My medical skills add experience

Chapter 548 The Heart's Stealing and Sly Mechanism, I Suggest You Check Your Liver

Tuya is different from those small hospitals that rely on inspection fees to survive.

When encountering inspection items that patients have checked in other hospitals, as long as that hospital is also a tertiary hospital, basically the patient will not be asked to repeat the inspection.Unless the doctor feels that the patient's test results are problematic and inaccurate, it is possible for the patient to be checked again.

The purpose of all examinations is to diagnose the cause and cure the disease.

If it is just to earn examination fees, it will lose medical ethics and easily lose the original meaning of examination.

But this has to be looked at from multiple perspectives.

In some small hospitals, due to the small business volume, the doctors in the departments have tasks on their heads, such as how many inpatients to admit this month, how many B-ultrasounds to prescribe, and so on.Under the pressure of performance, in order to survive, doctors can only give their ideas to the few patients who seek treatment.

Zhou Can followed Director Xueyan to the corridor.

A temporary bed has been added to this patient, which is considered a great deal.

You must know that it is hard to find a bed in cardiothoracic surgery, and many patients who come to see a doctor are forced to sleep on the ground in the waiting room and corridor.These patients without beds are still in the queuing stage and cannot enjoy the formulation and advancement of medication and surgical plans.

Only after being admitted to the hospital and going through the hospitalization procedures, can we enjoy the care and care of the nurses, medication, surgical planning, various monitoring and so on.

"Mr. Lan, this is Dr. Zhou Can, who specially took the time to come over for your consultation."

Director Xueyan introduced Zhou Can's identity to the patient.

The patient was a young man of seventeen or eighteen, very young.His face was unusually pale and his breathing was short of breath.These are typical symptoms of heart failure.

Usually, mild heart failure has no typical symptoms.

Because the heart function is damaged in the early stage, the reserve capacity of the heart will help to compensate for the damage.

It can be understood that the heart usually works 24 hours a day, and it is actually fishing.At least about [-]% of the remaining power was left unused.

It must be sneaky and cunning to retain its strength.

Because if the owner of the body ignores its feelings and eats very salty food, or other foods that will seriously increase the burden on the heart, the heart will not be exhausted because it retains its spare energy.

In addition, when the owner of the body does some strenuous exercise and wants to explode, the heart can sacrifice his life to accompany the gentleman.

This patient now has typical symptoms of heart failure, indicating that he is already suffering from severe heart failure.

"Hello, Doctor Zhou, I came here from the imperial capital to see your doctor. Because I have visited several hospitals but can't find out the specific cause of my illness."

The patient is very young, but his conversation is very imposing, his eyes are open and generous, frank, but with an indescribable indifference.His tone was neither fast nor slow, very steady, revealing an extraordinary demeanor faintly.

Children from ordinary families, let alone 17 years old, even 27 years old may not have such extraordinary bearing.

It's like saying that only three generations of a wealthy family can learn to dress and eat.

The cultivation of a child's temperament is a very complicated and long process, which takes into account the comprehensive strength of a family.It is by no means that you can cultivate a child with a "general demeanor" by giving him tens of thousands of dollars a month's pocket money.

For a family without that background, giving a teenage child 5 yuan a month's pocket money will most likely only make him feel that the money is too easy to come by, and then make a bunch of cronies, spend time and drink outside, and run amok.

Some fifteen or sixteen-year-old children are not yet fully developed physically, and they are more playful than old prostitutes.

Whoring, gambling, free and easy, proficient in everything.

Isn't it all parents who coddle their children at an immature age, give them a lot of pocket money, and raise him like this?
Families with real heritage will definitely pay great attention to their children's education.

From an early age, he will consciously cultivate his correct three views, increase his knowledge, and instill various philosophies and wisdom in dealing with people.

Such a child is young, has seen the world, and has a mature mind, far surpassing his peers.

There are often multiple shining points in the body, such as being very self-disciplined, calm in situations, able to distinguish right from wrong, and able to deal with people and things in a self-contained way, and so on.

The young patient in front of him belongs to this kind of particularly outstanding teenager.

Although Zhou Can is already a very good existence among his peers, but let him compare his state when he was seventeen or eighteen years old with this young man, he is far inferior to the other party.

"Thank you for your trust, let me check your body first!"

Zhou Can said to him.

"Excuse me."

The lad is very cooperative.

The middle-aged man standing next to the hospital bed was about 30 years old, his eyes were cold and he did not speak.This person must be a family member. As for who the patient is, it's hard to say.

Zhou Can secretly thought in his heart, it seems that the patients who come from the imperial capital can easily find noble people!
"How long have you been feeling unwell?"

"It seems that since I was 12 years old, I have felt that my body is not strong. At that time, I wanted to be admitted to a key class. I read books day and night, did questions, recited some hard knowledge points, and often sat in the juvenile library. Just a whole day. I didn’t feel anything at first, but then I felt a little uncomfortable when it was about a month before Xiaoshengchu.”

After thinking for a moment, he replied seriously.

"What's so uncomfortable?"

Zhou Can asked.

The patient is currently 17 years old and looks close.If the onset started at the age of 12, it has been five or six years now.

The course of disease has progressed for a very long time.

"I can't say it, I just feel tight in my chest, like a big stone is pressing on my heart, which makes people feel very heavy. Then I just need to exercise a little more, I will feel out of breath and my face will turn red .In severe cases, the hands and feet may even tremble uncontrollably."

The patient's answers were clear, well-organized, and accurate.

This also provides a good reference for Zhou Can's further diagnosis.

"I really admire you. You were able to work so hard for a goal when you were about 12 years old. At that time, you felt unwell. Did you go to the doctor?"

He really admired this young man.

"I didn't go to see a doctor. One is because I was in the critical period of junior high school. I wanted to get into the key class with my own efforts, and I didn't want my family to help me through the back door. And at that time, I thought that as long as I passed the exam, I could relax a little bit. , I will slowly recover. Later, after the exam, I was admitted to the key class of my choice. After a period of rest, my health improved. Later, as the learning tasks gradually increased, those symptoms became obvious again. "

I really feel sorry for this struggling child.

At such a young age, so motivated.

Zhou Can felt ashamed for a while. When he was twelve or thirteen years old, he was at the most naughty and rebellious stage.

I still remember when I was in junior high school, when I saw a beautiful female classmate, I wanted to go up to flirt and strike up a conversation.

For a while, he was like the demon king in the campus.

There have been many conversations between the head teacher and the parents.

Some children really seem to be born generals.They are born knowing how to strive for what they want through hard work and plan their lives reasonably.

"Do you know? At that time, I actually wanted to improve my physical condition by exercising, but as long as I exercised a little more, my body would feel very uncomfortable. Once, the school asked us to run a 1000-meter long-distance race. I just ran to I fainted after 400 meters. It was from that time that when I was in physical education class at school, the teachers didn’t dare to let me participate in too many sports events.”

Almost every child will experience a long-distance run in physical education class, and girls will run 800 meters.

Children with physical problems or lack of exercise are indeed prone to fainting.

But most people faint after running 1000 meters or 800 meters.

This young man fainted after running only 400 meters, which shows that his physical condition is very poor.

"Did you go to the hospital for an examination at that time?"

"Yes! My parents took me to the hospital for an examination immediately after they heard that I fainted in physical education class at school. At first, the doctor thought I had a congenital heart disease, but after careful examination, no problems were found. The doctor Let me strengthen my exercise, and I can do it step by step. For a while, I did feel a lot better by exercising for more than two hours a day. My parents and elders often buy me supplements, but I don’t seem to have much effect after taking them.”

"Later, in the second year of junior high school, the learning tasks were already very heavy. I represented the class in many competitions such as Olympiad and painting. In order to win honor for the class and the school, I could only gradually reduce the exercise time. In the third year of junior high school, I wanted to be admitted to a key high school, and I was even busier. I could spare less than half an hour to exercise every day. Later, my body gradually began to have problems. After I was admitted to a key high school, my study tasks were still very heavy. This year, I should have studied She is a sophomore in high school, but she has a serious physical problem, so she can only suspend school for medical treatment."

After listening to the young man's narration, Zhou Can really admired the young man.

If this young man's illness can be cured, I believe that after N years, this young man is likely to become a pillar of the country.

"Have you checked in many major hospitals, have you ruled out the possibility of congenital heart disease?"

Zhou Can asked.

"Yes, they all said that I didn't find congenital heart disease in my heart, but I found heart failure. At the beginning, it was left heart failure, and then it developed into right heart failure, which progressed to full heart failure. The joint consultation of experts from Imperial Renhe Hospital Finally, the advice given to me was to consider a heart transplant or an artificial heart. My parents thought the risk was too great, and they never agreed to this plan. A top cardiologist at Renhe Hospital was good friends with my father. He told my father, You can let me go to Tuya Hospital to try it. I also mentioned your name."

These words immediately made Zhou Can somewhat proud.

Unexpectedly, even the top cardiologists in Imperial Renhe Hospital knew about his fame.

It was just a live broadcast of the operation. Although the operation was indeed very difficult, in the eyes of the top cardiologists at Imperial Renhe Hospital, it shouldn't be a big deal, right?

In any case, Zhou Can was very happy to be recognized by those big bosses.

"I'm actually a very ordinary surgeon in Tuya Hospital."

Modesty is modesty, and the disease still needs to be checked.

After checking the patient's heart rate and pulse, he also specially auscultated the sound of the patient's pericardial area.A good cardiologist or cardiologist can diagnose many diseases by auscultating cardiothoracic sounds.

For example, aortic valve insufficiency, it is easy to hear murmurs.

In addition, pulse and heart rate seem to be the same thing, but in clinical diagnosis, they still have different meanings.

Some clues can be found through auscultation when the heartbeat is irregular or abnormal.

The pulse helps to understand the working state of the heart, especially the strength of the blood pumping ability, which will be more intuitively reflected on the pulse.

For example, the patient's pulse is very thin and fast.

Heart failure is actually a decline in heart function, and it will have a compensatory mechanism.

The main manifestation is that the ability to eject blood decreases with each contraction.At this time, it needs to increase the heart rate, and the heart rate increases within a unit of time, even if the blood released during each contraction decreases.

However, when the number of heartbeats increases, sufficient blood output can still be maintained within a unit of time, such a compensatory process.

This is why patients with heart failure develop tachycardia instead.

The work of the heart has a certain degree of flexibility.

It ejects less blood at one time, which can only be compensated by increasing the number of times.

"Your body is not thin, but you lack muscle. Your studies are very important, and your body is also very important. In the future, you will definitely need to make a comprehensive balance and maintain a balance between the two. Otherwise, no matter how good your academic performance is, your body will collapse. It’s over, and there’s nothing left.”

After Zhou Can finished the examination, he said to the patient.

"Sometimes I can't help it! I can't fight, because everyone is fighting. It may be that I didn't like sports when I was a child, and my mother had a difficult delivery when I was born, which made me weaker than other people of the same age. "

The patient gave a wry smile.

Adults don't understand the suffering of teenagers. If he doesn't work hard, how can he pass the key class?How to get into key high schools?
"Have you brought all the examination materials from other hospitals?"

"It's all here!"

The middle-aged man who accompanied him in front of the hospital bed finally opened his mouth and handed several large information bags to Zhou Can.

When picking up the bag, Zhou Can subconsciously glanced at the middle-aged man's hand.

It can be seen that the fist front on the back of the hand is full of calluses, and the palm is also covered with calluses.

Master!

This person is definitely a trainer.

The middle-aged man's attitude towards Zhou Can is quite cold.Maybe seeing that Zhou Can is very young, I think it is impossible for Zhou Can to have any great abilities, so I don't value him very much.

Zhou Can looked at the opponent's hand, and then stared at the opponent's face for a few more times.

The middle-aged man's face darkened slightly, and he stared back at Zhou Can.

"I suggest you do a liver test."

Zhou Can said lightly.

The middle-aged man's expression stagnated slightly, and he hummed noncommittally.

Judging by his attitude, he obviously didn't take Zhou Can's words seriously.

Zhou Can stopped persuading, but took out the patient's information and began to carefully check and study one by one.

Director Xueyan was always by his side.

(End of this chapter)