I can see the status bar

Chapter 189 Guidance
What is hospitalization?Although most people think that sleeping in a hospital is equivalent to being hospitalized.But in fact, this is a common misunderstanding.

Hospitalization mainly refers to the means adopted by the outpatient clinic that the patient's condition is considered to be urgent and serious, and he needs to receive medical observation and treatment in a place with sufficient medical conditions.It sounds a bit of a mouthful, but the popular explanation is - "stay in the hospital and don't run around, so that if something happens, we will have time to save you" treatment.

There are two key points in this passage. The first is "hospital".The medical conditions and emergency response capabilities in the hospital are of course the best.Although the level of each hospital is slightly different, it is always better than the hotel on the main road or the upcoming wedding.The second is "we".When the doctor sees any problem with the patient, he can immediately carry out corresponding treatment and rescue.But outside the hospital... it would be nice if someone with good intentions could call 120.Maybe everyone thought you were extorting money, and walked around one after another.

Nowadays, as long as it is a tertiary hospital, the beds in the inpatient department must be tight.In some big cities (yes, I’m talking about Shenzhen) where medical resources are relatively scarce, even second-class beds are too tight to die.As long as elective surgery is available, it is common to wait for a week or two - after the patient receives the elective surgery hospitalization notice at the outpatient clinic, he needs to call the inpatient department to make an appointment for the hospitalization time.

Although Zhao Mengli's condition does not require emergency surgery, it is more tense than elective surgery.In the event of further internal bleeding, she would have to be rushed to the operating table immediately.Blood transfusions are also required to correct blood loss.In the inpatient department, she will be the focus of the nurses.And in this situation, she actually tried to negotiate a price to be hospitalized tomorrow. To put it bluntly, she simply didn't know how to live or die.

"This is absolutely impossible." Sun Li'en directly vetoed her proposal, "You must be hospitalized for observation in your current condition. If there is further bleeding, you will have to go to the operating table immediately. The symptoms of internal bleeding are very hidden, and you will not have them yourself. No one else can see what it feels like—if you really want to feel it, you will pass out directly. And laymen can’t see the symptoms at all, and when the time comes, will you be sent to the hospital? Maybe you won’t be able to save it.”

Seeing that Zhao Mengli still looked unconvinced, Sun Lien sighed and asked, "Do you know what death is?"

"You may not have seen it." Sun Li'en shook his head, "I haven't been a doctor for long, and now it's only a year or more with the internship. I've seen it several times. Sometimes fate is cruel, no matter how much we use No matter how the family cooperates, they still leave. The family members are very sad, and we doctors are also very sad." He shook his head and smiled in a self-deprecating way, "You may still not understand...but you want You know, you only live once, and if you die, you have nothing."

Zhao Mengli blinked her eyes, as if she wanted to say something, but finally held back her words.

"During the hospitalization, you can eat normally. But it is best to eat liquid food." Seeing that the patient had no objections, Sun Lien continued to explain the specific content.He has never sent a patient to the inpatient department before. Although he heard that the nurses in the inpatient department will explain these things to the patient, he thinks it is better to strike while the iron is hot and explain everything that needs to be paid attention to—in case he arrives at the inpatient department , Zhao Mengli started things lawlessly again, and the doctors in the inpatient department couldn't suppress her. "Try not to cough, speak loudly, and don't use too much force when you defecate, these may cause the corpus luteum to rupture."

"Then... Could it be because of her corpus luteum rupture?" The man in the green hat asked quickly, "She is weak and prone to coughing."

Miscarriage at least five times, if it is still as strong as a cow, it will be a ghost.Sun Li'en couldn't help complaining in his heart, but he had to put on a thoughtful look on his face, "It's possible, but it may also be caused by other diseases or impacts. There are many causes of this disease, and there are The time really caught up for a while, maybe nothing happened before, but now it bursts and bleeds." Sun Lien concluded, "This can only be said to be bad luck."

Luck is not so good.During intercourse, the man's actions are too rough, and the woman's reproductive system congestion due to excitement is the main reason for the rupture of the corpus luteum.But Sun Lien couldn't say this, he could only repeatedly emphasize to the man in the green hat that it was his "bad luck".But if you are lucky, you can meet this kind of girlfriend?The grassland above his head didn't know it, and there was no other reason to explain it except bad luck.

The man in the green hat was very grateful to go through the hospitalization procedures. Sun Lien felt that Zhao Mengli was making him nervous by sitting in the room, and it was also mainly because he really didn't want to sit with a time bomb.So he simply sent Zhao Mengli out, and asked the man in the green hat to borrow a wheelchair, and pushed Zhao Mengli together to go through the hospitalization procedures.

After seeing off the couple, Dr. Pascal walked in before Sun Lien had time to take a sip of water.He winked at Sun Li'en, "Have you started going to the clinic too?"

Sun Li'en himself was still able to adapt, anyway, he only saw one patient.He was a little worried that Dr. Pascal would not be able to carry it. After all, Dean Song had let go. If Old Pascal could not carry it and left, he would have to hang his skin at the hospital gate.He hurriedly asked, "Is it the same for outpatient clinics in the United States?"

"For the sake of the dollar, it's much easier for us." Dr. Pascal probably learned badly from the immunologist who served as his translator recently, and he is very familiar with criticizing capitalism. "If I could see so many patients every day in the United States, I would have moved to New York a long time ago."

Sun Lien was relieved when he heard that Lao Pa's tone was okay. "You have something to do with me?"

Dr. Pascal looked at the expression of the patient who was getting more and more mentally ill, "You didn't ask me to come here?"

"Crack!" Sun Li'en covered his face before he realized that he had invited Dr. Pascal for a consultation. "I'm sorry... I'm too busy, so I forgot."

Yang Jianqiang’s test results have not yet come out. PCR runs three samples at the same time, and even if it is performed at the same time, it will take six hours to get the results. The Fourth Central Hospital still runs PCR-Elisa. If traditional fluorescent electrophoresis is used, then Had to wait at least ten hours.

"Your inference...is completely possible in theory." After hearing Sun Lien's diagnosis, Dr. Pascal pondered for a while and gave his own opinion. "But I also agree with Director Zhou that this diagnosis is too coincidental. Although there is no problem in terms of logic and onset time, it is not realistic to use this inference to treat the disease."

Sun Lien also knew this. He shook his head and said, "I didn't plan to give him radiotherapy right away. Even after the diagnosis, radiotherapy is not the first priority treatment. But I think, with his current immune system strength, it can weaken him at the same time." Toxoplasma gondii, and the only thing that made him resist the side effects is probably radiotherapy.”

"I really don't know about this." Dr. Pascal thought for a while, and suddenly suggested, "I suggest you ask Rachel, she is an expert in oncology, and she has a deeper understanding of radiation therapy than I do."

"I must ask other experts about the treatment." Sun Li'en nodded, "However, can you adjust his immunosuppressive regimen first? If the original method of suppressing the immune system may be able to alleviate his current symptoms performance. I fear that if his immune system continues to be active, he may develop a brain herniation soon."

Yang Jianqiang now has eight edematous areas in his brain.And most of the edema area is located in the junction area of ​​gray matter and white matter.Abscesses in the eight areas will almost certainly cause brain herniation if the edema continues to develop and even becomes an abscess.In case of brain herniation, Sun Li'en didn't need to bother to inquire about the feasibility of radiotherapy—just prepare to write the death certificate.

"The adjustment of the immunization plan is not that simple." Dr. Pascal shook his head and said, "His current immunization plan is the one with less hepatotoxicity. If he suddenly adjusts to the previous plan, it is likely to cause problems such as acute liver injury .Especially when drugs are used in combination, every time a drug is added, it may lead to more serious side effects.”

"Then what else can we do?" Sun Lien was in a hurry. Dr. Pascal's professional level and ability are here. If he said no, other doctors probably wouldn't have any good solutions.Could he just watch Yang Jianqiang's condition worsen, from cerebral edema to cerebral herniation?

"The most direct way is to increase his current hormone dosage." Dr. Pascale's answer was unexpectedly simple. "Although long-term medication needs to pay attention to hormone levels to prevent iatrogenic Cushing's syndrome, if it is only a short-term suppression, there is no problem in increasing the hormone dose."

Sun Li'en blinked his eyes, he really couldn't believe that there would be such a solution to the problem that had troubled him for a long time.

"You are a very talented doctor." Dr. Pascal looked at Sun Lien's appearance, and probably guessed what Sun Lien was thinking.He smiled, patted Sun Lien on the shoulder and said, "However, it is not necessarily a good thing for your growth to start contacting these patients with complicated conditions now. After a long time, you will gradually forget a very important principle ——The disease the patient suffers from and the means of treatment required are often very simple.”

In the class of medical school, there is a saying called "When you hear the sound of a horse's hoof, think of a horse instead of a zebra." This is exactly what it said.Sun Lien now has a tendency to "think of a giraffe when he hears the sound of a horse's hooves".Complicating the direction of diagnosis and treatment means will lead to big troubles.

A patient who obviously just has a cold, if you think he has severe pulmonary hypertension, then wait to be complained.A single shot of cephalosporin can solve the problem, but you still have to add some oseltamivir to rest assured that the complaints are considered minor—what if there are serious side effects?
Sun Li'en suddenly felt a little cold behind his back. He was a little disapproving of Pascal's suggestion at first, but now that he calmed down and thought about it, he realized that he really had this tendency.

In general, he is still not good at learning, and thanks to Lao Pa, a foreigner who doesn't care about people's sophistication, he said it directly.Sun Lien sighed, and nodded to Pascal, "Thank you for your guidance."

(End of this chapter)