godfather of surgery

Chapter 458 Gout is the Devil

In the afternoon, Yang Ping returned to the office after the operation.

Huang Jiahui has been waiting for a long time. She received the sample of spinal external fixator and sent it immediately.

"Boss Huang is quite efficient." Yang Ping sat down.

"Dr. Yang, please take a look. If you confirm that there is no problem with the sample, it only takes three days for the Guilin laboratory to receive the external fixator for the experiment."

Huang Jiahui put on protective gloves, opened the equipment box, carefully took out the scoliosis model and external fixator, put them on the desk, and demonstrated them to Yang Ping.

If the investment of this thing is spread out evenly, the unit price is much more expensive than gold in terms of grams.

Screws were screwed into the predetermined pedicle channel on the spine model one by one, and Huang Jiahui skillfully installed the external fixator.

A few minutes later, the external fixator was installed, and she began to demonstrate the adjustment again. With the rotation of the knob, the elastic spine model began to correct.

Jiahui practiced for several hours in her own company for this short demonstration.

"How is it? Dr. Yang, do you still have any questions?"

Jiahui has shed her immaturity as a fresh graduate and looks mature and capable.

Yang Ping was going to operate it himself, Jiahui hurriedly handed over the gloves, Yang Ping operated it from the beginning to the end, and checked repeatedly to confirm that there was no problem.

"We will produce according to this sample, and the experimental products will be sent directly to the Guilin laboratory." Yang Ping strives to complete at least [-] cases of animal experiments before the Asia-Pacific Orthopedic Association Congress.

It must be too late to bring the technology of spinal external fixation to the recent Asia-Pacific Orthopedic Forum, but there is still hope in catching up with the conference.

Theoretically, the correction speed of young monkeys is much faster than that of children, but it is estimated that it will take about three months to complete the first batch of animal experiments.

This technique is a brand-new scoliosis correction technique. Once it is brought to the conference, it will cause a sensation. It is completely different from the existing orthopedic surgery.

The size of the sample is very small, which is specially adapted to the size of young monkeys, and cannot be used on human bodies. After the animal experiments are successful, the equipment used on human bodies will have to be re-molded for production.

Jiahui was about to pack the equipment: "Dr. Yang, do you want to leave it on your desk for your usual research?"

Yang Ping had this intention, so he used it as an office decoration, placed it on his desk, and studied it when he had free time, so that everyone could get familiar with it.

"Dr. Yang, when will you go to Guilin, and I will go with you and be in charge of the equipment?" Although Jiahui has taken over as the manager now, she will personally follow the stage for Yang Ping's surgery.

"It's not sure yet, I'll let you know when the time comes." Yang Ping was very satisfied with the samples.

Thinking about children's scoliosis in the future, there is no need for surgery, as long as this external fixator is installed, parents help adjust the screws every day, and the deformed spine will gradually and automatically correct itself. What a miraculous thing this is.

Compared with surgical correction, this method not only has less trauma, but most importantly, it retains the normal range of motion of each spinal segment, and the obtained spine has complete normal functions.

However, surgical correction sacrifices a lot of spinal mobility.

This technology will be upgraded in the future. For adult spinal correction, the cortical bone of the vertebrae can be cut at some key parts, and then an external fixator can be used for correction using the Ilizarov principle.

Yang Ping was thinking, when suddenly, heart-piercing cries came from the ward, and the cries became louder and louder.

"What's going on?" Yang Ping asked.

Jiahui also looked blank, Yang Ping asked Jiahui to go back first, and called a Gui Peisheng to ask about the situation.

"Bed 24, Mr. Zhang is changing the dressing." Gui Peisheng replied respectfully.

The 24 beds are the gout patients admitted in the emergency department. There are gout nodules all over the body, and the largest nodules are as big as five adult fists.

Because of the severe pain, I went to the emergency department in the middle of the night and was sent to general surgery.

In Sanbo Hospital, everyone still likes to follow the name of general orthopedics, and call Yangping’s department general surgery, which is more down-to-earth than high-end surgical institutes.

Regardless of whether it is the emergency department, major surgery department, or the Overseas Chinese Building, as long as it involves surgery and there are cases that cannot be handled, it is natural to ask for general surgery consultation.

Gui Peisheng led Yang Ping to the ward, Zhang Lin was changing the dressing, Xu Zhiliang was directing, Song Zimo was watching, surrounded by a group of Gui Peisheng and interns.

The wound dressing was opened, and the wet dressing was covered with a white lime mud-like substance.

This patient, male, 60 years old, has gouty nodules all over his body. There are 44 nodules that can be counted. The largest is five fists, and two or three fists are several. The whole person looks severely deformed, like a monster. It makes people feel scalp numb and extremely uncomfortable.

Several huge gouty nodules were ruptured, and white lime-like substances flowed out continuously. These "lime" mixed with tissue fluid, looked like white mud.

Zhang Lin held a sterile cotton ball in his tweezers and stirred it in the ulcerated wound to clean up the lime mud.

The patient lay on the bed, groaning in pain, and screamed from time to time, clamoring to amputate all limbs with gouty nodules.

Gout sometimes hurts, which is really heart-piercing. In 1799, the famous British cartoonist James Geary described gout as a black little devil, vividly expressing the pain of gout.

After experiencing gout on the first metatarsophalangeal joint of the foot, this cartoonist drew a cartoon, depicting gout as a black scary little devil lying on the back of the foot, biting wildly.

"Fatty, use people as mirrors!" Xiao Wu was smacking his tongue.

Fatty Liang was sweating on his forehead, as if seeing his future self, gout could reach such a terrifying level.

"Gout is one of the oldest metabolic diseases of human beings. It is mainly due to the problem of uric acid metabolism in the body. Excessive accumulation of uric acid precipitates crystals and invades joints, internal organs and other parts. The records of gout can be traced back to the fifth century BC. At that time, Hippocrates, the father of medicine, had records about the clinical manifestations of gout.”

Song Zimo took this opportunity to explain some knowledge about gout to the regular trainees and interns.

"Historical celebrities that we are familiar with, such as Bacon, Newton, and Darwin in foreign countries, and Bai Juyi, Liu Yuxi, and Kublai Khan in my country, are all gout patients."

"In ancient times, gout was a real disease of the rich and the rich. Those who were eligible to get gout were all emperors, generals, and wealthy nobles. Ordinary people had little chance of getting this disease."

"In modern times, with the improvement of living standards, everyone lives a life that only ancient wealthy families have. In my country, gout has become the second largest metabolic disease after diabetes. According to statistics, the number of patients in my country has exceeded 8000 million. , and is still growing rapidly at an annual growth rate of 9.7%.

“Before the onset of gout, there are usually no symptoms. They often wake up in the middle of the night due to severe pain in the feet. The pain is progressively aggravated and reaches a peak around 12 hours. The pain is like tearing, cutting or biting. Bear."

"The vast majority of gout occurs in the first metatarsophalangeal joint, that is, the joint of the big toe. As the disease worsens, it gradually spreads upwards, and the dorsum of the foot, heel, ankle, knee, wrist and elbow will also occur. The affected joints and The surrounding tissue is red, swollen, hot, painful, and the function is limited."

"This is not over yet. Gout is a silent killer. It not only erodes and damages joints, but also erodes and damages internal organs. For example, it can cause gout and kidney disease. In severe cases, it can cause uremia, and eventually require dialysis or kidney replacement."

"Don't take him seriously. It's not a big deal to pay attention to this disease and treat it well. Ignore it and ignore it. One day it will make you regret it."

"If there is a chance, let Teacher Liang talk about gout for everyone. He is an expert in this field." After Song Zimo finished speaking, he turned to look at Fatty Liang, who was trembling.

At this time, Song Zimo also saw Yang Ping, and immediately leaned over: "Trouble! Without surgery, these wounds will never be closed. With surgery, all joints in the body will be eroded by uric acid crystals, and the wound may not heal."

Surgery must be done, it depends on how it is done.

"Be more cautious in the surgical plan, and make a detailed assessment of the blood vessels of the extremities." Yang Ping explained.

Zhang Lin led two Gui Peisheng, sweating profusely, and finally changed the medicine for several wounds, and the changed gauze filled the yellow trash can next to him.

We have never seen such a severe gout patient. If the patient is lying on the bed, if he is not mentally prepared, he will suddenly see his whole body covered in bumps and sweat from fright.

There is no filial son in front of the bed for a long time, and time can wear away people's patience.

"What are you calling, it won't hurt?" the patient's daughter scolded beside the bed.

"Before changing the dressing, I received an analgesic injection." Xu Zhiliang saw Yang Ping coming in and explained to him.

It turned out that the gout nodules were not ulcerated. The old man lived with his daughter, but later the nodules were ulcerated. He went to a nearby hospital for surgical debridement. The nodules also ruptured one after another.

The bad smell pervaded the house, so my daughter had no choice but to rent a house for the patient, and hired a nanny to take care of him. The nanny resigned after working for a month, and she refused to pay more. Nanny scared away.

There is a shortage of nannies in the domestic service market, and many are unwilling to take care of sick elderly people. The wages have been raised again and again, but they still cannot find suitable people, so the sick daughters have to take care of them by themselves.

"We are both only children, and now we have to take care of five elderly people, one in his 80s. We have no choice but to send him to a nursing home. He was hospitalized for a stroke not long ago and has just been discharged. We are almost driven crazy. We have money. The big boss is okay, we are all salaried workers, no matter energy or economy, we simply can’t take care of them, and now we are carrying it to death.”

The patient's daughter complained, which was an explanation for her loss of emotional control.

"I'm sorry, doctor, I'm about to collapse." The patient's daughter said in a calm tone, afraid of causing the doctor to misunderstand.

"Okay, okay, it's over, let's take a rest." The patient's daughter pulled the quilt to cover the patient.

"Forget it if you die." The patient said in a broken tone.

The patient's daughter scolded him again: "What kind of childish temper are you playing? Treat the disease with peace of mind. Doctor Yang has a solution."

"Trouble you, really." The patient's daughter was very guilty of her gaffe just now.

"We will do our best." Yang Ping comforted her.

(End of this chapter)