Chapter 191 Junior Brother Zhou, Incurable Crohn's Disease
Judging from her description, chronic ulcerative colitis is more likely.
The risk of intestinal polyps and intestinal cancer also exists.
Considering that she is still very young, only in her twenties, at the prime of her life, her risk of colorectal cancer is relatively low.
In addition, she was treated in a local hospital and diagnosed with enteritis.
But the effect of taking the medicine was not good.
In addition, she is now vomiting, so even if it is really enteritis, it is an extremely dangerous type.
"Qiuhong, give her a physical examination first."
Director Jia may have taken into consideration that the patient was a female, so he asked the female doctor Qiu Hong to perform a physical examination on her.
In fact, in the eyes of doctors, there is really no distinction between men and women.
When female patients have an electrocardiogram, they are likely to meet a male doctor. There are also many male doctors who treat breast diseases. During the physical examination, female patients will be asked to lift up their tops, and then the doctor will perform palpation and visual examination.
Depending on the hospital's requirements, there will be a female nurse or doctor present.
If there are only male doctors and female patients, if the patient says that the male doctor molested her, she can't clear herself from the accusation even if she jumps into the Yellow River.
Also, female patients can ask their husbands or other relatives to accompany them when they visit the doctor.
Family members can enter the outpatient department.
Only the operating room, examination room and intensive care unit are not allowed to have family members enter.
It depends on the situation in the emergency room. In principle, family members are not allowed to enter. However, after the rescue is completed, or the doctor feels it is necessary, family members can be allowed to stay to encourage the patient and stimulate the patient's desire to survive.
Will actively invite family members in.
Physical examination is actually much more complicated than you might think. It includes measuring axillary temperature, calculating respiratory rate, measuring right upper limb blood pressure more than three times, observing the patient's complexion, development, nutrition, auscultating bowel sounds, and many other items.
It is definitely not as simple as pressing the painful area twice as shown on TV.
While Qiu Hong was doing a physical examination on the patient, Zhou Can picked up the patient's examination report and looked at it.
The first thing to check is the blood test results.
When a person becomes ill, at least 70% of the diseases will be reflected in the blood picture to a greater or lesser extent.
The female patient's white blood cell count was significantly increased, while her red blood cells and hemoglobin were lower than normal. Her hematocrit was also significantly decreased, and her erythrocyte sedimentation rate increased. Her mucin increased, while her albumin decreased.
The blood test results alone were enough to confirm that she was sick.
With so many blood abnormalities, from a doctor's professional point of view, this disease is not a minor one.
Enteritis is only a minor illness.
So, what disease could be more serious than enteritis?
Intestinal perforation should be ruled out because it is often accompanied by abdominal infection and the symptoms are much more severe.
Patients may also experience severe pain, high fever, and even chills.
Zhou Can then checked the stool and found red and white blood cells, and the occult blood test was positive.
Most diseases are in the intestines.
CT scan revealed no obvious abscess in the abdominal cavity.
Based on these tests, the patient was diagnosed with common enteritis. The treatment plan and diagnosis given by her local hospital were all correct.
"Zhou Can, did you find anything?"
Director Jia's way of addressing Zhou Can changed unconsciously.
From Xiao Zhou to Zhou Can.
I don’t know whether it was because he considered that calling him Xiao Zhou in front of the patient was a bit disrespectful, or because Zhou Can discovered the hidden disease of the patient in bed 3 and he felt that he should be given a certain amount of respect.
All in all, this is a good phenomenon.
At least when Director Jia addressed the beautiful doctor Qiuhong, he did not call her Xiaoqiu, but called her by her name directly.
"It's hard to say right now, as there is too little test data. We can only roughly infer that the disease should occur in the intestines. It may be enteritis, but it is definitely not ordinary enteritis."
Zhou Can gave his own diagnosis.
Asking him to give a confirmed result directly would definitely be a bit unreasonable.
He has been able to reduce the scope of the disease again and again, which is already very good.
"Not bad. Your diagnostic thinking is not as impetuous as most young people. It is very down-to-earth. You are better than I thought."
This is the first time Director Jia has praised him.
And it happened in front of the patient.
It shows that he is very satisfied with Zhou Can's performance.
"The specific cause of her illness can only be further determined by a colonoscopy." Director Jia said this to the patient.
"Can I avoid the colonoscopy? I heard it's very scary. I'm afraid of the pain, and I'm even more afraid that the colonoscopy will rupture my intestines!" The patient is very resistant to the colonoscopy.
At the local hospital, the doctor may have discussed with her and asked her to have a colonoscopy.
"You need to do a colonoscopy, which has a little risk. If you really don't want to do a colonoscopy, then I'll give you a barium enema! But I personally recommend a colonoscopy, which is more intuitive."
Director Jia said to her.
"Well... no, no. One of my little sisters had a colonoscopy in the hospital and was in pain for many days. Unless you give me a painless colonoscopy, I can consider it."
She seemed a little childish.
In fact, most of these girls are kind-hearted, motivated and cheerful.
At least they are more open-minded when they encounter difficulties.
Her ability to withstand pressure is much stronger than that of ordinary girls.
"Girl, you are already sick, do you still care so much about the slight pain caused by the examination? Painless colonoscopy requires an appointment, and it takes at least half a year to wait. You can't delay your illness for a day. Also, the cost of painless colonoscopy is much more expensive, why bother?"
Director Jia shook his head helplessly.
Today's young people are very individualistic and their thoughts are very different from those of the older generation.
Finally, after the patient completed the physical examination, Director Jia prescribed a barium enema examination for her.
She dragged her weak body to pay the bill and get checked.
It's really worrying to see that the patient is so seriously ill, but has no parents or family members to accompany him to the hospital.
I don't know what her family is like.
Some young people are particularly sensible. In order not to worry their parents or add burden to them, when they are working hard outside, they handle everything by themselves, whether they are sick or encounter major setbacks at work.
It looks both pitiful and sad.
…
Around half past ten in the morning, Qiuhong's cell phone rang.
"Doctor Tang, are the test results of bed 3 patient out?"
Qiuhong asked proactively.
It turned out that the call was from the physician attending the patient in bed 3.
"Ah...it really is gallbladder cancer! Dr. Zhou, the new doctor in our department, is amazing." Her pretty face was full of shock. She felt extremely incredible that Zhou Can could predict the patient's hidden disease.
[Pathological diagnosis experience value +1. ]
[You have successfully diagnosed a difficult hidden disease, pathology diagnosis experience +100. ]
101 pathology diagnosis experience points were credited to his account at once, which made Zhou Canle very happy.
His efforts finally paid off handsomely.
Pathological diagnosis is now level 4, the lower level of attending physician. To upgrade to the level of deputy chief physician, he needs to earn 10,000 experience points. If he can only earn 1 point each time, he doesn't know when he can upgrade this medical skill to the deputy chief physician level.
After ending the call, the look in her eyes when she looked at Zhou Can changed completely.
"Teacher, Dr. Tang called just now and said..." Before she could finish, Director Jia waved his hand and said, "I heard everything. Zhou Can is really capable."
After praising Zhou Can, he sighed slightly.
"Oh, gallbladder cancer is known as the king of cancers, and the prognosis is very poor. This patient's condition is really terrible, and I'm afraid he has lost the opportunity for surgery. I'll go and see the results of the MRI after I finish my outpatient clinic!"
Director Jia felt sorry for the patient.
It would be great if gallbladder cancer could be discovered earlier, because by now it may have already metastasized.
The prognosis of pancreatic cancer and gallbladder cancer is particularly poor.
These two types of cancer are called the kings of cancer, each more dangerous than the other.
They have one thing in common: they can easily infiltrate surrounding organs and tissues, and the surrounding areas are all important body tissues.
If the disease is discovered too late, the patient will lose the opportunity for surgery.
Cancer cells can replicate themselves and spread rapidly throughout the body. If surgery is not done, it is fine. But if surgery is not done, they will grow wildly.
The time from diagnosis to death is often very short.
Gallbladder cancer is a malignant epithelial tumor with a very high degree of malignancy. According to different pathological mechanisms, it can be divided into adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, mesenchymal tissue tumors, neuroendocrine tumors, etc.
No matter which type, it's a life-and-death situation.
The five-year survival rate for gallbladder cancer is generally no more than 10%.
This patient is already very old, in his seventies. If the family has a mine, they can try to re-evaluate the surgical plan and risks. Otherwise, conscientious doctors will basically tell the family that if they really want to treat him, they should be prepared to lose both their money and their lives.
"Junior Brother Zhou, I'm very curious, how did you find out that the patient in bed 3 has cancer?" Qiu Hong stared at Zhou Can with her beautiful eyes.
The way she addressed Zhou Can had changed from the unfamiliar Dr. Zhou to Junior Brother Zhou.
Only at this moment did she take the initiative to accept Zhou Can calling her senior sister.
"Just observe! During the ward rounds, I noticed that the patient's complexion, eyes, hands, and facial skin color were all wrong. I suspected it was cancer at the time. Later, I asked Director Jia for leave and after carefully reading the examination report, I used the method of elimination and finally locked on the gallbladder."
Zhou Can generously shared his diagnostic experience.
"The main reason is that the patient's cancer symptoms were covered by his liver cirrhosis and duodenal ulcer. Otherwise, it would be easy to detect."
Having stolen the limelight from Director Jia, he naturally had to give him a way out.
Experts are also human beings, and they can make mistakes or omissions sometimes.
"Qiuhong, you may not know this! When Zhou Can was doing regular training in other departments, he was also very famous. Those chief physicians praised him highly, and each of them wanted to keep him in their own department."
Director Jia is quite well-informed.
He actually knew everything about Zhou Can's deeds in other departments.
Zhou Can's fame began after he finished his training in neurosurgery. At that time, he had already attracted the attention of Vice President Ye, who gave him special attention during his training in critical care medicine.
Until now, with the help of Director Xueyan, Zhou Can is frantically making up for his shortcomings in basic medical knowledge.
Nearly two months have passed and initial results have been seen.
The knowledge gaps in areas such as immunity and digestion have been largely made up.
This time, we were able to accurately locate the cancer of the patient in bed 3 to the gallbladder, which means that initial results have been achieved.
Just then, two groups of patients walked into the clinic at the same time.
The young female patient walking behind was the one who was initially diagnosed with enteritis.
She had returned from a barium enema.
"Mr. Jia, the test results are out, please help me take another look!"
While she handed the test results to Director Jia, she gave an apologetic smile to another patient who came for treatment.
"The barium shadow shows jumping signs... This disease is troublesome!"
After reading it, Director Jia frowned deeply.
This means her disease is very difficult to treat.
After reading the barium test results, Zhou Can's heart trembled slightly. Her symptoms were highly similar to those of enteritis, and now the barium shadow showed jumping signs, which basically meant she could be diagnosed with ulcerative colitis.
But combined with her electrolyte test results, this is definitely not ordinary ulcerative colitis, but may be the very deadly Crohn's disease.
We can already get a glimpse of the clues from the CT results.
Proliferative lesions that penetrate all layers of the intestinal wall have involved the mesentery and regional lymph nodes, and the lesions are limited to the small intestine and colon.
The lesions are characterized by segmental distribution.
It is separated from the normal intestinal segments, has clear boundaries, and presents the characteristics of a skip zone.
All signs point to Crohn's disease, which is known as the 'green cancer'.
This disease is not real cancer, but with current medical technology, patients need to take medication for life, and the cost is also quite high.
If imported drugs are used, the cost per treatment is approximately RMB 15,000 to 20,000.
I need an IV drip about once every two months.
Such expensive medical expenses, and the fact that it has to happen every two months, is definitely a disaster for an ordinary young girl.
"Just tell me directly. I can bear it."
The girl was quite brave. After seeing Director Jia's expression and hearing his tone, she knew the result would be very bad.
Director Jia was pondering and organizing his words.
When doctors communicate with patients, they will usually try their best to take the patients' feelings into consideration.
"It's okay. Go ahead! I don't have many people in my family anyway. My parents divorced when I was very young, and my grandma and grandpa raised me. Now my grandparents are no longer in this world. Even if I have cancer, I don't have anything in this world worth clinging to. So, I can accept any result."
I can’t imagine that these words came out of the mouth of a young girl in her twenties.
Hearing this and looking at her expression, Zhou Can felt particularly sympathetic.
Unfortunately, his medical skills are still limited, and no doctor has been able to cure Crohn's disease yet.
The only solution is to take medication for life.
Western medicine has been developed for so many years and has become very advanced in many fields such as diagnosis, surgery, medication, pathological mechanism, etc. Traditional Chinese medicine, which has lasted for thousands of years, and witch doctors in the Western world have been directly wiped out by it.
But many chronic diseases cannot be cured.
According to statistics, at least more than 80% of chronic diseases are incurable.
Are you shocked to hear this result?
Take a tumor as an example. After it is removed, it will grow again.
Medically, it is called relapse.
Why is cancer only curable if it is discovered in its early stages? In fact, it is not a cure, but rather it relies on the body's immune system to defeat the disease.
When cancer reaches the middle and late stages, it is like a wildfire in the mountains that has spread across the entire prairie. The body's immune system is either destroyed or no longer a match for the disease.
Therefore, at this time, the final result of surgery, radiotherapy and chemotherapy is basically left to fate.
Western medicine treats symptoms, while Chinese medicine treats the root cause.
The treatment principle of traditional Chinese medicine is to balance yin and yang. Perhaps one day, the whole world will highly recognize traditional Chinese medicine and make it the mainstream medicine in the world, while Western medicine will become a supplementary treatment.
However, when that day really comes, Chinese medicine may no longer be the strongest in China, but may be the strongest in developed Western countries.
Because they may have realized the value of traditional Chinese medicine and have already started planning.
There are not many famous Chinese medicine practitioners left in China, and many of them have been poached by foreign countries for large sums of money.
This makes people feel helpless and lost.
Fortunately, actions taken abroad have attracted the attention of relevant parties, and various policies have been initiated to protect and develop traditional Chinese medicine.
Compared with the serious decline and exclusion of traditional Chinese medicine from the late Qing Dynasty to modern wars, the current situation of traditional Chinese medicine has improved a lot.
"Girl, your disease is called Crohn's disease, an intestinal inflammatory disease of unknown cause. Theoretically, it can occur in any part of the gastrointestinal tract, but it is more common in the terminal ileum and right colon. Clinical manifestations include abdominal pain, diarrhea, intestinal obstruction, accompanied by fever, nutritional disorders and other extraintestinal manifestations. Your anemia symptoms, constipation symptoms, and even the vomiting after eating are all related to this disease."
Director Jia announced the diagnosis results to her.
She obviously had never heard of this disease, and asked in confusion, "Can this disease be cured? Is it cancer?"
