Chapter 2146: 2072 Old

"Finally, Dr. Oakland also didn't make any progress." Zheng Ren said.

"No way, I remember she did experiments on white rats, cutting the nerve on one side, and after a few weeks the other side also died." Su Yun retorted.

"I think this is a special case, with no universal significance." Zheng Ren said, "Clinically, Canadian doctors conducted a large-scale sample survey on kidney stones and found that mirror pain exists.

"But speaking of probability, I observed at Haicheng Shi Yiyuan, and the so-called 0.48% incidence seems a bit high." Zheng Ren said,

"Oh?" Su Yun didn't expect her own boss in that rundown place Hai Cheng had already started researching mirror pain.

"The Canadian data showed 3 cases of mirror pain out of over 600 patients," Zheng Ren said, "My data is over 400 patients with urinary tract stones, none had mirror pain. Clinically, this patient is the first I've encountered."

Clinical research is like that; whether it's 600 cases or 400 cases, they're considered small samples, and deviations are normal.

But from Zheng Ren, Boss Zheng's observations, mirror pain should be considered a very rare disease domestically.

"Then admit him to hospital? And then?" Yu Zong was somewhat confused.

"Admit, lithotripsy. If your director doesn't accept mirror pain, you can do a venous pyelogram." Zheng Ren's finger pointed at the X-ray upright flat film placed on the viewer, saying: "This should be some kind of stress change in the body. Once the stone is crushed and expelled from the body, no longer painful, it should improve."

"Boss Zheng, could you explain in more detail?" Yu Zong also had no good option; he couldn't say that when reporting the medical history to the director.

"Um… then you just report that to the director." Zheng Ren looked at the film and said: "Due to hydronephrosis, pressure increases in the right kidney's collecting duct, subsequently causing extension of the intrinsic layer nerve endings, smooth muscle spasms and contractions, attempting to move the stone's position."

"Increased lactic acid production stimulates the mucosa and activates chemoreceptors. Afferent nerves reach the spinal cord, connecting at T11-L1 level, then transmit to the central nervous system, producing the illusion of contralateral pain."

"……" Yu Zong remained silent, speechless.

If he said that to the director, he'd likely remain inpatient chief for another year.

But seeing Boss Zheng give a diagnosis yet unable to articulate a particularly convincing point, he could only nod.

"As for the image of the left ureter near the L2-L3 vertebrae, a venous pyelogram can rule it out. Regardless of whether it's mirror pain, afterward we still need to treat the right urinary tract stone." Zheng Ren finished speaking, took the film, put it in a bag, and handed it to Yu Zong.

Afterwards, the two inpatient chiefs began to get busy.

Persuading patients who previously refused hospitalization to undergo inpatient diagnosis and treatment is a relatively massive undertaking.

But the two, being rich in clinical experience, plus the patient's severe pain, had a relatively reasonable yet somewhat fantastical explanation, which he reluctantly accepted.

The pain of kidney stones is truly painful, with a feeling of apocalypse. Even if there were knives and fire ahead, one might still have to charge through.

Su Yun took this time to order breakfast.

Zhou Litao finished his work, and breakfast had just been delivered.

"Boss Zheng, Yun Ge'er, the patient has been sent to the hospital." Zhou Litao reported the concluding work.

"Hmm, lithotripsy will do. If it can't be shattered, urology has plenty of ways to resolve it." Su Yun said while eating a steamed bun.

"I also encountered mirror pain in the urinary system for the first time." Zhou Litao was still quite interested, "Patients with orthopedic amputations sometimes have contralateral pain, but I think it's hysteria."

"It's not hysteria; just that the scientific principle hasn't been found yet." Zheng Ren smiled, "Existing science doesn't have clear statements for the diagnosis and treatment of many diseases."

"I think we can use central nervous system plasticity to solve this problem." Su Yun said, "Unfortunately, I don't research this area, so I currently have no leads."

"There's no need to do that; when encountering similar patients, just knowing this possibility exists in mind and avoiding misdiagnosis is enough." Zheng Ren has an accurate self-positioning, always being a clinical doctor.

Earlier, Dr. Charles advised him to pursue theoretical research, but at the moment he decided to give up, he had already figured it out clearly.

The three ate breakfast while chatting a few sentences about speculation on mirror pain.

Zhou Litao felt somewhat emotional, "No wonder Boss Zheng has been smooth sailing all the way; people who served as inpatient chief in the Emergency Department in Hai Cheng already had some understanding of such esoteric matters."

Indeed, there's never a time when a pie falls from the sky.

Regarding Boss Zheng's speculation, Zhou Litao was wrong from the start.

Zheng Ren only began to reflect and recall similar patients he had encountered in his medical career after meeting this morning's mirror pain patient.

Therefore, pretentious thinking differs from others. Zhou Litao, using normal people's thinking to imagine Boss Zheng, can only go further down the wrong road.

Boss Zheng never…… rarely does forward reasoning; each time he knows the answer first and then does backward reasoning. Backward reasoning saves effort, but it also relies on Zheng Ren's strong memory.

"By the way, why hasn't Cui Lao been coming to work lately?" Zheng Ren asked casually after finishing his meal.

Zhou Litao sighed, saying: "Cui Lao got sick last time, and it's been over half a month now, with intermittent improvement and worsening. Came to the hospital for a check-up, but there's nothing serious."

Zheng Ren froze for a moment, knowing Cui Lao is old, and some things cannot be solved by human effort.

"Where does Cui Lao live? When I have time I'll go see him." Zheng Ren said.

"I'm off tomorrow, planning to take a look at Cui Lao's place." Zhou Litao said, "Boss Zheng, if you have time, shall we go together?"

"Okay, tomorrow… afternoon then." Zheng Ren said, "Morning affairs are relatively many."

Speaking of Cui Lao's illness, the atmosphere in the duty room became slightly oppressive.

But after all, he's nearly eighty, so some minor ailments are normal.

Not to mention nearly eighty-year-old Cui Lao, Zheng Ren sees in every doctor's office the system panel, which more or less shows a reddish hue.

This is a natural law; Zheng Ren wants to go once: first, he somewhat misses Cui Lao. Second, he wants to glance at the system panel to see if Cui Lao has any other condition that could lead to misdiagnosis.

Although the latter possibility is small, Zheng Ren still thinks taking a look is more appropriate.

After breakfast, Zheng Ren and Su Yun left the Emergency Department, returned to the Intervention Department to prepare for the early shift handover.

Lin Yuan still sat before the computer, busily writing medical records. Chang Yue chatted in the ward with patients' families; everything in the department looked as usual.

Plain and simple, yet rich and colorful.

……

……

Note: When writing about mirror pain, while looking up materials I recalled that in the former outpatient emergency department there was a post-amputation patient who always said the amputation site had contralateral pain. That person kept saying people were faking illness… I feel a bit ashamed. Mirror pain, I really only learned about it for the first time.