Patient question: disease:symptomatic (not sleeping, etc.) problem after the third surgery of glioblastoma grade IV Description:Patient female 68. 1, November 29, 2012 first surgery (caused by numbness in the left lower limb before surgery), removal of tumor (4 * 2.7 * 1.4), pathology report: glioblastoma grade IV. After the first surgery (no sensation in the left lower limb, but can walk normally with the right lower limb class), radiotherapy and chemotherapy (temozolomide) according to the standard hospital therapy. 2. The better condition was maintained until the second operation on April 24, 2014 (before the operation because the left lower limb could no longer walk normally with the right lower limb). After the second surgery, the tumor was removed (grade IV, 3.7*3*2.5), the left upper and lower limbs were unconscious, and the person could barely stand on the right limb. Considering the role of radiation and chemistry, no radiation and chemistry program was considered for the time being after the second operation. 3, to July 23, 2014, the third time into the operating room (preoperative condition is worse through the nuclear magnetic detection and growth), three surgical open position the same. The surgery was performed at the same location. The level of the surgery was grade IV, the resected tumor was a tumor, and there was fluid. 4. In mid-August 2014, I was admitted to the hospital (in preparation for radiotherapy). The hospital where I was seen advised my family to do radiotherapy and chemotherapy plus targeted if conditions allowed, and then after consulting the radiologist who had followed the patient’s condition for nearly 2 years, it was not strongly recommended that all three be done, and radiotherapy was recommended. The radiotherapy program 30 times, started on August 20 this year, and was suspended after three days (appetite loss and poor health condition after radiotherapy), because of the divergent views of the family (for the effect of radiotherapy and harm). 5. Current main symptoms: relapse around 19 days after the third surgery (around August 11) (found during radiotherapy positioning). After the third surgery, the symptoms of confusion, memory loss but still remembering certain matters before, indifference, little speech, body weakness, more than before, and the phenomenon of difficulty in defecation are also present. I can sleep with peace of mind if I can urinate and have a clean bowel movement. Can’t say where the pain, in short, uncomfortable, manifested as frequent bowel and urine intention, sitting and lying down, can not sleep for several days, often in the state of instant sleep and wake up, if through the drug sleep, the patient can also control in wake up after the bowel and urine, without bedwetting. Eating less, but feed other fruits and vegetables, but also can eat, often dry vomiting, drinking water is also easy to choke, ulcers in the mouth, three post-operative small clinics have dispensed Chinese medicine, drink about 7 payments, after catching the start of chemotherapy, can no longer drink, due to the emergence of convulsion symptoms (ground Chinese medicine powder noodles, water to drink, more bitter, with slag); 6, the current symptomatic use of mannitol, calf blood; diazepam, zopiclone tablets, alprazolam , flunitrazepam, clonoxicam, tramadol hydrochloride, citalopram hydrobromide, Depakene, olanzapine tablets, etc. Initially the above sleep medication in small amounts, after no effect after increasing the dosage or change the medication or combination of eating, for example, on September 5 take tramadol 2 tablets, zopiclone 2 tablets, Valium 1 tablet; September 6 take tramadol 2 tablets, alprazolam 1 tablet, Valium 2 tablets. Hope to provide help:Dear Director, thank you for answering my questions in your busy schedule, I would like to ask you the following questions: 1. Frequent bowel and urine intent (the actual number and amount of bowel movements and urination are not that much) makes the patient more exhausted. How to treat the symptoms? 2, such a large dose of psychotropic sleeping, pain class (the patient did not point out which pain, is not the pain medication should not be given to the family to take again?) The current phenomenon of often blurred consciousness and confused speech is aggravated by the use of these drugs, is it related to these drugs? Is there a better way (such as Chinese medicine) to solve the problem of not sleeping and not taking these western medicines? Hospital Department:Jidai First Hospital Neurosurgery, Radiotherapy Treatment:Time:2012-11-29 2014-08-00 Hospital Department:Jidai First Hospital Neurosurgery, Radiotherapy Treatment Process:Three surgeries have been performed, the first post-operative radiation and chemotherapy Medication:Drug name:Olanzapine tablets Instructions for use:Newly prescribed Drug name:Zopiclone tablets, Alprazolam, Flunitrazepam, Clonoxicam, tramadol hydrochloride, citalopram hydrobromide Dosing instructions:After the third operation, discomfort symptoms are frequent, such as not sleeping (due to frequent large, urine sense more), affecting the rest body overdose, etc.. I don’t know if it’s related to taking the above mentioned drugs. If you are able to sleep, you should not take the sleep medicine, but you should take it if you do not exceed the maximum dose. Drug name: temozolomide, mannitol, etc. Dosing instructions: First post-operative radiotherapy, followed by temozolomide for several months Yuan Ge, Department of Neurosurgery, Beijing Tiantan Hospital, replied: 1. Frequent bowel movements and urine intent (the actual number and amount of bowel movements and urine are not that many) make the patient more overdrawn, what causes this? How to treat symptomatically? A: It is related to the influence of the second stool center. There is no good way. 2, such a large dose of psychotropic sleeping, pain class (the patient did not point out which pain, is not the pain medication should not be given to the family to take again?) The current phenomenon of often blurred consciousness and confused speech is aggravated by the use of these drugs, is it related to these drugs? Is there a better way (such as Chinese medicine) to solve the problem of not sleeping and not taking these western medicines? A: Yes, the effect of traditional Chinese medicine may be milder, and I don’t know if the effectiveness of the effect can make you satisfied.