enjoyebooks Chapter 1518 - 613: The Importance of Inspection and a Breakthrough Discovery (Part 2)
Chapter 1518 - 613: The Importance of Inspection and a Breakthrough Discovery (Part 2)
Western medicine’s various techniques are easier to promote, as students with a bit of intelligence can study medicine.This can be directly screened through the college entrance examination to select suitable medical students.
Thus, it is now the era of Western medicine, and there is no shortage of talent.
Various instrument checks and operations can actually be performed by following the instructions if necessary.
Zhou Can found his way to the inpatient ward where the patient resided, based on the information in the medical history.
Neurology Ward Bed 37.
A pretty-faced female patient lay on the hospital bed, and an elderly woman in her late fifties was accompanying her at the bedside. She should be the patient’s mother.
Even if a woman is married, the accompanying family member during illness is usually a parent, husband, or child.
In any case, it’s rare for a father-in-law or mother-in-law to come to the hospital to care for a daughter-in-law.
"Is this Ms. Zhao Caixiu?"
"Yes, that’s me."
Seeing the doctor arrive, she quickly sat up.
"It’s okay, I’m just here to understand your condition, you can stay lying down."
Zhou Can quickly reassured her.
For patients with neurological disorders, it’s best to keep them relaxed and natural. Otherwise, anxiety can easily provoke symptoms.
"Let me check your eyes."
"Sure."
She readily accepted.
The vast majority of patients are very willing for doctors to check on them, concerned about their conditions.
Zhou Can looked at the patient’s eyes, noting a marked slowness of movement and upward gaze difficulty in the right eye.
"Look at my finger, don’t move your head."
After Zhou Can said this, he moved a finger up, down, left, and right in front of the patient’s eyes.
The movement of the patient’s right eye appeared even more sluggish.
Zhou Can first covered the patient’s left eye, then extended two fingers.
"How many fingers do you see?"
"Seems like four!"
Indeed, the patient experienced diplopia in the right eye.
He then covered the patient’s right eye and asked, "How many fingers?"
"Two!"
The patient’s left eye vision was normal.
Zhou Can did not stop the examination. Although these tests were already done by other doctors, he just wanted to reconfirm the results and observe the patient’s eye movements.
"Did your right eye hurt when you moved it just now?"
"It seemed to hurt a little. When the right eye moves, it feels like it’s pulling a nerve; my head hurts a little."
The patient answered truthfully.
"Okay. Let me touch your face, just relax."
Zhou Can felt both sides of the patient’s face, especially around the cheeks and the zygomatic area, and found no apparent abnormalities.
"Do you usually chew gum?"
"Occasionally, but rarely." The patient said, a bit embarrassed.
"Here, I’ll give you a piece of gum. Just open your eyes normally while chewing; I’ll conduct further examinations on your eyes."
Zhou Can fished out a piece of Green Arrow gum from his pocket and handed it to the patient.
This unique examination method immediately attracted the attention of other patients and family members in the ward. Everyone watched curiously.
The patient took the gum, unwrapped the aluminum foil, and put it in her mouth to start chewing.
Even though she wasn’t sure what Zhou Can intended to check, she still found this young doctor’s method quite unique and novel.
Zhou Can observed the patient’s eyes and noticed an unusual slowness in her corneal reflex.
However, her chewing was very vigorous.
"Close your eyes."
She obediently closed her eyes, and Zhou Can tried to flip her eyelids, feeling that her eye closure strength was significant.
He carefully scrutinized her face; there was no crooked mouth, the nasolabial groove was normal in depth, and she had fine fuzz on her lips.
Females don’t have beards, but fuzz is normal.
Some females experience an increase in male hormones at certain times, causing the fuzz on the lips to thicken and grow, resembling a beard. Often, many women panic, though there’s no need for concern, as this is a normal physiological phenomenon.
This is especially evident in older women, particularly post-menopause.
Facing it calmly is enough.
If it indeed affects aesthetics or one fears discrimination or ridicule, hair removal products can be used to remove the fuzz on the lips.
Additionally, for men choosing a female partner, there’s a small tip to gauge whether a woman has a dominating personality.
Simply observe her lip fuzz covertly; if it’s dense and long, such women are often quite assertive. Prepare to be a henpecked husband after marriage.
Of course, marrying such a girl can also be very fulfilling.
This type of girl often has strong career ambitions, is clear about her affections, may have a temper, but treats her husband and children well.
If she doesn’t get along with the in-laws, just don’t live together.
"Alright, please spit out the gum and try to drink some water."
Zhou Can’s test continued.
When the patient spat out the gum, she wrapped it in tissue, signaled for her family to throw it into the garbage. Based on her behavior, she seemed quite cultured.
She picked up a cup and took a sip.
Zhou Can noticed she seemed to have a bit of difficulty swallowing. This was actually observed when she was chewing the gum earlier.
The swallowing reflex was quite pronounced.
But there was no choking cough.
"Stick out your tongue, and open your mouth just a bit wider."
Zhou Can continued.
It was fortunate the patient’s husband wasn’t present, as these kinds of tests could easily be misunderstood by the husband of a female patient.
Doctors are merely aiming to ascertain the cause of a patient’s condition, without any malicious intent.
Upon observing, Zhou Can found the patient’s tongue could naturally stay centered, with no tongue muscle tremors or atrophy.
"Alright, that’s fine."
Zhou Can proceeded with other examinations.
The patient’s limbs muscles were all normal, muscle tone was normal, and no spontaneous muscle movements were detected. Coordination tests were normal, deep and superficial sensations in the limbs were normal, and tendon reflexes were neither hyperactive nor diminished.
There seemed to be a positive bilateral Babinski sign.
This was a new discovery.
The patient lay supine, with hip and knee joints extended, as the examiner stabilized the calf by holding above the ankle with the left hand and swiftly stroked the outer side of the foot sole from back to front towards the small toe’s base, then turned towards the big toe. This was known as the bilateral Babinski sign test.
A normal response is plantar flexion of the toes, which is negative.
This female patient showed distinct abnormalities, initially diagnosed as positive.
It seems personal contact with the patient is indispensable.
If he hadn’t come to the ward for an in-depth examination, he couldn’t have discovered so many details.
Just relying on examination results and medical records, everything about the patient’s body appears normal unless symptoms occur.
Who would have thought that beneath seemingly normal behavior, so many abnormalities were lurking?
"Let me feel your neck, try to relax, don’t tense up."
Zhou Can attempted to touch and press the patient’s neck, and felt the skin was smooth as silk.
There was a notable presence of neck resistance during palpation.
"Relax, don’t tense your neck, or my examination results might be inaccurate."
Zhou Can gently reassured the patient.
"Okay."
She closed her eyes, trying hard to relax.
But the neck resistance persisted.
Zhou Can performed the Kernig’s sign and Brudzinski’s sign tests on her, both resulting in a score of one plus.
Not exceedingly severe.
"Alright, thank you for your cooperation. We will inform you once there is a new diagnostic breakthrough." Zhou Can had gained considerable insights, and though the cause of the diagnosis wasn’t entirely clear, combined with the patient’s lab tests and various instrument checks, it should be possible to diagnose her condition.
"Are you the patient’s mother?"
He asked the elderly woman accompanying the bedside.
"Yes! I’m her mother."
"If she has an episode, try to have her lie on her side, preferably left side lying. It’ll be safer for her that way."
"Sure, thank you."
The family nodded, indicating they understood.
Generally, families adhere to the doctor’s advice.
But some suspicious families, or those who think they know a little bit about medicine, might hold doubts about the doctor’s instructions.
Putting it succinctly, not heeding the doctor’s advice could lead to immediate regret.
In some cases, it can result in significant misfortune.
Zhou Can returned to Director Yin’s office and found that Director Yin Hua had already returned.
"I thought you ran off! How about it, did you review the information on that female patient?"
Director Yin asked.
"When have I ever run?"
Zhou Can couldn’t help but roll his eyes. Director Yin appears serious, with an old-school academic personality, but once you get familiar with him and he acknowledges your capabilities, he’s quite open in conversation.