I Can See Health

   Chapter 108 Hypoglycemia? Cerebral infarction!

   After listening to Min Ling's story, Lu Chen understood.

  Clinically, many things are not black and white.

   In many cases, the patient's family factors and economic conditions will seriously affect the patient's treatment effect.

   It’s not just about drugs, or the medical standards of doctors

  Lu Chen began to write the patient's first course record.

   The main diagnosis at present is hypoglycemia coma, excluding cerebral infarction.

   In this case, it is necessary to complete the cranial DWI examination in time to exclude acute cerebral infarction.

   As for hemiplegia, hypoglycemia can also cause hemiplegia, but the current treatment mechanism is not very clear.

  …

   After half an hour.

   "Dr. Min, 18 beds, just checked blood sugar is 6.6mmol/L."

  The nurse walked into the doctor's office and shouted.

   "Okay, I understand, go ahead." Min Ling nodded, "Is the patient's son here?"

   The nurse replied uncertainly: "It seems that a man has come, and their family members are discussing something in the corridor."

   "Yeah." Min Ling stood up, "I can't delay any longer, I'm going to communicate with the family."

  Min Ling walked out of the doctor's office, and Lu Chen followed her.

   in the corridor of the ward.

   The four family members of the patient are in a group and are having a heated discussion.

   Seeing Min Ling coming, the middle-aged woman came out.

   "Doctor, my brother is here. He wants to know more about my dad's condition."

   A thin man with a scar on his right eye took a step forward and said, "Doctor, what's my father's condition now?"

Seeing that the patient's family members were all there, Min Ling explained patiently: "At present, it is considered to be a coma caused by hypoglycemia, but the existence of acute cerebral infarction cannot be ruled out, so now I have to go out to do a head MRI to rule out cerebral infarction! Diagnosed with cerebral infarction, the treatment method will be very different!"

  The middle-aged man touched his chin and asked in doubt, "Doctor, do you have to do this examination? Can't you do it?"

   "No, cerebral infarction must be ruled out." Min Ling said.

   The middle-aged man frowned, "I just told a classmate who is a doctor about my dad's situation, and he said it was hypoglycemia, so I don't need an MRI."

  Min Ling replied expressionlessly.

   "No, it's ok, the signature means refusing the inspection, and it's ok to take all the risks."

   Hearing this sentence, the middle-aged man hesitated again.

   "If the examination is done, it is a cerebral infarction, can it be cured?"

  Min Ling shook her head, "Not necessarily, it depends on the size of the patient's cerebral infarction and the individual's condition. Some people have no sequelae, some may become hemiplegia, and a small number of people may even be in a coma forever and become a vegetative state."

   "This..." The middle-aged man was stunned for a moment, then looked back at the other family members.

   "Actually, the inspection is not expensive. It only costs a few hundred dollars, and it can be reimbursed." Min Ling looked at the clothes of the middle-aged man.

   "This..." The middle-aged man paused, "Actually, it's my dad's medical insurance. This year, his medical insurance will stop paying, so he may have to pay for it himself."

  Min Ling raised her eyebrows.

   "At your own expense?"

   "Yes. I asked. Now that I have to pay for medical insurance, I will not be able to use medical insurance until three months later."

   "I know you have your own reasons, but your illness doesn't wait for anyone. You can make a decision within five minutes." Min Ling put down the ultimatum, "Do it, go now. If you don't do it, just sign."

   "Okay, okay." The middle-aged man nodded quickly.

  …

   Back to the doctor's office.

   "Little Lu, if your family members are willing to go out and do it later, you can accompany you." Min Ling smiled.

   "Okay, Teacher Min." Lu Chen nodded. , "Do you think his family will agree to go for an inspection?"

  Min Ling paused, then smiled: "Yes, after all, it's their father, just lying in bed like this, in case of acute cerebral infarction, not to mention the treatment, other family members of their family may gossip."

   "Sometimes, people's words are scary."

  Lu Chen nodded.

   "Hey, by the way, do you remember the last time you sent a patient to the ICU?" Min Ling said suddenly.

   "Well." Lu Chen nodded, "What happened to the patient later?"

  Min Ling shook her head: "Hey, the patient stayed in the ICU for a few days, and the cost was too expensive, so he was transferred back to the general ward. Within two days, the patient was dying, and he was dragged home yesterday."

   "This is the case with his family. If you don't take your last breath, you must not drag them home. Otherwise, the neighbors nearby and some relatives will gossip."

  Huaxia people love face and show it most vividly in many things.

  …

   Five minutes later, the middle-aged man walked into the doctor's office.

   "Doctor Min, we agree to do the examination, you can arrange it now."

   "Okay." Min Ling then glanced at Lu Chen, "Dr. Xiao Lu, you are now taking the patient's family out for cranial DWI."

   "Well. Lu Chen nodded, then followed the middle-aged man out of the doctor's office.

  The nurse has put the ECG monitor on the bedside.

   "Doctor Lu, you're ready, you can go out to check at any time."

   "Okay, then let's go."

   The four family members of the patient, two in front and two behind, pushed the beds out of the inpatient building of the Endocrinology Department.

   Generally speaking, there is no emergency examination for MRI.

   But head DWI is an exception.

  Cranial DWI refers to magnetic resonance imaging, that is, diffusion-weighted imaging.

   This is a generalized fMRI technique. Clinical application is mainly used to determine acute cerebral infarction, which can clearly display the lesions at an early stage and provide important help for treatment.

   Came to the MRI room.

   Four family members carried the patient to the examination table.

  Lu Chen also came to the operating room and stood beside the operating technician.

   "What's the condition of the patient?" the technician asked while adjusting the interface of the examination.

   "The patient was admitted to the hospital in a coma, with hypoglycemia and left hemiplegia. We consider the possibility of hypoglycemia coma, but cerebral infarction is not excluded."

   "Oh." The technician nodded.

  In the inspection room, the machine has started to run.

   On the computer, the brain magnetic resonance image began to appear.

  Lu Chen concentrated his attention and watched the video data on the computer.

   One picture after another, slowly developing.

   Until, on a black brain tissue map, a white cloud appeared.

   At this time, the technician glanced back at Lu Chen.

   "You asked the patient to do a DWI, and the diffusion DWI of magnetic resonance showed a high signal image, and consider the possibility of acute cerebral infarction."

  Lu Chen felt a little fortunate, but fortunately Mr. Min Ling insisted on pulling out to do DWI.

  If the patient has been treated for hypoglycemia and the patient does not wake up, the problem will be serious.

   Even if the patient's family has signed the informed consent, the hospital will still be partially responsible.

  Lu Chen immediately sent a WeChat message to Min Ling.

   "Mr. Min, the result is out, acute cerebral infarction!"

   (end of this chapter)