Surgery Godfather
Chapter 502 - 458: Gout is the Devil

Chapter 502: Chapter 458: Gout is the Devil

In the afternoon, Yang Ping finished his surgery and returned to his office.

Huang Jiahui had been waiting for a long time. She had received the sample of the spinal external fixator and delivered it as soon as possible.

"President Huang is very efficient." Yang Ping sat down.

"Dr. Yang, please take a look. If you confirm that there is no problem with the sample, the Guilin laboratory can receive the experimental external fixator in just three days."

Huang Jiahui put on protective gloves, opened the instrument box, and carefully took out the model of scoliosis and the external fixator, laying them on the desk to demonstrate for Yang Ping.

If the investment for this device was split evenly, calculated by weight, the unit price would be much more expensive than gold.

One after another, screws spiraled into the preset pedicle channel of the spine model, as Huang Jiahui proficiently installed the external fixator.

A few minutes later, the external fixator was installed. She then began to demonstrate the adjustment. With the rotation of the knob, the flexible spine model began to correct itself.

It had taken Jiahui several hours of practice in her own company to perfect this demonstration, which only lasted a few minutes.

"How is it, Dr. Yang? Do you see any problems?"

Jiahui had shed her youthful naivete and evolved into a mature and efficient professional.

Yang Ping decided to operate on it himself. Jiahui hurriedly handed him gloves. He operated on it from start to finish himself, checking repeatedly to confirm there were no issues.

"Produce according to this sample and send the experimental products directly to the Guilin Laboratory." Yang Ping planned to complete at least forty animal experiments before the Asia-Pacific Orthopedics Association Congress.

It would be too late to present the spinal external fixator technology at the upcoming Asia-Pacific Orthopedics Forum, but there was still hope to introduce it at the larger conference.

Theoretically, the rate of correction for infants is much quicker than it is for children. However, it was estimated that it would take about three months to complete the first batch of animal experiments.

This is a completely new scoliosis correction technology. Once introduced at the conference, it would cause a uproar. It is a completely different technical route from the existing orthopedic surgery.

The sample size is tiny and specifically fits the body of an infant monkey. It can’t be used for humans. After successful animal experiments, equipment for human use will need to be produced separately.

As Jiahui prepared to clean up the equipment, she asked, "Dr. Yang, would you like to keep it on your desk for your daily research?"

Yang Ping was thinking the same thing. As an office decoration placed on the desk, he could study it when he had time, and everyone else could familiarize themselves with it as well.

"Dr. Yang, when will you go to Guilin? I can follow you and be responsible for the equipment." While Jiahui had already taken on the role of manager, she was still directly involved in Yang Ping’s surgeries.

"I’m not sure yet, I’ll let you know when I am." Yang Ping was very satisfied with the sample.

Thinking about how children with scoliosis in the future won’t need surgical operations, but just need to wear this external fixator with their parents helping adjust the screws daily while the deformed spine slowly auto-corrects - what a miraculous thing.

Compared to surgical correction, this method is not only less traumatic, but more importantly, it preserves the normal range of movement of each spinal segment, with the spine retaining full and normal function.

But with surgical correction, much of the movement of the spine is sacrificed.

In the future, upgrades to this technology for the correction of adult spines could involve cutting the cortical bone at crucial parts, then using an external fixator and applying the Ilizarov principle for correction.

As Yang Ping was thinking, suddenly, a heart-wrenching scream came from the ward; the screaming grew louder and louder.

"What happened?" Yang Ping asked.

Jiahui looked at a loss. Yang Ping asked her to go back first and then summoned a standardized training student to enquire about the situation.

"Bed 24, Teacher Zhang is changing the dressing." The standardized training student replied respectfully.

Bed 24 was for the patient with gout admitted from the emergency department. His body was covered with gout nodules, with the largest being the size of five adult fists.

Because the pain was so severe, he was admitted to the Comprehensive Surgery Department after being seen in the emergency room during the night.

At Sanbo Hospital, everyone still preferred to use the name of the Comprehensive Orthopedics, referring to Yang Ping’s department as the Comprehensive Surgery Department, which seemed more grounded than the high-end Surgical Research Institute.

No matter whether it was the emergency department, general surgery, or the Overseas Chinese Building, if they encountered a case they couldn’t handle involving surgery, they naturally consulted the Comprehensive Surgery Department.

The standardized training student led Yang Ping to the ward, where Zhang Lin was changing the dressing. Xu Zhiliang was directing from the side, and Song Zimo was watching with a crowd of standardized training students and interns.

When the bandages on the wound were opened, the soaked dressings were covered with a white, lime-like substance.

The patient, a sixty-year-old male, had gout nodules all over his body. There were forty-four that could be counted, the largest being the size of five fists. There were several more that were two or three fists large. The whole person appeared severely deformed, like a monster, making people feel extremely uncomfortable just looking at him.

Several large gout tophi had ruptured, constantly oozing a white chalky substance. This "chalk" mixed with tissue fluid, resembling white mud.

Zhang Lin used tweezers to manipulate a disinfected cotton ball, stirring inside the ruptured wounds to clean out the chalk-like sludge.

The patient lay on the bed, groaning in pain, occasionally letting out a sharp scream, begging to have all the limbs with the ruptured gout tophi amputated.

Indeed, when gout pain flares, it can be excruciating. In 1799, renowned British cartoonist James Gillray portrayed gout as a black devil, vividly expressing the torment of gout.

This cartoonist, having experienced gout in his big toe joint, drew a cartoon portraying gout as a black, terrifying devil hunched over the foot, biting and tearing wildly.

"Fatty, watch and learn!" Little Five commented, his tongue clicking in awe.

Sweat was beading on Liang Fatty’s forehead as if he was seeing a frightening vision of his own future. He hadn’t realized gout could become this horrifying.

"Gout is one of the oldest metabolic diseases in humans, primarily resulting from issues in the body’s uric acid metabolism. Excessive uric acid accumulates and crystallizes, attacking joints, organs, and other parts of the body. Records of gout can be traced back to the 5th century BC, with the ’Father of Medicine’, Hippocrates, documenting its clinical manifestations."

Song Zimo took this opportunity to give the standardized training students and interns some knowledge about gout.

"Among historical figures we know well, such as Bacon, Newton, and Darwin from overseas, and Bai Juyi, Liu Yuxi, and Kublai Khan from our country, were all gout sufferers."

"In the ancient times, gout was truly a ’rich man’s disease’. Only emperors, nobles, and the higher echelons of society were likely to suffer from it. The general population rarely had a chance to contract this disease."

"In modern times, with improved living standards and lifestyles once exclusive to the wealthy, gout has become the second most prevalent metabolic disease in our country, next to diabetes. According to statistics, there are over 80 million sufferers in our country, and the number is rapidly increasing at an annual rate of 9.7%."

"Generally, gout attacks without warning, often causing individuals to be awakened in the middle of the night by intense foot pain. The pain gradually intensifies and peaks around the 12-hour mark, with a tearing, knife-cutting, or gnawing sensation that is unbearable."

"The majority of gout attacks occur in the first metatarsophalangeal joint, or the big toe joint. As the disease worsens, it gradually spreads upward, affecting the dorsum of the foot, heel, ankle, knee, wrist, and elbow joints. The affected joints and surrounding tissues become red, swollen, hot, and painful, resulting in movement limitation."

"However, it doesn’t stop there. Gout is a silent killer; it not only erodes and damages the joints, but also damages the internal organs, such as causing gouty nephropathy; in severe cases, it leads to uremia, ultimately requiring dialysis or kidney transplantation."

"Don’t overlook this disease. If you take it seriously and treat it well, it won’t be a big deal. But if you ignore it, one day it will make you regret it."

"Whenever there’s a chance, we should have Old Liang give us a lecture on gout – he’s an expert in this area." Song Zimo finished speaking and turned to look at Liang Fatty, who was shivering with fear.

At that moment, Song Zimo spotted Yang Ping and immediately went over. "This is trouble!" he said, "Without surgery, these wounds will never heal. With surgery, all joints in the body have been corroded by uric acid crystals, the wounds may also not heal."

The surgery was definitely necessary, but the question was how to do it.

"We should be more cautious with the surgical plan and conduct a detailed assessment of the blood vessels in the limbs," Yang Ping instructed.

Zhang Lin, along with two trainees, was sweating profusely but finally managed to change the dressings on all the wounds. The used bandages filled up the nearby yellow trashcan.

Everyone had never seen a gout patient this severe before. The patient lay on the bed covered in bumps and bumps everywhere. If you weren’t prepared and suddenly looked at him, it would scare you into a cold sweat.

Protracted illness wears out the patient’s family’s patience. Time has a way of eroding a person’s resilience.

"What’s all the yelling? Does it stop hurting if you yell?" The patient’s daughter scolded him by the bedside.

"We administered a painkiller injection before changing the dressing." Xu Zhiliang explained to Yang Ping who had just walked in.

Apparently, before the gout tophi began to rupture, the old man lived with his daughter. After the rupture, they went to a local hospital to clean up the wound. Post-surgery, not only did the wound not heal, it got worse exposing the bone and the other big nodes began to break one after another.

The unbearable smell pervaded the entire house. Left with no choice, the daughter rented a house for her father and hired a caretaker to look after him. The caretaker quit after a month, even a raise didn’t convince her to stay, the mere task of changing the dressings was enough to scare her off.

Caretakers are already hard to come by in the housekeeping market, and many are unwilling to take care of sick elderly people. Despite repeated raises, they still couldn’t find a suitable person, so the patient’s daughter had to take care of him herself.

"We both are only children and now have five elderly people to take care of. We were left with no choice but to send one who’s in his eighties to a nursing home. Recently, he suffered a stroke and has just been discharged. We’re about to be driven mad. Wealthy bosses might have it easier, but we’re wage earners. In terms of both energy and finance, we just can’t cope with it all, so right now we’re hanging on for dear life."

The patient’s daughter vented her frustration, a way to justify her emotional outburst.

"I’m sorry, doctor, I’m really on the brink of collapse." The patient’s daughter softened her tone, afraid she might give the doctors the wrong impression.

"Alright, alright, it’s done now. Rest a bit." The patient’s daughter pulled the blanket over her father.

"I’d better be dead." The patient muttered with a desperation in his voice.

"Will you stop throwing tantrums? Focus on getting better. Dr. Yang will have a solution." His daughter chastised him.

"I’m really sorry for the trouble," the patient’s daughter apologized, seeming regretful about her earlier outburst.

"We’re doing our best." Yang Ping comforted her.