Rebirth 1977 Great Era

Chapter 1340 Thyroid Cancer Neck Metastasis, Sudden Collapse (Two Chapters Combined)
As soon as I returned, patients came to my door, some even arriving from Hong Kong ahead of time for the emergency room.

I have to admit, even the dialect is something else.

He said to Gao Han on the other end of the phone:
"Okay, I'll go to the inpatient department right away. What's the patient's condition?"

"Thyroid cancer with cervical metastasis," Gao Han said into the phone.

Fang Yan's heart skipped a beat when he heard this; good heavens, they'd just increased his intensity.

"Okay, I understand." Fang Yan didn't say much more. He would know how to deal with it when the person arrived.

He has been treated for cancer before. He has been discharged from the hospital after treatment for several cancers, including a vascular tumor (see Chapter 586), an ulcerative gastric cancer (see Chapter 725), and a lung cancer (see Chapter 1097). Finally, he is still undergoing treatment for brain cancer, which is his aunt Wang Huiyuan's cancer.

He always responds to each move with a counter-strategy, dealing with whatever comes his way.

Since this overseas Chinese businessman has come to us, we can only receive him in dialect.

After hanging up the phone, Zhu Lin asked:
"What illness is it this time?"

“He was an overseas Chinese businessman who fell ill in Hong Kong with thyroid cancer that had metastasized to his neck. His condition suddenly worsened, so he made a special transfer back to come to me for treatment.”

“Thyroid cancer…” Zhu Lin paused, holding Fang Yan’s hand, her brows furrowing slightly. “Isn’t this disease quite troublesome? And it’s metastasized.” She had also studied medicine and knew the weight of the words “cancer metastasis.” Worry instantly surfaced in her eyes. Fang Yan was now Director Liao’s trump card, a special weapon to attract these overseas Chinese businessmen back to China, but he had to face this challenge every time.

This challenge is clearly very difficult.

"It's not exactly light, but it's not like we're clueless either." Fang Yan reached out and ruffled her hair, trying to keep his tone calm.

"I have treated patients with ulcerative gastric cancer and lung cancer before, all of whom were in the middle or late stages, and they all recovered quite well in the end. Thyroid cancer itself is not the most malignant, and although neck metastasis is difficult, as long as the diagnosis is accurate, the condition can always be stabilized by using traditional Chinese medicine to regulate it slowly."

He spoke calmly, but his mind was already racing:
In Traditional Chinese Medicine (TCM), thyroid cancer falls under the categories of "goiter" or "stone goiter." Neck metastasis is often related to phlegm and blood stasis, as well as deficiency of vital energy. It's crucial to first understand the patient's specific symptoms. Is the lump on the side of the neck as hard as a rock, or is it accompanied by pain and hoarseness? Are there any signs of deficiency such as hot flashes, night sweats, or sudden weight loss?
Furthermore, the size and location of the lesion need to be determined before a prescription can be formulated based on the actual situation.

"So you have to leave now?" Zhu Lin looked up at him, seeing that he had just returned and hadn't even had a chance to sit down before having to go to the hospital to take care of things. He really didn't give him a break.

Looking at her increasingly prominent belly as her due date approached, Fang Yan felt a pang of guilt. He reached out and took her hand, saying, "Yes, the patient was sent directly from the airport to Xiehe Hospital. I have to go and wait to see how things go."

He paused, then added, "I definitely won't be able to make it back for lunch to cook for you, but I'll stew chicken for you tonight when I have time."

Zhu Lin said:

"Hey, you still remember this? Go and treat your patients without worry. I'm not a child anymore."

Fang Yan nodded and added:

"If you feel tired, lie down for a while. Don't force yourself to write this article. You can write it after you have a baby. Your readers aren't waiting for you to update. If you feel unwell, immediately have Sophia call my mom or call the hospital. I can come back anytime."

"I know, stop nagging." Zhu Lin waved and urged him with a smile, "Hurry up, or the patient will be at the hospital."

Fang Yan then stood up, turned around, and walked outside.

After leaving the house, he said to Zhu Xian and Sophia:

"I have to go back to the hospital now. A patient is arriving soon, so I might not be back for lunch. You don't need to wait for me for lunch."

Sofia asked in dialect:

"Master, when should we kill the chicken?"

"We'll stew the chicken again tonight. You keep an eye on your master's wife, make sure she eats and rests well, and don't make her do any work." Fang Yan didn't stop walking, but as she reached the courtyard gate, she remembered something and turned back to call into the house, "Zhu Xian! Keep an eye on your sister for me, don't let her sit for too long!"

"I know, brother-in-law!" Zhu Xian's voice came from the main hall.

Fang Yan then opened the courtyard gate with peace of mind and walked towards Xiehe Hospital.

"Why are you back again? Did you forget something?" He Puren hadn't left yet and was chatting with Lao Tao about Huang Huijie's condition. He was also very interested in Lao Tao's treatment methods. When he saw Fang Yan return, he immediately asked him.

Fang Yan saw the two of them and said:
"Perfect timing, you shouldn't leave either. A very difficult patient is coming over in a little while, so we'll have a joint consultation."

The two were startled.

"Huh?" He Puren thought he had misheard when he heard the dialect say "high difficulty".

He had never heard Fang Yan say such a thing before, and it seemed that no matter what the problem was, it was a minor issue in his hands.

Old Tao was also somewhat surprised.

"A businessman with thyroid cancer that has metastasized to the neck, who transited through Hong Kong to return home, suddenly experienced a deterioration in his condition. His family specifically requested treatment for him." Fang Yan continued walking towards the inpatient department without stopping, quickly adding, "I just received the news at the airport. He's being sent directly to the emergency room and should arrive within half an hour."

He Puren narrowed his eyes and said in surprise, "Wow, you're serving up a real treat as soon as you get back! Thyroid cancer with cervical metastasis is no joke. If the tumor compresses the trachea or esophagus, it can be dangerous in a heartbeat."

Fang Yan said to them:

"Since you all have experience in cancer treatment, why don't you give me some advice here, and we can consult with each other?"

Both Lao Tao and He Puren nodded after hearing this.

They do have experience in this area. He Puren has treated cancer in Africa, and Lao Tao inherited this experience from his family elders.

Fang Yan was also their boss, and keeping them on was considered part of their job.

Of course I agreed.

Next, Fang Yan asked the nurse to prepare a relatively quiet ward.

There aren't many patients right now, so wards are relatively easy to arrange.

About forty minutes later, the person finally arrived.

Director Liao and Gao Han walked at the front, followed by several people whose clothes indicated they had just returned from abroad.

Fang Yan's gaze swept across their faces and found that they all seemed quite normal.

Just as Fang Yan was wondering what was going on, a man in a wheelchair appeared behind her, who looked to be in his sixties.

The man was wearing a loose, dark gray nightgown, his neck slightly tilted forward, as if weighed down by something heavy.

He was carried up the stairs by several strong men.

If this person were standing, he would be quite tall and somewhat overweight.

According to the dialect, it should weigh around 200 jin (approximately 100 kg).

"Fang Yan!" Director Liao greeted Fang Yan first.

Fang Yan immediately led He Puren and Lao Tao to greet them.

"Director Liao," Fang Yan replied to Director Liao.

"Let me introduce you. This is Mr. Sima, who has come back for medical treatment."

The compound surname is Sima?

Having treated so many patients with dialect, this is truly the first time I've encountered someone with the compound surname Sima.

“These are his family members, bodyguards, secretary, and assistants.”

He went up and shook hands with the group of people, speaking in a dialect.

"Mr. Sima, you must be tired from your journey." Fang Yan grasped the man's hand in the wheelchair. The skin his fingertips touched was warm but somewhat flimsy. The man tried to raise his hand in response, but due to his sluggish body, he only moved slightly. A muffled sound came from his throat, and the lump on the side of his neck rose and fell gently with his breathing, making a noticeable bulge at the neckline of his loose pajamas.

Fang Yan's gaze swept quickly across the man's face. His complexion was flushed but tinged with ashen paleness, fine beads of sweat glistened on his forehead, his lips were dry and cracked, and his mouth was severely distorted as he spoke, clearly indicating that the swelling was pressing on his facial nerve. He instinctively adjusted the armrest of the wheelchair, his fingertips inadvertently brushing against the man's arm. The touch was soft and lacked substantial flesh, a sign of prolonged illness that had depleted his vital energy.

“Director Fang, I’ve heard so much about you.” Mr. Sima’s wife stepped forward and handed over a medical record folder with a gold-embossed cover. Her voice was filled with barely concealed anxiety. “We’ve consulted many famous doctors abroad, but they all said that this lump can’t be eliminated. The other day, after we arrived in Hong Kong, the pain suddenly became severe at night. We couldn’t even sleep, and our breathing became increasingly labored. So we immediately transferred flights back overnight.”

Fang Yan took the medical record but didn't look at it; instead, he greeted them:

"Let's move Mr. Sima to a ward first."

The group nodded in agreement; now that they were in the hospital, they all heard the local dialect.

"Be careful, lift it slowly, don't touch the side of the neck!" The patient's wife turned to the side and directed the bodyguards. He Puren and Lao Tao kept their eyes on the patient's neck. The situation looked very serious, and they were not sure what to do at the moment.

Fang Yan is still talking with Director Liao.

"Thank you for your hard work. I just got back and I've already arranged a patient for you," Director Liao said to Fang Yan.

Fang Yan waved his hand and said to Director Liao:
"It's alright, this is my job. But his condition has probably been going on for quite a while, hasn't it?"

"Yes, my family says it's been around for quite a while," Director Liao nodded, then asked, "Are you sure about it?"

“We’ve brought everyone here, let’s take a look first. Old He and Old Tao are also here, they all have experience in treating cancer. We’ll discuss it after we’ve looked at them,” Fang Yan replied.

Upon hearing Fang Yan's answer, Director Liao nodded and said to Fang Yan:

“I’m right here, I’ll watch you treat him.”

Director Liao meant that they should handle the situation according to the local dialect, and if it wasn't handled well, he would have to activate other contingency plans.

After discussing the matter, Fang Yan returned to the ward. The patient was already lying in bed, and in the short time it took him to get into bed, he began to breathe heavily.

"What's going on?" Fang Yan asked.

The patient's wife, standing nearby, said to him:
“This is how he is now. His health has deteriorated over the past three years. He has taken a lot of medicine but it hasn’t been very effective. Now he is completely weak.”

"If he raises his hands above his head, he will immediately hold his breath and faint. He can only walk a dozen steps and then he will be panting for more than ten minutes before he can recover."

This surprised Fang Yan. How unbelievable is this?

Fang Yan opened the medical records she had previously examined. The most recent one was from Hong Kong Hospital, and there were also several medical records from overseas hospitals.

There was a pile of medical reports. The most conspicuous one was a private isotope scan, which confirmed thyroid cancer with cervical metastasis. The mass above his thyroid cartilage was the size of an apricot, the mass below it was the size of a ping-pong ball, and there was also a mass the size of a goose egg on the right side of his neck, which was uneven.

His report also stated that he had widespread lipomas on his chest and limbs.

Moreover, it was confirmed before treatment that he had bronchitis for thirty years.

After undergoing radiotherapy abroad, I experienced deafness and hearing loss, which persisted even after I moved to Hong Kong. Now, I can hear a little bit again.

However, I started experiencing a burning sensation in my chest and stomach.

There was blood in the snot from my nose.

Concurrent severe right-sided migraine.

Fang Yan sensed that this patient had quite a few ailments, and he said to the patient:
"Could you take off your clothes so we can see your body?"

While speaking in dialect and gesturing at him, the patient was clearly in a stage where one of his hearing was not working well. In the end, the patient's wife had to lean close to his ear and shout loudly before the patient understood what the dialect meant.

Mr. Sima struggled to lift his arm, and several bodyguards rushed forward to help, carefully unbuttoning his pajamas. The moment the clothes slipped off, Fang Yan, He Puren, and Lao Tao's expressions all turned serious. His chest, abdomen, and limbs were covered with lipomas of varying sizes, some as large as roasted chestnuts and others as small as broad beans.

These lipomas, some scattered and some clustered, had a pale bluish tinge on the skin. When pressed gently, the hard nodules under the skin could be felt sliding, but they would return to their original shape when the pressure was released. The three lumps on the side of the neck were even more menacing: the apricot-sized lump above the thyroid cartilage was firmly attached to the Adam's apple, as hard as a piece of cast iron. When pressed, Mr. Sima shuddered in pain and let out a muffled cry of pain; the ping-pong ball-sized lump below had slightly softer edges, but a distinct bumpy texture could be felt; the most troublesome was the egg-sized lump on the right side, which not only stretched the skin on the side of the neck until it shone, but also extended down to the collarbone, merging with the surrounding lipomas. It was immovable, and its edges had long since adhered to the muscle.

They then began asking about the patient's medical history, speaking in dialect.

The patient's wife spoke in dialect:

"He got sick from smoking. He started smoking a long time ago, at least forty years ago. Even after he got sick, he still smoked two packs a day."

"And he also likes to eat cold things, ice cream, cold drinks, chilled fruit, he has to eat his fill every day to be satisfied."

Fang Yan nodded and asked the patient's wife:
When exactly did the illness begin?

“It was probably five years ago.” The patient’s wife frowned, trying hard to recall the details, her voice filled with regret. “At that time, he had a small lump on his neck, about the size of a soybean. It didn’t hurt or itch, and he didn’t take it seriously, saying it was just a ‘hideout from being inflamed.’ We were abroad at the time, and we found a family doctor to see him. The doctor said it was a benign lipoma, prescribed some anti-inflammatory ointment, and sent him back home.”

She reached up and wiped her eyes, her tone becoming more somber: "Later, the lump slowly grew, getting bigger year by year. Three years ago, it grew to the size of a pigeon egg, and that's when he started to feel something was wrong. His voice became hoarse, and he had difficulty eating hard foods. When he went for another checkup, he was diagnosed with thyroid cancer, which had already metastasized to the cervical lymph nodes."

“In the past five years, I’ve never stopped receiving treatment.” She counted on her fingers, “First, I had my first surgery in Europe, where they removed my thyroid gland and nearby lymph nodes. But less than six months later, a new lump grew on the other side of my neck. Then I switched to targeted therapy, but after three months, I developed rashes all over my body, and even my eyes were so swollen that I couldn’t open them, so I had to stop. Then I went for radiation therapy, and after the radiation therapy, I went deaf. The lump did shrink a bit, but less than two months after I stopped, it grew back even faster, and I also developed migraines and bloody nasal discharge…”

Mr. Sima lay on the hospital bed, listening to his wife's words. His cloudy eyes were bloodshot. He opened his mouth, wanting to speak, but could only make muffled "ooh" sounds. The lump on the side of his neck rose and fell gently with his rapid breathing, making the hair on one's body stand on end.

“His health deteriorated very quickly after the radiotherapy.” His wife’s voice was choked with tears. “He used to be able to walk on his own, but now he has to be out of breath after walking only a dozen steps. Last month, he tried to raise his hands above his head, and he fainted as soon as he did. The doctor said it was caused by the tumor pressing on his trachea, coupled with his poor lung function.”

She pointed to the lipoma on Mr. Sima's chest: "These lumps also appeared after radiotherapy. There were two on his chest at first, and now they are all over his limbs, waist and abdomen. The doctor said it is related to low immunity, but there is no good way to treat it."

Fang Yan listened while quickly jotting down notes in the medical record book; the sound of the pen gliding across the paper was exceptionally clear in the quiet ward.

At this moment, He Puren asked the patient's wife:
What is his personality like normally?

The patient's wife was taken aback, not expecting that a traditional Chinese medicine practitioner would ask about personality, but after a pause, she replied:

"He has a terrible temper and a very strong personality. He gets angry when things don't go his way."

He Puren glanced at Fang Yan, who had already written down the questions he had asked: excessive smoking, burning his lungs, irritability, and stagnation of qi.

If no other conditions trigger this situation, then it is the original pathogenesis, which is called phlegm and qi obstruction. Over time, it transforms into fire and toxins, accumulating in the throat.

Of course, this is only a preliminary assessment.

Fang Yan then came to the patient's side and began to take his pulse.

At the same time, He Puren also took pulses on the other side.

Old Tao stood still, looking at the treatment file that Fang Yan had handed him.

Hmm... it's all in foreign languages, I didn't understand a single word.

Finally, he went to the patient's feet, touched the soles of his feet, paused slightly, and then touched his feet all the way up to his knees. After touching both legs, he said to Fang Yan:

"Hey, that's strange, his feet are cold. He's been sick lately and has been experiencing fever, so why are his feet cold?"

The pulse that Fang Yan felt at this moment was deep, slippery, and firm.

He said:
"It should be due to severe deficiency of kidney yin, where yin fails to embrace yang, causing the fire of dragon and thunder to burn upwards."

Hearing the dialect spoken, the patient's wife, looking completely bewildered, asked:

"what are you guys saying?"

Fang Yan said to him:
“When we talk about severe kidney yin deficiency, it’s like the water in your field has completely dried up. The kidney is the body’s water organ, responsible for storing yin, which is like the water that nourishes the body. Your husband has been smoking for over forty years, and the smoke has depleted the fluids in his lungs; he has also been eating raw and cold foods for years, which has damaged his spleen and stomach’s ability to transform and transport fluids; in addition, the chemotherapy and radiotherapy have almost depleted the little water left in his body. This is severe kidney yin deficiency.”

After speaking in dialect, she paused and asked him:
Do you understand what I'm saying?

The family members nodded.

He pointed to the lump on Mr. Sima's neck and continued:

"As for yin not embracing yang, it means there is no water in the ground, so it cannot retain heat. The yang energy that should be warming and nourishing the internal organs in the lower jiao rises up like a rootless flame. This rising false fire is called 'dragon thunder fire'. It is not that there is actually excess heat in the body, but that there is too little water to suppress the fire."

“You can see the match in his symptoms.” Fang Yan explained one by one, “The fire rises, burning his chest and stomach, and hardening the stagnant blood in his meridians. That’s why the lump on the side of his neck is hard and painful, his migraines are severe, and there’s even blood in his nasal discharge. All of this is because the deficiency fire has damaged the meridians above. But what about below? Because the ‘water’ and ‘yang qi’ are not protected, the lower abdomen is cold and deficient, which is why his feet and legs are cold. This is the root of ‘heat above and cold below’.”

He Puren added from the side, speaking in a more colloquial tone: "Simply put, he's not really suffering from internal heat; it's a false heat caused by his body being too dry. It's like a woodshed in winter. When the firewood is almost burned out, sparks will fly out, but the woodshed itself is cold. If you give him cold medicine for ordinary internal heat, it's like pouring cold water on a dying ember. The embers will go out completely, and the person will collapse."

Upon hearing this, the patient's wife immediately became somewhat nervous.

"Don't be nervous. Since we can tell it's a false fever, we will never use the wrong medicine," Fang Yan quickly reassured her when he saw her pale face.

As soon as he finished speaking, he noticed that the patient was sweating, and he didn't know if it was from nervousness or some other reason, and he was also a little out of breath.

Just moments ago, only sweat was seeping from his forehead, but in a short while, cold sweat was streaming down his temples and soaking the pillowcase behind his ears.

His breathing was no longer rapid, but shallow and weak. Each inhale was like pulling a broken bellows. His chest rose and fell so weakly that it was almost invisible. His lips also changed from dry, cracked pale pink to a bluish-purple.

"Something's not right!" He Puren also realized the problem.

Fang Yan then placed his finger on Mr. Sima's carotid artery. At this moment, the pulse was beating rapidly and weakly, flickering like a candle in the wind, which was a sign of deficiency of both Qi and Yin, and a risk of collapse.

He said in dialect:

"He's not nervous, he's just losing his vital energy! Radiotherapy depletes his energy and damages his yin, and moving his body just now further depleted his vital energy. Now he has internal heat rising and coldness in his lower abdomen, and his energy can't keep up!"

He Puren also tensed up instantly, reached out and pressed on Mr. Sima's philtrum, pinching hard with his fingertips, and Fang Yan immediately took out a needle.

The patient's wife was so frightened that her legs went weak. She asked Fang Yan in a trembling voice, "Director Fang, what's wrong with him? Is he dying?"

"Don't panic! This is a sign of impending collapse of vital energy. Stay calm!" Fang Yan reassured him while quickly locating the spot on Mr. Sima's chest. At the same time, he said to Lao Tao, "Please hold his shoulders down and keep him still!" He took out the Tiangong Needle and, with swift movements of his fingers, inserted the needle into Mr. Sima's "Shanzhong" acupoint. This is a point where qi converges, which can quickly regulate qi and relieve shortness of breath.

Then, Fang Yan said to He Puren:
"Old He prescribed a decoction to nourish yin and restrain yang, and to guide the fire back to its source. Have the pharmacy staff prepare it for you."

PS: The basic chapter of 6000 words has been updated.

(End of this chapter)