Rebirth 1977 Great Era

Chapter 1316 Half of the face is crooked, how to distinguish between facial paralysis and cerebral infarction (Bonus chapter for monthly votes)
"Alright then, I'll go take care of the patient first. You guys go find a fishing spot first, it'll be hard to find a place when there are a lot of people later," Fang Yan said to Lao Hu and the others.

Upon hearing the dialect, Lao Hu immediately said:

"No need, no need, we'll go with you. There aren't many people inside right now."

Director Chen also said:

"That's right, we came out with you, so of course we should stay together."

The eldest brother-in-law nodded in agreement, and Anton, of course, agreed even more.

Old Cui follows Old Hu; wherever Old Hu goes, he goes too.

Fang Yan turned to Old Chen and said:
“Alright, Uncle Chen, where is the patient? Let’s go take a look together.”

"Come on, it's just ahead." Old Chen pointed to a pavilion in front of Fang Yan.

"Not at home?" Fang Yan asked.

Old Chen waved his hand:

"No, this guy doesn't care at all. He says he'll be fine soon. We old brothers tried to persuade him, but we couldn't. Luckily, I met you here."

"I didn't expect you to be fishing. I've been fishing here for the past few days and I've never run into you."

He said in dialect:

"This is our first time here today... Alright, let's not talk about fishing anymore. Let's make this clear: if he doesn't cooperate later, there's nothing I can do."

Upon hearing the dialect, Old Chen said:
"No way! If he dares to waste another word on you, I'll slap him across the face!"

Soon, the group followed Old Chen to the pavilion.

As soon as we entered the pavilion, we saw an old man in a gray cloth jacket sitting on a stone bench. He had his back to us, his head tilted to one side, his right hand resting on his knee, and his fingers slightly curled.

Hearing footsteps, the old man slowly turned his head. Fang Yan immediately noticed that the left side of his face was droopy, his left eye couldn't close, his mouth was crooked to the right, and the nasolabial folds on his left side were so shallow they were almost invisible. When he spoke, he couldn't muster any strength from the left corner of his mouth, and his voice was muffled: "Old Chen, why did you bring so many people..."

Grandpa Chen strode over and patted him on the shoulder: "Old Wang, stop talking nonsense! I've found Doctor Fang for you, let him take a look at you!"

Old Wang, however, was unimpressed and waved his hand, saying, "What are you looking at? It's just facial paralysis! I had it once when I was young, a couple of acupuncture needles and I was fine. I was all better in a couple of days."

Among the several elderly men accompanying him, one of them chimed in, "Yes, doctor, Old Wang's symptoms are exactly the same as facial paralysis. People in our area have had this before, and they recovered after a few days of rest."

Fang Yan didn't reply. Instead, he walked over to Old Wang and squatted down, raising his chin slightly. "Grandpa, please look up." Old Wang reluctantly raised his head. His left eye was noticeably slower than his right, and the wrinkles at the corners of his eyes were only on the right side, while the skin on his left side was taut.

The dialect made him grin again. Old Wang tugged at the corners of his mouth, and while the right corner of his mouth could lift, the left side remained completely still, and even his left cheekbone didn't twitch at all.

"Raise your left hand a little higher, to shoulder height," Fang Yan gestured. Old Wang tried to raise his left hand, but his arm wobbled as soon as it left his knee, then fell back down as if it had lost its strength, a hint of impatience on his face.

"You doctor, why are you examining my arm when you're asking about facial paralysis?"

"Old Wang, straighten up your attitude! Doctor Fang is treating you out of respect for me, so stop your nagging!" Old Chen said to Old Wang.

After saying this, he spoke in dialect:

"Dr. Fang, could you check his pulse?"

Fang Yan looked at Old Wang carefully and said, "No need to check his pulse. It's not facial paralysis, it's a cerebral infarction. We need to get him to the hospital for medication right away."

The moment those words were spoken, the pavilion fell silent. Old Wang stared wide-eyed: "Don't talk nonsense! I just have facial paralysis, how could it be a stroke?"

Grandpa Chen also got anxious: "Dr. Fang, please take a closer look. Shouldn't someone with a cerebral infarction faint? Old Wang can still sit and talk!"

Fang Yan pointed to Old Wang's face and patiently explained:

"The most accurate way to distinguish between facial paralysis and cerebral infarction is by looking at wrinkles. In ordinary facial paralysis, no matter which side of the face is distorted, the wrinkles on the forehead are still there because facial paralysis does not control the muscles above the forehead; but cerebral infarction is different. A cerebral infarction is caused by a blockage of blood vessels in the brain, which will affect the control of the entire half of the face. You can see that there are no wrinkles on his left forehead, and he can't even raise his eyebrows. This is a sign of cerebral infarction."

As he spoke, Fang Yan asked Old Wang to extend his left hand, and pressed his left wrist with his fingers: "Try shaking my hand again." Old Wang squeezed hard, but Fang Yan didn't feel much strength. Looking at his left hand, the fingers were still a bit curled, unlike his right hand which could straighten. "Tell me again, when you woke up this morning, did you feel your left side was heavy? You almost dropped things when you tried to pick them up?"

Old Wang was stunned for a moment, a hint of panic in his eyes: "How did you know... I thought it was because I didn't sleep well last night, so I didn't take it seriously."

“Hey, stop talking nonsense, this is a warning sign of a stroke,” Fang Yan said.

Seeing that the old man still didn't believe him, Fang Yan was speechless. It was true that doctors shouldn't be stingy; after all, it was a life at stake. His tone became serious as he said, "A stroke doesn't necessarily cause fainting in the early stages. Many people experience weakness in their limbs, facial drooping, and slurred speech. If it's delayed, and the blood vessels remain blocked for a long time, the left side of the body might become paralyzed, and in severe cases, it can even affect breathing. When you had facial paralysis in your youth, you certainly didn't experience weakness in your limbs, right?"

Hearing this from the dialect, Old Wang lost his previous toughness, and his voice softened:

"No... At that time, my face was crooked, but my hands and feet were fine."

The old man next to me asked:
"What should we do, Dr. Fang? Which hospital should we take them to?"

"Get him to Xiehe Hospital quickly, it's close by. Don't move around on the way, it's best if he lies down." Fang Yan turned to An Dong and said, "An Dong, drive the car over here, take Grandpa Wang to the hospital first, I'll go with you, and give him some basic first aid on the way." An Dong quickly nodded: "Okay, Master, I'll go drive it over right away!"

Old Hu said to his bodyguard, Old Cui, "Go carry Grandpa Wang on your back."

Old Cui immediately stepped forward and carried Old Wang on his back.

Grandpa Chen patted Old Wang on the back, both angry and anxious:
"Look at you! I told you to go to the hospital, but you wouldn't go. You insisted on fishing here. If it weren't for Dr. Fang, you'd almost be dead!"

Old Wang didn't object and let Cui Changshou carry him.

The brother-in-law watched nervously from the side and whispered a question in Fangyan:

"Is it dangerous?"

Nodding in dialect:

"The worst thing about cerebral infarction is delay. The golden rescue time is only a few hours. If you get to the hospital early and the blood vessels are opened, there will be fewer sequelae."

"It gets worse as time goes on."

After a while, everyone came to the car. There were two cars in total. Fang Yan put Old Wang in the back seat and sat sideways in the back seat so that Old Wang could lie down. Then he asked some people to stay here and call Old Wang's family. Then he and An Dong drove to Xiehe together in the car.

As soon as the car left the alleyway of Shichahai, Fang Yan told An Dong to keep the speed below 40 miles per hour to avoid bumps as much as possible. He placed his right hand on the old man's left wrist and began to take his pulse.

Fang Yan didn't reply immediately. He felt the strength of the pulse with his fingertips. The pulse was deep and thin, not beating fast, but each beat seemed sluggish, like water encountering an obstacle, stumbling and bumping.

Then he switched to his right wrist, where the pulse was slightly stronger than in his left, but it still had the same sluggish feeling.

Old Chen, in the passenger seat, asked Fang Yan:

"Dr. Fang, how is his pulse?"

"This is the pulse of qi stagnation and blood stasis." Fang Yan withdrew his hand, then lifted Old Wang's eyelids to look at the whites of his eyes. He saw faint red blood vessels on the whites of his eyes, and then touched his forehead. The temperature was normal.

Then he said:

"This stroke is not the kind of acute blood vessel rupture; it's a slow blockage of the blood vessel, which is called an 'ischemic stroke.' It's like this: normally there's nothing wrong, but recently, as the weather has turned cold, the blood vessels constrict and become blocked, which is why symptoms like facial drooping and weakness in the hands and feet have appeared."

Old Chen complained to Old Wang:
"Oh dear, look at you! I told you so! You wouldn't believe me. Luckily you were lucky to have met Doctor Fang!"

At this moment, Anton, who was driving, asked:

"Master, would your Astragalus membranaceus vine be suitable for this situation?"

Fang Yan shook his head upon hearing this:

"The idea behind Astragalus and Cordyceps Decoction is correct, but it's not the right time to use it now."

"This prescription is for 'tonifying qi and blood, clearing the channels and dispersing stagnation.' Insect-based medicines have strong penetrating power. Now that we are in the acute phase and the blood vessels have just been blocked, we need to stabilize the situation first. It would be appropriate to use this to treat the sequelae after the hospital stabilizes the condition with other medications. Otherwise, it may easily disturb the qi and blood."

As he spoke, he moved closer to Old Wang, making sure the old man remained lying down and didn't move. He first pressed his right thumb on the "Hegu" acupoint on the web between the thumb and index finger of Old Wang's left hand, gradually increasing the pressure.
"Just bear with it, a little soreness is normal."

As he spoke, he pressed with his fingertips while gently rotating and kneading, saying:
"This acupoint can unblock the meridians and regulate qi and blood."

Old Wang initially frowned, but after a while his brows relaxed a bit, and he mumbled:
"Hmm...it is a little sour."

As he spoke in dialect, he moved his hand to the "Neiguan" acupoint on the inside of Old Wang's right wrist, pressing his thumb against the skin: "This acupoint governs the Qi in the chest. You just said you felt tightness in your chest, pressing it can help regulate your Qi." While massaging, he explained to Anton, "The most important thing now is to 'gradually unblock' the flow. We can't use strong medicine. We need to regulate the Qi through acupoints first. Later, we'll go to the hospital for thrombolysis with Western medicine. It's safer to combine traditional Chinese and Western medicine."

Old Chen, sitting in the passenger seat, turned around and couldn't help but ask, "Dr. Fang, are these acupoints really that effective?"

"This is enough for an emergency, and it can help buy some time." Fang Yan didn't stop, and moved to Old Wang's ankle, found the Taichong acupoint and gently pressed it. "This acupoint can soothe the liver and regulate qi. When the qi is smooth, the blood will not be blocked. You can see that there are light blood vessels on the whites of his eyes, which means that his liver qi is a little stagnant. Pressing here can relieve it."

After pressing the three acupoints, Fang Yan helped Old Wang move his right hand fingers. Seeing that his right hand could bend flexibly, he said with relief:

"Don't think about anything else right now. Just lie down and conserve your energy. We can get things taken care of quickly at the hospital. Once you can get out of bed in a couple of days, I'll adjust your prescription. I'll use Astragalus and Cordyceps Decoction with a few spleen-strengthening herbs to help replenish your qi and blood. Your strength on the left side will gradually recover."

Before they knew it, the car had arrived at Peking Union Medical College Hospital. Fang Yan told An Dong to park the car at the outpatient building and wait for him. After getting out of the car, he went straight to the pharmacy, wrote a prescription for them, and then asked them to prepare the medicine and send it to the inpatient building as soon as possible.

The doctor on duty at the traditional Chinese medicine pharmacy immediately agreed.

Fang Yan then took a box of their company's Tongluo powder and a cup of warm water, and ran back to the car to give it to Old Wang.

As soon as he swallowed it, Old Wang vomited with a "whoosh".

PS: I've gained another 100 monthly votes, so I still owe you 1000 words after finishing this chapter.

(End of this chapter)