mesbooks Chapter 280
Chapter 280
"This child's life is miserable~~~"
The patient's mother's tearful recounts the patient's past.
Lin Feng listened carefully,
Patient, Tan Xiaoli, 26 years old,
After repeated setbacks in the graduation job search journey,
Mood is abnormally low, and nothing can be done to raise the spirit.
Sleep also began to be poor, unable to sleep, easy to wake up, nightmares.
subsequently
There are fewer shopping and friends going out.
Began to stay at home, silent, with a sad face.
Later, a neighbor said that he might have depression.
When my parents heard this, they immediately panicked, and many patients with depression who used to watch the news committed suicide by jumping off buildings.
Isn't it possible for your own daughter?
Frightened, they hurriedly coaxed and sent them to the hospital to see a doctor.
The doctor asked a lot, and then he also found a psychiatrist.
"Are there any relatives who have mental disorders?"
"There is one, the child's cousin used to be mentally abnormal..."
"This is a family history..."
At last
The doctor gave a judgment of depression!
subsequently
The parents who did not die took the patient to several hospitals to see.
The result is the same!
Also diagnosed with depression!
Now it's my fate.
And so, 2 years passed.
Take the medicine according to the doctor's instructions, and the drug has been adjusted several times in the middle, and the condition has been repeated.
Until now,
The patient Tan Xiaoli has gained a lot of weight, from 90 pounds to 140 pounds.
Besides
There was severe snoring.
That snoring sound, loud, very scary, very scary.
"I looked at the doctor on the Internet at the time and said that snoring is so severe that it is easy to suffocate, so in the past few months, we have been guarding in front of our daughter's bed, as long as our daughter snores when she sleeps, we will shake my daughter awake, for fear that my daughter will suffocate directly and die."
Lin Feng nodded.
The cause of snoring may be that some tissues in the throat are too thick and fat (especially if the patient is so fat), these tissues will collapse and block the respiratory tract when sleeping, and the airflow in and out of the respiratory tract becomes difficult, and it will snore.
The mother sobbed: "But we keep shaking our daughter awake, not only is the daughter very cranky, we are also tired..."
"Doctor, what do you say?"
Lin Feng thought for a while and said, "I suggest, do a sleep monitoring first... Half admitted, sleeping in the hospital today, by the way for an examination ..."
The patient's parents: "Okay, thank you doctor..."
......
Patient admission,
Things went well,
Two hours later, at 10:00 a.m.,
The patient, Tan Xiaoli, was sleepy and fell asleep on the hospital bed.
And then......
Lin Feng finally heard the 'scary' snoring that the parents said.
The snoring is heaven-shaking!
It really scared Lin Feng!
And the results of sleep breathing monitoring are also amazing!
Patients often have apnea, the longest of which is nearly 40 seconds!
Simply amazing!
At this level, there may be a suffocation hazard at any time!
(Other: gasping or holding back, then the snoring stops.) ）
"Doctor, how is it going?"
The parents asked worriedly.
"It's quite serious, it's "SAHS sleep apnea hypopnea syndrome"!"
Lin Feng's expression was serious, and he also thought of a question:
Is the patient really depressed?
Or is it bad sleep?
The patient's breathing state, cerebral ischemia, lack of oxygen, usually must not concentrate.
Therefore, the patient's state is not necessarily depression, it may be breathing problems.
"Doctor, what should my daughter do?"
"There are two ways."
Lin Feng explained.
"The first is surgery, which cuts out the tissue that is thick and blocks the airway."
"The second is to sleep with a non-invasive ventilator."
The so-called "non-invasive ventilator CPAP" is a device that can continuously ventilate the positive airway, wear a mask, and the ventilator will pump into the mask when sleeping, and the gas will rush a way after entering the respiratory tract, thereby improving respiratory obstruction.
Clinically used for the treatment of sleep apnea syndrome and related diseases,
When parents heard about the operation, they couldn't help but be afraid.
Father exclaimed:
"Let's choose the second option!"
Lin Feng waved his hand.
"Wait a minute, let me think..."
Lin Feng began to recall some knowledge points of "SAHS sleep apnea hypopnea syndrome".
He felt that there was something wrong with this patient's disease.
SAHS has the following clinical manifestations:
Obstruction of the airways, lack of oxygen, snoring during sleep
When awake: drowsiness, lack of energy, fatigue, fatigue, lack of concentration, memory loss may occur.
There is also a possibility that it will be misdiagnosed as a mental illness!
Patients because of sleep breathing problems, resulting in cerebral ischemia and hypoxia, for a long time, may lead to changes in people's temperament, anxiety, depression...
In Lin Feng's many check-in experiences, there are many patients because of apnea-hypopnea syndrome, because some manifestations are misdiagnosed as schizophrenia, etc., once the breathing problem is cured, the mental problem will be solved.
Therefore, the patient in front of you may not be depressed!
Combined with the complaint of the patient's mother just now:
"The effect of taking medicine, over and over again..."
Therefore, depression is even less likely.
"Doctor Lin, what's wrong?"
The patient's parents were stopped by Lin Feng, and they couldn't help but wonder...
Lin Feng: "I consider, your daughter may not be depressed, there are other possibilities..."
Lin Feng's words came out!
The patient's parents are overjoyed!
Dr. Lin, that's a very good doctor!
What Dr. Lin said, that credibility is still very high!
Lin Feng: "It's not certain yet... Let me ask you a few questions..."
The patient's mother was excited: "Dr. Lin, you ask!" "
Lin Feng: "You just said that the diagnosis of depression was 2 years ago, and then snoring was only in the past few months, right?" Have you ever snored for a long time before? "
The patient's mother shook her head: "No, I'm sure." "
Lin Feng groaned,
Looking at the female patient sleeping on the hospital bed.
The neck is a bit thick.
So I asked the patient's parents another question.
"In the past two years, have you checked your daughter's thyroid gong and thyroid ultrasound?"
Lin Feng's initial considerations were:
The patient snores because he is too fat to breathe... This can lead to psychiatric problems (suspected depression).
However, the patient's mother said that the snoring time was a year and a half later than the depression time.
So rule out this one possibility!
But there is a second possibility: an enlarged goiter, which causes blockage of the airways and thus poor breathing... This in turn causes (suspected depression).
"Jia Gong? Thyroid ultrasound? "
"Nope."
Both parents shook their heads.
"Then I will open two orders for you, "A Gong" and "A B Super", you do it now, "A B Chao" will produce results in 10 minutes after doing it, "A Gong" is relatively slow, and the results can be obtained in the afternoon..."
The patient's parents were confused.
But
Out of trust in Lin Feng and expectations for his daughter.
"Okay, okay, I'll take my daughter for a check-up right away!"
......
It didn't take long for you to do so.
The female patient woke up choking on her breath.
Then he was pulled by his parents to draw blood and do B-ultrasound...
11：00，
The result of B ultrasound was brought back to Lin Feng.
• Goiter.
・Thickened thyroid echo, uneven distribution, consider "hypothyroidism"!
The patient, parents, and a family of three looked at Lin Feng with anticipation and longing.
That's right
The patient knows at this time that he may not be depressed, and he can't help but be refreshed!
Eyes are in mind!
As soon as Lin Feng got this result, his heart was a little more determined.
Earlier, the patient's mother complained:
In the past two years, the patient has appeared: little speech, no talking, slow movement, chills, and memory loss.
This performance is indeed very similar to depression.
But at the same time, it is like: "hypothyroidism" (hypothyroidism, the opposite of hyperthyroidism)!
When thyroxine is deficient, the entire human body will be reduced in function, and even edema will occur... And, "fattening"!!
This corresponds to the patient's fattening!
Of course
The results of the blood draw test have not yet come out,
Lin Feng couldn't really be sure.
"Show me your hand..."
Lin Feng was ready to give the patient a detailed examination.
It was found that the patient also had symptoms such as dry skin, roughness, low skin temperature, thinning hair, and edema of the lower extremities (a depression will appear when pressed in).
This is all a manifestation of hypothyroidism!!
The probability has risen to 99%!!
Lin Feng told his consideration to the family of three.
"Probably not depression, but hypothyroidism!"
As soon as these words came out,
A family of three, suddenly excited, tears on the spot!
......
In the afternoon of the same day,
The blood draw results of Jia Gong came out:
Hypothyroidism!
At this time, Lin Feng finally concluded: "Hypothyroidism"!
"Thank you doctor, thank you doctor!"
The family of three thanked excitedly.
The female patient and mother cried even more.
Depression, psychosis, in the past 2 years, they have been criticized a lot around them.
At this moment, they finally felt that the clouds were clear and spring was blooming.
All this,
It's all because of Dr. Lin Feng!
......
Watching the family of three leave,
Lin Feng smiled,
Continue to see patients.
Patient 58:
An old man, male, about 60 years old.
The old man was helped in by an old lady.
Old lady: "Doctor Lin, help me see my old man, my eyes are narrowed... Can't open your eyes. "
Lin Feng: ".................."
As soon as he entered the door, Lin Feng noticed that the old man's eyes were closed.
Lin Feng thought that the old man was having a tantrum and closed his eyes.
The result is that you can't open your eyes!
Sit down
The old lady began to ramble.
"My old man, in the past ten days, I don't know why, my eyes have always seemed to have no strength... At first, I thought that I didn't rest well and was tired, but it became more and more difficult to open my eyes later..."
"You see, that's it for today, it's a squint..."
The old lady pointed to the old man's eyes with a look of disgust.
Lin Feng observed this old man up close,
Close your eyes completely.
Pulled the old man's eyelids.
Pull it up,
Exposed black and white eyes, a little cloudy, but also a normal performance of the elderly.
Lin Feng let go of his eyelids,
The eyelids fell off at once.
————————
ps: Update complete...