After being fired, I became the light of medicine

Chapter 104 Renal Failure and Uremia! (Subscribe!)
Zhang Yang woke up at dawn.

He was so worried about something that he couldn't sleep well the whole night.

But at this moment, he felt somewhat fortunate. He had impulsively entered the simulator last night and had wasted one simulation. Fortunately, the final result was good, and he had discovered two other symptoms of the patient.

Heart failure, shortness of breath, nausea and vomiting.

Presumably these two symptoms can provide doctors with more reference.

Thinking of this, he got up and washed up. After he was done, he looked at the time. It was 7:30 in the morning.

He wondered whether he should go directly to the hospital, and after thinking for a while he decided to go there around noon.

After all, early morning is the busiest time for doctors, and my own affairs are not that urgent. It would not be a good idea to mobilize a large number of people and delay the doctors' normal work.

After waiting for a long time, it was finally 11:30 in the morning, and Zhang Yang appeared in the director's office of Chengdu Third People's Hospital.

Dean Zhou had already notified the heads of relevant departments in advance, and when Zhang Yang arrived, several chief doctors were already waiting in the office.

"Come on, let me introduce to you all. This is the role model of the times that everyone has been talking about, Mr. Zhang Yang from Qingshan Pharmaceutical."

"Zhang Yang, let me introduce you. This is Director Xiao from the Department of Gastroenterology, this is Director Xu from the Department of Endocrinology, this is Director Gao from the Department of Cardiology, and this is..."

"These are the departments that I found that might be involved based on the symptoms you described."

"Oh, by the way, Director Lin from the Nephrology Department is still in the outpatient clinic, but he will be here in a few minutes at most."

Zhang Yang nodded, feeling warm in his heart. He could tell that Dean Zhou really valued him.

After a moment, he stopped being pretentious and got straight to the point.

He looked at several chief physicians and said:

"Dear professors, I have recently encountered a very strange disease. After jogging for a while, I feel tired and short of breath, accompanied by nausea and vomiting."

"Besides that, the most special thing is that I really want to drink ice soda, but after drinking it, I feel the taste and it doesn't quench my thirst at all."

"I wonder if you have encountered similar symptoms in your clinical practice over the years? Or, what disease might cause these symptoms?"

As soon as the voice fell, the four or five chief physicians present frowned, but after a moment, Director Xiao of the Department of Gastroenterology took the lead and said:

"Mr. Zhang, normally, we often encounter patients with nausea and vomiting in our gastroenterology department, but patients who particularly want to drink ice water are very rare. No matter whether it is gastric disease or enteritis, no patient has ever said that they particularly want to drink ice water.

As for heart failure and asthma, they are not common symptoms in gastroenterology, so I think digestive system diseases can basically be ruled out. "

Zhang Yang also nodded. Vomiting is a common complication and should not be the main cause.

"Our cardiology department may cause heart failure and vomiting."

Director Gao of the Cardiology Department said:

"Coronary heart disease, myocarditis, and valvular heart disease can all cause heart failure and vomiting, but I've never heard of someone wanting to drink ice water."

"However, heart failure is actually very common in clinical practice. Many diseases can cause heart failure, the most common of which is kidney disease."

"Kidney disease?" Zhang Yang was slightly stunned.

"Yes, especially renal failure and even uremia can easily lead to heart failure."

Director Gao continued:

"Late-stage kidney disease is usually accompanied by renal hypertension, which can have a strong impact on the heart. Over time, excessive heart load can cause heart failure and asthma."

"Also, when kidney function is damaged, the ability to excrete water and sodium decreases, and a large amount of toxins and sodium will remain in the body, which can also cause heart failure."

"So...in the end, most kidney patients don't die from kidney disease, but from heart failure."

"However, I'm not sure whether kidney patients would particularly want to drink iced soda. You should ask Director Lin of the Nephrology Department."

After he finished speaking, Zhang Yang nodded slightly. Dean Zhou frowned and took out his cell phone to urge Director Lin who had not arrived yet.

Just as he was about to dial the number, the office door suddenly opened and a young figure walked in.

"Director Lin, you're here just in time."

Dean Zhou's brows relaxed, then he turned to look at Zhang Yang and added:

"Zhang Yang, this is our Nephrology Department's Director Lin Xiang. Although he looks young, he is a well-known expert in the field of nephrology both at home and abroad."

Zhang Yang looked over and saw that Director Lin was about forty years old, wearing a pair of silver-rimmed glasses. He looked like a traditional senior intellectual.

"Hello, Director Lin."

After a simple greeting, Zhang Yang said without further delay:
"Recently I encountered a strange disease. The patient felt tired and short of breath after just a little jogging, and also had nausea and vomiting."

"The strangest thing is that the patient really wants to drink ice soda, the colder the better; and after drinking it, it does not quench his thirst, and he still has a strong dry mouth and tongue."

"Have you ever encountered this disease?"

Lin Xiang was slightly stunned.

After a moment, he nodded and answered without any hesitation:

"If nothing goes wrong, it's uremia. If we're lucky, it's kidney failure."

"This situation is encountered frequently in the Department of Nephrology."

Uremia?
Kidney failure?
Even though Zhang Yang was somewhat prepared, he did not expect Lin Xiang to be so confident.

After a moment, he asked in surprise:

"Director Lin, in my impression, shouldn't kidney patients have edema all over their body and swollen eyelids?"

"This patient doesn't have edema. Could it be uremia or renal failure?"

Lin Xiang nodded and explained:
"Mr. Zhang, you are right. Most kidney disease patients will experience edema. Usually, the eyelids swell at first, and then the lower limbs swell."

"The reason is that the water in the body cannot be excreted through urine. In layman's terms, there is no urine."

"But in reality, many patients with early uremia still have 1500ml of urine every day. They can excrete water but cannot eliminate toxins in the human body."

"Only when their kidney function is completely lost and they reach the late stage of uremia will edema occur."

"Therefore, in the clinical practice of kidney disease, edema is not a criterion for determining whether or not there is kidney disease, but only a reference."

Zhang Yang suddenly understood, but...

He asked curiously:

"Then is the patient's craving for cold drinks also a major symptom of uremia or renal failure?"

Lin Xiang pushed the frame of his glasses and hummed.

"Yes, most patients with renal failure and uremia will want to drink cold drinks, but the degree varies from person to person."

"Well, to be precise, it's not ice drinks, but ice water, anything iced." "This situation is not only limited to patients with uremia. You should have heard of dialysis, right? Even those dialysis patients also have an abnormal desire for ice cubes and ice water."

"The cravings don't really go away until you get a kidney transplant."

Zhang Yang felt that he had gained more knowledge after listening to it, and he became more curious.

"So what is the reason for this situation?"

"Why do I want to drink it when I see it? I still feel thirsty even after drinking two bottles?!"

Perhaps after explaining so much, Lin Xiang felt a little thirsty. He paused for a moment, picked up the paper cup on the coffee table and took a sip.

Then he said slowly:
"From the perspective of modern Western medicine, the concentration of toxins in the bodies of patients with uremia and renal failure will increase, and there will be a large amount of sodium and potassium ions in the blood that cannot be eliminated from the body."

"These toxins will affect the body's osmotic pressure, and after feedback to the central nervous system, it will think that the body is dehydrated, thus producing a feeling of thirst and stimulating the body to actively drink water."

"The colder the water, the more stimulation it will bring to the nerve center. So it's not that patients with uremia and renal failure like to drink ice water, but the nerve center of the human body influences them to drink ice water."

Zhang Yang exhaled heavily, so that's how it is!

No wonder when I was in the simulator, I obviously didn't like Sprite, but the host licked his lips reflexively. This was the control of the nerve center.

Just as he was about to speak, Director Lin Xiang continued:
"From the perspective of traditional Chinese medicine, the kidney governs water. If the kidney yin is insufficient, internal fire will be generated."

"To put it simply, if the kidneys are damaged and out of regulation, the internal heat in the body will move to the stomach and lungs, causing the body to become hot and dry, so the thirst will be stronger and the desire to drink ice water will increase."

"It's the same with dialysis patients. Although they are on dialysis, modern technology still can't remove all the substances in the blood. In addition, their own kidneys are also damaged. Therefore, only after the kidney transplant is completed and the kidneys return to normal, this reaction of the central nervous system will be truly eliminated."

At this point, Zhang Yang was almost completely certain that the host in the simulator was most likely suffering from uremia or renal failure.

But he didn't expect it.

The host's symptoms were not actually too serious. He was just thirsty and wanted to drink ice water, and he was a little breathless and vomiting after jogging.

Under normal circumstances, such symptoms are likely to be attributed to lack of rest or a cold stomach, and are often not taken seriously.

But the reality is that it has reached the point of renal failure and even uremia!

"Hey, it's a bit hidden."

Zhang Yang sighed in his heart, and at this moment, he suddenly thought of the interface of the last simulated settlement last night.

【Discovery rate: 75%.】

【Found effective clues: 3/4. 】

Three clues have now been identified: desire for cold drinks, heart failure and asthma, and nausea and vomiting.

What's the last one?
After a moment, Zhang Yang decided to ask directly while Lin Xiang was here.

After thinking for a while and sorting out the questions, he asked:
"Director Lin, thank you for answering my questions. I basically understand now."

"But I have one last question. In addition to the symptoms I just asked you about, what other symptoms do kidney disease patients generally have?"

"Yes, urine!" To Zhang Yang's surprise, Lin Xiang immediately gave an affirmative answer.

"Urine?"

"That's right!"

Lin Xiang affirmed:
"Mr. Zhang, in fact, the symptoms you just mentioned are all relatively late-stage symptoms in clinical kidney disease. Often when symptoms are discovered and taken seriously, they are often diagnosed with renal failure or uremia upon examination."

"At this point, the kidney has reached a point where it is irreparable and the only options are dialysis or a kidney transplant."

"The real earliest symptom is urine."

"To be precise, it can be said that daily observation of urine can be used to simply determine whether there is a problem with the kidneys."

Zhang Yang's expression became serious and he listened carefully.

At this moment, Lin Xiang sighed slightly, with a hint of helplessness in his tone.

“However, firstly, because the rate of physical examination in our country has not increased, the rate of early detection of kidney disease is only 15%;

Secondly, ordinary people don’t know much about kidney disease, so even if there are some changes in urine, they don’t pay attention to it.”

"Therefore, kidney disease is called a 'silent disease' or a 'silent killer' in the medical community. Once discovered, it is almost always kidney failure or uremia, and the best case is chronic nephritis."

The silent killer...

It turns out that the simulator's node name comes from here.

After a slight sigh, Zhang Yang returned the topic to urine.

"Director Lin, you just said that we can make a simple judgment through urine. What do you mean..."

"It's very simple. It mainly depends on whether there is a lot of foam in the urine."

Zhang Yang's heart tightened, and he couldn't help but recall the urine he had when he got up this morning. Fortunately, there were bubbles but not many.

Not only Zhang Yang, but even several chief doctors and Dean Zhou in the office couldn't help but recall their own urine conditions in the morning.

After a moment, everyone came back to their senses and looked at each other awkwardly, with a smile on their faces.

The atmosphere in the office relaxed.

Lin Xiang also noticed the change in Zhang Yang's expression and his tone became relaxed.

"Mr. Zhang, don't worry. You're so young, there won't be any problems."

After that, he continued to explain:
"The main thing to look for in urine is the foam, because the kidneys are responsible for filtering toxins and impurities in the human body. If the kidneys function normally, the urine will basically be full of toxins and some impurities, and no other substances."

"Once the kidneys are damaged, the filtering function will decline. At this time, the protein in the body will not be filtered by the kidneys and will be excreted from the body with urine."

"Once there is protein in the urine, the protein will form bubbles due to the tension of water. Especially those dense bubbles that do not dissipate for a long time should be paid special attention to. This means that there is protein in the urine and the kidney's filtering function has problems!"

"If you seek medical attention at this time, it is very easy to control kidney disease, and it often won't get worse for more than 10 to 20 years."

"Therefore, the best way to prevent kidney disease is to do a urine routine test immediately after discovering foam. It only costs a few dozen yuan. If there is no problem with the urine routine test, then there is nothing wrong with the kidneys."

It turned out to be the case.

Zhang Yang completely understood that if his guess was correct, the last clue in the simulator should be urine.

Thinking of this, he looked at Lin Xiang with gratitude.

Director Lin not only explained to him what disease Jiang Chao had, but also gave him the last clue.

Next, you will enter the simulator and probably just need to pee to find clues to complete the copy simulation.

What would the reward be?

(End of this chapter)