My medical skills add experience

Chapter 650 In Hearing Impaired Patients, The Effects of Blood Path Changes on Nerves

The two were forced to communicate because of Zhou Can's appearance.

Because some neurological diseases require the concerted efforts of internal medicine and surgery to overcome them together.

Zhou Can had no choice but to act as a messenger between the two in order to let the two top leaders inside and outside the gods help to consult together.It is impossible for them to sit in the same consultation room for consultation.

The two are likely to fight directly after a disagreement.

In terms of physique, Wu Baihe, who is outside the gods, is short and lean, while Director Yin Hua, who is inside the gods, is much taller, but lacks physical exercise, and his body is relatively thin.

If there was a fight, Director Yin Hua would probably suffer.

After Zhou Can came back from Song's house, he didn't wait for a reply.

It's useless to worry about it. The patient's family members disagree with the treatment, and no one can do anything about it.

What's more, the Song family is not an ordinary family.

Zhou Can's diagnostic and medical skills are infinitely close to the seventh-level realm. In order to be more confident in treating Mr. Song, he simply spared a lot of time to specialize in various difficult cases.

Even the daily rounds of the emergency department have been changed from twice a day to once a day.

Later, it was changed to once every two days.

He had long intended to let other doctors do this matter.

Because any department is similar, after reaching the level of deputy director, basically they don't care about these trivial matters.When it's time to let go, you must learn to let go.

Otherwise, you can only live and die like Zhuge Liang.

Everything must be done by oneself, and one must bow to reality.

The director's rounds are generally once a week, and Monday is basically the time for the directors of each department to make rounds.

There is a reason for such a setting.

After freeing up time, Zhou Can has more time to delve into those difficult cases and learn relevant medical knowledge.

After only six days, his diagnosis and medical skills were successfully promoted from level six to level seven.

At the moment of the breakthrough, he was both excited and excited. After so many years of hard work, he finally borne a great fruit.

Seven-level diagnosis and medical skills, and almost general diagnosis, this is probably unprecedented in the medical field, and there will be no one in the future.

[Pathological diagnosis, level seven, current experience value 1/10000000.First-level expert rank. 】He is good at diagnosing cases in pediatrics, cardiothoracic surgery, general surgery, acute and severe disease, neurosurgery, neurosurgery, gastroenterology and surgery, and orthopedics.

It can be seen that there are many fields that he is good at.

It can be said to be fruitful.

After being promoted to the seventh level, it is an expert level.

It is higher than the level of chief physician.

Diagnosis of various diseases is almost at hand.

Especially in the diagnosis of diseases in the field of expertise, some do not even need to take radiographs or do laboratory tests. Just take a look at the patient and ask about the symptoms, and the diagnosis can be almost indistinguishable.

After successfully raising the pathological diagnosis to the seventh level, Zhou Can could clearly feel a feeling of invincibility when he went to the clinic again.

Among the cases he received, some were quite difficult, but in his hands, he was basically sure of any one.

And it's effortless to diagnose.

Intractable diseases that required racking one's brains or even asking experts from other departments to jointly diagnose them can now be diagnosed independently.

There are fewer and fewer examinations for patients, and they are more and more targeted.

For medical diagnosis, it is often a blood or urine test first, and then look at the results to basically locate the lesion.Then take a film of the lesion to diagnose the cause.

There are also some cases that require puncture to take pathological specimens for testing, and it is enough to check the pathology.

After sitting in the clinic all morning, Zhou Can found that the seven-level pathological diagnosis was really cool.

And it is more efficient when diagnosing patients.

Experienced old doctors often take a physical examination and ask a doctor first, and then have a first-diagnosis opinion in mind, that is, to determine the direction of diagnosis.Then apply for the corresponding examination to the patient, and then make a further diagnosis based on the examination results.

The more inexperienced the doctor is, the more tests he prescribes.

This is also a must.

Because the current medical environment is very poor, more examinations for patients can not only increase the income of the department, but also prevent the possibility of misdiagnosis as much as possible.

In fact, if the level is not enough, even if the patient is asked to do a whole body check, there is still the possibility of misdiagnosis and missed diagnosis.

The expert number is so expensive, but so sought-after, there is a reason for it.

Zhou Can looked at the time, it was past twelve noon.

Added more than 20 numbers.

There is no way, he is already very famous now, as long as he sits in the clinic, patients from all over the country will definitely come to see him.

Some patients arrived a few days earlier, lived in a hotel, and had to be accompanied by at least one family member.

It's not easy.

Zhou Can can sympathize with their hardships.

Seeing these patients rushing thousands of miles away, they themselves are sick, suffering from pain and torture, and then they have to bear a lot of expenses every day.Without them adding a number, it really doesn't make sense.

The human heart is fleshy.

Comparing your heart to your heart is the Buddha's heart.

It is precisely because Zhou Can is extraordinarily sympathetic to patients and can empathize with their sufferings that his reputation is getting better and better.

At least eight out of ten patients and family members who visited him praised his superb medical skills and noble medical ethics.

"Director Zhou, there is a patient outside who said that he has a hearing problem and would like to ask you to take a look. I explained to the family that Director Zhou's number has been released for today, but they insist on asking you to take a look."

The guiding nurse walked in and said to Zhou Can.

"Give them a number!"

Zhou Can wrote a note and handed it to the nurse.

The plus sign must be written by an expert who sits in the clinic.

Because the staff who register at the window do not have this power.

If they dare to add numbers indiscriminately, they will be scolded to death by the experts who sit in the clinic.No girl is that stupid.

Zhou Can's number, because he is now promoted to an attending physician, has risen to 16 yuan.

The deputy director number is 21 yuan.

The Special Needs Expert number is the most expensive, and the cheapest is 50, which is the worst.A little better is 300 upwards.

Zhou Can himself is not short of money, and he is born with the benevolence of a doctor, so he has repeatedly rejected the hospital's proposal to upgrade him to a special-needs expert.

Obviously, his level is better than that of an expert, but he only charges the patient 16 yuan.

This is after being promoted to an attending physician and forced to upgrade to the rank of an attending physician.

Otherwise, the fee is cheaper.

The patient with the plus sign finished registering and walked in quickly.

Three people in total.

The patient is a young man in his 20s, and the other two family members should be the parents of the child.

Zhou Can thinks he is not good at the diagnosis and treatment of hearing impairment.

Patients are usually referred to an otolaryngologist for treatment.

"Please sit down! Is there a total loss of hearing?"

Zhou Can motioned the patient to sit down.

Lip language that the young man can understand.

Many hearing-impaired people can guess what the other person is saying by observing the movement of the other person's lips.

This can also be regarded as a special ability that was forced to exercise.

"That's right, my child was fine when he was just born, but when he was over two years old, he climbed onto the table and fell off when we were not paying attention. There was nothing wrong at that time, only a bruise on his head. Later We gradually discovered that the child seemed to have a hearing problem. At the beginning, we had to speak to him loudly so that he could hear.

Afterwards, even yelling in his ear was useless.

I really regret it, if I had watched carefully at that time and didn't let him climb on the table, it would be great!Over the years, we have been seeking medical treatment everywhere, and his studies, work, and life have all been seriously affected.

Now I see that it is the age to find a partner.I introduced several girls, and as soon as they heard that our child had a hearing problem, they immediately shook their heads and were unwilling to even meet.

Worry! "

The boy's mother sighed and told what had happened.

Because children are young and ignorant, they don't know what is dangerous at all. Parents must take care of them.

Many tragedies happen in an instant.

Like this couple, they should be in their 40s, and both of them have gray hair.

After the son fell, he had a hearing problem, which has affected them all their lives.

Parents have been living in remorse, worrying about their son's illness every day, let alone being happy, the life of this family is probably suffering every day.

"Have you been to an ear doctor?"

"I've been there. We've been to the ENT department, neurology department, and brain surgery department of a big hospital. The doctor said that there was no way to do it. We heard that cochlear hearing aids can be fitted, but after the test, we couldn't fit them at all. The doctor Said, my child has lost his hearing completely."

Speaking of this, the boy's mother burst into tears.

"Don't worry, I'll show him first. Have you checked all aspects?"

"I've done a lot of inspections! There are so many bags of the films I took. I kept all the old ones at home. I only brought the latest films and inspection results taken in the past few years."

The male family member raised the white plastic bag in his hand.

It can be seen that there are thick inspection materials inside.

"Okay, let me have a look. If the examination done has diagnostic significance, I don't need to repeat it here."

Zhou Can saves money for the patient's family.

After receiving the information bag, he began to examine it carefully to understand the condition of the patient's brain and ears.

Hearing loss in both ears at the same time, and after the fall, he could hear at the beginning, but then he couldn't hear.

This shows that the lesion does not occur immediately, but has a progressive process.

There is a part of the brain dedicated to hearing.

According to Zhou Can's clinical experience, he preliminarily deduced that the auditory nerve may have been injured at that time, but he was not treated in time, which eventually led to the complete loss of hearing nerve function.

Specifically, it must be based on imaging studies, nerve signals, and ear examinations.

After inspection, the patient's head CT showed no abnormalities.

There are even two large hospitals that have performed high-definition MRI examinations on patients, and no problems have been found.

No wonder so many hospitals say it can't be cured.

Zhou Can also felt that this case was quite difficult.

"That's it, let's go for a color ultrasound of the head, and I'll check the blood flow in the head."

After a moment of contemplation, he discussed with his family members.

"Okay, we will listen to your arrangement."

The family members took their children to see so many hospitals, and they have long learned how to cooperate with doctors.

Because there are many doctors, when encountering family members who do not cooperate, they will adopt defensive medical treatment, or "persuade them to quit".

This couple must have encountered it before, and learned to be smart.

Zhou Can decided to start with the blood supply in the head, which is another way of diagnosis.

Because the patient was injured when he was two years old, he is now in his 20s.Nearly 20 years have passed.Ordinary injuries heal long ago, and it is difficult to leave any traces.

Examination for nerve damage is very difficult.

It is not like damage to bones, muscles, or blood vessels. If there is any problem, you can see it immediately after taking a film.

Nerve problems usually need to be checked by nerve electrical signals and myoelectric signals.

This patient has undergone EEG and brain nerve tests.

The nerve signal of the line of hearing disappears.

According to Zhou Can's experience, falls generally do not break nerves directly.

Because the brain has a hard skull and is protected by a dura mater.There is a thin cerebral cortex and a small amount of subcutaneous tissue on the outside.

Plus the head is round.

The chances of falling off a table and breaking a cranial nerve are slim to none.

Zhou Can suspects that there may be a greater possibility of blood vessel problems.

But judging from CT and MRI images, no problem can be found.The main reason is that it has been too long, and the 'criminal evidence' has disappeared.

After prescribing the patient's head color ultrasound, Zhou Can personally took the patient into the color ultrasound room for examination.

"Doctor Xing, help me to work overtime!"

Zhou Can called to open the door of the color ultrasound room, and said to the doctor inside with a smile.

"No problem, Director Zhou has spoken, let alone one extra class, even ten extra classes are necessary." Doctor Xing readily agreed.

"Really! That's great. I'm planning to discuss with you and ask you to work overtime!"

Zhou Can said happily.

"Ahem... Director Zhou, just kidding, just kidding. You can ask me to overtime one class, but if you really ask me to overtime ten classes, I'm afraid the guy in my family will fight with me every day."

Doctor Xing was in his thirties, and suddenly showed a distressed face.

The doctors in the ultrasound room have a heavy workload, and the advantage is that they can leave work on time.You can leave when you arrive.

You don't have to be called back by the hospital to work overtime after get off work.

It is common for doctors and nurses in clinical departments to be called back to the hospital in the middle of the night for rescue or emergency treatment.

Also, the salary of the medical technology department is not bad.

Neither high nor low.

The point is that there is no significant liability risk.

The boy's head color Doppler ultrasound started soon.Zhou Can stared at the screen, his gaze was as sharp as a falcon.

"Don't move, don't move, this is the position. The blood path here seems to have changed, don't you think so?"

Zhou Can asked Doctor Xing.

The latter stared at the screen carefully for a while, and then smiled wryly, "Don't scold me when you say it. Although I do color Doppler ultrasounds for patients every day, I really don't know the subtle blood path changes in the head. As long as I This level is only enough to sit in the color ultrasound room and get a dead salary, and it can't compare with a top level like yours."

Doctor Xing failed to find the problem after looking at it for a long time.

"You have to be a little ambitious, and the doctors in the ultrasound department can also be very good. When you examine patients in the future, you should study more carefully."

Zhou Can said a few words to him.

It's not a criticism, it's more like an encouragement and a reminder.

"Printing this out, I feel that there must be something wrong. The blood flow in his head has changed, which is probably related to the fall injury when he was a child."

Zhou Can seems to have found the reason for the young man's hearing loss.

But the specifics need to be carefully considered before coming up with a treatment plan.

Changes in blood flow are not common, nor are they rare.

(End of this chapter)