment.

Follow the treatment process arranged in dialect before.

First fumigate and apply medicine in an orderly manner.

During this process, Fangyan also took care of his good foot, because Fangyan remembered clearly that his medical records showed that both feet had been frostbitten.

After taking the medicine, the admission procedures were completed and the patient was transferred to the inpatient floor of the Traditional Chinese Medicine Department on a different floor of the same building.

Then Fangyan arranged a massage job for Yang Jingxiang. Anyway, the acupuncture points and meridians near the veteran's feet must be massaged for an hour every day, half an hour for each foot.

The methods used are kneading and rubbing, with warmth as the degree, to help dispel cold evil and promote the flow of Qi and blood.

Fangyan didn't let anyone else do this job, so he asked Yang Jingxiang to do it.

Doesn't he have a bad temper? Doesn't he like everything to be done quickly? Then leave this matter to him!

Another job, moxibustion, was originally quite challenging, but he invented the moxibustion box. Now this job has become easy. He only needs to pay attention to the temperature to prevent the patient from getting burned.

However, Yang Jingxiang did not dislike this job at all. He even felt that being able to massage the feet of the veteran comrade was like taking care of him.

Being able to treat a war hero and give him physical massage every day was something he had never experienced in his life before.

Fangyan then gave the patient some Chinese medicine.

Then half an hour later, the patient found that there was obvious pain in the wound on his foot, which changed from numbness and slight coolness to tingling and heat.

This is the effect of accelerating the flow of Qi and blood in the meridians and spreading Yang Qi into the injured area. Although the pain comes up, the patient gradually finds the feeling of his feet.

Before, he always felt that his legs were not his own. Only when he used hot water to scald his feet could he feel that they were his own.

In order to relieve his pain, Fangyan gave him acupuncture treatment and increased the dosage of two pain-relieving drugs, camphor and radix polygoni aviculare.

Try to get the patient to suppress the pain after using it tomorrow.

Today, all of Fangyan's work was recorded step by step in the medical records by his assistant Zhang Yanchang.

In fact, the gangrene of the veteran is a relatively special case.

The clinical manifestations of gangrene are divided into three stages.

The first stage is the local ischemia stage, which is manifested by: coldness, fear of cold, numbness, soreness in the extremities of the affected limbs, intermittent claudication, and a feeling of heaviness and pain in the calf or sole of the affected limb after walking 500 to 1000 meters. The symptoms will be relieved or disappear after a short rest, but the heaviness and pain will reappear when walking the same or a shorter distance again.

The second stage is the nutritional disorder stage, which is manifested by: the affected limb becomes cold, afraid of cold, numb, and heavy and swollen pain, intermittent claudication worsens, and there is resting pain, which is severe at night and difficult to fall asleep. The patient often sits with his knees hugged. The muscles of the affected foot are obviously atrophied, the skin is dry, the hair falls off, the toenails are thickened and grow slowly, and the skin is pale or flushed or cyanotic.

In the third stage, it will enter a bifurcation and may cause necrosis or gangrene.

At that time, the affected limb suffers from severe blood circulation disorders, resulting in ulcer necrosis or gangrene shedding, which usually starts from the toes and gradually spreads upward. The gangrene is dry or wet. When combined with infection, systemic symptoms such as high fever and chills appear.

However, the patient was about to enter the third stage, but before he entered the third stage, he suffered an unexpected traumatic infection and underwent a toe amputation surgery, and then he began intervention treatment again.

Although he has not recovered and his wounds are still worsening, he has not entered the third stage.

Then it was sent here.

In fact, if he had not suffered that injury, according to the soldier's temper, he would definitely not care about it. He might not think of treatment until his foot had completely entered the third stage.

It will be even more difficult to treat at that time.

So, as the saying goes, a blessing in disguise.

Even though he has a military doctor wife at home, in fact, this wife is just like the one in Meng Jimin's family. She is extremely busy all day and has no mood to pay attention to her husband's affairs.

After settling down here this time, he went back to work immediately.

He said someone would come to take care of me later.

I would like to trouble the comrades in the hospital to help take care of me during this period of free time.

At this moment, Fangyan suddenly understood Lao Meng a little.

……

At 11 o'clock in the morning, the dean told me that someone had come to the hospital to see him.

After hearing this, Fangyan took two assistants to the clinic.

There were not many patients this time, only three.

The dialect also specifically distinguished between family members and patients.

Only three confirmed.

If these three people read quickly, they should be able to finish watching all of them within an hour and then go back to eat.

In the afternoon he could go to Shuangqiao in Sanjianfang Township to visit Old Mrs. Luo.

The first one to come up was a woman in her early thirties.

She was wearing sunglasses and looked very cool.

The person who came with her should be her husband. When Fangyan asked them to see the patient, the husband supported the woman and came to Fangyan.

Fangyan saw that this person seemed to be blind, so he asked:

"Comrade, tell me about your situation."

The female patient said in dialect:

"My last name is Xiang, I'm 34 years old this year. I've been having blurred vision since three years ago, and now I can't see anything clearly at all." After hearing this, Fang Yan suddenly realized that this was the reason why he was wearing sunglasses, so Fang Yan said to her:

"Take off your glasses so I can see them."

After saying this, the patient took off his sunglasses.

Then Fang Yan saw the red cataracts at the corners of her eyes.

Cataract refers to the abnormal film-like or flaky opacities that appear on the eyes, and "red" means that this type of cataract is accompanied by a red color, which usually indicates inflammation.

In addition, there is a bunch of white clouds on the outer side of the right eye near the pupil.

To be more specific, it refers to the white flake or cloud-like opacities that appear in the black eye (cornea) and other parts.

"White flakes" are similar in shape to flakes, while "cloudiness" describes them as being like clouds, with relatively blurred boundaries, a thin texture, and white color. It is a common manifestation of corneal opacity.

There are white flaky and cloudy turbidities on the black eye. The color is porcelain white and grayish white. The boundaries are not very clear, like clouds and mist, as if someone has smeared a layer of frost on it.

Zhang Yanchang and Yang Jingxiang frowned when they saw this situation. Zhang Yanchang had no idea how to treat the disease, while Yang Jingxiang found that this was another difficult and complicated disease, and it had progressed to a very advanced stage.

"Can you close your eyes normally?" Fangyan asked the patient.

They behaved differently, but Fangyan remained very calm and was observing the patient's condition.

The patient closes his eyes and then slowly opens them again.

Fangyan found that something similar to eye booger was squeezed out from the red cataract at the corner of the patient's eye.

And when she closed her eyes, you could see that the white of her eyeball (sclera) protruded slightly outward.

At this time, the patient's husband took over the conversation and said to Fangyan:

"She was in a bad mood because of an argument with someone at work three years ago, and then she complained of chest tightness. She had chest tightness for about a week, and then her vision became blurry..."

At this point, the patient himself said:

"I'll just say it myself."

The patient's husband patted her hands and agreed.

Then the patient began to narrate herself. She said:
"Just like what my husband said, I had an argument with a colleague at work and was in a bad mood. Then I felt like there was a stone pressing on my chest. I felt tightness in my chest for about a week. It wasn't until a week later that I started to see blurry things. I saw blurry things and double vision when I started to feel tightness in my chest."

"I still remember clearly that I couldn't eat anything at that time. I felt very irritable and wanted to destroy and smash everything I saw."

Fang Yan thought for a moment after hearing this, and then asked:
"Did you seek medical advice at the hospital?"

The patient said:
"I went to the doctor at the hospital where I worked to diagnose my problem. The doctor said it was caused by a bad mood and asked me to relieve my mood. Later, I thought there was something wrong with the people in that unit, so I was transferred from that unit. After the transfer, I felt much better and could eat better, but the blurry vision and double vision never disappeared."

"Because I was afraid that people would say I was narrow-minded and I was so angry that I couldn't see clearly, I never went to the hospital for this symptom even though I could overcome it."

“……” Fang Yan and everyone else were speechless.

This kind of thing is obviously not a matter of mood, right?

But on second thought, it is understandable from the patient's perspective.

After all, not everyone studies medicine.

Her reaction was very much like what most women would normally do in such a situation.

The patient then continued:

"Then half a year ago, I suddenly started to have headaches, and my vision became increasingly blurry. First, my right eye lost all sight, and then my left eye did the same. We went to several hospitals for examinations and were diagnosed with retinal abscesses."

"Then I started taking all kinds of Western medicine."

Fangyan showed a puzzled look. Fundus retinalis? Why haven't I heard of this name?
After thinking for a while, he tentatively asked the patient:
"Did the hospital diagnose it as "fundus suppurative inflammation" or "tear duct pus leakage caused by dacryocystitis"? "

After hearing the two names in dialect, the patient's husband immediately nodded and said:

"Oh, yes, yes, Doctor Fang, you are still professional. The name you said is correct, it is suppurative inflammation of the fundus!"

Fangyan breathed a sigh of relief and said...how come there is retinal abscess?

This purulent inflammation of the fundus is mostly caused by infection by pathogens such as bacteria, viruses, and fungi.

It may also be that autoimmune diseases involve the fundus, such as birdshot retinal choroidopathy, etc. In addition, trauma leading to intraocular infection, or systemic diseases such as eye complications caused by diabetes, etc., may also cause suppurative inflammation of the fundus.

The main symptom is that patients often experience acute loss of vision, accompanied by a sense of black shadows, floating flashes, and flashes in front of their eyes.

The inflammation will cause severe pain in the eyes and restrict the movement of the eyeball.

Then in the most serious cases, there will be loss of vision, or you can't see anything but the perception of light.

But judging from the symptoms described by the patient in front of me, it doesn't seem like this is the disease.

Fangyan asked them:

"Do you remember what medicine you took? Or do you have the test report or something like that?"

He doesn't need to worry about other wards, but for the eye area, he really needs to see what medicine they are using.

"Yes!" the patient's husband nodded.

Then he took out a file bag from his coat pocket and handed it to Fangyan.

(End of this chapter)