My medical skills add experience

Chapter 550 Finding out the cause of the disease, from unbelief to belief

In the ultrasound room, Zhou Can stood next to the ultrasound doctor himself.

Echocardiography often refers to the application of ultrasonic short-wave ranging principle pulsed ultrasound to measure the periodic activities of the underlying heart walls, ventricles and valves and other structures through the chest wall and soft tissue, and the corresponding activities and time of each structure are displayed on the monitor. The relationship curves between them are recorded into images by a recorder.

It is good for assessing heart size, valve function, and left ventricular ejection fraction.

What Zhou Can wants to check now is the left ventricular ejection fraction.

"LVEF, down EF39%."

Doctor Chaosheng reported to Zhou Can.

"It's about the same as the left ventricular ejection fraction checked by other hospitals." Zhou Can nodded, and then said to the patient. "Come on, try to hook your feet and use some strength."

The patient does as he is told.

"What's the current left ventricular ejection fraction?"

"52%."

The sonographer's face was full of disbelief.

The ejection fraction is only 39%, which is a low level.Not particularly serious, but not light either.

A normal ejection fraction is between 50% and 70%.

The patient's left ventricular ejection fraction rose directly from 39% to 52%, which is really incredible.

If this state can be maintained for a long time, the patient can basically return to normal.

"Very good, relax, relax!"

Zhou Can had more confidence in the judgment in his heart, and directed the patient to relax.

"Bend your calves!"

Instruct the patient again to do what he asks.

"What's the score this time?"

"46%."

"It's not bad." At this stage of the test, Zhou Can basically knew where the patient's cause was. "I'm going to squeeze your calf, bear with it."

After instructing the patient to straighten his legs again and relax, Zhou Can tried to squeeze the gastrocnemius muscle of the patient's leg.

"How many?"

"43%, 42%.

This is the test result obtained by squeezing the left and right legs separately.

"Okay, thank you for your hard work! Type out the report and call it a day."

Zhou Can said to the sonographer.

"Doctor Zhou, is my leg really the cause?"

"That's right, it's in the legs. I'll tell you when I get back to the ward!"

The resources of the ultrasound department cannot be occupied all the time.

Now it's past off-duty time, and the doctors in the ultrasound department are forced to work overtime.

Unlike clinical departments, the working hours of medical technology departments are very punctual.They can come to work and leave work on time, and they can rest on Saturday and Sunday.However, departments such as ultrasound and CT have a huge business demand, so there will be a post transfer mechanism.

In addition, in a large hospital like Tuya, the ultrasound departments of the obstetrics, gynecology and cardiothoracic surgery departments are not managed by the general medical technology department, but belong to the obstetrics and gynecology and cardiothoracic surgery departments.

If you want to be an ultrasound doctor, the ultrasound department in these two departments is recognized as the most promising.

Doctors in the general ultrasound department have no way to break through the barriers, and have basically been mixed in the small circle of the medical technology department.The income is above average, but there will not be any obvious improvement.

Unlike doctors in clinical departments, although they are a bit tiring at work, after get off work or on vacation, they are called back by the hospital to work overtime with just a phone call.

And even after get off work, I still have to worry about the patients I manage, and pray that nothing will happen to those patients.

If the patient in charge dies or something, he must bear the responsibility.

This responsibility does not mean losing money to family members, or even revoking the practice certificate, but there will be an evaluation mechanism that will have a great impact on doctors.

If two patients die in three days under the supervision of a certain doctor, the superior doctor will focus on guarding against this doctor while scolding his mother, and marginalize this doctor in the future.Clinically, he will no longer be given weight.

To put it bluntly, speaking is no longer effective, and the doctor’s order must be read by a superior doctor before it can be implemented. For some clinical treatment measures, it is also necessary to ask the superior doctor for instructions, or directly let him follow the instructions of other doctors of the same level.

Not to mention the disqualification of the evaluation qualifications.

Zhou Can has a high weight in the emergency department, and even the deputy chief physician has to follow his instructions during clinical rescue.

……

Beside the temporary hospital bed in the corridor, Zhou Can held an echocardiogram and was explaining the cause of his heart failure to the patient.Director Xueyan has rushed over upon hearing the news.

"The cause of the disease has really been found out! It's amazing!"

Director Xueyan's face was full of smiles.

Every time such extremely difficult and difficult cases are successfully diagnosed or cured and discharged, she feels very happy.

As the director of the department, I naturally hope that the department will get better and better.

The accumulation of fame and word-of-mouth of a department plays a certain role in treating common cases, but it is limited.The most influential ones have to be difficult cases.

"I still don't understand why my heart failure is related to my legs?"

Patients are curious about this.

The Wei brother invited by his family was standing beside the hospital bed with an incredulous expression on his face.

I thought Zhou Can was talking nonsense, but I didn't expect that after the examination, the legs were really related to heart failure.

"There are several powerful muscles in the legs, called the gastrocnemius. Ordinary people may not know its function, but in the eyes of our doctors, it is called the second heart of the body. Since our human ancestors learned to walk upright, we There is a major defect in the human body. The heart becomes farther from the ground, which makes it extremely difficult for our lower limbs to return blood to the heart."

"At the same time, it is difficult for the blood pumped by the heart to reach the extremities of the lower limbs. At this time, after countless years of human body evolution, the gastrocnemius muscle in the legs has evolved the role of the accessory heart. Every time it exercises, it can pump blood from the legs Squeeze them back to the heart smoothly. Then when you relax, it will form a natural suction force to draw the blood in. In this way, it forms a blood pumping function similar to that of the heart."

Zhou Can explained to the patient the connection between the legs and the heart.

Hearing that the patient and Brother Wei have gained a lot of knowledge.

As for director Xueyan, nurses, and other doctors, they looked at Zhou Can with admiration.Everyone has learned the knowledge in books, and some have forgotten it after learning it, and some have not forgotten it, but there is no way to use it flexibly in clinical practice.

Zhou Can, on the other hand, can use what he has learned flexibly, and he can do it at his fingertips.

His clinical diagnosis thinking made every medical staff present feel envious.

"It turns out that our human legs are the second heart. It's amazing! But there is nothing wrong with my legs. How could it cause heart failure?"

The patient is currently a sophomore in high school. Because he is very eager to learn, he must have learned a lot.

But after listening to Zhou Can's explanation, he still felt extremely amazed and his eyes widened.

"This is about you. You usually read and study, sit all day long, and rarely exercise. And you are in the stage of physical growth, and your lower limbs are seriously lacking in exercise and exercise, which causes your lower limb muscles to relax and atrophy is quite serious. .This requires you to keep exercising every day in the future, and let it gradually return to normal levels. By then, your second heart will basically recover its function."

"Don't underestimate the role of the second heart. If it can work normally, it can reduce the pressure on the heart and promote blood circulation throughout the body. On the contrary, when there is a serious problem with it, the heart will do the work of two people. Live, after a long time, the heart can't bear it. Severe fatigue occurs and it becomes weak. In this case, it can no longer do the work of two people, and the left ventricular ejection fraction is lower than normal."

"Then because it was not corrected in time, and the real cause of the disease has not been found, the heart has been in this abnormal working state. After a long time, it caused total heart failure."

Sometimes Zhou Can treats patients like he treats his sons and daughters who don't live up to expectations.

Both distressed and annoyed.

Decline its misfortune, anger its indisputable, this is the true state of mind of most doctors at work.

Seeing that the patient is sick, even dying, the doctor is very sad.But some patients don't care when they are in good health.Tell him to stop smoking, drink less, and stay up late, so he won't bother to listen!
Quandang doctors are scaremongering.

Then when I fell ill, I realized that what the doctor said was advice.It's a pity that it was too late at this time, and there was no chance.

"Then... can my disease be cured?"

The patient has already regarded Zhou Can as a miracle doctor, and his trust in Zhou Can has risen to an unprecedented level.The real cause of the disease was found, which also allowed him to see the hope of a cure.

At least I finally know the cause of this strange disease.

"It can be cured! I will formulate a treatment plan for you, mainly based on your exercise. If you can't keep exercising, and once you start studying, you will forget your health again, and I can't do anything. Studying is hard work. Good thing, but you must pay attention to the balance between work and rest. While studying, you must also take care of your health, understand?"

Zhou Can thinks it is not difficult to treat this disease.

The only difficulty is that the patients themselves do not cooperate and refuse to persist in exercising.

"Don't worry, I will listen to you this time. After falling ill this time, my studies were also delayed, which made me deeply realize that haste makes waste. I will learn from this lesson deeply, and even after graduation I will always keep this lesson in mind when I go to work in the future.”

The patient expressed his opinion to Zhou Can.

This young man is a person with perseverance and perseverance, and he will definitely do what he says.

Zhou Can also nodded in relief, and went back to the office with Director Xueyan to discuss the young man's treatment plan.

The treatment plan was formulated overnight, the use of drugs was minimized, and physical assistance was the main method.However, since the patient's current heart failure is quite serious, there must be no way to use less medicine.

We can only wait until the patient slowly recovers, and gradually reduce the use of drugs.

It is a three-point poison of medicine, especially western medicine, many of which contain hormone ingredients.Their side effects on the body are very large and the impact is extremely far-reaching.

It is easy for the body to become dependent on drugs.

In addition, when the same medicine is used for a long time, drug resistance will also form.This can lead to poor absorption of the drug by the body, and the drug's effectiveness will be greatly reduced.

……

The next day, Zhou Can finished his rounds in the emergency department early in the morning, and rushed to the cardiothoracic surgery department to check on the young man's treatment.

A specific electric compression tool was temporarily used for the gastrocnemius of the patient's legs in order to assist the patient's gastrocnemius of the lower limbs to continuously contract and relax.It's like massaging your calves.

It can be seen that the patient's complexion has improved significantly, and his breathing is no longer so short and laborious.

These are all good things.

Even without an examination, Zhou Can could feel that the patient's heart failure symptoms had been greatly relieved.

"You can get out of bed and walk downstairs in a while, and let Brother Wei accompany you. What about others?"

Zhou Can has been here for so long, but he hasn't seen that brother Wei.

Not staying by the employer's side for a long time, is that guy constipated?Squatting toilet?

"Well...Brother Wei asked for leave with me, and went in line for an inspection."

The patient hesitated for a few seconds, but in the end he did not lie to Zhou Can and told the truth.

"Didn't you still be a good person yesterday? Why did you suddenly get sick?"

Zhou Can frowned slightly, it would be impossible for this patient to be accompanied by no one.

"Well, didn't you tell him the day before yesterday that you should go for a liver test? At that time, he probably thought you were too young and your medical skills were not high, so he didn't take it seriously. I saw you successfully diagnosed my cause yesterday. If he found it, he has already begun to believe in your medical skills. Worried about his health, he bought me breakfast this morning and took care of me to wash up, then he rushed to the hepatobiliary department to queue up to see a doctor."

The patient may also feel that it is a bit unreasonable to talk about these embarrassing things about the bodyguard.

But he couldn't lie to Zhou Can, so he seemed a little awkward when he spoke.

"So that's the case, then don't leave here alone without someone to accompany you. You can walk around the bed, move your legs, and increase the muscle strength of the gastrocnemius."

After Zhou Can finished listening, he couldn't help laughing.

That brother Wei is really interesting. The day before yesterday, he asked him to have his liver checked, but he refused to listen.

Now it's early in the morning and I rush to queue up for registration.

This man is so realistic.

"Okay! Doctor Zhou, do you think there is really a problem with Brother Wei's liver? How did you find out that there is a problem with his liver? I'm purely curious, and I think medicine is amazing. Especially your medical skills are really impressive. It opened my eyes."

the patient asked.

"There is nothing unusual about this. The first time I saw him, I found that his palms had a certain degree of liver palm symptoms, and then I saw red spider moles on his neck, and there were more than one, so I concluded that there was probably a problem with his liver."

Zhou Can didn't think how capable he was.

"There are many medical skills that seem miraculous to you ordinary people, but they are just the accumulation of medical experience. Because we can come into contact with a large number of patients every day, and through the accumulation of experience from generation to generation of doctors, we also have The ability to find out whether the opponent's body is suffering from obvious diseases."

"Understood! Thank you for your patience in answering me. This visit to Tuya Hospital for treatment should be another correct choice I have made. I have gained a lot of knowledge. Most importantly, my illness has finally been cured hope."

The patient is sincerely grateful to Zhou Can.

"You said that if my disease is really undergoing a heart transplant, is it still not curable?"

This question is actually not easy to answer, after all, it is necessary to take care of the face of those experts in the imperial capital.Those experts really had nothing to do, so they considered a heart transplant.

(End of this chapter)