The most enlightened doctor

Migraine is the most common type of primary headache in clinical practice, but its specific etiology remains unclear.

Hormone levels, emotional excitement, overexertion, even weather, food, etc. can trigger migraines.

The important point is that this migraine not only gives the patient a headache, but also gives the doctor a headache.

Because many migraine patients often undergo various examinations, but the results show that everything is normal.

This left the doctors at a loss as to what to do.

However, there is a type of migraine where the root cause of the problem is found. The "culprit" is a small hole in the heart.

It's the foramen ovale.

This is a channel between the left and right atria that forms during fetal life and closes around three months after birth.

Patent foramen ovale is actually not a rare disease, with an incidence rate of about 15% to 35% in the general population.

Most cases of patent foramen ovale will not have much impact on our health and do not require special treatment.

About 5% to 10% of migraine patients have a patent foramen ovale.

After the patent foramen ovale was blocked, most patients' migraines were cured or effectively relieved.

However, Yu Zhiming took over the hospital at nearly noon on Monday. The 34-year-old male patient who suffered from splitting headaches after a migraine attack could confirm that his migraine had nothing to do with the foramen ovale.

After examination, Yu Zhiming found that his heart was intact without any defects.

Not only that, after Yu Zhiming carefully examined the man's brain and body, he found no suspicious problems worthy of attention.

Yu Zhiming looked at the patient, who had a shiny head and was as old as forty-five years old, and asked: "You said that your first migraine attack was more than half a year ago, and it has been occurring one to three times a month since then."

"Do you still remember any physical discomfort or special events that occurred before the first migraine attack?"

The bald patient recalled: "There was nothing special during that period, but the mental pressure was extremely high."

"Anxiety at thirty-five!"

"I work in IT, and turning 35 is a life-and-death hurdle. I can't eat well or sleep well. However, I was lucky enough to be promoted to a management position and became the project leader."

"It's just that the good times didn't last long. Less than a month after I was promoted, I started to have a headache, which continues to this day."

Yu Zhiming said softly, took the person's medical records and quickly looked through them.

His migraine came on suddenly and violently, without any warning. The headache would reach its peak in just over ten seconds and last for dozens of seconds before the pain would slowly subside.

The entire migraine attack lasts about half an hour to an hour.

This period is sometimes accompanied by dizziness, nausea and vomiting.

Also, this man had variable intervals between headache attacks, ranging from five to twenty days.

The last attack was around 9pm the night before yesterday...

Yu Zhiming looked through the person's medical information and looked at Zhou Luo and Duan Yi standing aside.

"I haven't found any clues worth paying attention to yet. Maybe I can find out when the headache attacks."

Yu Zhiming warned: "You eight immortals are crossing the sea, each showing your magical powers, to see if you can induce his migraine..."

He handed over the job and completed all the work on Monday morning.

Yu Zhiming returned to the soundproof office to have lunch, only to find Teacher Qi Yue waiting for him with a father and son.

Qi Yue pointed to a man of the same age next to him with almost all white hair and dark complexion, and introduced him first.

"Zhiming, let me introduce to you. This is my friend An Wenming whom I told you."

"This is his son An Guohao."

Yu Zhiming waited for the teacher to finish the introduction, but before he could say anything, An Wenming quickly stepped forward, leaned forward, stretched out his hands, and held his right hand tightly.

"Dr. Yu, I cannot thank you enough for your kindness."

An Wenming said with a grateful face: "Please rest assured that our family will do our best to pay back the three million life-saving money with interest as soon as possible."

Yu Zhiming's bank account currently does not have three million.

However, Lime has money.

Knowing that Teacher Qi Yue's friend was in urgent need, Yu Zhiming transferred three million from Qing Ning.

Yu Zhiming said politely: "Uncle An, you are my teacher's friend, that is, my elder, so you should help."

"Don't worry about paying back this money. I don't need it on a daily basis."

After a pause, he said solemnly: "Uncle An, you need to take care of yourself."

"Your blood pressure is a little high, and this heart rate..."

Qi Yue interrupted with a concerned look on his face and asked, "Zhi Ming, what's wrong with your heart rate?"

"A little unstable!" Yu Zhiming replied.

An Wenming finally put down Yu Zhiming's hand and explained with a smile: "High blood pressure, unstable heart rate, etc. are all caused by being anxious and angry during this period."

"In just a few days, all the hard work gained over decades was gone, and I still owed two to three million to others."

"I feel like I'm in pretty good health because I didn't burp my butt all of a sudden to see the King of Hell."

Qi Yue said with a serious face: "You are already old, and something like this happened again. You should pay more attention to your health."

He also warned: "Zhi Ming, check him out."

With Qi Yue's insistence, An Wenming knew that nothing could go wrong with his body now, so he lay on the sofa and underwent an examination by Yu Zhiming.

This test result is not very good!

"Uncle An, your heart feels very tired to me. It feels like an eighty-year-old man struggling to pull a cart."

"You need to take a good rest for some time."

Yu Zhiming pondered for a moment and said: "Let's start in half a year. Within this half year, go to bed early and get up early, don't do strenuous exercise, and focus on relaxing fitness, such as walking and Tai Chi."

"In terms of diet, just less salt and less greasy food."

Yu Zhiming added: "Emotionally, don't be anxious and try to relax yourself."

An Wenming smiled bitterly and said: "Dr. Yu, what you mentioned is a bit difficult. The wealth accumulated over decades is gone, and I am burdened with millions of debts. How can I rest in peace?"

Qi Yue said in a stern tone: "You have to feel at ease even if you don't feel at ease."

"As my apprentice, you should know something about it. Since he explained it like this, you need to strictly implement it."

"His words fell on deaf ears before, but now they are either dead or seriously ill."

Qi Yue warned again: "Lao An, I am not alarmist. You must take it seriously."

"This heart problem is no child's play."

Seeing Qi Yue's seriousness, An Wenming quickly expressed his position: "Okay, okay, I will take a good rest after I go back. All business matters will be left to my son. I will let go."

He looked at his son who was silent on the side and sighed softly: "I have suffered such a big loss all at once. As the saying goes, one gains wisdom after one has suffered a loss. I believe that Guohao can also calm down and do business in a down-to-earth manner." ”

An Guohao looked ashamed, lowered his head and blamed himself: "It was my greed, and it was my fault that I made careless friends."

Yu Zhiming previously learned from Teacher Qi Yue that his friend was in the seafood business.

An Guohao's hard-earned money was deposited in a village bank in another province for the sake of high interest rates.

Unexpectedly, the person who solicited the deposit was a scammer and took the money away.

Part of the money saved was borrowed by An Guohao from relatives and friends.

In order to pay back the money, An Guohao borrowed a lot of money to buy a batch of high-end seafood without doing a serious inspection. Unexpectedly, the seafood turned smelly after it was delivered.

An Guohao said again: "Uncle Qi, Doctor Yu, I will take good care of my dad and won't make him tired and worried again after I go back."

Qi Yue solemnly warned: "Guohao, you must do what you say and take good care of your father."

"My apprentice has not made any mistakes yet..."

The time at noon was short, Yu Zhiming was also busy with work, and after chatting for a few words, Qi Yue left with the An family and his son.

Yu Zhiming started to have lunch with Zhou Mo.

Halfway through the meal, Zhou Mo reported softly: "That neighbor Lu Hui is really shameless. Contact me in the morning and ask me to arrange for you to do a physical examination on her husband and son."

"I just pushed her back."

Yu Zhiming asked with a smile: "She has never apologized to you? Did she forget about that? Or does she think she doesn't need to apologize?"

Zhou Mo snorted: "Never mind her, I've already blacklisted people like her anyway."

After a pause, she smiled again and said, "Dr. Yu, let me tell you some gossip."

"There is news circulating in the general surgery department that Dr. Cui has been living in the office these days and has not gone home. I heard that Dr. Cui has filed for divorce from his wife."

Yu Zhiming said softly.

Zhou Mo said again with a gossipy face: "After Dr. Cui's divorce, he will naturally be with the young and beautiful Dr. Feng."

"Hey, Dr. Yu, tell me, did Dr. Cui leave Binhai to go to Dr. Feng, or did Dr. Cui find a way to transfer Dr. Feng to our Huashan?"

Yu Zhiming glanced at her sideways.

"If you ask me about this kind of thing, who should I ask? Hurry up and eat, I still want to rest a little longer..."

Yu Zhiming's wish to rest for a while was not realized.

After dinner, Duan Yi rushed in within two minutes of him lying down on the sofa.

"Doctor Yu, Doctor Yu, I have a migraine attack."

"We use noise and bright light stimulation, as well as electrical stimulation, pain stimulation, and rotational dizziness stimulation."

Duan Yi said in a sullen voice: "Anyway, after all our efforts, he suffered a migraine attack and he held his head in pain..."

After getting up, Yu Zhiming quickly went to the soundproof examination room next door. He saw the patient clenching his teeth and lying on the examination bed with his body muscles tense, resisting the pain coming from the left side of his brain.

Yu Zhiming pressed his hand on the left side of the patient's head, breathed steadily, calmed his mind, and began to explore carefully...

With the adjustment of body and mind, Yu Zhiming's accuracy and depth in detecting the brain are slowly improving...

After a while, Yu Zhiming made a discovery.

A small artery with a diameter of about one millimeter has a slower blood flow rate than other small arteries of the same thickness.

He concentrated on exploring this small artery.

Soon there were new discoveries.

Yu Zhiming discovered the twisting traces of this artery, and a small vein entangled with this artery.

Is this cerebral ischemia pain caused by vasospasm?

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