There is no need to be too normal to be a doctor

Chapter 81 The real cause of the disease!
At this time, Zeng Hui and Zhang Juan were still chatting with the patient.

The old man's daughter was also very grateful to Zeng Hui.

"Director Zeng, thank you so much!"

"Thank you."

Zeng Hui smiled and said, "You're welcome. The old man's dislocation is a trivial matter. Dr. Zhang should be responsible for this neurological disease."

Zhang Juan also sighed after hearing the sound.

She has communicated with the patient many times, and even the director has held several case discussions on the patient's condition.

"Hey, the patient's condition is rather complicated."

"Speech difficulties, blurred speech came too suddenly, drooling at the corners of the mouth, difficulty chewing... etc. These conditions are all symptoms of cerebral infarction."

"But there is no impairment of limb function, and there is no obvious change in consciousness. This is very strange."

"It stands to reason that after the above situation occurs, consciousness, limbs, and muscle strength will all change."

"Currently, we can only follow the treatment plan for cerebral infarction."

The woman also sighed after hearing Zhang Juan's words.

It's not that she hasn't consulted experts about her father's situation, but... this is too special and can only be studied as a rare case.

The most important thing is that the elderly still have Alzheimer's disease. Now everyone is considering whether Alzheimer's disease has brought about a series of organic diseases?
Neurological diseases are inherently complex.

Medicine is often like this.

As a developing subject, it is always undergoing verification step by step.

……

At this time, Chen Gong was also a little curious as to why this happened.

but……

When he wiped the old man's saliva, he realized that the situation seemed different.

At this time, when the old man's daughter saw Chen Gong taking the initiative to wipe her father's saliva, her heart warmed up and she quickly said:

"Doctor, thank you!"

"I'll be fine."

Chen Gong heard the sound and asked, "How many days has the old man been drooling like this?"

The woman thought for a moment and said, "Five days."

"It just showed up."

"And there's no inducement."

"It stands to reason that my dad's blood pressure has been well controlled during this period. Alas... now the condition has worsened."

Chen Gong heard this, nodded, and suddenly asked: "Do you have the old man's original photo?"

"Recent photos."

The woman was a little curious by Chen Gong's words, but she still nodded and took out her phone and opened a video.

"My dad just celebrated his birthday a few days ago."

"Hey……"

"Now I wonder if I ate something bad that day."

"Although my father has a cerebral infarction and Alzheimer's disease, he...has always had a good appetite."

"I cooked a table of dishes that day, and my kids were there too. My dad was in great shape that day and was very happy."

In the video, Chen Gong saw the old man wearing a birthday hat, singing Happy Birthday, and smiling from ear to ear.

The whole picture is very warm.

but……

Chen Gong's eyes were on the old man's face.

After he read it, his pupils suddenly shrank, and then he looked at the woman: "Can I do a simple check on the old man's face?"

The woman heard the voice and immediately smiled: "No problem."

After finishing speaking, he lowered his head and said to his father: "Dad, I will ask this little doctor to examine your face. You close your eyes."

The old man chuckled, nodded, closed his eyes, and said, "Okay..."

Chen Gong actually discovered just now that there seemed to be something wrong with the old man's mandible.

His joint diagnosis is his own unique skill.

Chen Gong discovered at that time that the old man's face was a little longer, and most importantly, the temporomandibular area was a little wider.

This is not in line with normal human tissue structure, let alone aesthetics.

In fact, the so-called aesthetics does not necessarily have a fixed format. Everyone's body is an art.

Whether he looks ugly or not, there's no telling.

However, human body structure aesthetics is a kind of external coordinated beauty of human skeletal and muscle surface marks.

To put it bluntly, the joints have to be jointed.

Chen Gong found that the old man's face had a sense of disharmony.

And when he wiped his saliva, the feeling became even more sudden.

Therefore, Chen Gong suddenly thought of a disease that was not rare but extremely easy to ignore.

Bilateral temporomandibular joint dislocation!

To put it bluntly, the mouth was opened too wide and the joint was dislocated.

Perhaps many people in life have had this experience, because they opened their mouths too wide and could not close them.

In fact, this is temporomandibular joint dislocation.

It's just that ordinary people like us can recover slowly with the help of muscles after a while.

But... that's not necessarily true for the old man.

Under normal circumstances, most people can feel this discomfort. After all, it is too uncomfortable.

but……

Patients are different.

First of all, the patient is very old, over 80 years old, has Alzheimer's disease, cerebral infarction, and poor neurological perception.

I can't even feel pain when my arm is dislocated, let alone the temporomandibular joint.

The difference between the two is by no means 01:30 points.

After temporomandibular joint dislocation, if you don’t take the initiative to tell it, in fact, in many cases, you won’t be able to tell at all.

This is a disease with relatively strong self-awareness and relies on subjective perception.

Of course, temporomandibular joint dislocation also has degrees, and some people can see it clearly at a glance.

Chen Gong then slowly touched the old man's face with his hand. After touching it carefully, his face suddenly became happy.

He seems to have found the problem!
The patient's temporomandibular joint has a strange convex feeling, and the mandible protrudes forward, the cheeks become smooth, and after the condyle slides out of the glenoid socket, there are obviously some subtle changes, including a slight elongation of the face.

The most important thing is that due to condylar dislocation, there is a depression in front of the tragus, and the dislocated condyle can be palpated under the zygomatic arch!

This is the key to Chen Gong’s diagnosis.

And this time!
Chen Gong also became more certain about the patient's condition.

Because the main symptoms of bilateral temporomandibular joint dislocation are:
The movement of the mandible is limited, and the specific degree will be analyzed on a case-by-case basis, but most will have an open mouth, unable to close the mouth, saliva flowing out, slurred speech, and difficulty in chewing and swallowing.

At this time, the old man was just like this, with his mouth slightly open, salivation at the corners of his mouth... and other obvious symptoms.

For a moment, Chen Gong was very happy inside.

At this moment……

Zeng Hui suddenly saw Chen Gong's movements and was stunned for a moment. He couldn't help but ask:

"What are you doing?"

Zhang Juan also looked at each other awkwardly.

Chen Gong came over and said to Zeng Hui, "Teacher Zeng!"

"I see!"

"I know why the patient has symptoms on his face but no symptoms such as limb awareness."

Zhang Juan heard the sound and looked at Chen Gong curiously: "Oh? What's going on?"

Hearing this, Zeng Hui glanced at Chen Gong pretending to blame him, and said with a smile: "Doctor Zhang, Xiao Chen is an intern, don't worry about it."

after all……

This patient has a disease that neurologists have not been able to detect for a long time. How capable is Chen Gongneng?

Zeng Hui was also worried that Chen Gong would talk nonsense.

This is a hospital, family members and children, so the impact is not good.

Zhang Juan smiled: "Director Zeng, it's okay. Children's minds are active, and they might have some constructive opinions and ideas."

"Xiao Chen, tell me."

Chen Gong said directly: "The patient's drooling at the corners of his mouth... and a series of symptoms that appear to be cerebral infarction are not caused by cerebral infarction or Alzheimer's disease at all."

"So, treating the disease according to the treatment ideas of cerebral infarction will not make any improvement at all."

As soon as these words came out, Zeng Hui scratched his head in embarrassment, and Zhang Juan also frowned slightly.

"Then what are you talking about?"

Chen Gong smiled mysteriously, walked directly behind the old man, and then placed his hands on both sides of the old man's face: "Look!"

"Don't you think this face is a bit awkward now?"

"Actually, the symptoms of the elderly are a series of facial symptoms caused by temporomandibular joint dislocation."

"Director Zeng, come and take a look."

When Zeng Hui heard the sound, his eyes widened suddenly, as if he thought of something, he quickly walked over and touched it with his hand.

After this touch, Zeng Hui glanced at Chen Gong in surprise, and then said excitedly to Zhang Juan:

"Doctor Zhang!"

"Maybe Xiao Chen is really right."

"The patient most likely has a temporomandibular joint dislocation."

"Let me tell you, generally after the engaging joint is dislocated,..."

"The symptoms are very similar to the patient's!"

"Besides, I think you are all too preconceived."

"First of all, bilateral temporomandibular joint dislocation is rare clinically, and the elderly's situation is very special. Their perception and intuition have significantly decreased, so the pain threshold of this type of patient is very high."

"After temporomandibular joint dislocation, the pain is not obvious, so the patient does not feel the pain symptoms."

"The most important thing is that the elderly have a history of cerebral infarction, high blood pressure, and Alzheimer's disease. These are very intuitive."

"There is no history of temporomandibular joint dislocation in the past, so it is difficult to detect."

"The symptoms after temporomandibular joint dislocation are surprisingly similar to cerebral infarction, so... it is easy to have this unclear diagnosis."

"I suggest that we take a film first to make sure."

Although Zeng Hui said this, but... he was already [-]% sure in his heart.

However, what surprised him even more was how did Chen Gong know? !

……

(End of this chapter)