Chapter 907 Little Plum, your hands must be steady!
Because the pain of the old dean was so severe that it could sometimes kill someone, Yang Ping immediately sent a car to pick him up without any delay. Li Min and Li Guodong went with the car to Guandu Town in Beiqiao County.
The trip from the provincial capital to Beiqiao County is almost 300 kilometers, and the round trip takes more than six hours. It's only around five o'clock now, and I estimate that I will have to return to the hospital around twelve o'clock in the middle of the night.
Before departure, Yang Ping asked Li Guodong to bring some medicine, one each of ropivacaine and depotazine. When he arrived at Guandu Hospital, he immediately performed sciatic nerve sealing on the old director, which could immediately relieve pain and allow the old director to be pain-free.
We arrived at Sanbo Hospital comfortably.
Partial closure is a very effective symptomatic treatment method, especially suitable for primary hospitals. If it is mastered well, all kinds of joint pain can be treated with one shot.
Yang Ping has handed over various local sealing methods to Dr. Li Min, including local sealing methods for sciatic nerve pain, which Li Min has mastered proficiently.
The journey went very smoothly. At about midnight, the old director was taken to Sanbo Hospital. Because Li Min had performed partial sealing of the sciatic nerve on him, the old director was safe and comfortable all the way. There was no pain at all.
I slept in the car resignedly.
So when we arrived at Sanbo Hospital, the shaking of the stretcher woke up the old director who was sleeping soundly. The old director said confusedly: "Where is this?"
"This is Sanbo Hospital." Li Min said.
"Sanbo Hospital? What are you doing here?" The old director was a little confused for a moment.
Li Min said: "Didn't I pick you up for treatment? Have you forgotten?"
The old dean rubbed his eyes and tried to get up: "It doesn't hurt anymore. I'm fine now. What other disease can I treat?"
Li Min held him down: "That's a partial sealing effect. Once the effect of the medicine wears off, you'll have to roll around on the ground again."
The old dean thought for a while, and it seemed like this was the case. When he came, Xiao Lizi was given a series of partial sealant injections. Xiao Lizi was very promising, and now he can even perform partial sealant injections on the sciatic nerve. The old dean himself could only do the injections.
Simple partial closure of superficial soft tissue.
Now that he's here, let's treat him honestly. It's rare for Xiao Lizi to be filial and take him all the way to Sanbo Hospital.
In order to make a clear diagnosis as soon as possible, with the help of Yang Ping, the old dean completed an MRI examination even in the middle of the night. The lumbar spine MRI showed that although the old dean also had intervertebral disc herniation of lumbar 4/5 and lumbar 5/sacral 1, it was not
As for causing such severe pain.
On the MRI image of the lumbar spine, there is an abnormal signal in the anterior branch of the right lumbar 5 nerve root.
In the past, Li Min didn't know how to read MRI at all, but Li Min is different now. Through Yang Ping's step-by-step training during this period, Li Min has mastered the basic reading knowledge of X-rays, CT, MRI and color ultrasound. He saw
This abnormal signal immediately made a judgment: schwannoma.
Such severe symptoms of right sciatic nerve pain in the lumbar spine are not caused by lumbar disc herniation at all, but by schwannoma of the left lumbar 5 nerve root.
The sciatic nerve is composed of the anterior branches of the lumbar 4, 5, sacral 1, sacral 2, and sacral 3 nerve roots. It is the thickest nerve in the human body. Once these nerve roots are compressed or irritated, it will cause sciatic nerve damage.
pain.
Of course, the sciatic nerve has a long path. After it emerges from the spinal cord in the waist, it passes through the waist, buttocks, back of the thigh, posterolateral calf, and all the way to the foot, controlling skin sensation and muscle movement along the way.
If it is compressed or stimulated along its path, it can also cause distal pain or numbness. For example, at the outlet of the piriformis muscle in the buttocks, the sciatic nerve can easily be compressed and cause pain.
For identification, the old director also completed an MRI of the piriformis muscle outlet in the buttocks, and there was no compression of the sciatic nerve in this area.
"Schwannoma of the 5th lumbar nerve root?" Li Min asked.
Yang Ping nodded: "So for the evaluation of patients with low back pain, X-rays are unreliable. X-rays can only see bones and have little ability to distinguish soft tissues. The final identification still needs to rely on MRI. From the image performance
Look, schwannoma is most likely. If it is indeed a schwannoma, it is benign." Yang Ping pointed to the MRI picture and said.
"No wonder the pain is so obvious and the straight leg raising test is negative."
Li Min couldn't help but feel a little regretful. If he had given the old director a detailed examination earlier, he would not have been in pain for so many years. He had been treated as a lumbar disc herniation for so many years.
"I don't need to tell you what's going to happen next. I'll leave the old dean's illness to you. Can you handle it?" Yang Ping asked Li Min.
Surgery is the only treatment for this disease. Considering Li Min's current level, there is no problem in doing this surgery.
This is a simple lumbar spine tumor surgery. Li Min felt that he could also complete this surgery. When he heard Yang Ping said that he would do this surgery, he felt very happy and felt a sense of accomplishment. He could actually perform it for the elderly hospital.
Long primary surgery.
I happened to report my study progress to the old dean in this way, which showed that I studied very hard and the old dean did not value me in vain.
''You need to be patient when performing this operation. The tumor must be completely removed while protecting the spinal cord and nerve roots.'' Yang Ping told Li Min.
"Well, I must be careful." Li Min was a little excited.
Now that the test results have come out, Yang Ping took Li Min to explain the condition to the old dean. The old dean was lying on the bed and resting. There was a bottle of rehydration hanging next to the bed. Maybe he hadn't slept in the past few days.
I sleep very soundly now.
"How about letting him rest for a few hours tonight and do the surgery tomorrow morning? If the pain occurs again, add an additional injection to seal it?" Li Min saw that the old dean was sleeping so soundly, and it was hard to disturb him.
Yang Ping agreed with Li Min: "I haven't eaten anything for several days. I'll pay attention to the balance of water and electrolytes later. I'll make up for the fluids tonight and do the surgery tomorrow morning."
At this time, the old dean woke up. He rubbed his eyes in a daze and saw that the doctors doing rounds in front of him were Professor Yang and Xiao Lizi.
This chapter is not finished yet. Please click on the next page to continue reading the exciting content! "Professor Yang, look, I am troublesome to you. We, Xiao Li, have already troubled you enough while we are studying here. Now I have to trouble you again. How embarrassing."
." The old dean got up and leaned against the bed.
Yang Ping and Li Min helped him sit upright. Yang Ping said: "You should have a good rest and don't get up. The test results have come out. It's not a lumbar disc herniation, but a schwannoma of the lumbar 5 nerve root. This disease requires surgery. We
We plan to operate on you tomorrow morning. You should have a good sleep at night and don't eat or drink. We will operate on you tomorrow morning."
"Schwannoma? Not lumbar disc herniation? Don't you think this is a capsize in the gutter?"
The old dean sighed, he had been suffering from lumbar disc herniation, and he was still a doctor. He had been wronged and wronged for so many years. It was really embarrassing.
Li Min said to the old director: "This disease requires surgery, there is no other way."
The old dean nodded: "Let's just do surgery. This surgery requires entering the spinal canal and operating the knife on the nerve roots."
Yang Ping said to him again: "Then we won't disturb your rest. We will come to see you tomorrow morning, and Dr. Li Min will perform the surgery on you tomorrow."
It was fine just now, but when the old dean said these words, his heart suddenly jumped violently. Li Ming, this guy, can do this kind of surgery?
Immediately, the old dean cast a suspicious look at Li Min.
In the impression of the old dean, Li Min could only perform some simple operations, such as appendicitis, cesarean section, debridement and suturing, etc. This kind of lumbar surgery that enters the spinal canal, not to mention Li Min, the old dean himself also
Never done it before.
The old dean knows that lumbar spine surgery is a major surgery and can paralyze a person if he is not careful.
"Xiao Li?"
The old dean asked uncertainly.
"Yes, I will perform the surgery on you tomorrow, don't worry."
Li Min said happily that he thought the old director was surprised that he could perform such a high-level surgery, so he looked full of confidence.
Surgery is no joke. Li Min couldn't have asked for it. Normally, he has nothing to say to Li Min. He treats Li Min like a son and has not offended this kid. He will not seize this opportunity to practice on him.
Bar?
"Little plum? Are you trying to practice with me?"
The old dean asked cautiously.
Li Ming found the old dean's cautious tone funny in his heart, because the old dean was usually more optimistic and acted like an old naughty boy, often joking with others. Li Min thought that the old dean was joking again.
"Old dean! I've been here to study for so long and never had a chance to do anything. You have to give me this opportunity to study?" Li Min followed his words.
As expected, the old dean's heart was filled with chills.
This kid really uses his own hands to practice, so let him practice his hands.
"How about conservative treatment first? I think it's quite relaxed now. After all, I've been through it for so many years. What if I can't stand it again? I'm afraid my bones won't be able to withstand this knife." The old dean thought there was something more.
A glimmer of hope.
Yang Ping said clearly: "There is no way to treat this disease conservatively. At this point, if you want to cure it without pain, you must have surgery."
It seems that I can't escape even if I want to. I am already meat on the chopping block. Little Plum, can you do it? Don't be paralyzed. There will be no place to talk about it when the time comes.
The old dean's heart skipped a beat when he thought of Xiao Lizi undergoing spinal surgery.
The old dean is still aware of these matters of further training. Back then, the old dean also did advanced training in the county hospital. It would be great if he could go on stage to pull hooks. There was no chance of being the chief surgeon.
The old dean had no choice but to bite the bullet and said, "Okay, I'll give you some practice."
Li Ming usually works more seriously and down-to-earth, unlike the other two boys at Guandu Hospital who are careless. If it were those two boys, the old director would go home on crutches now.
"Don't worry! Li Min can definitely perform this operation, and he will definitely do it beautifully." Yang Ping gave the old director confidence.
"Well, I'm sure I'm relieved."
The old dean said incoherently, speaking calmly, but actually he was panicking in his heart.
Li Min's professional skills are good, and this kid studies hard, but a grassroots doctor is a grassroots doctor after all. Li Min weighs a few pounds. How can his old director not know how long he has been here, how can he perform such an operation? Besides,
In this kind of provincial doctor's training, there is no opportunity to do surgery, they are just doing odd jobs.
After Yang Ping and Li Min left, the old dean asked for two sleeping pills, otherwise how could he fall asleep.
This kid was taught about appendicitis by himself. He has only been here for a short time, and now he is performing lumbar spine surgery on himself. No one can sleep at this time.
The next morning, the nurse inserted a urinary catheter for the old director, but the old director refused. An old doctor who often performed obstetrics and gynecology surgeries actually refused the nurse to insert a urinary catheter. In the end, Li Min inserted the urinary catheter manually.
"You have been doing obstetrics and gynecology surgeries for decades, but why are you so shy when asking nurses to insert urinary catheters?" Li Min usually has a good relationship with the old director, so he has no scruples about what he says.
The old dean said seriously: "Can that be the same? I was a doctor then, and now I am a patient. Little Lizi, there are no outsiders now. I ask you whether you can really perform lumbar spine surgery. Don't force it. I
I know you have a good heart, and you are doing it for my own good. My old man is still strong, and this leg will still be used for a few years. You must hold it steady and your hands must not shake."
''Look what you said, who do you think has shaking hands of his own free will? Can he control the shaking of his hands?" Li Min said while collecting the catheter bag.
"Xiao Lizi, your hands must be steady!" The old dean took Li Min's hand.
"Old Dean, don't worry. Professor Yang has taught me a lot. This kind of surgery is a piece of cake. Not to mention my current level, not long after I came here, the few experimental pigs I just made were all...
Running all over the ground.”
You bastard, you have confessed to yourself that you have not done this surgery on humans, you have only done it on pigs.
"Have you had this surgery?"
"Of course I did."
"I mean in humans, not pigs."
"It's been done to people."
Nonsense! It’s useless to ask him.
Which doctor would honestly say to his first surgery patient: I have never done this surgery, and you are the first surgery I have performed. The patient was not frightened and was discharged directly.
''The first operation, sending the patient!"
A nurse's urging voice sounded outside the door.
The old director was pushed to the operating room on a flat cart. The old director had seen this scene for decades, and now it was his turn to lie on it. The surgeon was still a novice. Why was he always so nervous?
Forget it, it’s not easy for Little Plum either. As a doctor, there is always a process of growing up. No one wants to be the first, so who will be the first? Little Plum is also excusable. It’s definitely not good for strangers.
Take action, this acquaintance is easy to do.
Thinking this way, the old dean felt much calmer, and his state of mind improved instantly.
Li Min also accompanied the nurse to take the old dean to the operating room, and the old dean kept talking to him.
"Xiao Lizi, if you see that schwannoma is difficult to cut during the operation, just give up if it doesn't work. We won't force it!"
"Little plum! You must see your nerves clearly. Don't panic. Keep your mind clear. I usually teach you to be bold and careful. Your heart must be very careful, but you can't be too courageous."
"Old Dean! Don't worry, don't be nervous."
"Of course I'm relieved. How can I be worried? Why am I nervous? Aren't I very relaxed? I'm just chatting with you. We haven't seen each other for so many days, why don't we just chat?"
