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2020年5月24日
<<我終於完Sem啦>>
😭我終於從大學Year 3中生存過來了😭!Yeah~~
今年2個學期對我來說真的很不容易。
跟之前一樣,
也是想把真真實實的經歷和感受記錄下來!
雖然很長很長,但愛我的您請看到最後😎💕
還記得開學前幾個月我已經很興奮、很期待休學後再次上學,
但其實也有不少擔心....
5月才跟我媽從台灣旅遊回來就住院了,
出院沒多久又再住院,
不斷重複吃東西喝水然後吐的過程卻找不到原因。
天天都吊著含有鉀離子的鹽水,補充鉀質和水分,
我還幾乎每晚都腳抽筋到不能入睡......
血管很細、很難找的我幾乎每天都要打針、抽血,
手打不到就打腳,記得MRI Brain with Contrast(要打顯影劑的磁力共振)還因為嘗試了20幾針打不到而延遲了,胃鏡、CT scan(電腦掃描)、EEG(腦電圖)、胃食道吞嚥檢查、抽腦脊髓液.....
做了很多很多的檢查但都還是不知道原因,就是一直吐。
期間不能自主小便,導尿管就一直插在我身上,多次嘗試拔除都失敗,至今差不多一年了....
後來cognitions deteriorated,時地人都弄不清楚,加上特別的抗體血報告,我終於被確診Stiff Person Syndrome(SPS),
由醫生告知是個一百萬人中大概只有一個人患上的腦神經系統疾病,由我的原生疾病(SLE)導致的,
香港的患者除了我之外就沒有其他人了。
還記得2018年10月我也是因為住院期間突發腦抽筋而被迫休學,
那時候不知道原因,現在終於有了答案......
腦神經內科醫生在牌板寫下了“Recommend Plasma Exchange”這3個字,然後就意味著我只能選擇接受。
7月17那天晚上,醫生在我右頸打了一條導管,
痛但為了可以再次上學,我把痛楚和眼淚都一一吞下。
然後7月至8月期間做了5次血漿置換,
我只記得做的時候不舒服,好像有點東西壓住胸口,
它把我身體的血漿抽到機器裡面,
所以本來很怕熱的我會冷到發抖,
蓋3張毛氈很重,但我還是很冷....
每次從我身體拿走接近3000毫升的血漿,
再用接近3000毫升的Albumin(白蛋白)補給我。
每次做治療時我的血壓都比平常低,
有一次在血科做,上壓還一直只有70幾到80幾,
護士叫了醫生進來看我😂😂😂。
做一次血漿置換已經夠累,每次要用上差不多4小時。
機器停了還更累,
血紅素(Hb)、鈣和鉀離子也會跟著掉,
掉到某一個數字我就必須先輸血和補充才能再做血漿置換,
但為了能趕在9月開學,
我還是簽下了一張又一張的同意書。
8月15日,我再透過報章媒體籌款所得款項接受了三萬多港幣一次的生物製劑注射,
8月17日,住了2個半月的我終於出院了!
8月28日再來這次療程第二針生物製劑注射!
Yeah!我趕及了!樹仁大學我回來了!!!🥳
久違了~~~~~~~
其實出院前都有一直有跟學校的輔導員聯絡,
每一次我都跟她說我很怕、很擔心,
從身體到朋友,到學業,無一不擔心....
但我還是抱著平常心想去嘗試。
9月住到了宿舍,
到了Lecture Hall的門口,我很感動!!!!!
一年沒上課了!但......推門進去卻滿是陌生....
裡面每個人都有朋友,他們有說有笑,
而我則一個人拿著拐杖和Ipad默默坐到Lecture Hall最後沒有甚麼人的地方寫筆記...
這種孤獨不只是一種感覺,
也帶給我實際的學習困難。
以往我聽不懂、聽不及老師講的東西,
我瞄一眼朋友,然後他們就會主動把他們的筆記傳給我看、讓我抄下來,
但因為去年休學,我沒辦法再跟他們一起上課了...
心情難免有點失落😞....
恰巧那時候,發生了一件事,
我在大學的一位交心朋友傷了我的心,吵架了,
她說了一句「你永遠都不適合當輔導員因為你...」的話。
百萬中選一的罕見病,連醫生都不清楚該如何醫治,我覺得很孤獨;陌生的同學,我覺得很孤獨;聽到這句話,我頓時真的有點孤獨到不知所措,也有點失去信心的感覺,更試過質疑自己的能力
「到底我是不是真的不適合呢?」......
我year 3第一個個人presentation是定在10月3日進行,
要約client、找地方錄影,然後亦要剪10分鐘的片段加上字幕,讓老師同學評價表現。我那時準備了很久,拍好了影片.....但其他的還來不及做.....
到9月的後期,在學校好不容易認識了新同學的我,
忽然開始又手抖腳抖、吃甚麼吐甚麼,
不舒服...所以10月3日又住院了!對,我要跟老師講,
希望presentation 能夠延期。
醫生商討後決定再打導管做血漿置換,
還決定一個月做5次,而我根本沒辦法說不要!
這次因為要用很長時間,所以打的是Tunnel Catheter(中央靜脈導管),打在我右肩的下方。
讓我擔憂的還有這個月要進行的2個測驗,
於是我一邊治療、一邊溫習,
最後測驗前幾天我還不斷提醒醫生記得在牌板寫下這件事!
怕他們忘記!
當然那天回到學校我真的很累,沒有考好,但我盡力了!
10月21出院後,
10月24至10月29期間我在學校完成了3科的presentations😅,
1科個人和2科小組的!
現在回想,好鈞覺得自己真的蠻......變態的😎✨!
present完本來10月3那科,
老師說:「與其說是輔導員,你比較像個媽媽或者老師!」
雖然這段由老師說出口的話不是罵我的,
老師過程都是笑著的,
但其實我有點難過......
「到底我是不是真的不適合呢?」
😔這句說話又再次在腦海中響起。
11月13日我又再住院,原因忘記了XD😂😂😂
It’s just like a routine.
這次住了大概10天,
IVIG(免疫球蛋白注射),然後做血漿置換,做完就出院。
加了新鮮冷凍血漿(FFP)去進行治療,但我敏感🤦🏻♀️…..
所以最終比預計時間遲了2天出院,要注射類固醇和抗敏藥。
出院後休息了2天,
就又在醫院和學校之間奔波,
我第一個學期明明一星期有2天day off(不用上課的日子)
但幾乎天天day off都貢獻了給醫院,
真的很累,真的......
11月中受社會事件影響,學校轉了網上教學。
這種模式對我來說其實有比較好,
因為我就算上不了課我還是可以看錄影追上課的進度,
還可以一直重播老師說的重點和例子,聽不及、不明白就聽到明白為止。但同時也因社會事件,
有一科外系科目的group presentation改成了3000字的individual assignment(個人功課)🤦🏻♀,加重了我的工作量。
11月尾我常常有種異常的累.....
12月初開始,
常常接到醫院電話說我鉀質很低要再補充🙄🤷🏻♀️。
明明已經每天吃5顆補充鉀離子的藥,
為甚麼還不夠呢?後來加到一天6顆(現在一天9顆)!
12月2回學校見老師,談一談有關之後實習的東西...
Joseph聽完我的經歷分享,
他很驚訝我竟然早就在Year 2那年暑假就已經把120個小時的Pre-internship hours、15節的Individual counsellee hours和15節Group counsellee hours完成了!
哈哈,我只能說我要完成的事情我一定會努力做到😂😂
#其實是因為我人生中有太多預料不到的事
#所以能盡早完成就盡量早一點完成✊🏻
12月11日又要住院做血漿置換了,
很怕,因為這代表測驗、功課、考試都要在醫院進行。
住院前去了見輔導員,哭出來了,我告訴她我很擔心、很怕....
輔導員說她認識了我一段時間,
明白也清楚知道我是個對自己有要求的人,
也對自己和學業負責任。
她從來不會擔心我沒有動力做功課或者我不努力,因為她知道我會盡力,
但也希望我能好好照顧自己,
不要讓自己太累。
這次住院的壓力很大,
每天拿著電腦和Ipad,卻不能畫畫。
一邊治療、一邊做功課,還要一邊溫習。
累炸的我為了追趕時間,
而在病房門口通宵做功課和溫習
(我的床在走廊,為了不想吵到/阻礙其他人,
所以病房門口就是我晚上奮鬥的地方)。
壓力很大,我很怕自己完成不到!
記得那次在醫院測驗還wifi斷線😫!
嚇到我慌了,被醫生、治療師、抽血員看到我被嚇哭。
最後真的很感激物理治療師借她的數據給我救了我😭💕
然後Houseman(實習醫生)常常請我喝令我精神為之一振的鉀水,
可惡🧟♀️😒😒😒!還一晚3杯😫!
幸好病房很多愛❤️😂😂😂:
病房經理請的雞蛋仔;
護士的糖果和night food;
物理治療師的聖誕咭和禮物;
病房姐姐的無糖蘋果雪梨水;
抽血員的糖果;
病人和家屬會買早餐、順道煮午餐和帶水果給我🥰;
Eva醫生的小咭片、滿滿的文字;
血科護士給我的餅乾;
朋友的外賣;
一句一句打氣的說話;
當然還有我媽媽無限供應的零食、杯麵、外賣、葡萄適和咖啡haha😆❤️
謝謝大家的厚愛支持著我😭😭❤️
後來有一天我壓力很大,
很想念老師而發了一個email,
希望她能給我打一句加油,
結果她說想親自來醫院探望我😭❤️!
真的很感動!給我很大的力量!謝謝您Dr.Bobo!
小黃帽一直陪伴我😗!
這次住院再次因為血漿被洗走而出現凝血困難,
2隻手瘀黑到像被打,腳也是...
加上我又正在注射抗凝血劑防止血管栓塞,
因此醫生又要我補充血漿(FFP),
結果又敏感🤦🏻♀️🤦🏻♀️🤦🏻♀️!
考試前那幾天還在做功課,還在治療,壓力在累積。
記得有一晚我打電話給一個剛下班的護士哭了很久,
她陪著我,告訴我好鈞已經夠努力了;
另一天我在做那份外系的3000字功課,
連題目都沒看懂又沒在學校上過課的我很不知所措,
看著一份又一份關於社會學和馬克思主義的學術文章,
壓力就更大了。我哭到護士走過請我吃冰淇淋😫✌🏼;
夜班另一個護士回來,
我摟緊了她哭到她的制服都濕了。
哭完又再繼續奮鬥!🔥
有一天血漿置換後我血紅素又掉下去了,
胸口有點不舒服,血科那邊要我先輸血才能繼續療程,
但竟然輸到一半敏感...
所以早上的血漿置換做得很辛苦,
腳一直在抽筋,血科護士要一直幫我按摩。
那天做完很累很累,我有讓自己好好休息!
考試當天,開考前半小時我已開數據,確保我電腦的連線穩定。護士在我桌面寫了一個「考試中,請勿打擾」的牌子,心情怕怕的,有點緊張但同時也有點累....
不在狀態😭😭😭,但我盡力了!
經過一翻努力,12月21我終於完Sem了!
把第一個學期的功課、測驗、小組報告和考試都完成了,還去了某教育機構的奬學金面試。
住院期間照顧了我8年的醫生,我把他當成爸爸的醫生說了一句話,讓我陷入了傷心無助...
「你繼續留在風濕科只會加重大家的負擔。」
腦海迅速地把我今年遇到的言語傷害和經歷都連接起來了,產生出來的就是「我沒有能力當輔導員」「我不適合當輔導員」「我生病不斷帶給大家負擔和麻煩」....
12月27日,那個傷了我的同學在whatsapp找我說對不起,她說壓力很大不小心地把脾氣發了在我身上....
然後我原諒她了。
出院後休息沒幾天,
12月30那天去了醫院沖洗導管後,
那晚突然高燒起來,燒到1月1早上才全退,很累!
累不是重點,重點是這次高燒讓我走路的狀況又變差了一些,
穿回了我的「三吋高球鞋」😔。
1月3日我去泌尿科做檢查,但被發現我有點發燒,
檢查暫時不能做,卻因而早了見醫生。
見我的是一位泌尿科顧問醫生,
她看電腦知道我因為SPS而長期放置導尿管,
然後她問我為甚麼不self-cath(每天自行導尿),
我說我沒辦法......
她開始用罵我的語氣「為甚麼沒辦法?」
然後我說「我的腿連張開都沒辦法...怎樣...」
「哪你就只能選擇開泌尿造口或者一輩子都插著導尿管!你選擇如何呢?造口還是導尿管?」她的語氣絕對不友善。
這時醫生跟另一個護士用凌厲的眼神看著我,
而我則「我....我....我....可以給我一點時間想一下嗎?我想先跟家人商討一下...」
然後醫生有點兇:「吼!都25歲了,一個決定都做不了,還要別人幫你決定?」
「.........」之後,我腦海一片混亂,默默地撐著拐杖走出了診症室。
心理面突然又在想「對,或者我就真的那麼沒用,一個決定也做不了,或者我就真的別人的麻煩和負擔!」
那段時間心情有點低落.....我獨自回到宿舍,
其實是很想找個地方靜一靜。
那段時間最大的發現就是我眼淚蠻多的😂😂😂!
1月13又開始踏入了新的學期,
那天我做了一個勇敢的決定,
我寫了一封6頁A4 size的信給那群傷害了我的醫生,
我向他們坦白說出自己的想法和感受,只因為我想還自己自由、不希望再活在悲傷無限循環當中!
1月14我又再次開始隔天做血漿置換。
雖然累,但我還是很想回學校上課!
不用血漿置換的日子我就去上課,
我很抱歉的在Isaac的課堂累到趴在桌面上休息!
我趴著,但我有用耳朵聽,
感謝那時候身邊的K同學幫我抄下筆記💕💕
好不容易撐到1月23日完成1月的療程,累到不行。
後來2月因為肺炎疫情,所有課程都轉為網上教學。
可惡!知不知道我有多期待上學、上課?
知不知道我有多想跟老師、輔導員和同學見面?😭
大學畢業論文(FYP)還在這個時間正式展開....
這段時間其實有時候會吐、胃痙攣,
還試過2次全身肌肉痙攣🌚,長期low back pain(下背痛)。
當我再次努力抓緊狀態,以為自己的進度在軌道上,
3月我self-aware到自己的一些PTSD symptoms愈來愈多、愈來愈困擾我。
我知道影響可以很大、也希望可以快點處理那種被傷害的情緒,不想再難過了,所以我借了老師們和護士的耳朵 ☺️☺️💕💕嘻嘻,謝謝您們!!!真心的!🥰
功課、presentations 繼續進行。
3月13發現做血漿置換的喉管switch out了1cm,
又發現有點分泌物在喉管的出口,那晚還開始發高燒。
隔天早上我打電話去醫院,但醫生說種菌報告還沒出來,所以做不了甚麼。
3月17做了presentations,
但某些組員的不合作令人感到無奈🙂。
#不希望攬炒所有最後辛苦自己🤦🏻♀️
#同學們那是GroupWork不是Individual🙂
#請為大家的功課負點責任
3月19日跟Helen在zoom聊天,
老師跟我說「其實問題不在你身上,只是傷害真的太大了,根本沒有空間、時間讓你可以重整!」
然後隔天明明只是回醫院沖洗導管....
但我卻被醫生告知導管有細菌感染,
MRSA(抗藥性金黃葡萄球菌)🤦🏻♀️🤦🏻♀️!加上發燒,
所以要盡快住院:注射抗生素和拆除導管。
真的一波未平 一波又起🙄
住院還要做功課和處理自己的心理狀況:
天天都要面對讓我出現心理創傷的那群醫生。
這段時間既不能見輔導員,
媽媽、別人又因為疫情不能來探病,
那種感覺很孤單、很空洞......😔
還第四次在醫院渡過生日...
但真的很感激很多人用愛拯救我的心!
有護士的禮物、蛋糕、生日歌;
媽媽陪我請假外出半天,去吃我想吃的;
去了Dirty Team的護士隔著膠板和我在醫院樓下吃早餐;
輔導員的生日email;
Helen為我用心準備的生日會;
Helen、Isaac、Dr.Bobo、Dr.Sandrine、Dr.Alex Li、Dr.Alex Chan、佩芝老師的祝福很溫暖、很有愛🥰
還有朋友們的禮物和祝福!
謝謝您們!🥰🥰我覺得我真的很幸福❤️
3月31因為要趕功課的緣故,
我「任性」的簽下名字在自願離院聲明書上。
針口拔了發炎,我的右手腫了一星期,熱熱痛痛的。
回家努力追回進度,準時的交上一份又一份功課,
完成一個又一個presentations !
4月7和21又再次回醫院吊生物製劑。
還記得4月21那天吊完藥從醫院走已經差不多18:00,
吃點東西就極速由屯門趕回九龍的家,
洗個澡,22:20跟同學zoom到半夜1:35,累炸了....
就是為了4月22號中午的presentation🔥🔥
(事前已經開了2次zoom meetings),
幸好當天Helen和Isaac的評語大多都是正面的☺️,
而做得不好的地方我絕對接受,
希望未來的日子裡可以好好改進!
數數手指,光是第二個學期我就完成了:
1.中文小品文撰寫
2.Psychological Assessment的presentation
3.明清小品文讀後感
4.Group Coun的group proposal & session plans
5.Group Coun presentation
6.Group Coun的Personal Reflection paper
7.Clinical Assessment Portfolio
8.FYP的project plan presentation
9.FYP project plan
還完成了3科考試!!!
單單是FYP project plan也4次向老師申請延期繳交🤦🏻♀️
謝謝我supervisor理解我的需要😭💕
最後完成了,滿足感極大!!!
結果如何我都接受,因為我盡力了🖖🏼
中間身體還試過出現過變化,
突然臉上、手腳出紅疹、發低燒、關節痛、腿腫,我又要先讓自己休息...很怕是SLE復發🤦🏻♀️
10月到12月去了2次 A&E(急診室)
1月到現在也去了2次 A&E(急診室)🤷🏻♀️🙄。
時間不夠用,
讓我一度質疑自己的能力是不是真的那麼「力有不逮」😫,
能堅持到底真的全靠我不斷重複問自己:
「為甚麼當初要開始?」「不是早知道會辛苦嗎?」
「你是為了甚麼才堅持到現在啊?」
其實我心中的目標很清晰、很明確!✨✨
說實話壓力真的很大,我很擔心自己做不了!😭
5月見了兩次輔導,
兩次輔導員跟我做練習我都能哭到不能自拔...
但哭過之後我又能夠找回自己的狀態,繼續衝!
每天一起床就坐在電腦和Ipad前,
打字、溫習、打字,打一打就又晚上了!
我身體狀況不容許我長時間坐在同一個位置,
一覺得累就又要換位置,一時坐在書桌的椅子、一時床上!
要休息時就要休息!
有時候累到洗完澡會有點暈,
從小巴站走到文康大樓已經差不多虛脫🤦🏻♀️,
有時候喘氣喘到以為自己是個老人😭。
但我真是很怕時間來不及,
所以就算要休息,我都會為自己設定鬧鈴!
10分鐘,20分鐘,最長可以休息30分鐘....
鬧鈴響的一剎那很捨不得,但還是要繼續努力!
過程很艱辛,
吃很多藥和身體不好的我很容易累,
很難熬夜的我單單在這個學期就熬了10天夜,
腰很痛就墊枕頭,
不行就塗止痛藥膏,不行就再貼退熱貼降溫;
再不行就吃止痛藥!
我桌上長時間擺著1枝藥油、1枝止痛藥膏、薄荷藥膏、2枝眼藥水和2包止痛藥,櫃桶還有退熱貼。
還記得考明清小品文那天我打字打到左手快要斷掉,
還麻痺到要一邊用左手打字,右手一邊按摩左手🙄,
考完我要用止痛藥膏塗它。
我人生做過最瘋狂的決定,
莫過於下決心要讀樹仁的CounPsy,
但我沒有後悔做了這個決定💕!!!🔥🔥🔥
#這個雙學位課程簡直是在挑戰我的人體極限
#還有我不斷突破限制的決心💥💥💥
辛苦也能有所得著:
做FYP時、課堂上學到的東西都好像能夠回應我內心的感受和需要,Helen讓我接觸的IFS也好像讓我跟自己內心的距離縮短了一點點。
而且,辛苦也是可以很快樂的:
不得不提我上課很開心這回事🤣!
Helen用Insideout角色教我們Bipolar Disorder;
Bobo、Isaac所說的例子都太令我印象深刻;
新來的可愛miss真的很逗趣hahahaha ,
我一邊上她的課,一邊在宿舍哈哈大笑🤣🤣🤣!
發自真心我笑得很開心😂😂😂!
為什麼可以那麼可愛?我很想跟這個老師見面!❤️
她連教Statistics (統計學)也能教得那麼有趣,真可愛!
從小.....我就很討厭跟數字有關的東西,
以前常被爸爸和數學老師說我笨。
雖然有點白痴,明明您教一個多小時的課堂,
我要用上差不多3、4個小時才能把您教的一個lecture聽懂然後用自己的文字寫下筆記。
我記得我還傳給您一個很長的email希望您能為我再解釋一次Postdictive Validity。
您回覆我的那一刻我拿起apple pencil畫下了一條timeline,把自己畫在中間...我就明白了!!!
超興奮的😆💕💕!!!
還有一次😂,
您剛好教完Logical-Content Strategy(用logic推斷client的行為),然後Siri小姐又跑了出來,您的即時反應好可愛😂😂😂❤️
讓我情不自禁用logic推斷老師的行為🤓🤓XD!
我讀文言篇章的時候更加發現古人都是Introvert,
哈哈,他們內心世界何其豐富😂😂😂😂!
光是考試的7篇選讀篇章就被我發現:
一位古人疑似患上PTSD、一位Depression、另一位因為loss所以grief😅,我的筆記除了我應該不會有人看得懂我寫甚麼🤣🤣🤣!
上個學期我有回學校上David叔叔教的Motivation & Learning,所以學懂了用Positive Reinforcement,為自己提供持續的motivation(動機)hahahahaha~
😆✌🏼買冰淇淋和飲料去奬勵努力的自己!完成了任務就有獎勵XD
哈哈,我很享受這種愉快學習的過程🥰
很喜歡能抓緊知識那種實在的感覺!
而且每天就算多忙多累都一定會打電話給我媽媽,
媽媽是我最好的朋友!😘😘
有時候會聊天,有時候會跟她撒嬌說「我好累!」
然後我媽不知道為甚麼懂得說:
「比啲掙扎!!!」😂😂😂
媽媽您到底在哪裡學的???哈哈
雖然Year 3的過程很辛苦,我有哭過、有跌到過,
充斥著孤獨和無力感,或者你覺得我常常哭是軟弱。
但我還記得Helen曾經分享了我的發文,然後說「每滴眼淚都有它的意思」;
我還記得輔導員對我說「It’s okay to be not okay!」
hahahaha我有記起來😀!
哭不代表我軟弱,不代表我要放棄!
從來我都沒有想過要放棄!!!
Yeah我跨過去了,
未來的一年將會更加艱辛、有更多的困難和挑戰,
但正如我之前所說:
「任何的阻礙都不是我放棄的理由!」✊🏻
謝謝很多人的鼓勵和愛護,
謝謝您們默默的把小禮物和支持的說話/文字送到我那裡!❤️❤️❤️❤️
謝謝你們在我難過時讓我想起來自己是被愛的!
5月有一天我通宵做FYP的時候,我很質疑、很擔心自己沒辦法完成....
然後桌上的手機剛好竟然播放著「上帝早有預備」!真的很巧!嗯,對,可能很多東西我沒辦法控制和預計,但我知道上帝爸爸會為我提供一個最好、最適合我的安排❤️!
感謝每一個人、每一件事出現在我的生命裡,
讓我能成為更好的我🥰
最後我也很感激努力不懈的自己😘!
嗯!我一定會盡力克服困難、好好享受,
然後下年開心的畢業💕🔥🔥
#拜托請一定要賜我健康的身體🙏🏻
************************
哈哈,
一口氣打下了很多文字,比功課還要多!
不論開心不開心,
一點一滴都是我很珍貴的回憶!!!
最後送上一段影片🤓
我有個習慣(🤔應該不是習慣.....)
em…..而是因為自己集中力不足而想的應對方法:
就是工作時放手機在桌上錄縮時影片😌!
這對我來說蠻有效的!絕對不會玩手機因為玩不到XD😂😂😂!
#hahaha寶馬山上的日出真美麗✨✨🌤
#其實到現在還不敢相信自己正在讀雙主修課程haha
#wow六月有機會上我很期待的IFS課程😍
#我不會忘記不斷叫自己堅持住的日子✊🏻
#我期待已久的實習要來了🙌🏻
#一個學年結束後我由introvert變成更introvert的introvert🤣
#yearONE的時候還不明白為甚麼Isaac說我是偏向introvert😂
#我現在懂了👀
Reference
Kwan, H. K. (2020). Debbie’s reflection in these two
semesters. Retrieved from HoKwan’s brain & heart.
👆🏻😂hahaha笑死!快樂從來就是那麼簡單❤️🤣🤣🤣!
#Sem議員❤️
#寶寶辛苦了🤛🏻
(我打了9850幾個字,是時候停下來了!😂😂😂
說了出來果然很紓壓!☺️謝謝你看到這裡!❤️謝謝你愛我!!)
同時也有4202部Youtube影片,追蹤數超過82萬的網紅瀬戸弘司のゲーム実況 / Koji Seto Games,也在其Youtube影片中提到,※ネタバレ注意:今回は第4章をプレイしていきます。 2018年末に世間を騒がせたキムタクゲーム「JUDGE EYES:死神の遺言」から約3年。 続編となる新作「LOST JUDGMENT 裁かれざる記憶」をプレイしていきます! 【再生リスト】LOST JUDGMENT 実況まとめ https:/...
「syndrome switch」的推薦目錄:
syndrome switch 在 當張仲景遇上史丹佛 Facebook 的最讚貼文
TCM Treatments of COVID-19
Written in Chinese by Dr. Andy Lee, March 7, 2020 (http://andylee.pro/wp/?p=7660)
Translated to English by Dr. James Yeh, March 13, 2020
I published an essay “From SARS to Novel Coronavirus” in Chinese on January 21, 2020 (http://andylee.pro/wp/?p=7169). At that time, I tried to discuss possible Traditional Chinese Medicine (TCM) treatments of Novel Coronavirus based on my clinical experience of treating many severe cases of pneumonia caused by various influenza and other diseases. Since then, I have directly and indirectly participated in treating patients of Novel Coronavirus successfully, had discussions with many doctors fighting the epidemic at the front line and many researchers conducting related researches, and read many reports on this subject. Although the “Novel Coronavirus Pneumonia” has been renamed to “COVID-19” (coronavirus disease 2019) and the name of the virus has officially named from “2019-nCoV” to “SARS-CoV-2”, I now firmly believe that my original judgment, views, and interpretations are correct. For the sake of easiness for people to read and share, in this essay, I am reorganizing my previous discussions and including some explanations on certain confusions as well.
First, there are numerous provinces and cities in China using TCM to fight the “COVID-19” (I will use the term “Coronavirus” from now on.) No matter whether the treatments were primarily using TCM or the combination of TCM and the methods of Western medicine, there have been a significant amount of positive outcomes. On the other hand, the views of how to use TCM to treat and the use of corresponding herbal formulas vary quite a bit. Even when TCM remedies were effective, why did some patients fully recover and were discharged from the hospitals but other patients still could not get the virus-free “negative confirmation” from virus DNA tests?
Many TCM doctors participating in the treatments and discussions often look at the Coronavirus issue from a single “Point” or the condition of the patient at that specific moment. Some interpreted the disease as “Dampness” (濕), “Dryness” (燥), “Cold” (寒), or “Heat” (熱). (Translator’s note: These interpretations are often the opposite ends of the spectra, like Dampness is opposite to Dryness; and Cold is opposite to Heat.) From the clinical practice point of view, those treatments based on such conflicting interpretations all had positive effects to some degrees. Then, which interpretation is the “correct one”? In fact, those simple interpretations all have some merits but don’t fully cover the subject in hand. Although TCM is based on “Dialectical Treatment” (辯證論治), i.e. treatment is derived from “observation and diagnosis” of patients’ complex symptoms, the most important thing is that disease shouldn’t be viewed as an isolated problem at a specific time, but the whole development of symptoms along a timeline. Not only we need to observe and diagnose the current ailment but also we have to understand the development history of the disease and to project how the disease will develop in the future. For a single patient, we might be able to focus on the clinical results of this patient. But for epidemics, we have to look at a bigger picture and take into account how this Coronavirus develops health issues inside the human body from TCM’s perspective. And, in clinical treatments, we also need to consider many variants caused by each patient’s preconditions and one’s strength to fight off the disease.
From my experience of curing many patients who were inflicted with flu-induced pneumonia and complications, and the recent participation in treating and curing Coronavirus patients, it is proper to summarize that no matter whether the virus is Coronavirus, bird flu, swine flu, or the “common” flu, we found that the bodily deterioration caused by the virus, in general, follows the description from the TCM theory first covered in the ancient literature “Treatise on Cold Damage on Miscellaneous Disease ” (傷寒雜病論). However, the progressions of the disease from such special viruses are much faster, more severe, and/or more persistent than that of the common flu. Patients’ own original “health” condition also complicates the progression. (Translator’s note: For example, the infliction rate of young children is much smaller than that of adults for Coronavirus.)
As I explained before, the TCM theory discussed that for the common flu or “catching a cold”, the disease starts with “Exterior Deficiency or Weakness” (表虛). That is, the “exterior” of the body is invaded by the “External Pathogen” (外邪), like virus, and has adverse reactions. (Translator’s note: Here the exterior doesn’t mean just the outside surface of the body like the skin, but all the surfaces topologically exposed to the outside like lining of throat, nose, and bronchus of the body.) This is the first stage of the whole episode and often can be effectively treated with the herbal prescriptions such as “Gui Zhi Tang” (桂枝湯). If the patient is not properly treated, the body fluids within the surface and muscles could not function properly. It will cause the transition to the next stage “Exterior Excess” (表實). (Translator’s note: The word Excess has various meanings: excessive reactions all the way to neoplasm, excessive wasteful things, etc.) Viral infection at this stage is matched to one of the several syndromes named with the corresponding herbal remedies such as “Ge Geng Tang” (葛根湯), “Ma Huang Tang” (麻黃湯證), and others. The TCM theory calls this stage “Exterior Coldness” (表寒). In history, many TCM doctors considered this stage as the body being hurt by outside coldness (傷於寒) or in plain words “Catching Cold”. However, that is a misunderstanding. While outside coldness is one of the causes leading to the stage “Exterior Coldness”, it is not the only cause. When the body fluids could not function properly, the normal body fluids which had proper fluidity to circulate and to fulfill vital functions (活水) became a pot of “Dead Water” (死水), i.e. wasteful water which can’t fulfill vital functions. In other words, the ancient literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論) is much beyond the simple interpretation of how to treat the ailment caused by “cold damage”, but a classical literature of explaining both the physiology and pathology of human body functions.
Normally, the ailment or symptoms of the common flu would be limited at this stage of “Exterior Coldness”. Even without any treatment, the human body often could fight off the virus with an immune response and fully recover. But when the effects of Exterior Coldness started to penetrate into the interior of the body, the first common organs to be affected will be the organs that have a short path to the outside. (Translator’s note: Topologically, trachea and lung are only a membrane distance away from the outside air.) Then the Exterior Coldness gets transformed into the next stages such as “Interior Coldness” (裡寒) and “Lung Coldness” (肺寒). (Translator’s note: Here “Lung” means the whole respiratory system, not only the lung organ.) Clinically, the patients start to show symptoms of the syndrome named after its herbal remedy “Xiao Qing Long Tang” (小青龍湯). At this stage, the patients have serious coughing and running nose. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. Just like when the cooling system of a car malfunctions, the engine would overheat. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to the next stage of “Heated Interior” (入裡化熱) and often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). At this stage, it does not mean that the whole lung is “dry and heated”. In fact, many pneumonia patients exhibit “mixed coldness and heat” (寒熱夾雜) in the lung. For example, while the upper part of the lung is “dry and heated”, the lower part of the lung might suffer excessive mucus of a high density. Pleural effusion and hydronephrosis might start to develop quickly.
Such a complex situation was extensively discussed in Chapter 7 of the ancient literature “Synopsis of Prescriptions of the Golden Chamber” (金匱要略肺痿肺癰咳嗽上氣病脈證治第七篇). At this complex stage, the illness development varies significantly among patients of different preconditions and other variants. It is no longer the situation that a simple herbal remedy can be applied to all the situations. The TCM theory illustrates various treatments by those herbal remedies such as “She Gan Ma Hung Tang” (射干麻黃湯), “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯), “Xiao Qing Long Jia Shi Gao Tang” (小青龍加石膏湯), and others. It doesn’t mean that one of the herbal remedies should be selected to treat a patient directly. Instead, the TCM Theory used these herbal remedies to teach its practitioners how to “think” and create a proper herbal remedy based on the conditions of a specific patient.
For example, the Coronavirus has quite a puzzling situation that many Western medicine doctors haven’t yet fully understood. Some severely affected patients exhibited fibrosis of the lung like the SARS phenomenon. Other severely affected patients did not have SARS-like lung fibrosis but had massive liquid cumulated in the lung, which even “drown” some patients to death. From the TCM point of view, it is not strange at all. Fibrosis of the lung is the typical following stage of Heated Interior matching to “Da Qing Long Tang” (大青龍湯). It was named as “Lung Atrophy” (肺痿) in the TCM theory. And the situation that one suffers from massive dense liquid accumulation is matched to symptoms of severe development after the stages matched to “She Gan Ma Hung Tang”( 射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), and others as discussed earlier. The TCM theory called it “Lung Abscess” (肺癰). In the TCM theory, Lung Atrophy and Lung Abscess are two progression paths of this virus depending on which path develops faster or even simultaneously. From the past and current reports, SARS virus tilts toward the path of Lung Atrophy, while the Coronavirus tilts a little more toward Lung Abscess.
The above explained the progression of flu and other epidemic virus infections. Now you might understand how different TCM doctors had different views or treatment methods, but all of the treatments had some partially positive effects. If a TCM doctor’s diagnosis at one particular moment was slight hotness of the lung, some mild herbs to “clean up the heat” (清熱解毒輕劑), often used by the “Southern School” doctrine (溫病派), might relieve the patient’s symptoms. But if a TCM doctor’s diagnosis at a different point of the progression was massive mucus accumulation, heavy dosage of strong herbs, often used by the “Northern or Classic School” doctrine (經方派) might be needed to treat Lung Abscess (肺癰). That is why we saw some reports that the “Pneumonia Formula One” (肺炎一號) used in Guangzhou city, which was based on mild herbs to reducing the “heat”, had some positive effects in Guangzhou but not so effective in Shanghai. In Shanghai, many TCM doctors had to switch to stronger herbal ingredient often found in “Da Qing Long Tang” (大青龍湯) and “She Gan Ma Hung Tang”( 射干麻黃湯) as discussed earlier. This was due to different weather patterns and different patients, i.e. different progression paths described in the previous paragraphs. In other words, from the specific moment of the doctor’s diagnosis, both views were correct. But neither of them grasped the progression timeline of this severe illness.
Another point raised earlier was why did some patients fully recover while others did not? According to the information given by the doctors on the front line, there were so-called “Western medicine and TCM combined treatments” in which Western medicine drugs were continuously given to the patients and TCM herbs were used as supplements. When adding TCM herbs had a positive effect and made a speedier recovery, it was all goodness. But when adding TCM herbs did not have positive results, then what? According to the doctors on the front line, the medical team did not really think through the stages of disease progression as discussed earlier and switch to different TCM remedies, but only increased the dosage of Western medicine drugs such as Interferon (干擾素), Chloroquine phosphate (磷酸氯喹) used to treat malaria (抗瘧疾藥物), Arbidol (阿比多爾) used to treat influenza (抗流感藥物), and others. Heavy dosages of such drugs had severe side effects and sequelae. In those “combined” treatments, the medical teams didn’t have enough TCM expertise to make sound decisions on herbal remedies. Instead, they simply used TCM herbs as “extra help”.
How about treatments primarily with TCM remedies? The chief Western medicine expert who leads the fight against the Coronavirus, Dr. Nanshan Zhong, admitted under political pressure that TCM was useful against light or even medium threat situations of Coronavirus but insisted that TCM could not cure severe cases. His statement was based on his belief that there is no ingredient in TCM herbs that could kill Coronavirus. I am sorry to say that Dr. Zhong is incorrect in this aspect. With solid patient cases as proof, TCM can actually cure severe cases of Coronavirus infection and other flu-related infections. When it did not, it is the particular TCM doctors who had not mastered the whole theory and methodology of TCM. But one thing that Dr. Zhong said correctly was that no ingredient in TCM herbs can “kill” the virus. However, the TCM treatment isn’t based on the ability to kill the virus. (Translator’s note: Western medicine drugs could not kill the virus either.) Many people still have the level of limited understanding that TCM can only improve the immunization ability or some herbs such as the root of Isatis tinctoria (板藍根) has some natural antibiotic chemicals. Such understanding is unfortunately poor and very limited. Although modern medical science still could not fully comprehend TCM theory and its clinical outcome, against Coronavirus, the better explanation is that TCM remedies can “improve the internal environment of the human body”. (Translator’s note: So that the patient would not fall into the adverse conditions that the organs fail to function.) In plain words, when the virus causes more mucus, TCM remedies reduce the mucus. When the virus causes fibrosis, TCM remedies reduce the “heat level” of the lung. TCM remedies tend to push the body and organs back to the original healthy states. Once the environment is unfriendly for the virus to keep replicating, the patients will have higher chances to eradicate the virus by themselves and recover. One can probably say that this explanation and method is similar to the idea of using Western medicine Interferon but without severe side effects. That is, TCM can cure not because it has the ability to “kill” virus by some ingredients but to help to restore patients’ “internal environment” to healthier conditions that prevent the virus from replicating quickly. (Translator’s note: If one buys the same argument made by Dr. Zhong that a medication needs to have ingredients to kill the Coronavirus, then all the medications used today would not qualify. Then do we give up? In fact, why TCM was not selected to treat severe cases was because those stronger and less commonly used herbs were not applied properly or the TCM doctors at hand had less confidence for doing so. )
Now, we can go back to discuss how clinically TCM can treat and cure Coronavirus patients. For light to mild cases, most of the different TCM treatment methodologies could help. For medium to severe cases, as I discussed in my previous essay, we need to utilize the strength of certain herbs:
- Sheng Shi Gao (Gypsum, 生石膏): To reduce heat inside the lung (清肺熱) and enhance the liquid circulation in the respiratory system (加強肺津液運作)
- She Gan (Belamcanda chinensis, 射干)、Zi Wan (Aster tataricus, 紫菀) 、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、Sheng Ban Xia (Pinellia ternate, 生半夏)、Ting Li (Sisymbrium indicum, 葶藶)、Da Ji (Euphorbia pekinensis Rupr., 大戟), etc.: To reduce accumulation of excessive mucus and wasteful fluids inside the respiratory system (去肺下方濃稠痰飲、肺積水、胸腔積液等)
- Ma Huang (Ephedra sinica Stapf., 麻黃), etc.: To enhance the lung function (宣肺、發陽)
- Mai Men Dong (Ophiopogon japonicas, 麥門冬)、Xing Ren (Prunus armeniaca, 杏仁): To moisturize the lung (潤肺)
That is, we need to combine the theory and targeted responses of the various herbal remedies such as “Da Qing Long Tang” (大青龍湯), “She Gan Ma Hung Tang” (射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯)“, etc. as discussed earlier, and properly adjust the dosages and ratios of ingredients to fit the requirements of individual patients based on their conditions. In addition, if the patients have other ailments, those conditions need to be taken into account also, such as:
- For “Coldness and Wetness of the Middle and Lower Abdomen“ (中下焦寒濕) or “Deficient Kidney Function” (腎陽不足): Add Bao Fu Zi (processed Aconitum carmichaelii Debx root, 炮附子)、Xi Xin (Asarum sieboldii, 細辛), etc.
- When the liver function is weak or damaged by heavy dosages of Western medicine drugs such as interferon: Add Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩), etc.
There is no question that it is very challenging to fight off the Coronavirus. The clinical treatments will seriously test TCM doctors’ thorough understanding of TCM and their ability and courage to call the right shots under a great amount of pressure. On the other hand, it is also a good time to prove that TCM can be effectively used to fight various viruses in a superb and speedy fashion with little sequelae and at a much lower cost.
For fighting such a new and aggressive virus epidemic, there is no single TCM herbal formula that can treat all situations. One must have deep knowledge of the stages of the disease, along with close examinations on patients’ preconditions, so one can use the most effective prescription to intercept and turn the symptoms around. On the other hand, many provinces and cities in China provided TCM guidelines on Coronavirus treatments and pre-fixed herbal formulas to address people’s demands on a herbal remedy for “common usage”. Among them, I found the current recommendation from the Chinese National TCM Administration the most appropriate for a good percentage of Coronavirus patients. The herbal remedy was recently named as “Qing Fei Pai Du Tang” (清肺排毒湯), which could probably be translated to “clean up the lung and get rid of the toxic”. In line with the discussion above, this specific herbal formula includes Ma Huang (Ephedra sinica Stapf., 麻黃), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草)、Xing Ren (Prunus armeniaca, 杏仁)、Sheng Shi Gao (Gypsum, 生石膏)、Gui Zhi (Ramulus Cinnamom, 桂枝)、Ze Xie (Alisma orientalis, 澤瀉)、Zhu Ling (Polyporus umbellatus, 豬苓)、Bai Zhu (Atractylodes macrocephala Koidz., 白朮)、Fu Ling (Poria, 茯苓)、Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩)、Jiang Ban Xia (Pinellia ternate, 薑半夏)、Sheng Jiang (Ginger, 生薑)、Zi Wan (Aster tataricus, 紫菀)、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、She Gan (Belamcanda chinensis, 射干)、Xi Xin (Asarum sieboldii, 細辛)、Shan Yao (Dioscorea oppositifolia, 山药)、Zhi Shi (Citrus aurantium, 枳實)、Chen Pi (Citrus reticulata Blanco, 陳皮)、and Huo Xiang (Pogostemon cabin, 藿香). Since such an herbal remedy was designed for “common usage”, it has to consider all degrees of disease severity. Therefore, the dosages can’t be too heavy, as the majority of the patient cases are light to mild. As the result, “Da Qing Long Tang” (大青龍湯) discussed earlier became a lighter herbal formula named as “Ma Xing Gan Shi Tang” (麻杏甘石湯). The stronger herbal ingredients such as Ting Li (Sisymbrium indicum, 葶藶) and Da Ji (Euphorbia pekinensis Rupr., 大戟) to treat pleural effusion and hydronephrosis are not included. Hence, for severe cases, the herbal remedy from the Chinese National TCM Administration needs to be enhanced with additional ingredients and larger dosages.
In summary, as long as the TCM doctors have sufficient knowledge and clinical experience, by applying the proper methodology, TCM alone is capable of dealing with severe Coronavirus infections. (Translator’s note: There is much to do to develop a comprehensive diagnostic and treatment methodology which can help many TCM doctors to pinpoint the patient’s condition and stages of the infection to make the proper decision, especially when fully qualified TCM doctors are of short supply.) At this moment, there is no “special drug” in Western medicine to cure Coronavirus, but to resort to cortisone, antibiotics, interferon, anti-malaria, anti-flu drugs to maintain the lives of patients and passively wait and hope that the patients’ bodies can find their own way to turn the situation around. Even then, the Western medicine drugs mentioned above all potentially have significant side effects and sequelae. Patients with severe cases might be able to get out of the deathbed but most likely live with some permanent damages to the body. Dr. Zhong, China’s chief Western medicine expert on the Coronavirus epidemic, also warned that the current path of developing the “special drug” would most likely lead to severe sequelae to the patients. Given that is the case, why don’t we put much more effort to fully develop the TCM treatment of viral infection, not just for Coronavirus but also for future viruses which will bound to happen in the future?
(Translator’s note: As China is getting good control of the virus spread and gradually recovers from this epidemic, the knowledge learned will be invaluable to the rest of the world. Europe and the United States are on the exponential rise of new cases as of the writing on 3/14/2020. Various models predict that in the US alone Coronavirus infections can reach millions, as discussed in the Opinion Column of New York Times, “How Much Worse the Coronavirus Could Get, in Charts” by Nicholas Kristof and Stuart A. Thompson, March 13, 2020. China should continue to put efforts to develop TCM diagnostic and treatment methodology so that millions of people in the rest of the world can be helped and saved. TCM is not just for science, it is for humanity.)
(http://andylee.pro/wp/?p=7729)
#當張仲景遇上史丹佛
syndrome switch 在 Ming's Facebook 的最佳解答
【#YOUME #THEEQUALITY】#063
#當愛成為一種病《禁愛世界》(Equals)
未來世界裏什麼事都可能發生,也許地球再不適合居住;也許人們移居外星;也許個人情緒與感受將被銷毀。而《Equals》裏的未來世界,人們正是活於無情感的的反烏托邦世界。這個世界視擁有情慾的人類為瑕疵品,人們鄙夷任何的情感狀態,認為情緒是阻礙人類進步的禍根,因此人一出生便受科技SWITCH OFF 情感神經,而在後天得到「愛流感」(Switch On Syndrome, S.O.S.)者必須就診服藥,抑制病菌蔓延,病情難以控制時,就須進行隔離執行安樂死。...
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syndrome switch 在 瀬戸弘司のゲーム実況 / Koji Seto Games Youtube 的最佳解答
※ネタバレ注意:今回は第4章をプレイしていきます。
2018年末に世間を騒がせたキムタクゲーム「JUDGE EYES:死神の遺言」から約3年。
続編となる新作「LOST JUDGMENT 裁かれざる記憶」をプレイしていきます!
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【超瘦せ肉漬け】是非お試しください!
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syndrome switch 在 フブキCh。白上フブキ Youtube 的最佳貼文
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工作の世界をヨッシーが大冒険!
2019年3月29日(金)発売、Nintendo Switchソフト『ヨッシークラフトワールド』
のんびりヨッシーと遊んでいきます(^・ω・^§)ノ
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