My medical skills add experience

Chapter 254 Pharmacological Meridian Guiding, Patients with Persistent Upper Abdominal Pain

In addition to this patient being successfully cured and discharged, the gastric cancer patient has also been discharged.However, you still need to come to the hospital for chemotherapy and review regularly.

After the female lawyer with liver cirrhosis underwent surgical treatment, the therapeutic effect was obvious.

He was discharged from the hospital three days ago.

However, cirrhosis is a common clinical chronic progressive liver disease, which is diffuse liver damage caused by long-term or repeated effects of one or more causes.

This damage is often irreversible.

Liver and kidney have great similarities in this regard.

Once damaged, it is difficult to recover.

The best way is early detection and early treatment.

However, compared with the kidney, the liver has a strong regenerative capacity.If the quality of the liver is good, even if 80% of the liver is removed, it can be restored.

Because the liver of patients with liver cirrhosis has entered the compensatory stage of disease, the regenerative ability will definitely be affected, which is far inferior to that of a normal liver.

If it develops to the late stage of liver cirrhosis, that is, the decompensated stage, the liver at this time is basically abolished.

Not to mention removing part of the liver, even other operations must consider whether the patient's body can bear it.

The female lawyer in the 79th bed is the luckiest of misfortunes. Her liver cirrhosis is still in its early stage.After the real cause was found, after surgery, the hidden dangers were eliminated.

In the future, she only needs to take long-term medication to protect her liver, and her life will not be greatly affected.

Speaking of which, Zhou Can issued a doctor's order for the female patient to be discharged from the hospital, and managed to earn a reward of 100 experience points in pharmacological syndrome differentiation!
This is also the first time he has issued a doctor's order for a patient with liver disease.

His pharmacological syndrome differentiation has been successfully promoted to the fourth level, and the current experience value is 227/10000, which is the lower level of the attending physician.

This level is insufficient compared to the upper level, but more than enough compared to the lower level.

Not to mention being in Gui Peisheng, even if it is placed in the resident physician group, it is definitely an outstanding existence.

All doctors know that pathological diagnosis and pharmacological syndrome differentiation are the two most difficult medical skills to be promoted, and they are comparable to the promotion of anesthesia.Many doctors study medical skills all their lives, but they always stay at the level of attending.

It's not just because medical papers have blocked their way to be promoted to deputy chief physicians. It's also because many doctors are slack and lazy after work because of their limited understanding.

In the end, I failed to comprehend high-level pathological diagnosis and pharmacological syndrome differentiation even after I retired.

If it is Chinese medicine, in addition to pharmacological syndrome differentiation, there is also a more difficult medical technique called medicine effect meridian.

It is equivalent to the advanced medical skill of taking medicine.

After learning pharmacological syndrome differentiation, you can only treat the disease according to the disease, know which medicine to use for the disease, and accurately control the compatibility, dosage, and usage.

But compared with the real masters of Chinese medicine or internal medicine, there is still a clear gap.

Because they all know that the efficacy of medicine belongs to the classics of medicine.

Also referred to as guijing.

For example, Director Tan of the Department of Internal Medicine has studied the theory of traditional Chinese medicine, and I heard that he has also worshiped many old Chinese medicine practitioners as teachers.The purpose is to study the meridian distribution of medicinal effects in depth.

It is not in vain that someone can become a first-level professor, be selected as an academician, and firmly sit on the top spot as the director of the internal medicine department.

Director Tan's medical achievements in the field of internal medicine rank among the national internal medicine experts.

It's just that he is usually low-key and doesn't pursue false fame, so his reputation is not as great as Wu Baihe's.

Even Director Yin Hua of the Department of Neurology is more famous than Director Tan.

But Yin Hua usually respects like a student in front of Director Tan.

Like Director Tan, after obtaining certain medical achievements, there are many scholars who specialize in studying Chinese medicine.Almost all famous internal medicine experts have followed this path.Just like all famous scientists, they all embarked on the path of theology in the end.

Newton, Einstein, Edison... These people all went from scientific research to theology in their later years.No one can explain why.

Everyone guessed that they may have believed in the existence of God because they knew too much and found that many things could not be explained by science.

According to this logic, Chinese physicians began to study and study Chinese medicine in depth after they achieved certain achievements, and they also seemed to have discovered that many medical phenomena could not be explained by Western medicine theories.

On the contrary, the answer can be found in the theory of Chinese medicine.

Therefore, they will naturally start to explore Chinese medicine.

Despite the rapid development of western medicine in pharmacy, western medicine still firmly suppresses traditional Chinese medicine and belongs to the mainstream of the market.

But when it comes to returning to scriptures, foreigners shake their heads like rattles and only say NO, NO.

Because there are no such things as meridians and acupuncture points in Western medicine.

They don't even understand meridians, if you talk to him about the effect of medicine on meridians, isn't that playing the piano to the cow?

Zhou Can's pharmacological syndrome is currently level [-], and his understanding of pharmacology and medicinal properties has reached a new level, but compared with Director Tan of the Department of Internal Medicine and other medical leaders, his level is still far behind.

Therefore, his concept of the meridian distribution of medicinal effects is still very vague.

But it is much better than foreigners, he at least knows some basic knowledge of meridians and acupuncture points.

On this day, as usual, Zhou Can came to the ward early to check on the patients he managed.

The number of patients assigned to him by Director Shang has increased from seven to eleven.During these seven days, some of the patients under his care have been discharged from the hospital, and some are newly admitted.

So far, all the patients he has treated have received effective treatment, and for the time being, no intractable diseases have been encountered.

If you need endoscopic surgery, you should do surgery, if you need interventional therapy, you should use interventional therapy, and if you need medication, you should use medication.

Without exception, the patients he has managed can basically receive formal treatment within two days of admission.

It is precisely because of his excellent management work that Director Shang keeps adding burdens to him.

Zhou Can never refuses anyone who comes.

Especially after his pharmacological syndrome differentiation and medical skills were upgraded to the fourth level, his ability to prescribe various medical orders for patients has been greatly improved.The selection, compatibility, and dosage control of drugs can be more precise.

For example, to reduce fever, there are many kinds of drugs that can be chosen, such as ibuprofen, aspirin, acetaminophen, indomethacin, nimesulide, celecoxib and so on.

When taking medication, his former resident medical level would only blindly pursue the effect of reducing fever.

Now that he has been promoted to the level of attending, he will consider various factors such as the patient's age, gender, underlying diseases, and the cause of fever.

It is obviously more thoughtful and detailed than before.

The advantage of doing this is that it can better reduce the harmful effect of the medicine, and truly treat the disease according to the disease.

In this respect, the prescribing levels of attending physicians and residents are really not at the same level.

"Doctor Zhou, can you please help me see the patients in bed 65?"

Zhou Can was doing a bed check in the ward when Yu Xin, the female coach in the group, came over.

"what's wrong?"

Zhou Can turned his head and asked.

Since he entered the Department of Gastroenterology, all the patients in his care have been effectively treated, which is a fact for all to see.

Many people didn't say anything, but they admired his ability very much in their hearts.

Not to mention Yu Xin in the group.

"The aunt who was infected with salmonella last time has just been transferred from the intensive care unit. I think her condition is still very scary. My level is limited, so I am worried about accidents. Please help check, I can rest assured."

Yu Xin explained.

Now she would ask Zhou Can for help whenever she encountered a patient who was uncertain, or a situation that she was not sure about.

It is much easier to find Zhou Can, who is also at the level of regular training and more capable than the attending doctor, for help than Director Shang and Huang Xinggui.

There is no such psychological pressure.

"Hey, that aunt is really good. It would have been great if she had been diagnosed and treated as soon as she was infected with salmonella! It would be good if she was only willing to seek medical treatment if she was seriously ill. It would be good to save a life."

Zhou Can shook his head and sighed.

Follow Yu Xin to the ward where the 65th bed is located.

Aunt's husband has already been discharged from the hospital.

On the contrary, it was her escort who put herself into the intensive care unit because of ignorance and luck.

"Auntie, can you talk now?"

Looking at the aunt who was sickly on the hospital bed and had lost a lot of weight, Zhou Can felt very complicated.

The aunt almost shed tears when she saw him.

"Doctor Zhou... If I had listened to your persuasion, I wouldn't have stepped into the gate of hell with half a foot. My heart is in a panic, and my intestines are full of regret. I have harmed my family..."

The aunt's voice whimpered, and the tears couldn't stop flowing.

The daughter next to her who asked for leave to take care of her hurriedly wiped her tears.

"Money and wealth are things outside the body, and saving your life is the best result. Isn't there a saying that if you survive a catastrophe, you will have a future blessing? I believe that you will live happily in the future. Look, your daughter is so filial. Please I took leave to take care of you at the hospital bed."

Zhou Can is also not very good at comforting people.

I can only say a few words of comfort to my aunt.

"Let me measure your physical signs first. If you feel uncomfortable, you must tell us in time. Also, there is no need to worry about and regret what has happened. Keep a happy mood and you can be discharged from the hospital a few days earlier .If you feel depressed and your chest is stagnant, it will be very bad for your recovery."

Zhou Can continued to persuade the aunt.

There is no way, people are already so unlucky, and doctors should try to help patients as much as they can.

"Hmm... I listen to you, this time I will no longer be self-righteous!"

My aunt has suffered a loss once, so she dare not be willful again.

I really stopped crying and tried to adjust my emotions.

Her daughter also took the opportunity to comfort her mother.

"Mom, the doctor told you to keep your mood happy, so stop blaming yourself and worrying about this!" She sincerely hoped that her mother could live a happier life and untie her knots.

"I have good news for you! Dad was discharged from the hospital two days ago! He is recuperating at home! He is still talking about your mother not being at home. I always feel that something is missing! My sister-in-law and I laughed that he didn't see it. You seem to have lost your soul."

The aunt, who was still immersed in self-blame and regret, really showed a smile on her face after hearing this.

"He never said such nice things in front of me. When I am discharged from the hospital, I must cook a pot of chicken soup for him. Let him eat and recover soon."

The aunt suddenly remembered that she and her husband were infected because they drank the problematic chicken soup, and hurriedly asked Zhou Can, "Doctor Zhou, can the chickens raised at home be eaten?"

She was bitten by a snake once, was afraid of well ropes for ten years, and had psychological shadows after drinking "poisonous chicken soup".

"Of course I can eat it. As long as it's healthy chicken and it's cooked thoroughly, there's no problem at all. The tonic nature of chicken is mild, and it's very suitable for nourishing the body when you recover from a serious illness."

Zhou Can said with a smile.

Yu Xin, who was standing beside her, couldn't help smiling at this moment.

This aunt also has a cute side.

Zhou Can took the basic signs of the aunt's body temperature, blood pressure, and heart rate, and then learned about the physical symptoms of the aunt at this time.

"Auntie's current signs and symptoms are not bad. I believe that if she actively cooperates with the treatment, she will be able to recover and leave the hospital in a short time." Zhou Can's words gave Yu Xin, auntie and family members reassurance.

There were happy expressions on the faces of several people.

It is the common pursuit of patients, family members, doctors and nurses that patients can recover and be discharged.

"Doctor Zhou, can you help me to look at the patient's doctor's order again? Is there anything that needs to be revised?" Yu Xin might also be worried that Zhou Can thought she was busy, so she explained again. "Director Shang said that Duan Zifu and I are in doubt about the doctor's order, so we can ask you for advice."

"Director Shang really flattered me!"

Zhou Can showed a wry smile, he was just a Gui Peisheng, not as powerful as Director Shang thought.

Fortunately, his pharmacological syndrome differentiation has been promoted to the fourth level, as long as he does not encounter too complicated diseases, he can basically handle them.

I read the patient's doctor's order carefully, and there is nothing wrong with it.

"The doctor's order matches her current treatment and symptoms, and she can continue to use it. However, it is still necessary to closely observe the patient's medication response. If there is any abnormal reaction, it must be dealt with by the superior doctor as soon as possible."

My aunt has just been transferred from the intensive care unit and is still very weak.

According to Zhou Can's training experience in the Department of Critical Care Medicine, such patients belong to the key nursing objects.

Zhou Can was talking with Yu Xin when Huang Liang, a senior resident doctor under Director Zheng Hongtao, walked into the ward quickly.

I saw him go straight to bed 67.

It seems that the patients in this bed are under his care.

When Huang Liang saw Zhou Can, he couldn't help being slightly taken aback, his expression somewhat unnatural.

Because seven days ago, the patient with acute gastroenteritis almost died of his misdiagnosis and delay.

The situation was particularly dire.

As long as the delay in sending to the gastrointestinal surgery department is two or three hours, the patient may go into shock or even die.

Zhou Can discovered in time that the patient might have intestinal perforation, which not only saved the patient, but also saved Dr. Huang Liang and Director Zheng Hongtao.

It's just that the attitudes of the two towards Zhou Can are very different.

After Director Zheng shook hands with Director Shang to make peace, his attitude towards Zhou Can has become very warm and friendly.

When they met, they would even greet Zhou Can with a smile on their faces.

It shows that Director Zheng Hongtao knows how to be grateful.

"morning!"

Huang Liang nodded to Zhou Can and said hello.

"morning!"

Zhou Can knew that he was still struggling in his heart, but he didn't have the same knowledge as him.

Huang Liang's status in gastroenterology is quite high, and his reputation is not small.Among the residents, he is one of the best.

Being able to take the initiative to say hello to Zhou Can at least shows that he is a reasonable person, but he just takes his face very seriously and is arrogant, so he behaves so unnaturally when he greets Zhou Can.

To put it bluntly, I just don't want to appear too weak in front of Zhou Can.

But Zhou Can saved him once, this kindness is there, and after meeting his benefactor, he still can't act like a stranger.

At this time, an intern under Director Zheng also walked into the ward quickly.

"Good morning, Dr. Huang! I heard that you entered the ward and came here quickly. This patient was admitted yesterday. When he was admitted, he had unbearable pain in his upper abdomen. It was a paroxysmal severe pain that lasted for more than 10 hours. He was admitted to the emergency department. Afterwards, blood routine and B-ultrasound were performed on the patient, and anti-inflammatory treatment was given to the patient, but there was no effect. This was transferred to our Department of Gastroenterology.”

The intern on duty quickly reported the patient's condition.

Epigastric pain, and extremely severe, the hospital will generally attach great importance to.

At the beginning of the emergency department, it must be suspected that the patient ate unclean or irritating food, which caused gastritis or enteritis.Therefore, anti-inflammatory treatment will be given to patients.

It now appears that the patient's condition is more complicated than imagined.

After Huang Liang listened carefully, he picked up the patient's information to check.

His brow furrowed more and more.

It shows that the etiology of this patient is not easy to diagnose.

(End of this chapter)