[Patient Story] Nine Ailments, A Thousand-Mile Journey for Treatment, One-Stop Resolution!

News
2023-12-20

Mr. He from Yunnan Province accidentally injured his left foot two years ago. After treatment, he was left with sequelae of edema and numbness in both lower limbs, significantly affecting his ability to walk. Mr. He thought that “treating the numb foot” would suffice and that the problem was minor, but his journey to find a cure proved far from easy. Over the past two years, he had traveled to multiple hospitals in Yunnan, Beijing, and other places. He had been hospitalized eight times this year alone and had almost lost confidence in continuing treatment.

At the point of despair, Mr. He finally had his lower limb edema and numbness cured at the Geriatrics Department of HeYou Meihe Hospital in Shunde. Surprisingly, during the same visit, nine other chronic and common diseases were also improved or resolved in a “one-stop” manner.

Numb Foot Untreatable

Actually Multiple Diseases Left Doctors “At a Loss”

Mr. He had been suffering from diabetes for over 10 years, which was the main reason the wound on his left foot had not healed for two years, with recurrent purulent exudate. Although the wound finally healed after more than a year of treatment, it left sequelae of edema and numbness in both lower limbs, making it difficult for him to walk freely.

To treat these symptoms, Mr. He had visited several well-known hospitals in Yunnan, Beijing, and other places, but the results were unsatisfactory. Doctors informed him that he was a comorbid patient (suffering from more than two diseases), with unstable blood sugar, blood pressure, and cardiac conditions. Treatment of the lower limbs involved issues such as bleeding and wound healing, making it difficult to cure.

It turned out that Mr. He not only had diabetes but also a 10-year history of gout and a 5-year history of hypertension. He also suffered from coronary atherosclerotic heart disease and had undergone a right coronary artery stent implantation just three months prior.

Recently, the numbness in Mr. He's lower limbs had become increasingly severe. Due to poor blood circulation caused by edema, there was significant skin pigmentation, and the skin on the upper part of his left foot was nearly black. “With so many diseases, I felt completely unwell and my mental state was very poor,” Mr. He said.

After extensive inquiries, Mr. He learned that the Director of our Geriatrics Department, Xie Zhiquan, specializes in the comprehensive diagnosis and management of complex comorbidities. He then traveled thousands of miles from Yunnan to Shunde to seek consultation with Director Xie.

Multidisciplinary Consultation

Personalized Treatment Plan Reverses Multiple Diseases

Mr. He was admitted to the hospital on the day of his consultation. After the geriatric medical team completed relevant examinations, Director Xie Zhiquan determined that Mr. He had nine concurrent diseases:

1. Type 2 Diabetes Mellitus with Multiple Complications

2. Coronary Atherosclerotic Heart Disease (Status Post Coronary Stent Implantation)

3. Grade 3 Hypertension (Very High Risk)

4. Hyperlipidemia

5. Gout (Recurrent Episodes)

6. Left Inguinal Lymphadenopathy (Plasma Cell Reactive)

7. Suspected Left Metatarsal Suppurative Osteomyelitis (External Hospital)

8. Chronic Kidney Disease (Proteinuria)

9. Mild Anemia

Director Xie Zhiquan Examining Mr. He

The complexity of Mr. He's condition exceeded expectations, so the Geriatrics Department immediately organized a multidisciplinary consultation. After a comprehensive assessment, Director Xie Zhiquan led the team in formulating a personalized treatment plan for Mr. He:

Glucose-Lowering Regimen

Changed from four daily subcutaneous insulin injections to a once-weekly injection of Semaglutide, along with daily oral Metformin and Dapagliflozin. After the regimen adjustment, medication adherence improved, which also enhanced cardiovascular and renal protection and reduced the occurrence of hypoglycemic reactions in Mr. He.

Antihypertensive Regimen

Considering the patient's diabetes complicated by hypertension and coronary heart disease, along with diabetic nephropathy complications such as proteinuria, the antihypertensive regimen was adjusted to oral Bisoprolol and Allisartan Isoproxil. This approach lowers blood pressure while also improving proteinuria and inhibiting ventricular remodeling. For the coronary heart disease, dual antiplatelet therapy and gastric protection were continued, along with enhanced lipid management.

Lymph Node Biopsy Plan

For the enlarged left inguinal lymph node, an ultrasound-guided lymph node biopsy was performed by the surgical department under local anesthesia. The postoperative pathology report showed predominant plasma cell proliferation and infiltration, consistent with plasma cell reactive hyperplasia (non-malignant), which also alleviated Mr. He's concerns about the enlarged lymph node.

Comprehensive Treatment Plan

For issues such as hyperuricemia and anemia, concurrent comprehensive treatment was administered.

After two weeks of implementing the above treatment plan, Mr. He's blood sugar and blood pressure were well-controlled. The numbness and swelling in his lower limbs were also significantly alleviated, and the skin pigmentation gradually faded. Proteinuria decreased, and uric acid and blood lipids were comprehensively managed.

Compared to his anxiety and distress upon admission, Mr. He's mental state had significantly improved. Upon discharge, he specially presented a banner and a thank-you letter to Director Xie Zhiquan and the medical staff of the Geriatrics Department, Surgery Department, and Inpatient Ward.