original Afraid of “white lung”, the girl who lived alone in Beipiao was transferred to two hospitals for CT scan, but the results were normal three times. Still panicked. Don’t tell others

Original title: Afraid of “white lung”, the girl who lived alone in Beipiao transferred to two hospitals for CT scan, but still panicked after three normal results

Data map. Tuyuan Vision China

Summary:The lung CT showed “normal”, the common blood test indicators of myocarditis showed “normal”, and the ECG also showed “normal” – Li Wei, 21, was still unable to rest assured of the three results. She asked her doctor friend to confirm again and again, and began to make an appointment for a round of review.

Half a month ago, she was glad to finally confirm her positive results. It was like a stone falling to the ground. Now she is in a cycle of doubt. Recently, the demand for lung CT examination in various regions has increased dramatically. Many hospitals have scheduled relevant appointments from years ago to the middle of January. In some social platforms, how to arrange a team to do CT has become a popular strategy.

In the big data push and information transmission between relatives and friends, young people have shifted from easily coping with infection to worrying about “white lung” and myocarditis. The results of some pneumonia confirmed their anxiety, and some people used “open blind box” to describe their own course of disease. Can it infect the lungs? How serious is the infection—— Unexplained uneasiness caused them to squeeze into the CT room.

Article |Wei Ronghuan, Yang Donghai

Edit |Mao Yijun

Young people’s worries

At 11:00 a.m. on December 26, seven CT rooms of Yuhuan People’s Hospital in Taizhou were crowded with people. Li Wei, 21, was wearing cotton slippers with pink bear pattern, which was very conspicuous in the team. In her mind, except for another woman in pink pajamas, who looked 30 or 40 years old, the rest were old people accompanied by their families.

The outpatient doctor asked her why she needed CT without cough? “I’m just afraid, I want to check.” The doctor didn’t say much after listening, and gave her a list. She did not turn negative. Looking at so many people in line, she was still afraid of the virus, but “the fear of myocarditis is far beyond this”.

At the beginning, when she was confirmed positive by single tube nucleic acid, she felt “very happy” and finally found the cause of discomfort. However, after the fever symptoms subsided, she had been nasal congestion, fatigue and dizziness. As soon as she opened the WeChat official account, many articles were about COVID-19 causing myocarditis, and she was a little flustered. She remembered clearly that when she went to see rhinosinusitis, she asked the doctor if she could exercise with palpitations. The reply she got was “exercise with virus infection, and you will die if you get myocarditis”.

A 30-year-old patient also saw many posts saying that he had a fever for a short time and did not cough, but his lungs were infected by CT. What worried her more was the discussion about “white lung”. She usually has sensitive bronchi and coughs when she has a cold. In junior high school, she once had viral myocarditis because of a long-term cold. The COVID-19 still coughed ten days after turning negative this time. Every time he went downstairs to throw garbage and then went upstairs, he would feel frustrated. Before Christmas, she asked for leave to go to the hospital.

Others couldn’t help checking because their parents kept forwarding these relevant content. Wang Xiao learned that her mother found pneumonia in her hometown and was hospitalized. She began to feel stuffy in her chest, so she decided to take a CT. She was 25 years old and lived alone in Beipiao. There was not much medicine in the house. She had a high fever at 3 am when she was infected, and her whole body was “not very normal cold”. Afraid of an accident, she did not dare to tell her family. In the morning, she went to the nearby hospital alone and found that the fever clinic might have to wait for 10 hours. She went back again.

That night, she ordered a flash off, asked the runner to help see which hospital had fewer lines, and then took the bus again. The bus was empty. It was almost early in the morning when I registered and waited outside for 3 hours in the cold wind. I saw a boy under 30 years old in front of me. He was pushed into a wheelchair by his parents and burned to more than 40 degrees. He was half comatose and began to talk nonsense. Fear has been increasing. Later, she took medicine to reduce her fever for two days, but her cough is not good.

It was also because there were too many people to see a doctor. She went to two hospitals to register before she had an examination. It took 3 hours for initial diagnosis, blood drawing, CT, follow-up visits, and medication. After seeing the film, the doctor only prescribed some lung clearing drugs, telling them not to catch cold, stay up late, and rest.

Wang Xiao’s CT results. Presented by the narrator

Pang Bo, a doctor in the respiratory department of a public hospital in Tianjin, clearly felt that the number of outpatients had suddenly increased in the past month. “The patients who had been shunted in the fever clinic had returned, and a group of young people was rare.” He said that there were few young people coming to and from the respiratory department, usually asthma, even in the flu season, which accounted for 30%. Half of the young people he is currently receiving are infected with pneumonia, but the condition is relatively mild. They will recover completely within three weeks and a month after taking the medicine.

“The other half has nothing to do but worry too much.” On the last day of the New Year’s holiday, Pang Bo remembered that a girl in her 20s came to the hospital on the first day of a fever, worried about her pneumonia and myocarditis. It was OK to check the CT and ECG, but she was still worried. She waited until the end of the outpatient service and went to the ward of the inpatient department to ask.

A doctor in the emergency department of a public hospital in Beijing also found that the number of young people had doubled in the past week and asked for CT, “It’s no big problem, let’s have a rest.” Kang Jian, a doctor in the imaging department of a county hospital in Shanxi, was responsible for writing reports based on the images of patients. Recently, his daily workload has increased from 50 to 170, and 20% belongs to young people.

Liao Mei, a nursing graduate, has also become worried recently. After turning negative for more than a week, her mental state recovered fairly well. She may cough four or five times a day, and there is no thick sputum, but she still wants to take a CT in the next two days. Five years ago, she was infected with bird flu in Guangzhou. At the age of 24, she didn’t care much about the pain. Even if she had a headache for a long time, she wouldn’t bother too much. If she felt really bad, she would take a painkiller. Until there was a fever, she could not go back for a week. The doctor suspected it was pulmonary tuberculosis, which scared her to do a series of examinations. Although she finally ruled out the possibility, she became very careful from then on.

These young people share their experience of seeing a doctor on the social platform, and recommend hospitals with few queues to each other. Someone suggested that you go to the nearby community or the second class hospital first. “The third class hospital is too crowded, so we should give more medical resources to the patients with severe diseases. I saw a lot of people on the verge of life and death in the hospital.”

Some help stickers ask whether to take CT, worried about the whitening and fibrosis of the lungs, and worried about the hospital infection of COVID-19 again. A senior student in Sichuan described his pain feeling in detail in his post, and drew a sketch map of the part. He suffered from costal neuralgia before, but since the infection, the pain scope has expanded, and the left chest often pricks, especially when lying down at night. Originally, he planned to go to the hospital for filming when he was less nervous, but he saw a chat record forwarded by his friend about “many young people in the hospital have white lungs”. He didn’t know whether it was true or not, so he hurried to the hospital.

Help note for senior students. Platform screenshot

Pneumonia without hospitalization

However, Yan Kai, a cardiothoracic surgeon in a hospital in Chongqing, only received two or three young people in the past week, who had coughed for a week or two and suspected lung infection. The number of the hospital is still very tight, and the number within a week is empty, mainly for elderly patients transferred from the emergency department.

The young people Yan Kai received were basically mild pneumonia. “At most, the sputum is thick, and sometimes they can’t breathe when stuck in the throat, but in fact, COVID-19’s cough for two weeks is quite common.” If the cough is very severe, he suggested that you can take some Suhuang cough syrup and cucurbitacin capsule to alleviate the symptoms.

“Even if you feel sore throat and cough, it is not necessarily (pneumonia).” Yan Kai said that because COVID-19 will cause sore throat and cough, if you cough up more sputum, you may have pneumonia. “There is no way to prevent this. Some people will get pneumonia even if they take antibiotics in advance, mainly depending on their own immunity.”

According to Kang Jian, a doctor of Shanxi Imaging Department, in addition to trauma and work physical examination, few young people came to check chest CT before. In the past week, Kang Jian found three cases of “white lung” patients from the imaging films, all of whom were over 70 years old. Among them, an 81 year old woman developed rapidly in the course of her illness, and the area of infection in three days expanded from 10-20% to 70%.

In his treatment, half of the young people who came to take pictures did have inflammation in their lungs, but compared with the elderly, the scope and area of infection were very small. Some young people have “ground glass” on the imaging film, which means that the inflammatory exudate enters the lung medium, causing congestion and edema. “The young people’s words are reversible. When their own immunity is relatively good, the lungs will slowly absorb, and there is no difference between the absorption and normal lung tissue.”

According to Yan Kai, a cardiothoracic surgeon in Chongqing, “white lung often appears in severe pneumonia, but the probability is not high, just because the number of infections is too large, in fact, the proportion may be less than 1%.” He explained that the main reason for white lung formation is viral infection, and the lung will produce an inflammatory medium, such as the lung is a balloon. After infection, the air inside becomes water slowly, and the balloon cannot open well – that is, breathe normally. In the CT image, the gas appears black, and the blood, water and other liquids are white. If the exudation exceeds 70%, it is called “white lung”.

In fact, the films of normal people will have white filamentous dispersion, which is the blood circulation in the lungs. Only a thick white film can be exudate, Yan Kai explained. Last week, he received a young man in his twenties. He coughed for two weeks and felt chest pain. CT showed that there was indeed a little lung infection. In the doctor’s opinion, there was no need to be hospitalized, but the other side felt that it was “white lung” as described on the Internet and insisted on staying in for infusion.

“The online statement can only be used as a reference, but chest pain may be a heart problem or a lung problem. They can’t judge which category they belong to, but they will increase panic,” Yan Kai said. As for hospitalization, Pang Bo, a doctor of Tianjin Respiratory Department, mentioned that before, the patients were not so saturated, and they could accept if they wanted to live. Now, they need to be assessed. The priority oxygen saturation is lower than 93, and there are severe patients with chronic diseases such as diabetes, chronic obstructive pulmonary disease, or basic diseases such as coronary heart disease, heart failure.

A young man had a fever repeatedly for more than ten days because of infection. He went to the emergency room at night. He had to wait for the number of 200. The next morning he went to the emergency room and was called to the number. After checking, the doctor suggested that he be hospitalized for anti fever injections, but there was no bed. Finally, he had to go to the small clinic for injections.

In the past two or three weeks, there have been more than a dozen “white lungs” among the inpatients in charge of Pang Bo, accounting for about a quarter. Except for three people in their forties and fifties who survived, the rest of them died. He believed that the symptoms of the current Omicron virus strain in China were similar to those of the seventh wave of BA. 5 in Japan, most of which were high fever. “From the data of Japan, the mortality rate of young people was not high.”

“Too scared to die”

The senior boy who suffered from rib neuralgia finally showed normal results. He was diagnosed with anxiety disorder in November last year, and often lost sleep. The original pain became more obvious after Yang. Later, I had better insomnia, so it didn’t hurt so much. In the past two weeks, it was reported on the Internet that several cases of unconfirmed myocarditis caused sudden death: “Yang, a 29 year old boy, fainted after climbing a mountain after his health”, “a lawyer in his 40s suddenly fell to the ground playing football a few days after he became yin”… A netizen said that he would think a lot every day when he saw these.

Li Wei of Taizhou also had no lung infection after CT examination, but her worries did not end. Two days later, she went to the hospital for a common blood test and ECG of myocarditis, and the results were normal. That night, Li Wei repeatedly confirmed to his medical friends on WeChat, “So I’m sure I don’t have myocarditis, right?” “What should I do?” Even after being reassured by his friends, Li Wei still wanted to go for a recheck, “I plan to go again on January 9. Doesn’t it mean that it may appear within 1-3 weeks after the infection?”

A chat record between Li Wei and a friend studying medicine. Presented by the narrator

“In fact, the main reason for myocarditis is that you don’t pay attention to rest when you are positive, and you may also exercise violently, which will lead to this complication.” Yan Kai, a cardiothoracic surgeon in Chongqing, reminded that you should not do high-intensity aerobic exercise such as fitness and playing ball within a month after you become positive, to avoid increasing the probability of myocarditis, but it is OK to walk a long way and do mild aerobic yoga.

“I’m so scared of death, I’m really scared.” Li Wei first learned that myocarditis was still in the summer vacation of his junior year. He saw a post on the campus forum. An 18-year-old girl died of fulminant myocarditis. She found that fulminant myocarditis was difficult to predict and could be fatal in a short time, which happened to many healthy peers. At that time, she stayed up late for a long time, overeating, and sometimes felt chest tightness. After that, she felt her heart was tight and stuffy, so she could only breathe deeply with strength. She soon went to the county hospital to check her ECG and troponin.

Although the results showed normal, since then, she has always felt that she had heart problems. She has had more than 30 ECG tests, more than 50 troponin tests and CT tests every six months in two years. In April 2021, a close relative died of sudden myocardial infarction. After attending the funeral, Li Wei always felt uncomfortable with his heart and chest. In the cardiology department of the Second Affiliated Hospital of Zhejiang University Medical College, the doctor heard with a stethoscope that it was OK. He suggested going to the psychiatric department to have a look. After doing the psychological test scale, the psychiatrist said that she was suffering from moderate anxiety disorder, and those discomfort were the somatic reactions brought about by it.

Li Zixuan, a psychology teacher and psychological consultant from a university in the north, said that this fear of getting sick and repeatedly seeing doctors is “health anxiety”, which has increased since COVID-19 started in 2020. When she was a consultant at the National Psychological Assistance Hotline, she often heard people say that her heart beat faster and she was dizzy, worried about whether she was infected with COVID-19. After learning about it, she found that it might be because she stayed up too late recently and didn’t get enough sleep. “Some people have a low tolerance for uncertain things and are prone to disastrous ideas, and tend to interpret things very badly.”

She suggested that those who are still anxious with normal results should try to avoid reading articles that arouse anxiety, because every time they read it, they are rewarding themselves and solidifying the vicious circle. Then emotionally realize that you are anxious, rather than having “white lung” or myocarditis. Remind yourself in this way, and your attention will turn to your “anxiety”, and then do something to divert your attention and soothe your emotions.

However, for young people who can’t breathe in calm, have blood or very thick sputum, and have basic diseases such as diabetes, cancer or immune system diseases, doctors unanimously recommend that they should go to the hospital for examination. Pang Bo, a respiratory doctor in Tianjin, said that a young man who did not eat during his fever kept sweating and suddenly fell to the ground and could not get up. When he went to the hospital, potassium was already very low, almost endangering his life. “It is obvious that the number of people infected is much larger than the flu, whether mild or severe.”

(Except for Li Zixuan, all of them are pseudonyms.)Go back to Sohu to see more

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