Paralysed bedridden or high risk surgery, how should an 85 year old grandmother and her family choos

Mondo Finance Updated on 2024-01-30

Historically, older patients, especially those with serious chronic diseases, have been at high risk for surgery. But sometimes, risks and illness** can put families and doctors in a dilemma.

It all goes back a year. At that time, Grandma Li (pseudonym), who lives in Inner Mongolia, inexplicably began to experience numbness, weakness and pain in both legs, and the condition of her right leg was even worse. Six months ago, 85-year-old Grandma Li's condition gradually worsened, and the numbness gradually spread to the chest down, and she could not even pass urine and urine, which became extremely difficult.

The family couldn't bear to see the old man being tortured like this, and they also took Grandma Li to a local hospital in Inner Mongolia for diagnosis and treatment, but due to the high risk of surgery, they did not take corresponding measures. After checking on the Internet, it was learned that Beijing Temple of Heaven Puhua Hospital has rich experience in neurology, and in order to make Grandma Li get better, the family decided to go to Beijing.

Dr. Xu Qiang, Department of Neurosurgery, Tiantan Puhua Hospital, after a preliminary diagnosis and imaging analysis, found that Grandma Li had a spinal cord mass lesion, and her nerve function was severely impaired, and the tumor compressed the spinal cord, which would lead to limb weakness and inability to urinate normally. If left untreated, the patient's ability to walk and urinate will be completely lost. If surgery, faceHigh-risk conditions such as advanced age, hypertension, heart failure, and the installation of pacemakers can lead to cardiac arrestThe second is the appearance of the lungs after surgeryInfection, hypertension, heart failure, arrhythmias, incision infection, poor wound healing, and other consequences. However, if the surgery is successful, it is possible for the patient to regain standing and walking and regain the ability to take care of themselves.

In this dilemma, Dr. Xu Qiang and his family repeatedly communicated and weighed the pros and cons. After many discussions, the family finally decided to undergo surgery**, fully understood the risks of the operation, and signed the consent form.

At this time, the pressure shifted from whether the family agreed to the operation to the neurosurgery team of Tiantan Puhua Hospital"We must not live up to the trust and understanding of patients and their families, and do our best to avoid adverse events" has become a severe test for the Shenwai team。In order to ensure the safety of the operation, they took corresponding measures: first, the department reported to the medical department to organize a consultation with experts in the hospital, comprehensively analyzed the perioperative situation and implemented the solutions one by one;After that, consult a cardiologist to further improve the examinations and adjust the physical condition to the best stateFinally, make a surgical plan, arrange the connection between surgery and postoperative management, and closely monitor the patient's vital signs and clinical symptoms.

After many preoperative discussions, the Department of Neurosurgery of Tiantan Puhua Hospital invited Wu Hao, director of the Department of Neurosurgery of Beijing Xuanwu Hospital, to perform surgery on Grandma Li. The operation was carried out as scheduled, anesthesia, surgical field exposure, tumor resection, anatomical reduction and incision suturing were successfully completed, and the operation time was shortened from the usual three hours to two hours. After the operation, Grandma Li was sent to the recovery room for continued monitoring**, and the tumor tissue was also sent for pathological examination.

After the operation, Grandma Li's lower limb muscle strength was restored, and the Shenwai team also formulated a comprehensive postoperative recovery plan for her, including blood pressure, breathing and blood oxygen saturation monitoring, prevention of infection, hemostasis, acid suppression, dehydration, prevention of epilepsy, etc.**, follow-up bedside** and acupuncture**, and closely observed the changes in the condition.

At this time, the doctor also sent good news to Grandma Li and her family - the removed tumor specimen was tested and found to be benign. Dr. Xu Qiang, a neurosurgeon, told the family, "The risks you took have finally paid off."

By the time she was discharged from the hospital, Grandma Li had gone from being able to lift her right leg in bed to going to the toilet normally, and then to being able to stand and walk again with the support of her family, basically returning to a normal life。In order to express their gratitude, the family members sent pennants when they were discharged from the hospital.

Seeing Grandma Li getting better day by day, we believe that this is the greatest significance and value of this "difficult" operation. Even though they are old and sick, they still need to live with dignity, instead of being paralyzed in bed and cared for day and night.

Trust and understanding between doctors and patients are the key to clinical efficacy, and the patient's best is the common wish of the family and the doctor. Give the doctor a trust, the doctor will give you a blue sky!

This article is only for popular science, not as a basis for diagnosis and treatment, please follow the doctor's advice for personal conditions.

This article *** Baotu.com.

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