I can see the status bar

Chapter 1092 Somatic Symptoms

When Sun Lien conveyed to Lu Zhimin that "the blood plasma of recovered patients will be sent from Nanyue to Yunhe soon", Lu Zhimin stayed for a while before asking, "Really?"

"Really." Sun Lien nodded and said seriously, "The total amount is not much, but I ordered two units of type A convalescent plasma for our department."

Lu Zhimin stomped his feet fiercely, "Okay!" If it weren't for the fact that Sun Lien and Sun Lien were separated by the isolation window in the corridor, Lu Zhimin might have hugged Sun Lien vigorously, "When will the things arrive?"

"It takes off from Nanyue at two o'clock this afternoon, and it will take about two hours to arrive at Yunhe." Sun Li'en roughly estimated the time, and then said, "From the airport to here, I estimate that we will arrive at around 05:30 in the afternoon."

"Okay." Lu Zhimin nodded, "The sooner her treatment starts, the better. I will give her a plasma exchange first to replace part of the pathogens in the blood, and then give her the convalescent plasma at night."

Triple therapy with tocilizumab and gamma globulin and CRRT is not perfect.Although this treatment regimen can suppress the concentration of interleukin-6 in the patient's blood, it lacks a strong inhibitory effect on the levels of other types of inflammatory factors.The medical team has always suspected that the drop in Sister Pan's blood oxygen saturation is related to systemic inflammation induced by other inflammatory factors.

However, everyone is a little uncertain about how to deal with all the problems caused by other inflammatory factors.In theory, the fastest and most effective method should of course be plasma exchange, but plasma exchange will also replace the tocilizumab injected into Sister Pan's body, as well as other antibodies produced by the human body against the new coronavirus.The course of her illness was too long, and logically she should have had enough antibodies to attack the virus, but Sister Pan's nucleic acid tests showed positive again and again, even the blood samples were positive.

Whatever was going on in her body, it was clear that Sister Pan's immune system had the wrong focus.Instead of producing enough antibodies against the virus, her immune system activated a large number of immune cells to attack other tissues in the body.

This is the reason why the treatment group has been hesitant to give Sister Pan plasma exchange before—immunological tests showed that a certain amount of IgG antibodies had been produced in her blood, but the antibody levels were very low.If plasma exchange had been done, her systemic inflammation would likely have improved, but at the same time the antibodies that are extremely potent against the novel coronavirus would have been flushed out of her body.

Plasma exchange in such patients would be a very risky treatment option.To put it bluntly, performing plasma exchange on Big Sister Pan is drinking poison to quench her thirst—her body produces antibodies too slowly, and it is very likely that she will not be able to suppress the virus after the exchange.

But now with convalescent plasma, things are very different.

"No matter what treatment you plan to use, it must be done as soon as possible." Sun Lien said to Director Lu, "Start treatment as soon as possible, and we must reverse her condition."

Having said that, Sun Lien suddenly had an idea and asked, "How many intestinal microbial ecological preparations are used for her now?"

"15 BIDs, same as other patients."

"How bad is the diarrhea?"

"It's about the same as before, two to three times a day."

Sun Li'en thought for a while and suggested, "Give her more dose, try changing it to 25 BIDs."

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After leaving the hospital, Sun Li'en rushed to the nearest shelter hospital without stopping.The third batch of medical team members from Song'an Province are stationed here. At the same time, Section Chief Wang Zhenyu, who has cooperated with Sun Li'en several times in He'an Hospital before, is waiting here.

"Director Sun." Seeing the car stop, Wang Zhenyu ran towards Sun Li'en from a distance, "This is really hard work for you."

"I don't have any hard work, just take a train." Sun Lien shook his head, he really didn't think he could have any hard work, "It's you...you didn't take the blood pressure medicine I prescribed for you?"

"Uh, I've been too busy with work recently, so I really can't take care of it." Wang Zhenyu smiled a little naively, "I'll eat when I get back today."

"Don't wait to go back today." Sun Lien took out his mobile phone and started calling his colleagues in the shelter hospital, "Have we prepared nifedipine tablets in our team?"

On Wang Zhenyu's status bar, the status of "high blood pressure level two" has clearly appeared, and according to the time calculation, it is almost after Sun Li'en and his team members went to He'an Hospital for support for the last time.

"At your age, high blood pressure can cause great harm to people!" Seeing Wang Zhenyu's refusal, Sun Li'en became anxious immediately, "Your body is not just your own! At this time, there is a shortage of manpower everywhere. If you Sudden brain congestion in two days, who will take over the job at hand?"

In the past, Sun Li'en's speech would have been enough to be hung on a street lamp by netizens.But now... what Sun Lien proposed is a real "dilemma".

All civil servants in Quan Yunhe, especially the public servants of the Health and Medical Commission and other health officials are now valuable resources.They have working experience in the health field, and at the same time they are local government staff who are familiar with both administrative and health resources.They are an important intermediate link connecting Yunhe and even the Xiangbei government and medical team.

Without them, Sun Li'en can't imagine how bad Yunhe's situation would be now.

For example, this time, Sun Lien was hastily called out by Section Chief Wang, just to advise the Fangcai Hospital.

The number of doctors stationed here in the Fangcai Hospital is very small, currently only 15 per shift.However, the number of nurses is quite large. In the case of three shifts, at least 80 nurses can be guaranteed to be present in each shift.But the number of doctors is too small, and the distribution of departments is very uneven.

In the Fangcai Hospital, most of the diseases of the patients are relatively simple.It is nothing more than some traditional chronic diseases, plus a new type of coronavirus infection.The real challenge is the nervousness of the patients, and the sheer volume.

As an advanced creature, human beings have the biggest characteristic of "good brains".

This is not nonsense, but a real truth—compared with other creatures, human beings are probably the only kind of creatures that can show somatic discomfort due to mental problems.

This is the so-called "somatic symptom".

Many patients with depression or anxiety have various ailments, but there is no problem at all under various objective examinations.

The problem now is that although the doctors and nurses in the Fangcai Hospital are doing their best to ease the tension of the patients, such problems are always inevitable.What's more terrible is that when more than 1000 patients who have already been infected with the new coronavirus get together, there will always be a few of them who have somatic symptoms due to nervousness.

It's hard to say how things like somatic symptoms come from.But one thing is for sure - its performance is very strange and unpredictable.

Since yesterday, seven or eight patients in this shelter hospital said that they suddenly had difficulty breathing recently, accompanied by symptoms such as severe diarrhea and rash.

This phenomenon has spread further today. At present, ten patients have expressed the same symptoms. What's more dangerous is that two nurses of the medical team also have the same symptoms.

This made Wang Zhenyu, who was newly transferred to take charge of the shelter hospital, extremely nervous.He is very worried. This is a shelter hospital, and any movement will be watched by the people of the whole country.If something goes wrong...there will be too much trouble.

However, Li Jinfang, director of the Endocrinology Department of Ningyuan Fourth Central Hospital, who is in charge of managing this shelter hospital, does not think so. She is more inclined to think that this is a somatic symptom caused by the emotional tension of patients and medical staff.And the main reason she made this judgment was that most of the patients who showed the same symptoms were women, and there was only one man.

One of the characteristics of somatization symptoms is that women are the main patients. It is not difficult to find in the widely conducted research on somatization symptoms that the incidence rate of women is basically above 80% or even higher.

"I'm not at ease because of this gender distinction... Although there are not too many hard partitions in the shelter hospital, the men's area and the women's area are still separated." Wang Zhenyu said to Sun Lien, "The six sick male patients The residences are all close to the women's quarters, if it is some kind of unknown infectious disease, or if there is food poisoning, it is indeed possible..."

Sun Lien sighed, "Just for this?" He walked to the door with Wang Zhenyu, and then Sun Lien stopped and said, "I think... Director Li's opinion should be right."

In fact, no other evidence is needed, just look at the two nurses who also showed symptoms—the third batch of medical teams that came this time were all female nurses, and two of them felt unwell.

If the virus has mutated enough to break through the layers of protection of the nurses' N95 and protective clothing, the number of people who will be sick will definitely be more than 40 people. How long has this shelter hospital been in use?After an infectious disease infects a patient, there is no need for an incubation period, right?

Food poisoning is even more out of the question, the meals of medical staff and patients are separated.Moreover, the sources of box lunches are different, so how could the same symptoms of poisoning appear?
Of course, although Sun Lien personally thought that it might be that many people had somatic symptoms at the same time, he couldn't stop going into the cabin to have a look just because of this judgment.As a doctor, as a party member - practice is the only criterion for testing truth.At least he had to use the status bar to confirm that these patients did not suffer from some strange new infectious disease before Sun Lien could make his own judgment clear, and then let other professional doctors such as psychology come over and treat them in exchange.

Asking Section Chief Wang to wait at the door, Sun Lien entered the shelter hospital through the staff passage on the side, and then met Director Li Jinfang who had been guarding the door long ago.

"I really didn't expect that you would be troubled by this matter." Director Li Jinfang greeted Sun Li'en very out of sight, "Director Sun, you have had a hard time these days...you seem to have lost weight."

"Leave this to Mr. Chen." Sun Li'en smiled, put on the protective clothing very skillfully and said, "Chen Tianyang has lost weight these days, and I'm afraid he may have lost [-] to [-] catties. I almost lost weight when I saw him in the last meeting." recognize."

Old colleagues met in a foreign country, and the chat naturally went on very enthusiastically.However, Li Jinfang meticulously checked the protective clothing on Sun Lien's body, and then wrote the words "Sun Lien, Yunhe!" on his back with a pen.

"Let's go, let's hurry up and take a look." Sun Lien walked forward, and said as he walked, "Although I also feel that it is a somatic symptom, I have to give an explanation to Section Chief Wang..."

"Anyway, you are wearing our protective clothing, and you have to make the best use of it." Li Jinfang said with a smile beside him, "I will ask the nurse to bring some patients who feel uncomfortable recently, and you can also take a look at them by the way." look."

Sun Li'en and Li Jinfang walked quickly through the other wards of the Fangcai Hospital, and then came to the ward near the northwest corner - this is where the "somatic symptoms" originated.

"Doctor, when can we transfer to Vulcan Mountain?" Sun Li'en and Li Jinfang had just stood there when a female patient with a nervous expression came over, "Many people in our ward are feeling uncomfortable. Hurry to the hospital!"

Sun Li'en stood by and didn't speak. He just watched Li Jinfang comfort the patient, then moved away and walked around the ward.

"I've seen enough here." When Sun Li'en came back, Li Jinfang just finished talking with the female patient.Sun Lien signaled Director Li to go to other places with him. On the way, Sun Lien expressed his opinion, "I'm not sure about other things, but these patients are indeed very anxious."

Whether a patient is anxious or not, you can actually tell by looking at his expression.Each of these patients who claimed to be uncomfortable wore two layers of ordinary surgical masks, and they had compulsive behaviors—anyway, Sun Lien felt that their coughs were quite rhythmic, and each cough must be six times, not many times. Not one at a time.

The cough does not sound like a deep cough with phlegm, nor does it sound like an emergency cough after the trachea is irritated.Sun Lien had never seen such a rhythmic coughing method in clinical practice, let alone heard of it.

"If you want to be safe, then send these patients to a centralized isolation point for separate isolation." Sun Lien put forward his own opinion to Director Li Jinfang, "You can consider sending mNGS, but I don't think it is necessary-this is a waste testing resources."

"These people are all confirmed patients, and they have not yet reached the discharge standard." Li Jinfang said helplessly, "When they are all negative, they can be transferred to the centralized isolation point."

Sun Li'en slapped his thigh, and he forgot about it.

"Then we can only find a psychiatrist." Sun Li'en said helplessly, "And it has to be done as soon as possible. There are only two thousand people in this shelter hospital. If the number of patients with somatic symptoms increases...then it will be a big trouble."

"I have asked the police comrades in our shelter to help maintain order, and the patients in these two areas are temporarily isolated from other areas." Li Jinfang said, "I have submitted the request for psychological intervention, and it is estimated that people will come in the afternoon .”

"That's good." Sun Li'en nodded, "You can actually learn from others. In order to prevent this kind of thing from happening, other shelter hospitals have come up with a bunch of methods to relieve the boredom of patients. I see you You can also imitate it—dancing in the square, playing poker, doing handicrafts... If it’s not possible, give out a broom, let the patients take turns to clean the residential area.”

"The reports have been typed up, but there is no supplies." Li Jinfang spread his hands, "Our cabin has just been put into use, and the heating was fixed yesterday. Today's main task is to set up several mobile phone charging centers. Every day, we need to distribute to the patients. The medicines and materials consumed by the shelter hospital are all bulky, and these entertainment items are indeed almost..."

Now it's Sun Li'en's turn to be helpless, "Anyway, I have nothing to do. You can't give these patients sertraline just because they have somatic symptoms. Anyway, when I was in the infectious disease hospital, the psychologist gave me advice. Just let the patient tear up the paper and play with it.”

Li Jinfang thought for a while and said helplessly, "The current problem is still the shortage of manpower, but I heard that we will have two more medical teams coming here tomorrow, and the situation should be better by then."

(End of this chapter)