Doctors remind: "A new factor causing spinal cord injury: dance practice is quietly increasing, which should attract the attention of the whole society." "A hospital treated 75 of these children in five years, all of whom were girls.
Lu Yisheng, a dancer who was the president of the Beijing Dance Academy and vice chairman of the China Dancers Association, wrote an open letter "to dance teachers across the country", "There is something I must remind you."
Neurologists determine that it is myelitis, which may also be a spinal cord injury. He noticed the child's bulging abdomen and said empirically, "Is it possible that the urine cannot come out?" ”
At that moment, Luo Jing reacted, there was a black shadow in her daughter's bladder, but she said that there was no intention of urinating, which meant that she was incontinent.
01
▲ On July 9, 2015, in the training room of a dance school in Zhangjiajie City, Hunan Province, children trained their lower back under the guidance of teachers. Courtesy of Visual China
They suggested in the paper: "A new factor causing spinal cord injury: dance practice is quietly increasing, which should attract the attention of the whole society." They warned that the injuries would cause "catastrophic damage" to the child's future.
02
"There is one thing I must remind everyone," he reminded his peers in recent years of cases of children's lower back disabilities, "dancing is not the same as practicing." He pointed out that regardless of whether Chinese or foreign, dance major enrollment and professional training are generally set after the age of 12, because at this time, children's bones, muscles, joints and nervous systems are basically mature, and the brain development is relatively sound, suitable for education. He called on society to pay attention to this issue, "we must be responsible for the future citizens of the Chinese nation."
Beijing Bo'ai Hospital, a rehabilitation ward for children with spinal cord injury. Gong Ayuan/Photo
03
The very low incidence, the inability to see abnormal images, and various objective factors can explain to a large extent why the vast majority of teachers, parents and even doctors cannot make correct judgments at the first time and cannot predict the severity of the consequences.
04
In order to cultivate a "long-term hobby" for the child, they signed up for dance classes. In the local area, learning dance is not expensive, and the annual tuition fee is 2400 yuan, which is 1000 yuan cheaper than the elocution class.
She will tell parents that the basic skills are not only the technical level of "pressing legs, small waist, stepping on the crotch", but also the control of muscles, the performance of the stage and the standardization of movements. For children before the age of 6, beautiful melodies and playful movement imitations are the starting point for cultivating an interest in dance. Practicing the basics too early will only cause your child to develop fatigue and pain, which will lead to fear and abandonment of dance. The most serious is damage to the child's body.
After the students are 9 years old, Zhang Pan will select children with innate advantages and communicate with parents to let them enter professional classes. In addition to the flexibility of the body, these children must also conform to the proportion of "three long and one small", that is, hands and feet, long neck, and small face. Not many children enter professional classes, less than one-fifth of the original interest classes.
As a result, her dance students often have a watershed in two time periods: in the first or fourth and fifth grades of primary school, a group of children give up dancing.
05
However, the court will also point out the responsibility of parents. Similar descriptions often appear in such judgments published on the China Judgment Documents Network: "The appellant participated in dance training under the arrangement of his parents, and the parents, as their legal guardians, should realize that there are certain dangers in participating in dance training and may cause damage, so they should bear corresponding civil liability." ”
The verdict he got wrote: Even if the participation in forensic evaluation of trauma is 100%, as a parent, he should foresee the risk and need to bear 20% of the responsibility.
Beijing Bo'ai Hospital, the rehabilitation ward where children with spinal cord injury are located, wheelchairs are common. Gong Ayuan/Photo
06
For this treatment, many doctors worry that even if the treatment of a disease is effective, it is difficult to ensure that it will not cause greater harm at the same time. Beijing Children's Hospital also observed some children with spinal cord injury who had undergone stem cell transplants and found that there was no improvement.
In medicine, reaching a specific conclusion is a very complex process. The basic threshold is that the incidence of a disease is relatively high, and hundreds of people with similar conditions can be randomly found for control group trials. Spinal cord injuries do not have this condition.
In the field of spinal cord injury, the recognized and effective treatment is methylprednisolone hormone shock therapy. The American Acute Spinal Cord Injury Research Association conducted 3 clinical trials at the end of the last century and found that within 8 hours of acute spinal cord injury, a large dose of impact methylprednisolone hormone is effective for patients with complete injury and incomplete injury. In patients who were treated with methylprednisolone after 8 hours, there was no significant difference in the neurological recovery effect and the control group that was given a placebo.
After this treatment was widely used worldwide, it was found that high doses of hormone shock may leave sequelae. But this is already one of the treatments that most hospitals must choose during the emergency period.
For children without fractured and dislocated spinal cord injury, Beijing Children's Hospital tends to use only impact hormone treatment during the emergency period and does not recommend surgery. Doctors believe that part of the reason for the occurrence of non-fractured and dislocated spinal cord injuries is that the spine is not stable enough, and surgery will further destabilize it, and the probability of spinal deformity will be higher in the subsequent rehabilitation process.
For children, Beijing Children's Hospital will strictly follow the recommended dose of methotrexone shock therapy guidelines, generally no more than 1000 mg. The function of children's various organs has not yet fully matured, and the tolerance to drugs is not as good as that of adults, which is a problem that must be carefully considered before taking drugs.
Although this therapy has only been shown to be effective within 8 hours, many children simply cannot rush to the hospital or receive the correct treatment within the "golden 8 hours" after the incident. Doctors in the Department of Neurology at Beijing Children's Hospital have seen too many children who rush to the hospital for treatment after a few days of an incident.
The degree of rehabilitation from spinal cord injury is basically determined by the degree of injury. Complete injury is a difficult problem that current medicine cannot solve. Liu Genlin found that in recent years, 70% of children who have been rehabilitated from fracture-free and dislocated spinal cord injuries caused by lower back are complete injuries at Beijing Bo'ai Hospital.
Doctors at Beijing Children's Hospital will tirelessly take gymnast Sunland's lifelong paralysis after falling down as a case study, repeatedly stressing to parents that even the world's most advanced technology cannot cure complete spinal cord injury.
In Han Tongli's view: "If you have blind hopes, you are violating the principles of science and medicine." Letting the impossible happen will only bring more pressure to yourself and your child. For children with complete spinal cord injury, the ultimate goal of rehabilitation is to reintegrate the children into society. Instead of letting them stand up and walk like normal people and defecate on their own, they exert the residual functions of their bodies to the extreme. ”
The longest hospitalization, Zhao Yinghong's daughter stayed at Beijing Bo'ai Hospital for 419 days. In addition to some rehabilitation programs fixed by the hospital every day, he would sneak out of the ward with his child and go outside to look for the possibility of "rehabilitation".
Compared with the "cruelty" of the doctor, some people promised him that "in three months I will let you (the child) go back to school". In an old residential building a few hundred meters away near the hospital, a "doctor" massaged Zhao Yinghong's daughter's fingers for an hour and a half every day, and gave the child two bottles of sesame oil after pressing. He looked it up on the Internet and knew that the oil only had the effect of moisturizing the intestines. 300 yuan for a massage, or the price he cut from 500 yuan.
Several of the patient's family members had told him that it was all a lie, and he still had a "just in case" mentality – what if it worked? For more than two months, he spent more than 20,000 yuan, but there was still no effect. But what really made him give up was that the "doctor" restored the original price, and the family could not afford it.
07
From the moment of spinal cord injury, complications followed. In addition to common urinary tract infections, hydronephrosis, and bladder stones, girls around the age of 10 at the peak of growth and development have atrophy of the spinal cord rapidly within two months after injury. Muscles also atrophy and scoliosis occurs in the spine. Some children will form an S-shaped arc up and down the navel, which not only makes parents look uncomfortable, but also affects breathing and digestive function by squeezing internal organs.
These children's paralyzed areas lost feedback on the pain. Sometimes parents are distressed that their children's feet that lack blood circulation are cold to the touch, and soaking their children's feet with warm water of 40 to 50 degrees Celsius is at risk of being burned. Doctors at Beijing Children's Hospital have seen many children who have caused burns of grade 2 or above – their skin is far less nutritious than the average person's, and they can only accept water below the temperature of the body temperature.
One night, He Jun's wife suddenly found that her daughter's knee was swollen badly, and rushed to the hospital overnight, only to find that she had broken a bone. In two years, the child fractured her bones twice, both after the parents saw a lump on the child's body.
Less than half a year after the accident, He Jun took his daughter to Beijing Bo'ai Hospital for treatment. At the time of admission, X-rays indicate that the child has osteoporosis.
The most tedious thing in daily life is the need to help the child urinate and defecate, He Jun and his wife have to change the catheter for the child at least 5 times a day, despite this, the daughter will still have a urinary tract infection and have an operation because of the bladder stones.
He described every day as a "fearful" day.
At 5:40 a.m. in the morning, Zhao Yinghong needed to get up and prepare breakfast. After 6:30, give the confused child a urine session. After breakfast, he pushed the child to the classroom on the third floor with a wheelchair, and then waited at the door until the first recess to feed the child water. The number of milliliters of each sip of water needs to be within the control range - both to ensure that the daughter is given sufficient water, and not to be so much that the catheter needs to be replaced at school.
The court awarded him more than 1.2 million yuan in compensation, which was originally agreed to be paid within 3 years, but only received more than 300,000 yuan.
This is not unique. In a dance training class run by the mother of movie star Liu Haocun, a 6-year-old girl was paralyzed after practicing lower back movements in 2012 and was diagnosed with a fracture-free and dislocated spinal cord injury. The court awarded compensation of more than 1 million yuan for medical expenses. It was not until 2018 that the Liu family completed the payment.
Luo Jing's daughter is now lying in a hospital bed at Beijing Bo'ai Hospital. In order to save paper, she divided a piece of paper into large and small pieces of paper and drew meadows, houses, sweets, and crops on it. She also kneaded the clay out of the ice cream, donuts and rainbows to play with with other little patients.
In the same ward, children sometimes act carefree and wake up from nightmares at night. Parents spend their days smiling, worrying about their children's medical bills and a bumpy future.
In October 2021 alone, Dr. Liu Genlin admitted four more girls with non-fractured dislocation spinal cord injuries to the lower back, three of whom were completely injured. Every doctor knows very well that no miracle will happen, and a few families are about to start the days of "fear".
(In order to protect privacy, the patient's family members in the article are pseudonyms)
Source: Freezing Point Weekly