Chapter 2162: Chapter 1423: Feeling Something (Part 2)
"Do you feel anything here?"
"Yes!"
"How about here?"
"Yes!"
The needle tip moved downward, past the collarbone, past the chest, and past the upper abdomen. Upon reaching a certain point, Chen Jianguo’s response changed.
"How about here?" Manstein asked.
Chen Jianguo furrowed his brow and carefully felt.
"Yes! But it’s different from above. It’s not as clear, like there’s something in between."
Manstein noted this location in his notebook. This was the beginning of sensation decline, not a complete loss. He moved a small distance further down.
"How about here?"
Chen Jianguo was silent for a few seconds.
"Maybe... I’m not sure."
Manstein pricked again. This time, Chen Jianguo shook his head.
"No! I can’t feel anything."
Manstein marked that spot, then moved slightly up and then down, confirming it three times.
He straightened up and looked at Chen Jianguo.
"Mr. Chen, your injury is at the fifth thoracic vertebra, the body of the fifth thoracic vertebra, corresponding to the fifth thoracic spinal segment." Manstein drew a simple side view of the spine on paper, "The nerve root of the fifth thoracic spinal segment controls the lower chest and upper abdomen skin, and intercostal muscles, as well as part of the abdominal muscles. Specifically..."
He marked several areas on the diagram.
"In terms of sensation, the dermatome controlled by the fifth thoracic spinal segment is roughly between the nipple line and above the navel. That is, the lower chest and upper abdomen. In terms of motor function, it mainly controls the upper part of the intercostal muscles and the rectus abdominis, the muscles you use for coughing, forceful exhalation, and abdominal contraction."
Chen Jianguo looked down at his own abdomen. The skin between his navel and nipple line had been completely numb for the past eleven years. His intercostal and abdominal muscles couldn’t contract; he couldn’t cough forcefully or tighten his abdomen.
"So," Manstein continued, "we won’t see any changes in your legs within the first week, the first month, or even the first two months after surgery. Because the legs are controlled by the lumbar and sacral spinal segments, which are separated by thoracic spinal segments 6 to 12 and lumbar segments 1 to 5 from the fifth thoracic spinal segment. Nerve regeneration progresses at about one millimeter per day. From the fifth thoracic spinal segment to the first lumbar segment is about fifteen to twenty centimeters. This means it will take at least five to six months for the regenerating nerve ends to reach the spinal segments controlling the legs."
Chen Jianguo was silent.
"Five to six months." He repeated.
"At least," Manstein said, "This is the most optimistic estimate; it could actually take longer. We’re not sure which will regrow and which will be locally repaired. Also, when the regrowing nerve arrives, that’s just the first step. It needs to establish synaptic connections, undergo myelination, and require functional training. From the nerve reaching the leg to the leg moving might take even longer."
Chen Jianguo said nothing, staring for a long time at the diagram drawn by Manstein.
"Professor, what should I focus on now?"
"Focus on your upper abdomen," Manstein pointed to the spot on the diagram, "This is the area controlled by the fifth thoracic spinal segment. If our method works, the first change you should notice is not your leg or foot but your upper abdomen. The area above the navel and below the nipple line. It could be the restoration of skin sensation or the improvement of abdominal muscle contraction ability."
Chen Jianguo placed his hand on his upper abdomen and pressed gently.
"Here!"
"Yes! Here, closest to the injury. The nerve’s travel distance here is the shortest. If all goes well, you should see changes within a few months. Not the leg, not walking, but here."
Manstein put away the needle and diagram, closing the folder.
"Mr. Chen, I know you’ve waited eleven years and want to see results quickly, but science has its own rules. Nerves won’t grow faster just because you’re anxious. They grow one millimeter a day, no more, no less. Our job is to create a good environment for it and then wait."
Chen Jianguo looked at Manstein, silent for a long time.
"Professor, if I wait six months and nothing happens?"
Manstein put down the folder and looked into Chen Jianguo’s eyes.
"Then I’ll continue waiting, until it happens."
In the first week post-surgery, there was no change.
Manstein came to the ward daily, repeating the same evaluation. The needle tip stopped at a spot on Chen Jianguo’s upper abdomen, the boundary where sensation disappeared. Every day it was the same spot, no descent, no rise.
Every day, Chen Jianguo had Sister Li gently run her fingers over his upper abdomen, from the area of sensation to the area of no sensation. That boundary felt like an invisible wall across his body. For eleven years, this wall hadn’t moved.
"Jianguo, don’t rush!" Sister Li said every time.
"I’m not in a rush," Chen Jianguo would respond each time, but he was. So much so that he couldn’t sleep, couldn’t eat, stared at his upper abdomen daily, as if staring long enough would reveal some change.
But he saw nothing.
In the second week post-surgery, there was still no change.
Chen Jianguo sat up, counting the days in his mind. One millimeter a day, fourteen millimeters now. One centimeter and four millimeters. How could such a length not bring any sensation?
He asked Manstein.
Manstein was writing a record, and upon hearing the question, he put down his pen.
"Mr. Chen, nerve regeneration is not like a wire growing directly down from the cut end. It’s a complex, multi-step process. First, the microenvironment in the injury area needs to change from inhibiting growth to allowing growth, then neurons need to extend growth cones, extending along the correct path, finding the correct targets. Even if the leading growth cone reaches a position, the chemical signals it releases may not be strong enough for you to perceive. You may need to wait until more nerve fibers grow over, forming a denser network before feeling any change."
Chen Jianguo listened with slight understanding.
"Professor, can you just tell me... what should I do now?"
"Do what you’re doing, wait."
In the fourth week post-surgery, changes came.
Not the leg, not the foot, but the upper abdomen.
That afternoon, Sister Li, as usual, gently ran her fingers over Chen Jianguo’s upper abdomen. As her finger passed a certain line, Chen Jianguo suddenly said, "Wait a moment."
Sister Li’s hand stopped.
"What is it?"
"At that spot earlier, try it again."
Sister Li moved her hand slightly up, then down again. When her fingertip passed a certain line, Chen Jianguo furrowed his brow.
"Do you feel something?" Sister Li’s voice trembled slightly.
"Yes! It’s not pain or itch, just a... hard-to-describe feeling. Like something lightly touched it, but very lightly and distantly."
Sister Li didn’t wait; she immediately went to find Manstein.
Fifteen minutes later, Manstein arrived at the ward with August and Clara. He had Chen Jianguo lie down, using a fine cotton swab, gently gliding over the skin of Chen Jianguo’s upper abdomen from top to bottom.
"Do you feel anything here?"
"Yes!"
"How about here?"
"Yes!"
The cotton swab moved down to a location, and Chen Jianguo went silent.
"How about here?"
"...No, nothing at all."
Manstein marked that position. Then he took out a ruler, measuring the distance from this position to Chen Jianguo’s xiphoid process and then to the navel.
He wrote a line in his notebook: "Fourth week post-surgery, sensation plane descends approximately two centimeters from the dermatome corresponding to the fifth thoracic spinal segment. The new boundary lies between the xiphoid and navel, one-third up."
After writing, he put down the pen and looked at Chen Jianguo.
He pointed to Chen Jianguo’s upper abdomen: "Nerve growth isn’t this fast!"
"Then why does it feel different here?" Chen Jianguo asked anxiously.
Manstein honestly told him, "That’s because some originally healthy nerves were being compressed by scar tissue. After surgically removing the scars, these nerves regained vitality. However, this is also a positive sign."
No matter the reason, Chen Jianguo felt a bit more confident.
