I run a clinic in the United States

Chapter 308 A person who is not from the royal family, but suffers from the disease of the royal family

Accompanied by Ava and Fang Yuanyuan, Xu Tiantian came back from the examination and met her master, an opera actor in her sixties, Shang Chunyan, in the lobby of Iris Clinic.

When the other party was young, she was also in Tsing Yi, but now that she is older, she mostly plays the role of Lao Dan. Even Zhou Qiao, a layman, heard people talk about it when chatting with some friends in Chinatown. It was said that this teacher Shang played Wang Baochuan and Li Yanfei when he was young.

"Master, why are you here?" Xu Tiantian was a little surprised when she saw the master.

Although she hasn't told the master yet, and she doesn't know how to speak for a while, and her throat hurts, but thinking about it, it must be Master Chu Xuan or Master Huang who went to "spread the news."

"Don't talk, don't talk." Master Shang felt extremely distressed when he heard his apprentice's hoarse voice, "Silly boy, your parents are not here. I am your only relative. If I don't come, who will?"

It was not convenient for Xu Tiantian to speak, so Fang Yuanyuan did it for her, chirping the whole story and the process of the examination.

Teacher Rao Shishang had already learned the general story from Master Huang, but Master Huang's explanation was simple, and Fang Yuanyuan's explanation was so vivid that he was inevitably frightened and worried again.

When he heard that Miss Veronica was willing to fund Xu Tiantian's medical expenses, Master Shang was even more moved and came over to thank Veronica.

Shang Chunyan was still worried about medical expenses before, and was wondering whether she should tell Xu Tiantian's parents and ask them to help raise some money. However, Xu Tiantian's family is poor, and her parents are in rural areas in China, so they may not be able to get the money. Come.

She brought Xu Tiantian out, and she should be responsible. Who would have thought that medical expenses could be solved so easily?

Master Huang had not mentioned this incident to her before.

Not long after, the examination report was sent, and Zhou Qiao took them into Murphy's clinic and introduced them to the condition.

Sure enough, as Zhou Qiao and Murphy had expected, it was a neurological disease.

Zhou Qiao and Murphy carefully analyzed the imaging report of magnetic resonance neurovascular imaging and found that Xu Tiantian's right posterior inferior cerebellar artery compressed the glossopharyngeal nerve.

The glossopharyngeal nerve is a pair of cranial nerves in the human brain that control the movement of throat muscles.

Glossopharyngeal neuralgia occurs when the glossopharyngeal nerve is affected by factors such as blood vessel compression, tumor compression, and traumatic stimulation.

The principle of this kind of pain is actually similar to that of trigeminal neuralgia.

In addition, electronic laryngoscopy showed that Xu Tiantian's glottis was "leaked."

Yes, people’s glottis can also “leak”.

Human vocal cords are like rubber bands connected at both ends. The area between the vocal cords is the glottis. When speaking and singing, both sides of the vocal cords close to resist the air. The air squeezes the vocal cords apart, causing the air to vibrate during the flapping process of the vocal cords, thereby producing sound. .

The glottis "leaks", that is, there is a gap when it closes. Xu Tiantian's situation is combined with the typical glottal insufficiency.

Fortunately, there are no vocal cord space-occupying lesions, such as polyps, cysts, tumors, etc.

The two are actually related. Her artery compresses the glossopharyngeal nerve, causing neuralgia. Then, due to the pain, the bilateral vocal cords are not closed enough when speaking, resulting in hoarseness, weakness of voice, aphonia and other voice disorders.

Of course, most of the causes are due to excessive use of the voice, too high a volume, poor breathing control, or incorrect vocalization methods when trying some new singing styles.

Vocal cords have been fatigued for a long time, and physiological structural changes will naturally occur.

This kind of thing is actually very common, just like some track and field athletes who often sprain their feet, rupture their heel tendons, etc. Which part is used more, and if you try some new tricks, the probability of problems will naturally be greater.

In addition, women's estrogen will change during menstruation, and their vocal cords will experience mild congestion and edema, reducing tolerance.

"Oh my god, Sister Tiantian is so pitiful." Fang Yuanyuan exclaimed.

Xu Tiantian: "..."

She thought she had a cough, but she didn't expect the specific reason to be so complicated... Well, she really didn't understand much, but it didn't stop her from knowing that the condition was serious, and she was immediately panicked, not knowing whether it could be cured.

My throat couldn't make any sound. It hurt so much when I opened my mouth, or even when I swallowed without opening my mouth, that it was inconvenient to ask.

Her master Shang Chunyan was also worried, frowning even more, and sighed in her heart. It turned out that the cause was in the brain and the glottis. No wonder those seniors who had collapsed throats in the past could not be cured.

What should I do?

After all, this disease sounds much more serious than pharyngitis or acute sore throat. I guess it can't be cured by taking medicine.

"Dr. Zhou, can this disease be cured? Can she still sing in the future?" Shang Chunyan said anxiously.

Fang Yuanyuan blinked her eyes and did not ask such a question, because she felt that Dr. Zhou could definitely cure it. After experiencing what happened to Chu Xuan, Fang Yuanyuan now had a kind of blind admiration and trust in Zhou Qiao.

Zhou Qiao said: "If the condition is mild, methods such as symptomatic analgesia and nerve nutrition can have a certain effect on early neuralgia. But her condition is so serious that conservative treatments are useless and surgical treatment is needed as soon as possible."

"Ah?" Xu Tiantian was immediately afraid. Surgery, it must be a craniotomy, right?

She was young and had hardly been to the hospital. Her brain was about to be cut open. Oh my god, who could bear this? What's more, she is even more frightened because she is still a girl.

Shang Chunyan: "..." Although I had expected it, well, a craniotomy would be a craniotomy.

Zhou Qiao observed their words and saw that their expressions changed after hearing this. He couldn't help but comfort him and said, "Actually, there are many 'minimally invasive' neurosurgeries nowadays."

"Minimally invasive?"

"Yes, although it is a craniotomy, it is only a very small opening, so it is not that scary. I just communicated with Murphy and we plan to use microvascular decompression, which is the most effective way to treat glossopharyngeal neuralgia. Safe and effective surgical treatment.”

"That is, a small opening is made behind the ear on the affected side, and a spacer is used to isolate the compressed blood vessels and nerves under a microscope. This operation has small trauma, short operation time, and no scars on the body surface. Most patients suffer from pain after the operation. The feeling will disappear immediately.”

"As for glottis insufficiency, it is not a big problem. After the neuralgia is relieved, combined with drug atomization inhalation treatment, anti-inflammatory and swelling, the glottis leakage should be improved."

Hearing what Zhou Qiao said, Shang Chunyan and Xu Tiantian immediately knew that they had gone astray, and thought that medicine was really advanced now. If they were decades ago, or more than a hundred years ago, they would probably be out of luck.

I can't sing, so I can only go behind the scenes or do other things.

Zhou Qiao continued to give them reassurance: "This operation is actually very fast, and the subsequent treatment will take about half a month. During the treatment, it is best not to talk."

Everyone immediately laughed.

Especially Xu Tiantian, she was really completely relaxed and happy. not talking? It hurts like this and my voice is hoarse. I don’t want to say anything.

Immediately, Zhou Qiao arranged for Xu Tiantian to be admitted to the neurosurgery ward of the community hospital, and it was Ava who contacted her and took her there.

Park Soo-joo is in charge of nursing work.

In fact, glossopharyngeal neuralgia is very easily misdiagnosed as trigeminal neuralgia. Because the prevalence of glossopharyngeal neuralgia is very low, about one in 90. Zhou Qiao and others subsequently improved the tetracaine spray test, and the patient's symptom improvement rate was %+, ruling out trigeminal neuralgia. In fact, the diagnosis can be confirmed without doing this. It is just to be sure.

When everything was ready, the operation began.

As Zhou Qiao said before, the operation time was very short, and Ava didn't even play a few songs before the operation was over.

On the day after the operation, Xu Tiantian's excruciating pain completely disappeared as soon as she opened her mouth and swallowed. Although I was still speechless and still needed follow-up treatment, I felt much calmer inside.

She was typing on her phone, telling her master not to notify her family. He said it was so that his family would not worry.

Teacher Shang: "..."

I touched the child's bald head gently and felt pity for him. This was reporting good news rather than bad news. This child was too sensible.

Such a major surgery... well, it doesn't seem like much. If you don’t want to say it, just don’t say it. Teacher Shang agreed to her.

Neurosurgery naturally requires skin preparation. Since the scalpel is being operated on, the head needs to be shaved.

But Xu Tiantian has a better head shape. After shaving her head, her beauty is not reduced. Even if she becomes a nun, she is still a beautiful nun.

Zhou Qiao flew to Crystal Mills County, Texas.

One was to visit Luo Ya, and the other was that Sequoia Hospital encountered a difficult patient and needed his support.

Luciana drove to the airport to pick her up, and that night, Zhou Qiao and Luo Ya slept in each other's arms.

Since they were quadruplets, even though they were only four or five months old, Luo Ya's belly was already swollen.

Various prenatal check-ups are also being carried out regularly. Currently, all indicators are normal and the fetus is developing well.

Luo Ya's congenital conditions are good, Zhou Qiao's genetic material is excellent, and her nutrition can keep up. Luo Ya doesn't have to run around now. She stays in the winery to raise her baby every day, and her work is directed by remote control. Such good conditions , how could something go wrong?

However, Luo Ya is used to traveling all over the world, and now she is staying in Texas for several months, and she is really not used to it.

"My dear, hold on for a few more months. When the baby is born, I will accompany you to travel around the world." Zhou Qiao hugged Luo Ya, gently caressed her bulging belly with his hands, and said softly.

"This is what you said. Well, I will go to China then. I will go to your house with the baby in my arms!" Luo Ya said with a smile.

Zhou Qiao was startled and suddenly worried, because how would he explain it to his family then?

They didn't even get married, but they had four children.

Luo Ya giggled. Anyway, she didn’t care, she had to go!

Zhou Qiao had no choice but to agree.

I thought about it, and then I would say that America has an open atmosphere. Well, I have many girlfriends and will have many children in the future. Sigh~, your parents will never sever ties with you because of this, right?

As for relatives and friends, leave them alone! If the mouth is on someone else's body, can it still be blocked?

However, his domestic profile is expected to collapse and the society will die.

Just when he was frowning, Luo Ya beside him had already fallen asleep with a smile on his face. In fact, Luo Ya was joking with him.

Luo Ya does want to go to China, but to do serious business. In addition, by then, the warship she ordered before should be almost delivered. She plans to select some confidants from the East African base to receive it and receive relevant training in the name of the Suesokeng government army.

Although she is now a Texas congressman, the East African base is her private property. In the future, he might take advantage of the chaos to build a small country and leave it to one of his sons.

Now pregnant with four sons, she is already planning how to distribute the territory in the future.

The next day, Zhou Qiao went to Sequoia Hospital under the escort of Luciana.

When they arrived, Dean Joachim Langley was already waiting at the gate with a large group of people to greet him.

"Dr. Zhou, I'm very happy to see you again!" Dean Joachim Langley enthusiastically stepped forward and hugged Zhou Qiao.

"Let's talk while we walk. What's going on?" Zhou Qiao asked.

Dean Joachim Langre briefly introduced the condition. The patient was a local middle-aged white woman in her fifties from Crystal Mills County.

While seeing a doctor at Sequoia Hospital, a CT scan revealed that the upper lobe of his right lung was occupying a space in his chest, and the possibility of malignancy was considered.

After completing further examinations, many reports pointed to the possibility of malignant tumors. Therefore, surgery is imperative.

However, preoperative examination revealed that the woman was severely deficient in coagulation factor VIII.

The activity range of normal people's coagulation factor VIII is generally 50-150%, but this woman's was very, very low, only 2%, which is very rare.

The prothrombin time (PT) of normal people is usually 10-16 seconds, but this woman's PT is 45 seconds, which means that her "coagulation time" is significantly longer than that of normal people!

The human body actually has a variety of coagulation factors that play a role in the process of hemostasis, and the coagulation factor VIII that this woman was severely deficient in is one of the more important ones.

Coagulation factor deficiency is a recessive inherited bleeding disorder, including sex chromosome recessive inheritance and autosomal recessive inheritance.

For example, the famous "hemophilia" is the lack of coagulation factor VIII or IX.

What this woman lacks is coagulation factor VIII.

It has to be said that she is not from the royal family, but she suffers from the "royal disease".

Because the most famous carrier of the "hemophilia" gene in history is Queen Victoria of England.

Victoria gave birth to nine children. Three of the four princes were hemophilia patients. All five princesses were hemophilia gene carriers. Her children married into royal families in Europe, causing the hemophilia gene to spread to European royal families. , so this disease is also nicknamed the "royal disease".

The main clinical manifestations of lack of coagulation factors are difficulty in stopping bleeding due to bumps, trauma, and surgery, or even spontaneous bleeding. In severe cases, the patient may die.

Such patients are like "glass men", and patients with coagulation factor deficiency are at extremely high risk for surgical treatment. Once bleeding occurs, it may be life-threatening.

Previously, when the chemical plant exploded, Sequoia Hospital actually encountered a patient who had difficulty stopping bleeding, but that patient's coagulation factor deficiency was far worse than the current woman.

The main reason why the previous patient couldn't stop bleeding was because there were many hidden bleeding points in her body. Later, Zhou Qiao helped her perform a second laparotomy and solved the bleeding points one by one, thus saving her life.

But now this lady has a malignant tumor and needs surgery, but she has the famous "hemophilia", which causes bleeding at the slightest touch. How can she do surgery?

Therefore, after discussion, the doctors at Sequoia Hospital decided to seek help from Dr. Zhou, who has excellent medical skills.

They also flatter Luo Ya, showing that they can't live without Dr. Zhou.

(End of this chapter)