Blood's relationship to the body is very much like gasoline to a car.
Without gasoline, cars lose their power source. When blood circulation in the body is compromised, nutrients and oxygen can't reach the body's cells.
Paralysis often accompanies issues with blood supply.
For instance, patients with hemiplegia feel especially cold on the paralyzed side, experience poor blood circulation, numbness, and so on.
"Her lower limbs' blood supply hasn't been severely affected!"
Director Yin stated confidently.
If so many renowned doctors have examined her and couldn't identify such a simple issue, wouldn't that discredit those renowned doctors?
"No, no, no, I'm referring not to the circulation in the lower limbs, but in the upper limbs."
Zhou Can's eyes were resolute, emitting a light of excitement for seeking the truth.
"Upper limb blood supply has issues?"
Director Yin frowned. If he hadn't witnessed Zhou Can's capabilities, he would likely have scolded, "You need a few more years of study!" and then turned and left.
At this moment, however, he maintained great patience and even harbored a hint of anticipation.
This challenging case was one he couldn't solve three years ago, and to this day, he still couldn't make a definitive diagnosis.
The more challenging it was, the more it intrigued him.
Because at his level, cases of ordinary difficulty no longer posed any challenge.
"Patients with paralysis naturally experience insufficient blood supply due to muscle atrophy, especially at the extremities. Frankly, I've shaken hands with the patient, and her hand was very cold, which indicates definitely there's an issue with her upper limbs' blood supply. Initially, I was merely curious. After hearing your point just now, I gained some inspiration."
"Since her electrocardiogram showed no major abnormalities, it indicates that her overall blood supply should be relatively balanced. So I suspect she developed a systemic insufficiency in blood supply after damage to her motor neurons."
Zhou Can boldly made a series of inferences and diagnoses.
"Indeed, there's such a possibility. However, this doesn't explain much as paralysis patients commonly exhibit a weaker-than-normal blood supply."
Director Yin Hua wasn't very impressed with Zhou Can's discovery.
Even a bit disappointed.
Weaker overall blood supply is a common phenomenon among most paralysis patients.
In terms of traditional Chinese medicine, this would be discussed as a deficiency in qi and blood.
"I've reviewed the patient's causes of miscarriage from that year. According to her statement, she first lifted a heavy object upstairs, then felt unwell, and finally fainted at home. However, the hospital's diagnostic opinion at admission was a viral infection? Neurological abnormality?"
Zhou Can opened a diagnostic report from her first hospital admission.
This was a very basic medical record.
At that time, after she fainted, she was taken by the 120 ambulance to the city's Third Hospital following the nearest emergency care principle.
After the miscarriage led to lower limb paralysis, the Third Hospital couldn't identify the cause, prompting her family to transfer her to the higher-caliber Provincial People's Hospital. Later, when the Provincial People's Hospital also failed to diagnose her, the patient fell into severe depression.
Her family then transferred her to Tuya Hospital for further diagnosis.
Many patients undergo such experiences, initially thinking it's a minor illness, becoming ineffective after treatment in a general hospital, and ultimately having to be transferred step-by-step to higher-level hospitals.
Three years ago, the Provincial People's Hospital was almost on par with Tuya, even slightly better.
Now, Tuya Hospital has left it behind.
Becoming the leading hospital in the province in terms of medical standards and diagnostic capabilities.
"Do you think the patient might have already shown symptoms of lower limb paralysis before admission?" Zhou Can made another bold speculation.
"It's not very likely. Before admission, the examining doctor would surely have conducted a series of tests. The Third Hospital's medical standards and diagnostic capabilities are not poor, and their medical quality control is always very strict. If the patient had shown signs of lower limb paralysis then, it would definitely be mentioned in the admission records. Yet, they explicitly wrote 'post-miscarriage paralysis' in the medical records."
Director Yin was well aware of the strengths and medical ethics of hospitals in the city.
At his level, he would often be invited to various hospitals for exchanges, guidance, or lectures.
After interactions with doctors at those hospitals, he naturally had the opportunity to understand each hospital.
"Could it be that the symptoms of lower limb paralysis were not prominent upon admission, thus overlooked? The 120 emergency reception record mentioned that the pregnant woman fainted in the bathroom at home."
Zhou Can persistently upheld this determination.
"This scenario is possible."
Director Yin agreed with Zhou Can's view this time.
"It's a pity that the Third Hospital lacked high-level doctors who could handle the situation; it would have been good to perform an electromyography test on this patient at that time."
If an electromyography test had been done when the pregnant woman was admitted, it could have provided solid evidence for later diagnostics.
Now, more than three years later, performing a test that wasn't done initially means the significance is profoundly different.
"Director Yin, please look at these few examination reports. These are the electromyography tests done by Imperial Renhe Hospital, and just yesterday I specifically compared it to many normal people's electromyography reports. Qiu Jie's nerve conduction speed is not slow, only the signal strength of the electromyography from the neck down keeps decreasing. It's like climbing a slope; the closer it gets to the limbs, the weaker it becomes."
"Then her evoked potential electromyography and motor unit count tests also showed no significant abnormalities."
Zhou Can pointed these out, but Director Yin had already noticed.