Gout is a medical disease and rarely requires surgical intervention.
However, this patient had not only many gouty nodules all over his body, but also large ones. The skin of several gouty nodules could not hold up and broke out on their own, forming wounds that would not heal for a long time. At this time, without surgical intervention, the wounds were almost impossible to heal. Because all gouty nodules are wrapped in uric acid crystals, human tissues are eroded by uric acid crystals, resulting in extremely poor or even no healing ability of such wounds. Even if surgery is performed, the wound will not heal and will continue to ooze.<
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The reason why gout can develop to this extent is usually because the patient does not pay attention to it.
Some patients think that gout does not need treatment. Anyway, sometimes it hurts, sometimes it doesn’t hurt, it hurts less often, and it doesn’t hurt more often. When it doesn’t hurt, it is just like normal people, so there is no need to treat it.
There are also some patients who feel that gout needs treatment, but to treat it, they must take medicine. They think the medicine has side effects and are afraid of the side effects, so they put it off again and again until they can't handle it.
Gout is a disease, and it must be treated. Dietary adjustment can also be regarded as a treatment method, but it is only limited to patients with hyperuricemia without gout attacks, or early mild gout patients.
The vast majority of gout requires drug intervention to reduce the uric acid content in the blood.
In the human body, uric acid is the final metabolite of purine.
In gout patients, there is a breakdown in purine metabolism, so its metabolite, uric acid, increases. This breakdown is often irreparable.
"Fat man, you should be a gout expert. When you have time, you can share with everyone some knowledge about gout." Yang Ping saw this patient and felt it was necessary to share with everyone some knowledge about this disease.
The hospital holds health classes every week at the Sanbo Hotel, which are lectures on popular science knowledge about health. The audience is usually hospital employees, inpatients, or their family members.
Fatty Liang once recommended himself to the medical office, hoping to be responsible for popularizing gout science. However, adhering to the principle of specialist teaching, the medical office rejected Fatty's request and handed over the gout lesson to endocrinologists.
The fat man went to the endocrinologist's class and was very disappointed. He felt that it was not popular enough, not lively enough, and the pain points were not mentioned.
Now Yang Ping asked him to give a lecture on gout, and he was eager to give it a try.
"It's better to choose a day than to hit it. Anyway, if you have time now, how about giving a lecture now? If possible, we recommend you to go to the health lecture class of Sanbo Hotel?"
Xiaowu is very interested because his father-in-law is a gout patient. Every time he asks Fatty about it, he gets some fragmentary knowledge. He always hopes that Fatty can give formal lectures. He knows that Fatty is really knowledgeable about gout.
"How about? Now? Let's teach it in our demonstration classroom?" Zhang Lin also supported it. Every time his father had a physical examination, his blood uric acid was high.
"Fat man, can you give a lecture now without any preparation? If you do well, I recommend you to go to the health lecture class." Yang Ping encouraged him.
With Yang Ping's recommendation, the medical office should give you some face and go to the health lecture class to show off. This is what Fatty Liang dreams of.
"Okay! Since you guys are so complimentary, let me choose a day that is worse than hitting the sun. Give me half an hour, no, an hour, and I will popularize science for everyone. When it comes to gout, I feel the pain, so I collected papers and monographs from all over the world and studied them carefully. , and then use yourself as the subject of research, accumulate over time, and make some small achievements, and I will show my shame today." Fatty Liang handed over.
Xiaowu Zhang Lin immediately supported him, and Zhang Lin shouted: "Let's get ready, right away, right away, everyone, Liang Jing, the gout leader of Sanbo Hospital, is giving a lecture. It's all practical information. Those with hyperuricemia and gout in your family are called
Come and listen to the class, one class will make you gout without asking for help."
Hyperuricemia, where blood uric acid is elevated but does not cause gout symptoms, can be regarded as an early stage of gout.
If blood uric acid increases and symptoms of gout appear again, a formal diagnosis of "gout" will be announced.
Immediately, everyone crowded into the demonstration classroom, and the trainees and interns told each other that the general surgery lecture was about to begin.
It doesn’t matter what is being taught or who is speaking. The key is that comprehensive surgery is a lecture. As long as you have time, you must listen.
The topic is about gout, and the anesthesiologist is the speaker. It’s not important!
The important thing is that the anesthesiologist is a fat man and he is a gout patient, so when the news came out, everyone immediately put down their work and gathered at the general surgery department.
Most of the first ones to arrive at the demonstration classroom were obese students trying to get a good seat.
Unexpectedly, the impromptu lecture attracted so many people. It seems that the potential number of gout patients is extremely strong.
The fat man stood on the stage, a little overwhelmed by the situation. He coughed a few times into the microphone and prepared to speak.
"Today, I will tell you about gout. I am both a doctor and a gout patient, so I am the most qualified and obligated to teach this lesson."
"Let me say it bluntly, half of the people sitting here don't know about gout, and the other half who know about gout are all OUT."
"Of course, the statistical scope does not include Dr. Yang."
Although the people here are all trainees, interns, graduate students, and young doctors, they all have dignity. Who are you looking down on? Who hasn’t read the chapter on gout in internal medicine?
When giving lectures, in order to attract attention, it is necessary to make appropriate headlines.
"Currently, the number of patients with hyperuricemia in China has exceeded 100 million. What does 100 million mean? Brothers, about one in 10 people has hyperuricemia. If you have high uric acid, raise your right hand. If there is someone in your family who has high uric acid, raise your right hand.
Left hand."
Many hands were raised immediately in the venue. No need to count. Those who attended the class today were doing it either for themselves or for their families.
"I won't go into details about the definitions of hyperuricemia and gout. They can be regarded as two different stages of the same disease."
"In a word, hyperuricemia and gout are caused by the failure of the body's metabolism of purine. Uric acid is a product of purine metabolism. If there is a problem with purine metabolism, blood uric acid will increase. When a blood test shows an increase in uric acid, but you have never had any problems
If you feel it, it’s called hyperuricemia; if a blood test shows increased uric acid, if you have experienced gout symptoms, it’s gout.”
"There is a problem with purine metabolism, and uric acid increases and cannot be excreted. When the uric acid content in the blood exceeds a certain level, uric acid crystals will precipitate. It is similar to middle school chemistry knowledge. Salt crystals will precipitate if the salt water is too thick. The crystal erosion and
Irritating surrounding tissues and causing gout symptoms."
Fatty Liang still had some ideas, and everyone started to get into the mood.
"Many people think that gout comes from eating, and they think that it is high-purine foods, such as eating too much seafood, so they get gout. Wrong! Big mistake!"
Fatty Liang looked distressed, and the atmosphere in the venue was immediately aroused.
At this level, you can be on CCTV.
“Many people are diagnosed with gout for the first time and are very surprised: I don’t eat seafood or drink beer, how can I get gout? Others follow this logic: I have strictly followed the gout diet and abstained from seafood, animal offal, and beer.
Soy products, etc., why isn’t gout cured?”
"Gout has nothing to do with what you eat. It's not that you get gout if you eat too much seafood. It's because you have gout, so you can't eat a lot of seafood. Seafood is just a trigger. You already have gout. If you eat too much seafood,
, it just induces the symptoms of gout."
"Then since gout is not caused by eating, do I still need to hold the recipe and eat neither this nor that, and live an ascetic life?"
The fat man asked questions to the crowd.
Everyone immediately responded: "Yes, then should we avoid eating it?"
In everyone’s knowledge, it is a matter of course that gout should be avoided.
"Very good, let me start with the question of whether gout should be avoided. I tell you responsibly that gout does not require strict dietary restrictions. You can eat seafood, including chicken, duck, and fish. You won't eat this, and you won't eat that either.
What you avoid is precisely high-protein foods. If the nutrition of the diet is unbalanced, the uric acid will be higher. Maintaining a balanced diet is more conducive to reducing uric acid." The fat man said confidently.
His conclusion is not just a spiel, but a conclusion drawn from reading the latest research results on gout.
Such a novel argument certainly attracted everyone's attention, and everyone was attentive.
"Eighty percent of purine in the human body comes from endogenous body metabolism, and only 20% comes from exogenous food.
Elevated uric acid is not because you eat too many high-purine foods, but because your purine metabolism is malfunctioning.
Therefore, what you eat has very little impact on purines in your body.
At the same time, the human body has a dynamic balance system of purines. If you eat more purine foods, the endogenous sources will decrease; if you eat less purine foods, the endogenous sources will increase, thus maintaining a dynamic balance. p>
The food you eat from your mouth has a very small impact on purine. How small is it, about 5%.
Following a gout diet to avoid dietary restrictions will not only have little effect on reducing uric acid, but will also cause some side effects due to an unbalanced diet.
Therefore, in terms of diet, the most important thing for gout patients is to eat a balanced diet and not be partial to eclipses. They should eat vegetables, fruits, chicken, duck, and fish.
Dieters who strictly follow the gout diet can generally only reduce uric acid by 50ummol/l, while those who eat a balanced diet without dietary restrictions can reduce it by 100mmol/l.
But remember, a balanced diet is not an uncontrolled diet, and you will still hiccup after drinking too much water."
Fatty Liang talked endlessly in one breath, telling everyone how to abandon the backward concept of dieting and establish a new concept of balanced diet.
I have summarized a few golden rules for gout. I won’t tell the average person, so everyone should take notes.
"Don't drink,
No sugary drinks,
Eat less salt,
Eat vegetables and fruits freely,
Seafood, meat, eggs, fish and poultry, etc., should be eaten normally, without any dietary restrictions, and do not overdo it.
You must exercise, you must sweat, and you must lose weight, otherwise it will all be a dream.
Drink more water and urinate more, this is the key point highlighted in red.
Exercise, lose weight, drink water, and eat a balanced diet, but uric acid is still very high. In addition to continuing to maintain the above points, take medicine decisively."
These simple rules are much better than the dense gout recipes.
Although Fatty Liang is an anesthesiologist, this is not a problem when a doctor from West China concentrates on studying gout.
His new and easy-to-understand arguments are well-founded and supported by scientific data rather than hearsay.
"Then if medication is necessary, how do you choose it?" Xiao Wu was very anxious.
He understands Fatty very well, and the things Fatty invests his energy in research are quite reliable.
