Chapter 1467 Gretel: This Headache Is Giving Me a Headache! (Planet Watcher Leader Adds 1 Update)

Since it is not caused by high blood pressure, we need to find another reason. While Gretel was writing down his medical history, he chatted casually with the old dwarf, and the two middle-aged dwarfs also added to his information.

As we chatted, we found out that the old dwarf had married four wives since he was married at the age of 15, and had given birth to twelve children to him.

Sons and daughters, there are more than thirty people in total, and the children have grandchildren, and the grandchildren have children. The descendants of one person support half of the tribe——

Fortunately, dwarfs don't take up much space and don't eat much. To make something jingling, it also requires more people and strength. If a race like the Frost Giants and Cloud Giants married so many people and had so many children, they would have no choice but to wage war.

Although Old Mart is a spellcaster, he is not the kind of person who can only mutter spells and throw some wind blade skates. On a daily basis, he is like other dwarves, picking up hammers, wrenches, etc., knocking, smashing, and making devices. .

One of the middle-aged dwarfs was his son. He brought along a hammer used by his old father. Gretel took it and weighed it. It was not light in weight.

He can drink alcohol and eat meat. Even at this age, he still has nearly thirty teeth in his mouth, making a crunching sound when chewing chicken bones.

This situation shows that he is in good health and looks less like he has been suffering from high blood pressure for twenty years.

"Then what should I do when he usually has a headache? How to treat it?"

"If you have a headache, drink alcohol, or chew some medicinal herbs or smoke some medicinal cigarettes." The old dwarf replied tremblingly:

"The Dragon Master took pity on me and treated me twice. I was cured at that time, but relapsed after a while..."

Without waiting for Grete to ask, he waved his finger, and the other son hurriedly took out a pile of leaves, grass roots, dried mushrooms, dried flowers, and various unknown objects, and laid them out one by one.

Gretel frowned immediately. The medicinal properties of herbs have always been his weakness. Even if he memorized the names of these strange plants, he probably couldn't relate them to his previous life——

It is normal for a plant to have dozens of names in different places and different races. Although the identification technique could tell him what this thing was called and what its medicinal properties were, it was not consistent with the pharmacology he had learned.

Asking more carefully, most of these herbs were used in sacrificial ceremonies. Even he frowned seriously.

The medicinal herbs used in sacrificial rituals by indigenous tribes are said to be able to improve spirituality and connect to the gods. Most of them are either hallucinogenic drugs or narcotic drugs. A small number may be central analgesic drugs:

In any case, these drugs have no reference value for the cause of the disease. Gretel wanted to figure out why the old dwarf had a headache, or he had to rely on himself.

The causes of headaches are extremely complex. In addition to migraines, cluster headaches, tension headaches, and trigeminal neuralgia with autonomic symptoms, there are also a large number of secondary headaches with various causes.

Primary headaches are roughly equivalent to "the cause is currently unknown" or "modern medicine has not understood its mechanism of occurrence". Apart from throwing painkillers, Grete has nothing to do for the time being;

Secondary headaches need to be investigated slowly. In addition to malignant hypertension, Grete could think of other brain diseases such as intracranial infection, intracranial mass occupying, and cerebral hemorrhage.

Headaches caused by toothache, glaucoma, rhinitis, sinusitis, cervical spondylosis and other head and neck diseases;

Headaches caused by alcoholism, poisoning, electrolyte disorders, endocrine disorders, various medical diseases...

Gretel felt like he had a headache just thinking about so many possibilities. There is no choice, as a doctor, I can only continue to check:

"Come on, let's do a CT scan first, and then an MRI..."

The old dwarf stared at him blankly, hearing the incomprehensible words in his mouth as if he were reading from heaven, but he did not dare to ask any questions. The high-level spellcasters on the left and right all have some nagging words, so there is no need to delve into them, just obey them.

Sure enough, Gretel immediately gave instructions:

"Well, you don't need to do anything extra. Come on, take off your clothes, don't leave any metal objects, and stand on this board. Yes, just stand..."

Buzz buzz, buzz buzz buzz. The magic circle lit up one by one, and the huge magic power rolled over and flattened. Gretel stared at the images released by the oak staff, looking at each one carefully, and then asked the old dwarf:

"During the recent period, has your walking been normal? Is your running and jumping normal? Have you seen anything blurry? Are there any hand-eye coordination problems when using any device?"

"No! No, no!" The old dwarf shook his head quickly, pulled out a box, and held it in both hands:

"This is a cup I made a few days ago. I made it for more than a month and just finished it the day before yesterday. Look at the texture of the gold wire and the gems inlaid on it. It's very good. There are no flaws at all!"

Gretel took it and looked at it carefully. On the silver cup as big as a human head, thin gold wires were used to coil out patterns of figures hunting and birds and animals running. The gold wire lines were smooth and smooth, and the gemstones were inlaid perfectly.

The silver cup is shiny and has no traces of oxidation. It has fine chisel lines and sharp edges. It is obvious that it was made not long ago. I secretly threw another identification skill, and the feedback was "last week's"...

Well, this situation at least shows that the old dwarf has no neurological dysfunction. Grete breathed a sigh of relief. Combining head MRI and CT, he ruled out another possibility:

Malignant brain tumors develop very quickly. I heard from my colleagues in Shenai that young patients often develop out of control in two or three months, and it is too late to save them. I feel very sorry for them.

Although benign tumors develop slowly, if you survive with the tumor for more than 20 years, the symptoms will gradually worsen, and recurrence is possible. Repeated recurrence without neurological dysfunction is impossible...

Thank God, there is no intracranial mass, and there is unlikely to be intracranial hypertension. Grete chose CT and MRI first. Another reason is that these two examinations are non-invasive examinations:

To measure intracranial pressure, the simplest method he knew was to perform a lumbar puncture and measure cerebrospinal fluid. It looks scary, and the patient may not accept it. Even if he accepts it, what is the normal intracranial pressure of a dwarf?

He still has to perform waist piercing on each of these dwarfs, right?

In addition, there is good news. According to the results of CT and MRI, there is no cerebral hemorrhage or cerebral infarction.

As for the cerebral vascular malformation, at first glance, the cerebral blood vessels are quite normal. There is nothing particularly strange or obvious stenosis. It should not be the case.

Intracranial infection is also unlikely. Without timely symptomatic treatment every time, without a large amount of antibiotics, and relying on a little unknown herbal medicine for pain relief and anesthesia, do you want to survive twenty years?

Gretel swore that if such a thing really happened, his last name would be the old dwarf! Well, the surname "Nordmark" belongs to the original person anyway, not to him...

To rule out cranial problems, there is no need to open a craniotomy, let alone perform a craniotomy while awake. There are other head and neck issues to consider. So, glaucoma?

Grete had already paid attention to the first wave of physical examinations when the patients were brought in just now. The pupils on both sides are equal and round, the pupils are of normal size, sensitive to light reflection, and the conjunctiva is not congested——

If it is chronic angle-closure glaucoma, resulting in a sharp increase in intraocular pressure and repeated attacks of headaches and dizziness, the eyes will generally become red and red, and the conjunctiva will be congested and edematous;

Moreover, the sympathetic nerves will be excited, causing the pupils to dilate. These symptoms are all connected together and can be understood at a glance.

When he was an emergency doctor in his previous life, he also examined many patients with severe headaches. After the examination, he found that several of them had glaucoma. The eyes looked completely different from those of the old dwarf!

toothache?

rhinitis?

Sinusitis?

Gretel asked the old man to open his mouth and take a look at his teeth, and then scanned it with a CT scan to make sure that the teeth were not rotten.

In terms of listening, speaking, appearance, and images, there are no obvious lesions on the nose. Speaking of headaches that have lasted for 20 or 30 years, if they were caused by toothache, rhinitis, or sinusitis, what would they look like...

I do have some problems with my cervical spine. For craftsmen who often lower their heads and knock, it is normal to have some occupational diseases. But looking at the narrow part, it doesn’t appear to be compressing the nerves in the brain;

I used [Detoxification Technique] twice more, but no results came out. Lead poisoning, organophosphorus poisoning (does organophosphorus exist in this era?), and other possible poisonings should be ruled out.

Alas, when the patient opens his mouth, the doctor breaks his legs. If this was a tertiary-level hospital in his previous life, he would probably have opened orders, and the patient's family and patients would go for check-ups and break legs one by one;

Now he does the MRI, he does the CT, he does the tests (if any), he does all the outpatient imaging surgeries by himself, and he is the only one doing the so-called troubleshooting...

"Ah, what is the reason?"

Gretel lowered his head, meditating. I dare not pinch the bridge of my nose, rub my temples, knock my head, or roll around.

As the patient's attending physician, he must not appear hesitant in front of the patient. This will seriously affect the patient's confidence in the doctor, and thus affect the patient's compliance——

You can think about it for a while, but if it shows that you are confused, have no ideas, and have no direction, you can only find a superior doctor to end it.

There is no old director here, no senior directors from other departments, and no experts from outside hospitals. He himself is the highest-ranking doctor, and he must hold on!

But I really can’t think of the possibility... Should it be determined to be a "primary headache"?

There is no good solution for primary headaches, other than taking painkillers regularly. Now it seems that the effect of painkillers is getting less and less effective on the old dwarf...

In fact, he could also say, "I've cured you, go back and take care of yourself, don't overwork yourself, don't drink too much, be too excited, and eat light."

However, as a doctor, I know that this statement seems to appease the patient, but in fact it is equivalent to "I have not found any cause of the disease." The patient may not understand, but the doctor himself has surrendered to the cause of the disease...

Over and over again, blood oxygen, blood pressure, blood lipids, and blood coagulation were measured, but no problem could be found. Gretel sighed and was about to give the final medical advice, when suddenly an idea flashed in his mind:

"Wait, let's do another check!"

Thanks to x-on:Golden Wrench for the 500 starting coins reward