Chapter 383 Between Surgery and Conservative Treatment

"If it's BIID, this surgery has a long history. Someone should have started trying this surgery in North America. Then, because the laws there didn't allow it, as far as I know it has been mainly done in Malaysia. In Southeast Asia. Thailand has developed very fast in recent years, and Bangkok is almost an international city. More and more people are applying for medical visas to go there for medical treatment and treatment of chronic diseases, so if you say you went to Bangkok , I guess it’s probably this kind of amputation surgery,” Mu Chun continued running.

Zhang Wenwen raised his wet wrist and gave Muchun a thumbs up, "I suspect there is something else in this world that you don't know."

"Yes, I want to know if you have spent time studying the brain problems of BIID patients and whether they can be corrected through neurosurgery." Mu Chun said.

"The right parietal lobule of the brain of BIID patients is thinner than that of ordinary people. Currently, neurosurgery has no way to improve this problem and is almost powerless. Moreover, these patients neither have epilepsy nor have clear consciousness. There are no obvious other physical problems, but I am actually very troubled," Zhang Wenwen told frankly.

Zhang Wenwen was a little irritated after taking a few sips of Coke. This paper straw is definitely a stupid invention that opposes the great pleasure of human beings enjoying carbonated drinks.

Zhang Wenwen simply pulled out the straw, because every time he took a sip, when his lips left the end of the straw, he would be extremely embarrassed by the cola that poured out.

After handling the straw, Zhang Wenwen said: "I can't find any benefits of brain surgery for [Body Integrity Identity Disorder] (BIID), and there is no relevant research so far. This is why I want to go to Thailand to have a look. After returning, I also want to know what kind of advice I can give if a patient like Gu Yiping appears again. "

"It will definitely reappear. Even Gu Yiping may reappear. Body integrity identity disorder is the same as other identity disorders. It is very difficult to correct because we have to reconstruct the part of the brain that has no such connection at all. It is even worse than this It's even more complicated. One part of the brain is convinced that they are in the body, but the other part doesn't perceive their existence at all." Mu Chun ran faster and faster, but his thoughts were not confused at all.

"That's right, so the patient should know very well that he is going to undergo amputation surgery. If there is no misdiagnosis, I think this kind of surgery will be done."

"Wait a minute." Muchun interrupted Zhang Wenwen.

Gradually slowing down the speed of the treadmill, Mu Chun changed from running to fast walking and said: "Don't easily say that such an operation should be performed, even if you think so."

"I understand, because this kind of thing is on the edge of the law after all, and there is no way to perform this kind of surgery in our country, so what else can we do? What else can we do when we encounter this kind of patient?" Zhang Wenwen eagerly said Want answers.

"It's a long story. The first thing is to improve the assessment. It's not just the assessment of patients with BIID. This type of assessment cannot be completed by the psychosomatic department. It obviously requires the advice of the neurology department. In addition to a set of standardized subjective assessments and examinations , there should also be a longer observation period. In addition, the entire content of the amputation surgery must be fully communicated with the patient to ensure that the patient fully understands the impact of the amputation surgery on his future body and life; strictly speaking, it should be required The patient makes a complete plan for his clothing, food, housing and transportation after amputation.

How will he cope with the important parts of life after amputation, and how will his work continue? Do you want to give up your job because of this? How to ensure the family's financial status? Will you be able to maintain your current family economic level after amputation?

How will the patient take care of themselves? Or whether there is a clear plan for who will be responsible for taking care of him during the recovery period after the amputation and his future life.

In addition, whether you have made sufficient preparations to obtain the approval of your family.

All I can think of is to implement all of this into more subtle details to avoid possible problems to the greatest extent.

Of course, as far as I know, most adults who have undergone amputation experience a higher sense of well-being. "

After Mu Chun finished speaking, Zhang Wenwen nodded after fully agreeing, "I believe these have been done perfectly. But how do you know so clearly? Did Teacher Mu Chun think about it himself? Or do you know something?"

In order to avoid Zhang Wenwen's doubts, Muchun immediately explained that although he knew a little about these things, he did not know anyone who engaged in this type of surgery, nor did he know the organizations and groups in this area.

As for the rest, he summarized and thought about it after Gu Yiping's case appeared.

Muchun continued, "We should also be able to do something besides these and try some other potentially effective treatments, especially when dealing with teenagers or even children around ten years old. We should be cautious and cautious. What else can be done?”

Zhang Wenwen immediately followed Mu Chun's words, "When dealing with children or young people under the age of 25, the best way, and the way that has always been done, is to wait.

Every one to two years, the patient submits an online assessment form, or in the case of a minor, a parent completes it. There is nothing else on my side, this is all I know. "

"It's very comprehensive. I've talked about some of the treatment methods I can think of with you before. I wonder if you still remember them?" Muchun's attitude was very modest.

"Okay, don't be so polite to me. Tell me what you have to say." Zhang Wenwen said.

"No, you are more professional than me in this regard. After all, I am still in the initial stage of establishing an evaluation system. One part is the doctor's evaluation, one part is the patient's self-report questionnaire, and the other part is the medical examination. In addition to the treatment methods we just discussed, there are also [aversion therapy] and [talk therapy].

Let's talk about [talk therapy] first. The key is to let patients think with questions. We need to give relatively clear and simple questions, such as: If there is a medicine in the world that can make you not want to amputate, would you be willing to take that medicine?" Mu Chun finished speaking and looked at Zhang Wenwen quietly.

Zhang Wenwen suddenly felt that he was a BIID patient, and immediately thought about it according to Mu Chun's words.

"I don't know, I can't think of it, maybe it should be." Zhang Wenwen answered seriously.

"Dr. Zhang, your sense of substitution is a bit too strong. It's easy to be hypnotized." Mu Chun said and threw a chocolate to Zhang Wenwen.