本帖最后由 老钱 于 2023-9-22 21:22 编辑
急诊室的故事
The story of theemergency room Parotitis/腮腺炎 Parotitis/mumps 老钱 9/8/23
9/8/23，凌晨3am左右，还在睡梦中，我突然感到，我的右侧耳垂下部有异况。我还记得，在梦中我重复念叨着一串词汇，如“uu，vv，ww，xx，yy，zz。。。”。每当我每念到第偶数个词时，就感到剧烈疼痛难忍。用手去摸，就清晰地感到“肿起”。自我右侧耳垂下起，沿着右颚骨外沿往下延伸，有一个大约长5cm，宽1.5cm的半椭圆体的“肿起”。 On 9/8/23, around 3am, still sleeping, I suddenly felt thatthere was something abnormal in the lower part of my right earlobe. I rememberrepeating a string of words in my dreams such as "uu, vv, ww, xx, yy,zz... ”。Every time I read the even word, I felt severe pain. When I touch it with finger, I will clearly feel"swollen". From the right earlobe of the self and down the outer edgeof the right jawbone, there is a "swelling" of a hemiellipsoid about5 cm long and 1.5 cm wide. 这样梦呓重复了多少次，终于彻底痛清醒过来了。刚刚痛醒时，我还记得这些词汇。我继续清醒地重复着这个“梦呓”，已经清晰地意识到，不再是梦了，而是真实的“Scenario/现实”了。见下图左边的照片。 How many times did this dream repeat, and finally completelysobered up. When I first woke up, I remembered these words. I continued torepeat this "dream" soberly, already clearly realizing that it was nolonger a dream, but a real "scenario/reality". See the photo on theleft of the image below. 很快，这个梦呓中的词汇串，就变得越来越模糊。后来就彻底忘记了具体的词汇了。只记得这样一个模式和节奏了。所以我要赶快写下来。为什么会出现这样一个模式和节奏？为什么会有这样的scenario？大概Floyd在世的话，可以从做梦的心理学给以解释。 Soon, the string of words in this dream became more and moreblurred. Later, I completely forgot the specific vocabulary. Just remember sucha pattern and rhythm. So I'm going to write it down quickly. Why such a patternand rhythm? Why is there such a scenario? Perhaps Floyd's words can beexplained by the psychology of dreaming. 究竟怎么会事？我的第一个猜测是不是被什么毒虫咬了？爬过了？室内很偶尔会有“百足虫”发现。自幼就听说“百足虫”极毒。但是从来未有体验过。 What'sgoing on? My first guess was whether I was bitten by some poisonous insect?Climbed through? Occasionally, "centipedes" are found indoors. Sincechildhood, I have heard that "centipedes" are extremely poisonous.But never experienced it. 我的思维还仍然很清晰，继续飞快地思索着最近的经历，分析可能的原因。 My mind was still clear, and I continued tothink quickly about my recent experiences and analyze possible causes.1. 有老朋友（南工78级校友），自加州来。住在他的朋友家（80级）。9月7日下午去他的朋友家接他。西北方向的Canton市边缘处，约20哩，开了1小时的车。结果一见如故，畅谈极其投机，近两个小时。太太打电话来催了。索性把朋友的朋友一起邀请来我家。约7pm到家。8pm开始晚饭。和朋友的朋友尽兴海阔天空，喝泸沟老窖，一人不到二两。1. There are old friends(Nangong Class of 78 alumni) from California. Stay at his friend's house (level80). On the afternoon of September 7, I went to pick him up at his friend'shouse. Northwest on the edge of Canton, about 20 miles, a 1-hour drive. The resultswere the same, and the conversation was extremely speculative, for nearly twohours. The wife called to urge. I simply invited friends of friends to myhouse. Arrived home at about 7pm. Dinner starts at 8pm. Have fun with friendsand friends, drink Lugou old cellars, less than two or two for one person. 2. 再往前追溯，8/24自Boston归。8/27感到感冒症状。8/28查实为阳性。傍晚拿到Paxlovid，就开始服用。不过，症状已经开始减退。其间发烧最高至100.2°F/37.9°C。到午夜已经回归正常了。8/29就完全正常了。像我1/14/22的中招过程一样（见《老钱：我也中招过了，26087》）。五天的Paxlovid服完，到了09/03，再测已为阴性了。Going back further,8/24 returned from Boston. 8/27 Feel cold symptoms. 8/28 confirmed positive.Get Paxlovid in the evening and start taking it. However, symptoms have begunto subside. During this period, fever peaks as high as 100.2°F/37.9°C. By midnightit had returned to normal. 8/29 is completely normal. Like my 1/14/22 trickprocess (see my article). After five days of Paxlovid serving, by 09/03, thetest was negative. 这样思考着，疼痛继续发展着，肿大在迅速扩张。但是我清醒地自我检测排查着。还没有影响呼吸，吞咽，口腔，牙床的功能，都还正常。关键的是头脑清醒。我知道还隔着面部几层组织和脑壳，还有脑颅组织保护，即使有毒素侵入面部，也不会立刻伤害大脑。于是就想自己撑着。 Thinkinglike this, the pain continues to develop, and the swelling expands rapidly. ButI soberly self-checked and checked. It has not affected the function ofbreathing, swallowing, oral cavity, and gums, all of which are still normal.The key is to be clear-headed. I know that there are also several layers oftissue and braincase on the face, as well as brain tissue protection, even if atoxin invades the face, it will not immediately harm the brain. So I wanted tosupport myself. 但是，最害怕的仍然还是毒侵大脑，如果那样发展就严重了。毕竟自己不是医生，没有把握。三点半左右，决心叫醒了太太。她观察着，拍照记录比较，觉得发展快，肿块已经从颚骨边缘发展到面颊颧骨了。于是立即决定还是去医院急诊。Johns Creek Emory HospitalEmergency也就离我家3哩的距离。3:49am出发，4:02就到了。4:15进入病房。如果call急救车，只会更慢更麻烦。 However,the most feared thing is still poisoning the brain, and if that happens, itwill be serious. After all, he is not a doctor and is not sure. Aroundhalf-past three, Resolve woke up his wife. She observed, took pictures andcompared them, and felt that the development was fast, and the lump haddeveloped from the edge of the jawbone to the cheekbone. So I immediatelydecided to go to the emergency department of the hospital. Johns Creek EmoryHospital Emergency is 3 miles from my house. Depart at 3:49am and arrive at4:02. Enter the ward at 4:15. If you call an ambulance, it will only be slowerand more troublesome. 护士们立刻给我接上EKG，血压，脉搏。。。全套监测。同时询问病史概况。。。显然他们已经排除我的生命危险了，因为所有的生命体征都正常。我也一直对答清晰。所以一刻钟后医生才到。医生简单看看问问，就说是唾液管道的感染炎肿堵塞引起的问题。我有足够的医学词汇能听懂他的描述。 Thenurses immediately hooked me up with EKG, blood pressure, pulse... Full set ofmonitoring. At the same time, ask for an overview of the medical history...Apparently，they had ruled out my life as all vitalsigns were normal. I've always been clear. So the doctor arrived after aquarter of an hour. The doctor simply looked at the question, and said that itwas a problem caused by the infection and swelling of the salivary duct. I hadenough medical vocabulary to understand his description.
医生说，细菌，病毒，stone/结石等多种原因都可以引起唾液管道的感染炎肿堵塞，可能是infection，也可能是inflammation。从而造成我的症状。我告诉医生，我两周前感染了Covid19和昨天晚饭还和朋友一起喝了一点Liquor/烈酒。医生说，这些都有可能是诱发原因。 Doctorssay that bacteria, viruses, stones/stones and other causes can cause infectioninflammation and blockage of the salivary duct, which may be infection orinflammation. This caused my symptoms. I told the doctor that I contractedCovid19 two weeks ago and drank a little Liquor/spirits with friends lastdinner and yesterday. The doctor said that these may be the cause. 为了确诊，医生还是按排了做CT。同时给我静脉输液消炎，加了增强免疫止肿的dexAmethasone/地塞米松，和消炎止痛的ketorolac。。。我睡着了。。。6:30醒来时，痛已经镇住了。于是可以出院了。7am到家，立刻再睡至11am。醒来耳下颚骨边缘的肿胀已经差不多消减下去了。 Inorder to confirm the diagnosis, the doctor still did CT according to theschedule. At the same time, I was given intravenous fluids foranti-inflammatory, plus dexAmethasone/dexamethasone to strengthen immunity andrelieve swelling, and ketorolac for anti-inflammatory and pain... I fellasleep... When I woke up at 6:30, the pain had subsided. So I can bedischarged. Arrive home at 7am and sleep again immediately until 11am. When Iwoke up, the swelling at the edge of the lower jawbone of my ear had almostsubsided. 这一场风波历时4小时就基本结束了。 Thistrouble lasted 4 hours and basically ended. 现在回忆起来，急诊医生的诊断是正确的，处理是及时的。我们立刻去急诊的决定是必要的，正确的。 Inretrospect, the emergency doctor's diagnosis was correct and the treatment wastimely. Our decision to go to the emergency room immediately was necessary andcorrect. 随后，我Google学习了一下。才知道人体的吐液系统也是很复杂的。 Then，from Google，I learn that the humanbody's salivation system is also very complicated. 人的唾液/Saliva(亦称口涎、口水，吐液）是由唾液腺/Salivary Gland产生。唾液腺是一个复杂的系统。其包括三个主腺，左右对称的共六个。其中最大的一个腺体的名字是Parotid，见上图中的右边的解剖图示。其余还有数百个小腺。分别分泌各种各样的蛋白质，消化酶。每天能产生1-1.5L的唾液。结石，细菌，病毒都可以导致唾液管道/duct堵塞，引起发炎肿胀。 Humansaliva/saliva (also known as salivation, saliva, spit) is produced by the salivaryglands/Salivary Gland. The salivary glands are a complex system. It consists ofthree main glands, six symmetrical on the left and right. One of the largestglands is named Parotid, see the anatomical illustration on the right in theimage above. The rest have hundreds of small glands. Secretes a variety ofproteins, digestive enzymes, respectively. It produces 1-1.5 L of saliva perday. Stones, bacteria, viruses can all cause salivary duct/duct blockage,causing inflammation and swelling. 我的紧急状态就是发生在右侧这个Parotid里的炎肿引起的Parotitis/唾液腺炎。 Mystate of emergency is Parotitis/sialadenitis caused by inflammation in thisParotid on the right. 从急诊室带回来一个My Emergency Folder/我的急诊文件夹。里面有三个文件。 Brought back a My Emergency Folder from the ER.There are three files inside.1. After Visit Summary/情况总结，相当于急诊报告。有如下内容： · 医生姓名，诊断Parotitis， · 常规指标数据 · 检测报告，主要是血相检测报告（32项）。 · CT检测报告，（看不懂） · 治疗用药，Amoxicillin（对付细菌感染/Infection） & iBuprofen（对付病毒感染/Inflammation），药方，医嘱 · Follow up 2. 关于Salivary gland/Parotitis唾液腺焱肿的基本知识。特别强调，对于Parotitis，一定要请医生处理。发生在夜间，就必须是急诊了。 3. 一封给病人雇主的信，以备病情需要请假之需。 原来一无所知，突然半夜痛醒，确有点惊恐。现在知道了就是唾液腺的发炎肿大。 Ididn't know anything, but I suddenly woke up in the middle of the night, and Iwas indeed a little frightened. Now I know that it is the inflammation andenlargement of the salivary glands. 后来告诉一个医生朋友，她立刻说，就是腮腺炎。我才知道Parotitis的中文就是腮腺炎。面颊上那个部分就是叫腮帮子。说到腮腺炎就是我们几乎每个人都是从小就耳熟能详的了。腮腺也叫痄腮。其炎症经常是流行性腮腺炎。在小孩子中，是一种传染性极强的炎症。到了美国以后，我就好像没有再听到过了。至此我才知道腮腺也是唾液腺。但是，美国医生一点也不提传染性的问题。 Latertold a doctor friend, she immediately said that it was mumps. I knew that theChinese of Parotitis is mumps. The part on the cheek is called the cheek. Whenit comes to mumps, it's something almost every one of us has been familiar withsince childhood. The parotid gland is also called pygill. Its inflammation isoften mumps. In small children, it is a very contagious inflammation. When Iarrived in the United States, it was as if I hadn't heard it again. Only thendid I know that the parotid gland is also a salivary gland. However, Americandoctors do not mention the issue of contagion at all. 我想，急性腮腺炎，还是要找医生。作为普通人毕竟不是医生，不能正确判断，也没有条件，不能自作主张。 Ithink, acute parotitis, or to find a doctor. As an ordinary person after all,he is not a doctor, he cannot judge correctly, he has no conditions, and hecannot make his own claims. 所以我记录下来，作为一次经验分享。也给朋友们提供一个参考描述，也许谁以后也会遇到。 SoI write this article about this experience sharing with friends, maybe who willmeet the same situation in future.
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发表于 2023-9-14 02:37:04