Chapter 146: Paralytic Nerve Plexus Regression Syndrome
Since it was approaching noon soon, Chang Yue insisted on inviting the patient’s son to a nearby noodle restaurant for lunch.
The patient’s son quickly rejected the kind offer, but Chang Yue was firm in her decision.
Yang Lei went along with Chang Yue. Zheng Ren, who was unable to leave the hospital, spoke to the patient for a while and saw them out before heading to the cafeteria.
If subsequent issues would take more than ten minutes to complete, every experienced clinician would have to perform a very important task before taking their leave—a ward round.
Only when all patients were stable could one remain undisturbed. Otherwise, they would be in constant anxiety over any potential emergency and unable to enjoy any meal in peace.
Zheng Ren went for the second ward round of this brand new day.
Every patient, including the two that had been transferred from the ICU to the emergency ward, was in a stable condition.
The war of words in the office just now had embarrassed Tang Xiu, but Zheng Ren pretended as if nothing had happened.
He treated her father the same as he did all other patients in the ward.
The patient’s vital signs were stable. Apart from slight abdominal distention, he experienced only mild postoperative pain, which was one of the benefits of interventional radiology.
Zheng Ren speculated that the pain was a result of peritoneal inflammation secondary to accumulated blood in the peritoneal cavity. He then took a while to convince him not to return home tonight.
What a joke. His condition had pushed him to the brink of death yesterday afternoon, and he wanted to return home now?
Even though there was no place like home, doctors were at least always available in the emergency ward and could immediately wheel the patient into the operating theater for an exploratory laparotomy, which was far safer than wasting time waiting for an ambulance at home.
Thus, he firmly denied the patient’s request to return home.
Tang Xiu’s father was merely trying his luck, but after being informed that ambulation would be possible in one day, the old man finally managed a warm smile.
The patient with splenic rupture, who was kept nil by mouth until he passed gas due to laparotomy, was currently lying on his bed and chatting happily with his wife. Judging by their hearty laugh from time to time, it seemed like their relationship was stable and harmonious.
Who could have thought that the wife had stabbed her husband, leading to hemorrhagic shock only yesterday?
Anger was one’s worst enemy. A quarrel was perfectly normal, but the consequences were disastrous once one party started using brute force.
Zheng Ren entered the room and talked to the patient’s wife for a while. Seeing that the patient was recovering well after the surgical repair of his ruptured spleen, he informed them that he would be able to ambulate after passing gas and eating today.
Every patient in the ward was in a stable condition, but his work was far from complete. As chief resident, Zheng Ren still had to go for a ward round in the emergency department as well.
Su Yun had not followed Chang Yue to lunch; it was presumably due to the emotional trauma of eleven boxes of Snow or simple unwillingness to communicate with the family member that she had brought along.
They both went for a ward round in the emergency department along with the doctors on duty. As usual, there were no misdiagnosed cases or patients in critical conditions, and the cases admitted consisted of minor illnesses and mild injuries that could be settled with topical administration of anti-inflammatory drugs or injection of osmotic diuretics.
That was good news. The stable conditions soothed Zheng Ren’s mind and maintained his heart rate at 80 beats per minute.
‘Eat, sleep and wait for emergency cases to arrive.’ He drew up the day’s work schedule.
He left the observation unit and gave a few instructions to the doctors on duty. Just as he was about to leave the department, he saw two family members pushing a small stretcher trolley into the emergency building.
On the trolley lay a thin and withered old woman in her seventies.
“What happened to her?” asked Zheng Ren as he quickly approached them.
“My grandma fell down when crossing the road a few days ago, and now she has trouble walking on her own,” answered a sturdy young man in his twenties.
“Get a wheelchair over here.” Zheng Ren gave an instruction to someone behind him.
Whoever—Su Yun or one of the doctors on duty—returned with it was none of his concern.
On the upper right corner of his vision floated the System panel with its words painted in green, signifying nothing wrong with the patient. Perplexed, Zheng Ren took a closer look at the old woman lying on the trolley.
Her skin was heavily wrinkled and her eyes narrowed into a slit with wet tracks vaguely visible down her sunken cheeks, presumably due to tooth loss from advancing age, making her look especially haggard.
Several layers of thin mattresses had been placed on the trolley, above which she lay, buried beneath a thick quilt.
She appeared dusty and travel-worn.
‘Did they push the patient over? That’s insane!’ Zheng Ren thought.
“You pushed her all the way here?” asked Zheng Ren tentatively.
Another older family member answered bitterly, “My mother can’t stand, and she could feel uncomfortable in a car, so we had no choice but to push her here.”
‘Her family members are dutiful,’ Zheng Ren thought.
A general surgeon on duty arrived with a wheelchair, and several people assisted with patient transfer from the trolley.
Zheng Ren, who had doubts in his mind, suddenly released his grip on purpose and immediately made to grab onto her.
The moment he let go, the old woman stumbled toward him.
She was not in any danger as Zheng Ren was using his body to break her fall.
However, he noticed that the patient suddenly contracted her right thigh to support her body.
Many thoughts and differential diagnoses flashed past his mind in that instant, and he came to a conclusion after cross-referencing it with the information on the System panel.
“Where was she injured during the fall last time? Did you consult a doctor after that?” asked Zheng Ren as he pushed the wheelchair to the emergency resuscitation room.
“She was fine except for an accidental knock to her head. We went to a rural clinic for consultation afterward and were told that she was fine, but we have to be careful of potential complications such as delayed traumatic intracranial hemorrhage. Once it happens, she can end up paralyzed or even die. Two to three days later, she gradually lost her ability to walk, so we brought her to a township hospital where she underwent B-scan ultrasonography and a CT scan, but the results were normal.”
Upon reaching the resuscitation room, Zheng Ren took the test results that the family had brought along and carefully read through the imaging films.
Everything looked fine.
There was no intracranial hemorrhage, fracture or abdominal visceral bleeding, but why was she paralyzed?
Zheng Ren stood in front of the radiographic film viewer and pondered, leaving the family members confused and worried.
They fought the urge to question Zheng Ren and interrupt his train of thought.
However, if they did not inquire… Sea City General Hospital was the largest hospital that they could think of. If her condition remained undiagnosed, the elderly woman could end up not being able to stand for the rest of her life.
“Is she pretending to be sick?” Su Yun stood behind Zheng Ren and asked softly.
Zheng Ren shook his head and remained silent.
“This is a rare condition called paralytic nerve plexus regression syndrome,” he said grimly as he approached them.
“…”
Su Yun and the general surgeon on duty were bewildered.
What the hell was that? Why had they not heard of such a diagnosis before this?
Zheng Ren’s solemn expression and confident tone fueled their doubts even further.
“Huh?” The patient’s family members were stunned.
The diagnosis sounded serious.
The elderly woman was not deaf and clearly heard the diagnosis. Then, two rows of tears streamed down her cheeks.
“But you’re lucky,” said Zheng Ren plainly.