Rebirth of Medicine Practices the World

"After admission, the three routine routine tests and biochemical tests were all normal, and the results of the three thyroid function tests were also normal."

"The hormones currently used by patients are prednisone 40 mg once a day and bistigmine 60 mg four times a day."

"The problem now is that the patient's diarrhea is uncontrollable, more than ten times a day, with watery stools, and the amount is not large each time. Because the patient's symptoms cannot be controlled, please ask Director Lin to come back and guide us in the next step of diagnosis and treatment."

Dong Huayu's report was focused and not much nonsense.

"Dr. Dong's report is very detailed. What we are worried about is that if the diarrhea cannot be controlled, the patient's nutritional status will deteriorate and myasthenic crisis is likely to occur again." Zhuo Yiming added.

"Okay, let's go see the patient." Seeing that no one added anything, Lin Lin stood up. At this time, he didn't want to waste any time.

Under the guidance of Ding Feng, we came to the ward. This was the first time Lin Lin came back for ward rounds after the new ward was put into use.

Looking at the clean, bright and well-equipped ward, Lin Lin felt very happy and relieved.

As soon as Lin Lin stepped into the room where the patient was, she immediately called out: "Brother Shi, why are you here?"

It turned out that what Lin Lin saw was Brother Shitou of Shishan Village.

"My sister was sick, and it was only at my insistence that she was transferred from the People's Hospital."

"Ah, is it Sister Shujing?" Lin Lin looked at the hospital bed. Shi Shujing, who was lying on the bed, smiled and nodded to Lin Lin.

"Brother Shi, why are you here now? I have just heard the report on Sister Shujing's situation. It is indeed a bit complicated."

"Alas..." Shitou let out a long sigh, staring closely at his brother-in-law Xie Long who was standing beside the bed. At this moment, Shitou exuded a violent aura and seemed to tear Xie Long to pieces.

"Let me take a look and try to fix Sister Shujing's situation." Lin Lin realized that the problem lay with Xie Long.

"Sister Shujing, what do I ask and what do you answer? I don't ask and you don't need to say anything. In your current situation, it will be very hard if you talk too much." Shi Shujing listened and nodded.

"Have you adjusted the amount of hormones and pyridostigmine you are taking in the past month?"

"Yes, yes."

"Are the two medicines adjusted at the same time?"

"right."

"Why do we need to prepare medicine?"

"I feel a little weak recently. I went to the People's Hospital for a follow-up visit and my doctor in charge adjusted my medication."

"What was your original amount?"

"The hormones are six tablets every morning, and the pyridostigmine bromide is one tablet three times a day."

"Is your current situation related to this medication transfer?"

"Yes, after increasing the amount, the strength will be better, but the diarrhea will be obvious."

"Is your diarrhea more obvious at night or during the day?"

"It's obvious during the day, especially after eating."

"Okay, I understand, let me check it out." Over the past ten years, the beautiful Shi Shujing has changed beyond recognition. Only a pair of beautiful eyes are left, telling Lin Lin that she is the Shi Shujing back then.

Lin Lin did not let Shi Shujing do a fatigue test. For a patient with a clear diagnosis, Lin Lin did not want to increase the patient's pain. Lin Lin took the stethoscope Ding Feng gave him and listened carefully to the patient's abdomen. Sure enough, the bowel sounds were very active.

Lin Lin touched the patient's abdomen and limbs with her hands, and felt a "wet" feeling. At this moment, Lin Lin already knew what was happening.

"Brother Shi, Sister Shujing, and Brother Xie, we will discuss Sister Shujing's condition for a while. Next, please ask Sister Shujing to take medicine according to our plan. If there is any situation, please report it to Dr. Dong or the doctor on duty at any time. Don't ignore it.

Sorry."

Hearing this, Shitou breathed a sigh of relief, stretched out his hand, and held Lin Lin's hand tightly.

"Dr. Lin, I haven't seen you for more than ten years. Let's see when you are free and let's chat."

"Let's find a time. This is Director Ding. If Brother Shi has any questions, you can ask Director Ding for help at any time. By the way, Brother Shi, tell me your mobile phone number. I'll dial it. You and I have both kept it. If anything happens,

You can also contact me directly."

"Okay." When Shitou heard about it, he immediately gave Lin Lin his mobile phone number. Lin Lin dialed the number Shitou said, and the two of them saved each other's mobile phone numbers.

Back in the office, everyone sat down and Lin Lin spoke.

"Everyone can talk about your opinions and speak freely. I also want to hear your thoughts."

"I am the doctor in charge. Let me share my humble opinion first." Dong Huayu spoke first.

"There is no doubt about this patient's diagnosis. The key is how to adjust the medicine to control the diarrhea."

"The patient's current condition should be related to an overdose of pyridostigmine bromide. The patient's abdominal pain, diarrhea and sweating are all typical precursors of cholinergic crisis. If not handled properly, it can be very dangerous."

"What puzzles me is that the patient adjusted the medication because his weakness worsened. After the medication, the patient's weakness did improve. If we reduce the amount of pyridostigmine bromide, will the weakness worsen again?

Woolen cloth?"

"So far, I have never encountered this situation and cannot give a good solution." Dong Huayu was very honest.

"I agree with Dr. Dong's opinion. Should we reduce hormones and pyridostigmine at the same time, or should we reduce hormones or pyridostigmine first? I dare not give a definite answer, but I am more inclined to reduce hormones and pyridostigmine first.

Pyridostigmine bromide." Zhuo Yiming's attitude is relatively clear.

"I also agree with Teacher Zhuo's opinion, but how to reduce it and how much to reduce it is a question." Ding Feng expressed his position before Ling Xiaoyun.

"I agree with the opinions of Dr. Zhuo and Director Ding. To be honest, this kind of patient is very sensitive. Reducing medication will test our doctor's judgment and observation. Therefore, once the decision is made to adjust the medication, Dr. Dong and the doctor on duty must

Pay close attention to the changes in the condition." Ling Xiaoyun still has rich experience.

"I also hold the same opinion. We should first reduce pyridostigmine bromide. Since diarrhea is obvious during the day, let's start reducing it during the day. This way, if there are changes in the condition during the day, it will be easier to deal with." Ye Xiu's opinion is more specific.

Some.

"Everyone's opinions are basically consistent, and I also agree with this direction of drug reduction."

"Myasthenia gravis is an autoimmune disease that affects the quantity and quality of cholinergic receptors in the neuromuscular postsynaptic membrane."

"Immunosuppressive treatment is indispensable. As long as there is an autoimmune reaction in the patient's body, it cannot be stopped."

"Of course, the ideal way is to reduce the hormones to the optimal maintenance amount. However, this is not what this patient needs to consider."