"If it's BIID, this surgery has a long history, and it should have been tried in North America at the earliest, and then, because the law there doesn't allow it, as far as I know, it has been performed in Southeast Asia, mainly Malaysia. Thailand has developed very rapidly in recent years, and Bangkok is almost an international metropolis, and more and more people are applying for medical visas to go there for medical treatment and treatment of chronic diseases, so if you say you go to Bangkok, I guess most of it is this kind of amputation surgery. Mu Chun finished speaking and continued to run.

Zhang Wenwen raised his wet wrist and gave Mu Chun a thumbs up, "I suspect that there is something else in this world that you don't know." ”

"Yes, I wonder if you've taken the time to study brain problems in patients with BIID and whether they can be corrected with neurosurgery." Mu Chun said.

"The right parietal lobule of the brain in patients with BIID is thinner than the average person, and at present, neurosurgery has no way to improve this problem, and there is almost nothing that can be done. And these patients have no epilepsy, and they are conscious, and they don't have any obvious other physical problems, which is actually very troublesome to me. Zhang Wenwen told him calmly.

Zhang Wenwen, who drank a few sips of Coke, was a little irritable, this paper straw is definitely a stupid invention against the great pleasure of human beings enjoying carbonated drinks.

Zhang Wenwen simply pulled out the straw, because every time he took a puff now, when his lips left the end of the straw, he would be extremely embarrassed by the coke that gushed out.

After handling the straws, Zhang Wenwen said: "I can't find any benefit of brain surgery on [Body Integrity Identity Disorder] (BIID), and I haven't seen any relevant studies at present, which is why I want to go to Thailand to see the patient, and I also want to know what kind of advice I can give if a patient like Gu Yiping reappears." ”

"It will definitely appear again, even Gu Yiping may appear again, the physical integrity identity disorder, like other identity disorders, is very difficult to correct, because we are tantamount to reconstructing the part of the brain that has no such connection at all, and it is even more complicated than this, one part of the brain is convinced that they are on the body, and the other part is completely unaware of their existence." Mu Chun ran faster and faster, but his thoughts were not chaotic at all.

"That's the case, so the patient should be very clear that he is sure that he wants to have an amputation, and there is no misdiagnosis in the case of this surgery."

"Wait a minute." Mu Chun interrupted Zhang Wenwen's words.

Gradually slowing down the speed of the treadmill, Mu Chun changed from running to fast walking, and said, "Don't easily say that such an operation should be performed, even if you think so." ”

"I understand, because this kind of thing is on the edge of the law after all, and there is no way for us to carry out this kind of surgery in China, so what else can we do? What else can we do when we encounter such a patient? Zhang Wenwen was desperate for answers.

"It's a long story."

"It's a long story, but the first thing is to improve the assessment, not just for patients like Biid, which can't be done by psychosomatic and obviously requires neurological advice. In addition to a standardized set of subjective assessments and examinations, there should be a long observation period, and in addition to this, the full content of the amputation must be fully communicated to the patient to ensure that the patient fully understands the impact of the amputation on his future body and life; Strictly speaking, patients should be required to make a complete plan for their clothing, food, housing, and transportation after amputation.

How will he cope with several important parts of his life after the amputation, and how will the work continue? Do you want to quit your job because of this? How is the family's financial situation guaranteed? Will I be able to afford to continue with my family's current financial level after an amputation?

How will you take care of your own daily life? Or is there already a clear plan for who will be responsible for taking care of his post-amputation recovery and his future life.

In addition, whether you are well prepared to gain the approval of your family.

All I can think of is to put it all down to the smallest detail to minimize possible problems.

Of course, as far as I know, most adults who have undergone amputation experience a higher level of happiness. ”

After Mu Chun finished speaking, Zhang Wenwen fully agreed, and nodded, "I believe that these have been done perfectly." But how do you know so clearly? Did Teacher Mu Chun think about it himself? Or do you know something? ”

In order to avoid Zhang Wenwen's doubts, Mu Chun immediately explained that although he knew some of these things, he did not know the people who were engaged in this aspect of surgery, nor did he know about the organizations and groups in this area.

As for the rest, he summarized and thought about it after Gu Yiping's case appeared.

Mu Chun continued, "We should be able to do something beyond these and try some other treatments that may be effective, especially when dealing with teenagers or even children around ten years old, what else can we do in addition to being cautious and cautious? ”

Zhang Wenwen immediately picked up Mu Chun's words, "In the face of children or young people under the age of 25, the best way, and the way to do all the time, is to wait."

Every year to two years, the patient submits an online assessment form repeatedly, which in the case of a minor is filled out with the help of his parents. I don't have anything else, that's all I know. ”

"It's already very comprehensive, and I have talked to you a little bit about the other treatments I can think of here, I don't know if you remember?" Mu Chun's attitude is very modest.

"Okay, you don't have to be so polite to me, what the hell is there to tell me." Zhang Wenwen said.

"No, you are more professional than me in this regard, after all, I am still in the preliminary establishment of an evaluation system, part of which is a doctor's assessment, part is a patient's self-report questionnaire, and some is a medical examination. In addition to the ones we have just discussed, the treatments include aversion therapy and talk therapy.

Let's talk about [talk therapy] first, the point is to let the patient think with questions, and we need to give more clear and simple questions, such as: If there is one in the world that makes you not want to have your limb amputated after eating, would you be willing to take that medicine? After Mu Chun finished speaking, he looked at Zhang Wenwen quietly.

Zhang Wenwen suddenly had a sense of substitution that he was a BIID patient, and immediately followed Mu Chun's words and thought about it.

"I don't know, I can't think of it, maybe I will." Zhang Wenwen replied seriously.

"Dr. Zhang, your sense of substitution is a little too strong, it's easy to be hypnotized." Mu Chun said and threw a chocolate to Zhang Wenwen.

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