Chapter 877 - 419: The Hazards of Premature Rehabilitation Exercise, Respiratory Diseases?

Chapter 877: Chapter 419: The Hazards of Premature Rehabilitation Exercise, Respiratory Diseases?

Let’s first look at the pathogenesis of a pseudoaneurysm to understand why it’s dangerous.

It occurs due to an abnormality in the vessel wall, where there’s a rupture in the aortic wall, and blood slowly leaks out through this rupture. However, because of the soft tissue or other tissue present at the site of the ruptured vessel, a closed false cavity is formed.

At this point, blood fills this false cavity, forming a tumor-like structure.

In most cases, this false cavity is only wrapped in a thin layer of tissue around the blood vessel.

The risk of rupture is extremely high.

If there’s a lack of experience during imaging, it’s easy to misdiagnose and mistreat.

The danger of a pseudoaneurysm is similar to an aortic dissection.

When this false aneurysm ruptures, the patient’s blood will drain out in a very short time, ultimately leading to death.

Even if it doesn’t rupture, some false cavities can continuously enlarge, which is equally dangerous.

Overall, there are still some differences between it and an aortic dissection.

In an aortic dissection, only the inner wall of the vessel is ruptured, while the outer wall remains intact.

However, in a pseudoaneurysm, the vessel wall is completely ruptured.

In clinical cases, the mortality rates of both conditions are very high.

However, as long as a pseudoaneurysm is detected in time and treated, it can generally be turned from danger to safety.

Director Zhang did not discuss with Li Jingsheng on what treatment to give the patient.

The treatment plan is the responsibility of the attending doctor.

Whether they plant rice or corn, that’s their freedom.

Endovascular aneurysm repair is generally more commonly used.

Open surgery and interventional surgery both can resolve the issue well. The specific treatment method used will be determined by the attending doctor based on the patient’s actual condition and combined with their specialized skills to recommend the best treatment plan.

...

In the afternoon, Li Jingsheng continued his consultations.

Each patient received effective treatment under his care, and he felt a great sense of accomplishment.

At this moment, five young men and women accompanied an elderly man to Li Jingsheng’s desk.

"Dr. Li, this is our teacher. He accidentally slipped and injured his right shoulder. We had it checked at Qiaobang Hospital, and they said it was a subluxation of the shoulder joint. They performed a reduction treatment there. Now it’s almost been two months, and our teacher’s right hand is still unable to move, so we would like you to take a look."

The elderly man looked about sixty-five or sixty-six years old, not particularly old.

His right hand hung at his side in an unusual posture.

Being skilled in bone setting, Li Jingsheng immediately noticed that either the reduction was unsuccessful, or there has been a joint pathology.

Qiaobang Hospital is known for its strict medical standards, and shoulder joint reduction is a simple procedure.

In theory, there shouldn’t be any problems.

"Are you all this teacher’s students?"

"Yes! We’re all Teacher He’s students. Mr. He has dedicated his entire life to education; he has no children and never married. We are his children."

Li Jingsheng found this a bit hard to believe.

No matter how busy teaching is, it shouldn’t stop someone from building a family.

No teacher, to his knowledge, was too busy to get married.

However, in such a vast world, anything is possible. Perhaps there are indeed some educational enthusiasts who choose to sacrifice extensive personal time to help students excel in their studies and achieve top scores.

Having five students accompany the elderly man to the hospital indicates this teacher possesses a remarkable side.

It is only through genuine devotion that one can earn the respect and admiration of these students.

That’s why they are willing to repay the teacher for the gift of knowledge.

"I think you must be a very respected teacher. Can you grasp objects with your right hand now?"

"I can hold light items, but I can’t exert strength. I can’t lift it, nor can I bend it. Every time I move this arm, it feels particularly painful, like an invisible rope is binding it, making movement very inconvenient."

The elderly man’s thoughts were clear, and his speech was well-organized.

"Have you had a follow-up at Qiaobang Hospital?"

"A month ago, I went for a follow-up once, and they said the recovery was good."

"Let’s take an X-ray to check the situation! I charge a hundred yuan for an X-ray here, is that okay?"

Li Jingsheng decided to first have the patient take an X-ray to assess the situation.

Since the follow-up a month ago showed no issues, theoretically, the patient’s condition should continue to improve.

Why is this happening?

After taking the X-ray, Li Jingsheng found that the patient’s right shoulder joint position was normal. However, the surrounding soft tissue appeared abnormal.

"The shoulder joint has been treated, but the soft tissue around your shoulder seems abnormal. Let me palpate."

After palpating the area, Li Jingsheng found the results consistent with the X-ray findings.

The patient’s right shoulder joint had indeed been successfully reduced, but there were some lumps around the shoulder joint.

Moreover, the soft tissue had a very strong pulling sensation.

The feel was similar to muscle spasms.

It was hard like stone.

This indicates a large formation of fibrous tissue in the soft tissue.

And those hard lumps didn’t feel like tumors to Li Jingsheng.

This area, in theory, shouldn’t have nodules.

What exactly were those?

It is now basically confirmed that the patient’s inability to move the right shoulder normally is related to a soft tissue abnormality.

"Were you able to move your right shoulder normally before you fell?"

"Yes. I am an old teacher and often had to raise my hand to write on the blackboard. Due to occupational diseases, I had shoulder inflammation before. Later, I saw a doctor who told me to exercise more. I’ve kept both arms moving as usual, and they were always fine. Only after this fall did I find it very difficult to lift my right hand."

The elderly man explained.

As he spoke, he moved his left hand a bit, which was indeed normal.

It seemed his left hand rotated very flexibly.

Li Jingsheng had a flash of inspiration, thinking of a possibility.

"Did you begin rehabilitation training soon after the treatment on your right shoulder?"

"Yes! How did you know?"

The old man nodded calmly in acknowledgment.

Li Jingsheng gave a wry smile, "You shouldn’t have hurried into rehabilitation training! Elderly people recover slower than younger ones, and after a manual repositioning, there’s only a short fixation period. At this time, you should rest well, rather than rushing to regain all your motion functions. Just now, I felt some lumps in the soft tissue where your shoulder joint was injured.

I was curious what those little lumps were. They neither felt like tumors nor nodules.

Now, I understand what they are.

They’re likely scar tissue resulting from your rehabilitation training."

Li Jingsheng was at a loss for words.

He couldn’t tell whether Qiaobang Hospital’s doctors did not explain clearly, or the old man was too stubborn, acting on his own method.

Haste makes waste.

Sometimes being too aggressive isn’t beneficial.

"So, does this mean my exercise turned out to be harmful? Young man, please explain it thoroughly."

"Exercise isn’t bad itself, but since your right shoulder joint was injured, the soft tissue was already damaged. In such cases, it requires a long time to recover slowly. However, you rushed to exercise before it was fully healed, which was akin to rubbing salt into the wound. It not only failed to facilitate recovery but also aggravated the injury to some extent.

Leading to the formation of a large amount of fibrous tissue and scars.

Once they form, the more you exercise, the more they develop, and your right hand becomes increasingly restricted in movement."

Li Jingsheng explained the underlying pathological mechanism.

Upon hearing this, the elderly man was filled with regret.

Slapping his thigh, "Oh dear, I shouldn’t have hurried to exercise. The nurse advised me when I was discharged, but I didn’t pay attention. Now, what should I do!"

"Take some time to rest for now! Be sure not to stimulate those damaged soft tissues anymore. Scar proliferation can be quite terrifying; the more you irritate it, the worse it grows."

Li Jingsheng was also helpless regarding scar proliferation.

Over time, it may spontaneously regress.

This period will be rather lengthy, possibly requiring two or three years, or even longer.

If one has scar-prone skin, the situation is pretty dire.

After seeing the elderly teacher off, a young female patient sat down at Li Jingsheng’s consultation desk.

A strong scent of perfume wafted over.

With ultra-short shorts, a stylish crop top, and wavy hair, this woman was not only young but also dressed quite boldly.

"Doctor, my throat hurts a lot. Perhaps it was because I drank too much alcohol and ate too much barbeque and spicy food the night before yesterday. I bought some anti-inflammatory medication at the pharmacy, but it feels ineffective."

As she spoke, her breathing was quite heavy.

It seemed like her nostrils were blocked.

"Let me take your temperature and see."

Li Jingsheng measured the ear temperature of this fashionable woman.

Her earrings were so large, they looked about half the size of an adult’s palm. They appeared very wild.

37.1 degrees, a mild fever.

A slight fever.

In the morning, he had just treated a patient with a sore throat but no fever.

Now another one comes in.

Luckily, this one shows symptoms of fever, making it slightly easier to diagnose.

"Did you take the anti-inflammatory medication yesterday?"

"Yes! I felt my throat hurt when I got up last night, and since I am a presenter, if my throat gets hoarse, it can affect my work. So, I quickly bought anti-inflammatory medicine and Malva nut. But it didn’t seem to work. My throat has been very uncomfortable. Now, eating anything causes severe pain."

This woman turned out to be a presenter, which was unexpected.

No wonder she’s dressed so fashionably.

"Let me take a look at your throat, open your mouth!"

Li Jingsheng examined her throat, and there was no swelling of the tonsils.

Strangely enough, a sore throat is supposed to be one of the easiest symptoms to diagnose, yet today he encountered two cases with unaffected tonsils.

What’s wrong with this patient?

The presence of a low fever suggests there should be some inflammatory reaction in the body.

"Has your breathing always been this heavy?"

Li Jingsheng asked her.

"Oh my, if my breathing was always this heavy, when I speak into the microphone, the audience could probably only hear my breathing sounds! My breathing was always normal before the throat pain occurred."

The woman covered her forehead with her left hand.

No issue with the tonsils, yet the patient has heavy breathing, indicating respiratory difficulty.

Could it be bronchitis or tracheitis?

Li Jingsheng further investigated the cause.