Chapter 650 - 298: The Weakest Department, Hypokalemia_3
But at this moment, she was playing with her phone, seemingly indifferent to the arrival of Li Jingsheng.
Or rather, she didn’t really care about her husband’s condition.
"What’s his issue that requires hospitalization?"
Li Jingsheng decided to first understand the patient’s situation.
To be honest, he wasn’t very adept in the field of endocrinology.
Pulmonary medicine, gastroenterology, cardiovascular, orthopedics—he was more skilled in these areas.
Even though he had helped multiple teams or chief physicians win awards in skill competitions, he knew well that he wasn’t particularly outstanding.
In many aspects, he relied on clever tactics.
At least, he personally believed there was still much room for improvement.
"The patient’s symptoms upon admission included weakness in the limbs, struggling even to walk. These were the tests done after admission."
Director Kuo handed the information to Li Jingsheng.
The male patient’s wife, upon hearing this, retorted, "He’s always been useless! Can’t do anything right."
She said this right in front of the patient.
The woman appeared very resentful.
Li Jingsheng looked sympathetically at the patient on the bed.
The medical records indicated that the patient had been experiencing body weakness for over ten years. No wonder his wife held such deep resentment.
When physiological needs are unmet for a long time, emotions can also fade over time.
It’s fortunate there hasn’t been a divorce.
From the test results, the patient has low potassium levels.
Blood pressure is 170/110mmHg, about 28 breaths per minute, and the body temperature should be around a low-grade fever at 36.9 degrees Celsius.
In medical practice, some hospitals and doctors like to adhere rigidly to rules, believing a patient’s body temperature below 37 degrees is not a fever.
Li Jingsheng despised this approach.
The most fearsome thing in practice is encountering dogmatic, inflexible doctors.
They operate entirely by the textbook.
Little do they know, textbooks are also written by doctors.
The content is just their summary and judgment based on clinical medical experience, but it’s not an edict.
Different patients can have vastly different conditions, requiring tailored treatments and diagnosis.
Rather than carrying out rigid analysis and treatment according to textbooks.
The patient is currently still conscious.
Hearing his wife’s complaints, cursing him as useless, he showed a guilty expression.
The patient’s serum potassium was 2.14mmol/L, and there were U waves present on the ECG.
Firstly, the patient’s serum potassium level was clearly below normal.
Normal blood potassium levels should be above 3.5 and within 5.5.
Too low or too high blood potassium is never a good thing.
There’s a saying that goes "too much is as bad as too little."
This patient, besides having blood potassium far below normal, also had a U wave on the ECG, which is equally a major issue to be wary of.
In general, when a U wave appears in a clinical ECG, it can first be determined as bradycardia or electrolyte imbalance.
Possibly even myocardial infarction.
And the dreaded myocarditis can also show U waves.
Li Jingsheng was not adept at diagnosing and analyzing endocrine diseases, but he had a quite high level of expertise in cardiovascular fields.
The patient also had symptoms of difficulty breathing.
He could use cardiovascular and pulmonary diagnostic techniques for comprehensive analysis.
Bradycardia most commonly arises from arrhythmia, cardiomyopathy, or cervical trauma, etc.
Cervical trauma-induced bradycardia is often seen in traffic accidents or accidental injuries.
Then, analyzing the second cause of the U wave, electrolyte imbalance.
This is often caused by sodium-water metabolism disorders or hypokalemia.
Such conditions cause abnormal fluid and electrolyte concentrations, thereby affecting systemic cardiac organ function.
If the U wave of this patient is due to the second cause, there will also be a symptom of nausea.
This patient has severe hypokalemia, so the first target for Li Jingsheng was the electrolyte imbalance causing the U wave.
"Do you feel nauseous, like you want to vomit?"
Li Jingsheng asked the patient.
"Yes. My heart feels panic-stricken, very uncomfortable, and this area also feels uncomfortable."
The patient weakly pointed to the pericardium area and the stomach area.
Someone once jokingly said that to capture a man’s or woman’s heart, you must capture their stomach.
Because the stomach is the closest place to the heart.
Whether or not it makes sense, at least from a medical anatomical perspective, this saying makes sense.
The stomach is just below the heart, located in the upper left abdomen of the body.
Many people can’t tell the difference between the position of the stomach and heart.
When the stomach bloats, they think it’s chest tightness, then nervously rush to the hospital emergency, taking the chest pain and stroke green channel for diagnosis. Ultimately, the doctor finds it’s just simple gastritis, making it a laughable matter, a false alarm.
When people eat to their fill, they can generally feel the presence of the stomach by hand in the upper left abdomen.
Certainly, overeating is not a good thing.
From a traditional Chinese medicine perspective on health, eating until 70% to 80% full is most appropriate.
Even in recent years, a fad called hunger therapy has become popular among circles of wealthy Westerners. They believe letting the body experience hunger can awaken vitality and make one feel younger.
They certainly don’t do it out of foolishness.
There is indeed some scientific basis.
Recent studies have shown that moderate fasting has benefits for the human body.
Overeating is more likely to cause various problems.
Some people jokingly call it a disease of affluence.
In ancient times, the wealthy landlords usually ate until they were overweight, and living to fifty or sixty years was considered a long life.
It wasn’t just overeating that shortened their lifespan.
First, the average lifespan was short in ancient times; it was a time with limited medical care, and seeing a doctor was quite a luxury.
Finding a good doctor was even more difficult.
Secondly, in ancient times, wealthy landlords had many wives and concubines, living in excess pleasures, which also consumed their lifespan.
Hearing the patient clearly express symptoms of nausea and discomfort in the gastric area, Li Jingsheng had basically pinpointed the cause of the U wave on the ECG.
This patient’s illness wasn’t complicated; it was a series of symptoms and pathologies caused by hypokalemia.
The main issue was the delay in addressing it.
It had been dragged on for more than a decade.
Treating hypokalemia isn’t difficult, unless the cause is special, otherwise treatment costs aren’t expensive.
It’s really puzzling why this patient didn’t seek hospital treatment earlier?