078 Physical examination
Li Xiuli was immersed in thinking about the condition, and it stands to reason that the lumbar intervertebral disc herniated compressed the nerve roots, causing sciatica, and the straight leg raise test was positive.
But Li Qing was negative, and it was positive before the operation, that is, Li Qing's nerve entrapment was lifted.
But why are the symptoms not alleviated?
She was a little puzzled.
"Dr. Sun, show me her film."
"Dr. Li, the films are all under my bed."
At this moment, Li Qing's impression of Li Xiuli has changed. Looks young, can be physically examined.
She is an old patient, who has been conservatively treated in the hospital many times, and has also been served by various doctors in turn, with a vicious eye, so she naturally knows that Li Xiuli's movements are skillful.
Li Xiuli squatted down, and sure enough, he found a white bag under the bed.
The bag is a special bag for the CT room of Uiseong Traditional Chinese Medicine Hospital.
took out several films, all of which were Li Qing's.
Li Xiuli frowned, he saw the lumbar spine and hip CT and magnetic resonance before the operation.
He doesn't understand the head CT very well, but he can still understand the lumbar spine and hip joints.
After all, dealing with this disease every day, I have more or less learned a little.
"Dr. Lee, you saw it! The patient's lumbar 4/5 intervertebral disc was prolapsed, and two-thirds of the entire spinal canal was entrapped. ”
Intervertebral disc herniation, the most serious type of intervertebral disc herniation, often indicates complete rupture of the annulus fibrosus and posterior longitudinal ligament of the intervertebral disc, and the protrusion of the nucleus pulposus into the spinal canal.
Once this happens, conservative treatment is relatively poor, and most patients require minimally invasive intervention or surgery.
In Li Qing's case, on the basis of a herniated disc, a prolapse occurred.
Li Xiuli knew in his heart that since Sun Miaomiao was willing to hand over this potential bomb to herself, she had to share something for her.
So he patiently explained: "Aunt Li, your disease does require surgery, otherwise the nerve will be entrapped for a long time, the nerves below the waist will be irreversibly damaged, the muscles of the lower limbs will also atrophy, and the prognosis in the future will be very poor." ”
"Ahh
When Li Qing heard this, his mouth opened wide, "Doctor Li, is it so serious?" ”
"We didn't lie to you, you can ask the doctors in the big hospitals about this film, and they say the same thing."
"Oh." Li Qing nodded, she had already gone to the big hospital to inquire about this disease, and it was because she had to have surgery that she chose the orthopedic department of Yicheng Hospital of Traditional Chinese Medicine.
The two orthopedic departments of Yicheng Hospital of Traditional Chinese Medicine are still very well-known in the southern part of Beijiao Province, and even patients from other provinces in the northernmost part of Jiaozhou Province will choose to come here for surgery.
"But Dr. Li, why did I have surgery for this disease, and it is still the same?"
Li Qing was very puzzled, if her symptoms were alleviated, she would not have to find a leader.
Poor postoperative outcomes are common in spine surgery.
There are often patients with severe cervical spondylosis who choose surgical treatment, but the postoperative effect is average, or even aggravated.
Li Xiuli has received several patients after cervical spondylosis, and the patients complained and regretted the operation.
"Doctor Li, does Aunt Li need to recover from this condition?"
At this time, Sun Miaomiao asked the topic she was most concerned about. She took the risk of asking Li Xiuli for a consultation, not to ask him to do a physical examination and chat with the patient, but to solve the problem.
"You can do rehabilitation, but you have to transfer to our department."
"What? Do you want to change majors? Li Qing suddenly lowered his face, changing departments means that treatment is still needed, which means that it still needs to spend money.
She asked Li Shan before the operation how long it would take to be discharged from the hospital after the operation.
Li Shan said that he could be discharged from the hospital after the stitches were removed, and the time should be a week later.
"Doctor Sun, your orthopedic department is unavoidable, obviously said that after the operation, my waist and legs will not be numb or painful, but now I am asked to go to the rehabilitation department for rehabilitation!"
She is very angry, she has spent tens of thousands of dollars on surgery, and she may not know how much it will cost to do rehabilitation this time!
At this time, Li Shan was late.
He looked at Li Qing with a smile, "Sister Li, your surgery has been very successful, and what you have to do now is to recover after surgery for a while." ”
"Director Li, you... It's finally here. Suddenly, the corners of Li Qing's mouth twitched, her slightly bloodshot eyes turned red and choked.
At this time, Tateyama was late.
"Director Li, it's not easy for us rural people to make money, it has cost tens of thousands, if I knew that this is the effect, I might as well not have surgery!"
She looked up to the sky and sighed, beating her chest, how miserable.
"Auntie, why don't you do this now?"
Li Xiuli smiled faintly as he took out a plate of acupuncture needles from the pocket of his white coat on his left side.
"Huh? Do you still need to get a needle? ”
Li Qing was a little surprised, she didn't know what recovery was at all, and thought that she was going to have to take injections and medicine again.
"Yes." Li Xiu bowed his head, "You shouldn't have gotten out of bed and walked yet, right?" ”
"Aunt Li Qing really hasn't gotten out of bed and walked yet." At this time, Sun Miaomiao added.
Li Xiuli shook his head slightly, this patient has undergone lumbar spine surgery, and the joints of the lower limbs must be moved on the first day after surgery, including knee joints, ankle joints and toe joints.
The next day, you can try sitting.
On the third day, you can try to walk on the ground.
But Li Qing hasn't gotten out of bed and walked yet, and it's been a few days since this operation, right?
"Doctor Li, I'll help you get a disinfectant swab." After Sun Miaomiao finished speaking, she trotted away.
At this time, only Li Xiuli and Li Shan were left in the ward.
"Dr. Lee." Suddenly, Li Shan shouted at Li Xiuli.
"Director Li."
"You're an acupuncture major, right?"
"Hmm."
"Li Qing's situation can indeed be transferred to your department, but I suggest letting Wang Ming take care of it."
MMP!
What's the situation, when you come up for a consultation by yourself, you still have to help Wang Ming accept patients?
Li Xiuli was unhappy, it doesn't matter if your MD is the director of the second orthopedic department, since I came to the consultation, this patient will be under my control!
"Wang Ming doesn't have as much experience in this field as I do." Li Xiuli showed an expression that seemed to be smiling but not smiling, staring at Li Shan.
The corners of Li Shan's mouth twitched, and he was a little unhappy in his heart, after all, he was the director of the second orthopedic department, and he couldn't dampen the confidence of the juniors.
But what is Li Qing's situation, there really can't be any mistakes, otherwise it will be a big trouble.
He changed his tone, "Then you can ask Wang Ming to take a look together, and the two doctors will treat it together, and the effect will be better!" ”
"Director Li said it well! Director Li is still thoughtful! Li Qing, who was lying on the bed, heard Li Shan's suggestion, and she nodded in admiration.
If she really wants to change departments, she naturally wants multiple doctors to discuss her condition together so that they can formulate the best rehabilitation plan.
"Thank you Director Li for the reminder, I will consider it." Li Xiu bowed his head, did not agree in person, and did not refuse immediately.
"Anyway, I don't care, even if you said that after the operation, it will be fine, and now it is still the same, you have to be responsible to the end!"
Li Qing was a little displeased, she had already paid tens of thousands of yuan in advance, and she felt sorry for her.
"Dr. Li, the disinfectant swab is here." Sun Miaomiao came back from the nurse's office with a few wet cotton swabs in her hands.