This miracle doctor just wants to be fired!

Murphy's Law is always true: the more you worry about something, the more likely it is to happen.

Less than a week after being transferred to the respiratory department, the elderly patient experienced profuse sweating and a sharp drop in blood oxygen levels again without any warning. He was intubated for the third time and admitted to the ICU.

This recurring respiratory failure left all the doctors deeply perplexed.

No matter how many tests were conducted, the specific cause of the illness could not be found. The only option was to carry out emergency rescues time and time again, subjecting the elderly person to the pain of tracheal intubation.

In order to find the root cause of the illness, the respiratory team conducted a comprehensive examination on the elderly patient and even improved sleep breathing monitoring. The results showed that the elderly patient had severe sleep apnea.

Doctors speculate that the elderly man's respiratory failure may be related to sleep apnea.

Therefore, it is recommended that the elderly wear a non-invasive ventilator while sleeping to assist breathing and prevent sleep apnea.

This trick seems to have really worked.

In the two months after wearing a non-invasive ventilator, the elderly man miraculously did not experience respiratory failure again, and his mental state improved significantly. He was able to eat and rest normally, and his family thought they had finally found the "culprit".

Life seemed to be back on track, and everyone breathed a sigh of relief, thinking that this long ordeal was finally coming to an end.

But they didn't expect that this was only a temporary period of calm.

In the third month after being discharged from the hospital, the elderly man experienced a similar situation again while eating steamed buns.

Without any warning, the elderly man suddenly had difficulty breathing, fell into a coma, and was intubated.

This happened several more times, and the local hospital was at its wits' end.

Including the illness that occurred on New Year's Eve, this is the seventh time in a row!

……

Looking at the patient on the emergency bed, Zhou Cheng fell into deep thought.

This disease is so strange!

What kind of disease can cause acute respiratory failure without warning, to the point that emergency intubation is required and life is sustained by a ventilator?

However, once the tube is removed, the patient can recover quickly, with respiratory function and even limb movement returning to almost full capacity!

It was as if that life-threatening danger had never happened.

This sudden onset and cessation of symptoms is extremely rare in clinical practice!

"Could it be myasthenia gravis?"

Zhou Cheng's first thought was this common neuromuscular junction disease, which often manifests as muscle weakness and, in severe cases, may also affect the respiratory muscles and cause respiratory failure.

But Zhou Cheng quickly ruled out this possibility.

Zhou Cheng saw the old man's past medical records that the middle-aged man had brought over.

Myasthenia gravis usually worsens gradually, starting with localized muscle weakness and spreading throughout the body. Symptoms tend to worsen after exertion and improve with rest, exhibiting a clear disease progression.

The patient's illness occurred without any warning, a typical case of "sudden onset and sudden cessation".

More importantly, the other hospital had already conducted antibody tests for myasthenia gravis, and the results were all negative.

This completely ruled out the possibility of myasthenia gravis from the perspective of laboratory tests.

"Is it hysteria?" Zhou Cheng wondered again.

Could the physical symptoms be caused by the patient's own psychological factors?

But Zhou Cheng dismissed this idea as soon as it crossed his mind.

The physical symptoms caused by hysteria are mostly functional. Although they may manifest as difficulty breathing, they will never be so severe as to require multiple tracheal intubations or reach the point of near death. Nor will they present with the life-threatening signs of respiratory failure that patients often exhibit.

Such symptoms, which can truly push a person to the brink of life and death, could never be caused by hysteria!

"And then there's... ALS?"

ALS, or amyotrophic lateral sclerosis, is a disease caused by limb sclerosis.

Zhou Cheng did not draw any conclusions about the disease, but instead re-examined the typical course of ALS.

ALS that begins with respiratory muscle involvement does exist. These patients may experience respiratory weakness in the early stages, which can lead to respiratory failure.

This is similar to the symptoms experienced by the elderly.

However, ALS is a progressive and irreversible neurodegenerative disease!

Once the disease develops, the symptoms will continue to worsen, and the muscles will gradually atrophy and become weak.

Even if it is temporarily relieved, it is impossible to return to a completely normal state.

The elderly man was able to move freely each time his endotracheal tube was removed, and his limb muscle strength was completely normal, with no signs of atrophy or weakness. This is completely inconsistent with the characteristics of ALS, so it can be ruled out.

……

Zhou Cheng brainstormed for a while, but had no clue whatsoever, so he gave up.

The elderly man was not a local; he had come to Beijing to spend the Lunar New Year with his son, but unexpectedly, he fell ill again on New Year's Eve.

"Dr. Zhou, we'll observe you tonight. If there are no problems tomorrow, we'll be discharged."

Although the patient's condition was urgent, the family had faced it many times before and had even become accustomed to it.

With timely intubation and the use of a non-invasive ventilator, the patient can be lively and energetic again the next day.

Zhou Cheng wanted to let the patient stay for a few days so that he could have a good chance to investigate the cause of the illness, but it was the Lunar New Year, and it wouldn't be appropriate to leave the patient in the hospital.

"Dr. Zhou, although my father has never been to your hospital before, I have taken him to Shanghai and Beijing to see very famous professors..."

The family's response was quite polite, but the unspoken message was that they still didn't quite trust Jinghua Hospital, a small hospital.

After all, the medical resources of hospitals in Kyoto and Shanghai far surpass those of the small city of Beijing.

Zhou Cheng did not continue to persuade him, but simply told him, as usual, that the patient's condition was critical and that unpredictable adverse events such as a drop in blood oxygen could occur at any time.

……

By the time we finished dealing with the elderly man, it was already past 2 a.m.

The Spring Festival Gala had long ended. Zhou Cheng returned to the small lounge, finished the rest of his milk tea, and then watched some videos.

However, he didn't feel sleepy at all during the long night, perhaps because of the milk tea he drank.

Since I can't sleep, I'll find something to do.

Zhou Cheng thought of the old man from earlier again.

If you're bored, why not spend some time studying this interesting case?

Zhou Cheng arrived outside the emergency room and asked the patient's family for all of the elderly man's medical records from the past eight years.

Although the patient's family wanted to be discharged the next day and did not want to stay at Jinghua Hospital to investigate the cause of the illness, they did not refuse the attending physician's request. Instead, they packed up the patient's previous medical records and sent them to Zhou Cheng.

The package contains all of the patient's past medical records, examination reports, test results, and records of all treatments at different hospitals.

Having obtained the patient's firsthand information, Zhou Cheng returned to the small rest room and began another brainstorming session.