Chapter 200 This is pseudoenteritis. Family members strongly request this examination.
A few decades ago, there were many selfless and dedicated teachers, and teachers were highly respected by everyone. But today, there are all kinds of disguised ways of collecting money and charging fees. Teachers secretly investigate the parents of students in the class, to see which one is rich or which one is an official, and then give them special treatment.
The various miscellaneous fees collected from some schools make parents question their lives.
Teachers are no longer interested in teaching children well, but are thinking about how to make money, actively completing the school's fee collection tasks, and getting promoted and evaluated for excellence. This is worrying.
Not to mention doctors, there are more and more bad apples and fewer and fewer doctors with integrity.
Kamata hospitals are sweeping the world.
Hospitals and marketing are tied together.
So much so that some hospitals put up all kinds of shocking slogans: Welcome to visit next time! Congratulations to a certain department for setting a new record in performance! Special meetings were held to discuss how to retain patients...
Ultimately, the vast majority of civilians will become victims.
"The medical records are so thick. You must have visited many hospitals, right?"
While chatting with the family to improve the doctor-patient relationship, Director Jia began to give the child a simple physical examination.
"That's right. I went to at least 20 hospitals, but they couldn't find any disease."
The child's father said with a bitter face.
“How much food can he eat in a day now?”
"He eats two small bowls of rice a day, and likes to eat strong-flavored dishes, spicy and salty. He likes them all."
The child's mother replied .
Normally, it is the mother who takes care of the children more.
"A 17-year-old boy only eats two small bowls a day, which is indeed a bit too little." Director Jia said, and then turned to Zhou Can and said, "Measure the patient's temperature, pulse and other basic data."
Director Jia continued to ask the family about the child’s condition.
"Is he still having diarrhea?"
"Diarrhea! I have diarrhea whenever I eat."
"This illness has lasted for two years?"
"It has been more than two years now. My child was in the third year of junior high school, around the second half of the semester. One day, the teacher called us and told us that our child had lost weight rapidly in a short period of time, and asked us to take him to the hospital for a check-up. After asking, we found out that the child had been suffering from diarrhea at school for more than a month, and his appetite was also decreasing."
The school is a closed management system.
Many children who live far away from home may only go home once or twice a semester.
The possibility of having diarrhea from eating dirty food in school should be very small. Otherwise, it would not be just this child who would have diarrhea, but a large number of children.
And it’s impossible for there to be problems with school meals every day.
"After bringing the child home, does he still have diarrhea even if he eats home-cooked meals?"
"Damn! He still has diarrhea. I took antidiarrheal medicine and it worked a little at first. But then he took it more and more often and there were obvious problems with his body, so we didn't dare to give him the medicine anymore."
Many Western medicines have serious toxic side effects.
Long-term use of a certain type of Western medicine can easily lead to 'drug overdose'.
Because our body needs to metabolize the drugs we take into the body, there is a cycle.
It could be a day, a week, or even longer.
The metabolic cycle depends on the drug.
So far, there is no drug that can remain in the body for a long time.
This is why many diseases require taking medication on time.
The child's digestive function was problematic, so he had to take antidiarrheal medicines over and over. It was fine for one or two days, but after a while, the old drug components had not been completely metabolized, so he took new antidiarrheal drugs, which continued to cause the drug components to accumulate in his body.
When this amount reaches a certain concentration, the body will experience obvious discomfort.
If negative effects occur after taking western medicine, stop taking it immediately and the condition will basically improve quickly.
"Director Jia, the patient's blood pressure is high, heart rate is too fast, body temperature is normal, physical condition is extremely weak, and there is anal rectal prolapse..."
After Zhou Can completed a basic physical examination on the patient, he gave the data to Director Jia for review.
Now, Zhou Can records the patient's pre-diagnosis records, medical records, medical history and other information. Director Jia is only responsible for diagnosing the disease and asking the patient for key information.
This is also further training for Zhou Can, laying a solid foundation for him to see patients independently in the future.
"The high blood pressure is probably related to the body being too thin. The heart rate is higher than normal, which is probably related to the body being overloaded. The root cause of all the symptoms is probably still the diarrhea."
Director Jia made a series of analyses of the condition.
Many people think that only fat people have high blood pressure, but this is actually not true.
Strictly speaking, both fat and thin people have the chance of getting hypertension.
It is caused by an excess of blood circulating in the body.
The patient's long-term diarrhea may lead to anal prolapse, which means that the patient's diarrhea is very severe.
Director Jia took the patient's blood test, B- ultrasound films, X-ray examinations, colonoscopies, electrolyte tests... and checked them one by one.
The doctors tried every possible means to find out the cause of the patient's diarrhea.
Even E. coli was checked.
Unfortunately, the patient's illness was complicated and confusing, and the real cause was never found.
Many diseases are very cunning. They are good at disguising themselves in various ways and creating many smoke screens, making it impossible for doctors to find their "true self".
After Director Jia carefully read through all the patient's examination records, his brows were tightly furrowed.
All necessary checks have been done .
Basically there is no need to do it again.
There were several abnormal data in the blood picture, but they all had traces that could be linked to diarrhea.
All tests pointed to one disease, enteritis.
The patient had undergone a colonoscopy and indeed had enteritis, but it was definitely not ordinary enteritis. Otherwise, the doctors who had diagnosed the patient before were almost all fake doctors.
In addition, some doctors have treated the patient's illness as chronic enteritis, but the results have been disappointing.
Director Jia was in trouble for a while.
Even though he was knowledgeable, it was difficult for him to diagnose the real cause of the disease at once.
The patient has become so emaciated that if we cannot find the cause of the disease and blindly prescribe medicine, it would be tantamount to pushing the patient to the gates of hell.
It is estimated that within a month, the patient will have to be admitted to the intensive care unit.
"Qiuhong, Zhou Can, you two should take a look too!"
Director Jia felt a little embarrassed facing the expectant eyes of the patient's family, so he temporarily hired two cobblers to fill in the gaps.
Ease the awkward atmosphere.
Qiuhong finished reading the examination materials and raised several questions, but they were all rejected by Director Jia.
Zhou Can remained silent.
His rule is not to speak easily, but when he does speak, his opinions are always very constructive.
Time passes by every second.
The family members had been disappointed many times, so when they saw that Director Jia was unable to give a specific result, they seemed to have expected it.
The despair in my heart increased a little.
At this time, Zhou Can heard a slight abdominal gurgling sound from the patient. He was moved and quickly leaned over to listen to the sound from the patient's abdomen. When a patient has a lung disease, doctors often listen to see if the patient has any sputum sound or something like that.
Diarrhea rarely requires bowel sounds.
"Does he have frequent bowel sounds?" Zhou Can asked the boy's mother directly.
Normally, his mother should take care of him more. Plus, women are more attentive, so she might notice the bowel sounds.
"Not bad! The closer it gets to mealtime, the more his stomach growls. Also, about half an hour after a meal, it makes a noise. But it's a different kind of noise, a bit like water sloshing around in a bottle, making a gurgling sound."
This information provided by the patient's mother is extremely critical.
Zhou Can has always been good at starting from an unconventional approach and using unconventional ideas to diagnose patients' pathological mechanisms and lesions.
After asking the family members, Zhou Can had no further comments.
Instead, he picked up the patient's examination report again and looked at it, with a thoughtful expression on his face from time to time.
He accompanied Director Jia in the Department of Digestive Surgery and made many contributions, helping to diagnose nearly ten difficult cases.
Director Jia praised him as a genius more than once.
At this moment, Zhou Can showed such an almost obsessed performance that Director Jia actually felt a little bit of anticipation.
He was very patient and let Zhou Can think carefully.
The family members were secretly wondering why this expert named Jia focused on his students?
Usually, students mainly rely on their teachers!
Naturally, they didn't know Zhou Can's abilities, let alone his special status in digestive surgery.
Director Jia and Qiu Hong were both waiting for Zhou Can very patiently, so the family members naturally would not rush him.
For them, the most important thing is whether they can find out the cause of their son's illness and cure it. As for who can find out, it is not important at all.
Time is passing.
The family members are becoming increasingly hopeless.
At this moment, Zhou Can suddenly said something out of context.
"His enteritis must be pseudoenteritis!"
"What's the meaning?"
The family members asked in confusion.
"That is to say, your son might have false enteritis." Qiuhong helped explain.
"False enteritis? Then what disease does my son have?"
The patient's father's eyes lit up slightly.
"When I took my son to another hospital for treatment, a specialist named Qin said something similar. He said my son's enteritis might just be a symptom, and the real cause of his diarrhea might be something else. Unfortunately, he tried everything he could but still couldn't find the real cause. What this young doctor said was very similar to that specialist's opinion, which shows that he has real skills."
The patient's father waited for so long and originally felt that Tuya Hospital did not live up to its reputation.
It would have been fine if they could not diagnose the cause of the disease, but the attending physician, who was known as a top-level expert, actually asked a young doctor to help diagnose the disease. And the young doctor was the main one.
It's just ridiculous.
At this moment, Zhou Can said that his son's illness was pseudoenteritis. He realized that this young doctor was not ordinary and had real skills.
"Director Jia, do you think the patient is not sick at all?"
What Zhou Can said again was even more shocking than the previous one.
If he hadn't diagnosed his son with pseudoenteritis, the child's father would have stood up in anger and flipped the table.
What the hell.
If there is no illness, who would go through so much trouble as to take the child around to seek medical treatment and medicine?
"Doctor, my son is so sick, how could he not be sick?" the child's mother asked angrily.
"Well... what I mean by not sick is different from what you understand as not sick. I mean, he doesn't have any substantial disease."
Zhou Can explained and looked at Director Jia again.
His eyes revealed his determination to eliminate the false and retain the true, and shone with confidence and determination.
"you mean?"
Director Jia narrowed his eyes as he quickly thought about what Zhou Can meant by this sentence.
Qiuhong's beautiful eyes were fixed on Zhou Can.
She felt that when she consulted with Zhou Can, they were on two completely different levels of thinking. She couldn't even grasp the wind.
I have no idea what Zhou Can is thinking.
The bigger the gap, the more she admired this junior fellow apprentice. She could even call him worshipful.
"Can we monitor the patient's brain waves 24 hours a day? I suspect he may have a mental illness that causes digestive system disorders." Zhou Can gave his own diagnosis.
The family members didn’t understand these professional medical terms at all and could only watch and listen blankly.
However, there was a glimmer of hope in their eyes.
That is the endless hope after finally seeing a ray of light in the endless darkness.
They are looking forward to the exciting moment after the cause of the disease is diagnosed.
“Neurogenic digestive dysfunction? But his symptoms are clearly not similar! I have diagnosed many cases of this disease, but I have never seen one like this.” Director Jia has decades of diagnosis and treatment experience, so it is impossible that he has not encountered cases of neurogenic digestive dysfunction.
He had already conducted screening for similar diseases.
"Tell me about your diagnostic basis and diagnostic thinking."
Director Jia did not rashly agree to Zhou Can's request for brain wave monitoring.
He first wanted to see whether the young man's diagnostic basis and dialectical thinking were reasonable.
"My basis is relatively simple. I start with the patient's bowel sounds, and then combine various examination data, medical history, and symptoms to make inferences." Zhou Can said bluntly.
"The patient's mother said that when it's time for meals, the patient will make 'gurgling' bowel sounds, which signal hunger. This means that after the patient's intestines detect that there is no nutrition being delivered, they can normally send hunger signals to the body. About half an hour after a meal, his intestines will make a 'gurgling' sound again, which is a precursor to diarrhea."
"I think we can confirm whether it is a neurological digestive disorder by doing two tests. The first is 24-hour EEG monitoring, which aims to check the peak values of EEG at different times and infer the patient's mental state at different times of the day. The second is to listen to the specific location of the patient's bowel sounds about half an hour after the patient's meal. This can indirectly infer the speed and state of the intestinal contents in the colon before diarrhea occurs."
Zhou Can briefly explained the diagnostic ideas.
Since the patient has diarrhea every time he eats, it means that the food is still in liquid form when it leaves the colon.
Based on the bowel sounds and inferring the peristaltic speed of the colon, it can only be said that Zhou Can deserves the title of genius.
"Director Jia, please agree to do these tests for our son! We don't care how much money it costs. Even if the cause of the disease is not found, we are willing to do it, and we will not blame Dr. Zhou."
The patient's family was the first to strongly request Director Jia to agree to do this EEG monitoring.
They didn't know how to treat the disease, but after listening to Zhou Can's detailed analysis, it seemed to make sense.
In any case, it's worth a try.
The examination is not like surgery, and the risk of EEG monitoring is almost zero.
As for spending some money, they really don't care.
The most frightening thing is to see no hope.
Now that there is hope , what else is there to say?
"Just be patient, I'll arrange it for you right away!"
After listening to Zhou Can's analysis, Director Jia felt that this novel diagnostic idea was unique, unconventional and very interesting.
He was even more looking forward to the diagnosis results.
If the cause of this disease is found to be a neurotic digestive disorder, he should be able to write a paper on it.
