Chapter 243 Controversy, the aunt who doesn't listen to advice is going to get into trouble
"Okay then! I've been waiting for more than a year, so I don't mind just one day. Thank you for your concern." The woman nodded in agreement.
The cause of the disease was found out, which was the most exciting news for her.
It also gave her hope.
After enduring for so long, she finally saw the light.
"Xiao Qiu, please help send the patient back to the temporary bed. You guys can go about your own business!"
After Director Shang communicated with the family members, he directly assigned Qiu Chengyu to do odd jobs.
Zhou Can had established a relatively stable position in the Department of Gastroenterology in two days. Both Director Shang and Huang Xinggui dared not treat him as an ordinary trainee anymore.
Director Shang didn't say it, but his respect for Zhou Can was reflected in some details.
"I have to coordinate and arrange the surgery. Zhou Can, can you take care of this patient?"
I thought the attending physician had already been assigned.
Unexpectedly, another patient was given to Zhou Can.
"Okay! I have no problem taking care of four patients." Zhou Can has been assigned four patients so far.
The task is neither heavy nor light.
Generally speaking, the gastroenterology department doesn't have many critically ill patients, and managing ten beds at the same time doesn't put too much pressure on us. But the workload is definitely not small. Just writing medical records and course of events, changing dressings, and making rounds are enough to keep people busy.
I really don’t know what it means in some hospitals that one intern has to be in charge of twenty or thirty beds?
Under normal circumstances, one person definitely cannot take care of it all.
The quality of medical care has dropped significantly, and it is almost certain that templates will be used to write medical records.
"By the way, is it convenient for us to discuss the condition of the female patient who is a lawyer in bed 79 with you now?" Zhou Can had already found out the cause of the female patient's illness, but he was busy in the afternoon and had no chance to discuss it with Director Shang.
"Oh ! Have you made significant progress in the diagnosis of that patient?"
After hearing this, Director Shang was surprised and delighted.
This intern is really good. No wonder all the departments where he has been rotated are scrambling to keep him.
"After taking over the patient this morning, I have been curious about how her liver cirrhosis developed. Later, I accidentally discovered that she occasionally had diarrhea..."
Zhou Can repeated his diagnostic ideas.
"To sum up, I suspect the patient has portal vein thrombosis. If we can do a splenic portal vein angiography, we can diagnose whether this is the disease!"
The attending physician usually decides which tests to request.
Zhou Can is just a resident in charge of the patients. He has the right to make suggestions but not the right to make decisions.
"If it is really this disease, the symptoms would not be so mild. Portal vein thrombosis usually progresses very rapidly. If it is combined with mesenteric vein thrombosis, the patient often dies in a very short time. According to her, she had abdominal discomfort, loss of appetite, and fatigue symptoms for at least one month, which is too mild compared to the symptoms of portal vein thrombosis."
Director Shang does not agree with Zhou Can's diagnosis.
Portal vein thrombosis is like a ferocious tiger, but the patient's symptoms are consistent with the disease, but he is as gentle as a sheep.
The styles of the two are very different.
"I thought about this question at the time. Later, I thought about it carefully and felt that the patient might have a type of slow portal vein thrombosis. This type of thrombosis can form collateral circulation, and the portal vein can be recanalized, although it will eventually progress to portal hypertension. But it is much milder than ordinary portal vein thrombosis. The time span can also be extremely long."
Zhou Can had thought about this problem a long time ago.
After thrombosis occurs, multi-lumen diversion of the portal vein is also a common phenomenon.
The human body is much tougher than we think.
It is like a super castle with multiple warning and defense mechanisms.
But when one part is attacked by the enemy, other parts can automatically replace some of the functions of this part, thus ensuring that the body will not be too vulnerable.
Human beings have a history of at least more than 6.5 million years from ancient times to the present.
In this long period of time, we have been able to survive until now and become the overlord of the earth. The vitality of human beings is far more tenacious than imagined. The various protective mechanisms of the body are also extremely complete.
Many people think that the human body is just like that, isn’t it just two eyes, a nose and a mouth?
There are muscles beneath the skin, and various organs in the chest and abdominal cavity.
It's all obvious, nothing special.
In fact, human organs and even any cell have many unsolved scientific mysteries. For example, the human body is born with various oncogenes and tumor suppressor genes.
In other words, cancer has been with each of us since we were born.
However, the tumor suppressor genes of most people can protect the body very well and suppress all proto-oncogenes. When a cell wants to rebel, mutate, and become a cancer cell, the tumor suppressor gene can directly kill it in the cradle.
And it is 100% accurate, there is no chance of any fish slipping through the net.
Only when the tumor suppressor genes in a person's body become ineffective or disappear will there be a risk of cancer.
There is just this risk.
It does not necessarily mean that you will have cancer.
The human body is not just about the oncogenes and tumor suppressor genes. The skin, which we think is ordinary, also has magical abilities that we can't even imagine.
For example, the sense of touch of the skin is more complex than you can imagine.
If you close your eyes and touch something, you can immediately tell whether the surface is smooth, what material it is made of, whether the temperature is hot or cold, how thick it is...
Even the most advanced science and technology today cannot simulate the human skin's perception ability.
When we touch something that is hot, our brain immediately receives the signal "hot".
At this time, you will quickly move away from the object to avoid getting burned.
Or if they touch a sharp object, it will cause a frightening stinging pain and they will immediately avoid it.
The human skin has so many capabilities.
In addition to the touch of God-like power, it can also help humans resist the invasion of bacteria and viruses. At the same time, it can also retain the body's moisture. When our body is in an overheated environment, it can also regulate body temperature by evaporating water. When it is cold, it can shrink the pores and lock in body temperature.
From this point of view, it is equivalent to an 'air conditioner' for the human body.
There are so many magical organs in the human body like the skin that it is impossible to count them all.
Some people speculate that humans are descendants of aliens.
There is no creature on earth more amazing and complex than humans.
However, Zhou Can believes that humans are more powerful than alien creatures.
At the current rate of development, it is possible to conquer the entire solar system, even the Milky Way and the entire universe.
In fact, humans have already begun to enter the interstellar age.
It's just in its infancy.
After listening to Zhou Can's point of view, Director Shang fell into deep thought again.
After four or five minutes, he finally seemed to have figured out what was going on.
"Your analysis makes sense. I'll observe the patient's condition again. If there are no new findings, I'll do as you say. Give her a venous angiogram."
Director Shang was still a little undecided in the end.
Decided to observe the situation for another night.
There was no way to do angiography today.
Unless the patient has an emergency and must undergo angiography immediately to save his life, it is possible to ask the teachers in the interventional department to work an extra night shift.
Zhou Can was just making suggestions, and he had no say on whether Director Shang would adopt them.
Doing your job well is already excellent.
I have been working and studying in the outpatient clinic in the afternoon. I don’t know how the three patients in my care are doing.
Before leaving, he handed the patient over to Mr. Luo for care.
There will definitely not be any big mistakes.
Zhou Can first checked the gastric cancer patient in bed 77, and found that his vital signs were stable.
"Doctor Zhou, you are here!"
Patients are full of endless gratitude and deep trust in him.
Seeing Zhou Can enter the ward was like seeing a relative.
In fact, Zhou Can just bought her a meal.
"There haven't been any major changes in your body, have you? For example, any particular part of your body is particularly painful or something like that."
Zhou Can asked gently.
"I feel no different from usual. I had a stomachache for a while, but I feel much better now."
Her stomach cancer was in the early stages, so she wasn't experiencing unbearable, severe pain.
When cancer reaches the late stage, the most terrifying thing is the pain that penetrates deep into the bone marrow.
It can torture people to the point of wanting to commit suicide.
Because it hurts so much.
"Rest well, and wait for your mother to come over. Then try to choose active treatment. If you treat your disease now, there is a great hope that it will be cured. Then, you can start a new life, be a confident and strong woman, and repay your mother well."
Zhou Can can only use her relatives to awaken her desire to survive.
In the fight against cancer, it is also very important to maintain a positive and optimistic attitude.
"Thank you! I am so lucky to have met such a good doctor like you!" As she spoke, she burst into tears again and her voice choked up several times.
Zhou Can sighed after seeing this.
What a good girl, but she was ruined by that vicious man who didn't know how to cherish her.
He walked to bed 79 to check on the female lawyer.
Not bad, the patient's vital signs are quite stable and there are no sudden conditions.
Zhou Can came to another ward to check on the patient in bed 71.
This patient with esophageal-jejunal anastomotic fistula and anastomotic segment occlusion is receiving nutritional injections.
There was no other way. He couldn't even drink a sip of water and could only rely on intravenous infusion to keep himself alive. He would be scheduled for surgery tomorrow, so there was no need to worry too much.
“Oh… oh…”
There was a groaning sound coming from bed 73.
Zhou Can turned his head and saw the couple singing a duet in perfect harmony. You just finished humming and I came on stage.
It is understandable that the patient keeps groaning and crying out in pain.
I had just undergone pancreatic duct stone removal surgery and was infected with salmonella. Without the use of medication, the patient's body could only resist.
But the patient’s wife, the middle-aged lady who refused to listen, also started humming. What was going on?
This lady is definitely not joking.
He was lying on the edge of the bed in pain , his face full of painful expression and groaning constantly, which meant that his stomach was in severe pain.
"What's the matter with you?"
Zhou Can walked over and asked with a concerned look on his face.
"Don't mention it. It might be because I drank that bowl of chicken soup. I started having stomachaches not long ago. It has been hurting until now, and it's getting worse and worse."
The old lady was in so much pain that she was shaking even when she spoke.
After being infected with Salmonella, some people develop symptoms early, within 12 or 13 hours. Some people may have stronger body resistance and the number of infected Salmonella is small, which may lead to a longer incubation period.
But one thing is certain, once infected, it is only a matter of time before you get sick.
“No salmonella test?”
Zhou Can asked.
"Not yet... do it! It's not easy for the two of us to make money, so we should save as much as we can. My health has always been good, so I will get through it after a while."
The old lady was lying on the head of the bed, speaking incoherently.
It can be seen that the pain is quite severe.
She had gone to the hospital to take care of her husband who was having surgery, but now her husband had been knocked out by the poisonous chicken soup she had bought, and she herself was not spared. Suddenly, she had become two patients.
But this old lady is really able to fight. She will not leave the front line and will continue to fight even if she is seriously injured.
She just stayed by her husband's bedside, gritting her teeth and holding on.
Zhou Can felt both sympathy and helplessness towards the couple.
It was because she was too smart and didn't follow the doctor's advice that she got into such a disaster.
After the problem occurred, she still ignored the doctor's advice and kept hoping for a lucky break.
To put it bluntly, there must be something hateful about pitiful people.
"When you are infected with salmonella, sometimes it is not entirely determined by your physical health. If your symptoms worsen, I suggest you receive regular treatment to avoid serious consequences. Some people can survive this disease, but others may experience worsening symptoms, leading to sepsis, typhoid fever, and septicemia. At that stage, the mortality rate is very high."
Zhou Can really wasn't trying to scare her.
This disease varies from person to person.
Some strong men became seriously ill and died soon after being infected.
Some seemingly frail people contract the disease but survive.
It mainly depends on whether the body's immune mechanism can be activated in time, especially the third immune mechanism, whether the helper cells can successfully activate a large number of inactivated macrophages.
This is very critical.
If the body is damaged by Salmonella to a certain extent, but the macrophages are still not fully activated, this would be dangerous.
A large number of cells are killed by Salmonella, which can lead to necrosis of intestinal tissue.
The pathological mechanism at this time is similar to the inability to amputate a necrotic limb in time.
The prognosis will be very poor.
"Let me take a look first... Thank you!"
The aunt couldn't persuade him at all.
Her husband was lying on the hospital bed, just groaning by himself and not caring about this at all.
Maybe they just don't want to care.
If you are not from the same family, you will not live in the same house. If the wife's thinking is backward, the husband's thinking may not be much advanced.
Zhou Can has fulfilled his duties as a doctor. Since the family members won't listen, there is nothing he can do.
At this moment, the aunt's face changed. She took the half-used roll of paper towels from the bedside table, covered her stomach and ran out quickly.
One of the main symptoms of Salmonella infection is diarrhea.
If you run too slowly, you will definitely poop in your crotch.
Zhou Can shook his head helplessly and walked out of the ward.
It was time to get off work, and he was going to leave after handing over to the doctor on duty.
Ordinary trainees need to work overtime, and it is a normal thing. His status is a bit special, so no one will arrange overtime for him for the time being.
"Doctor Zhou is helping me take care of my patients again!"
At this time, Dr. Yu Xin from the team walked quickly into the ward.
Judging from her light steps, she can work an early shift today.
After getting to know Zhou Can, she would no longer have a cold face and be self-admiring.
Take the present moment for example, taking the initiative to greet Zhou Can is already a rare thing.
"I just checked and his condition has improved. His temperature has not risen and his complexion is better than before. I think his abdominal pain and diarrhea will be much relieved by tomorrow morning."
Zhou Can gave her his feedback.
"Very good!"
She surprisingly trusted Zhou Can's diagnosis.
Hearing him say that the patient's condition had improved, a rare smile appeared on his face. But he closed the case very quickly.
Maybe she was born not to like smiling.
"His condition is improving, but his wife's condition is currently unknown. When I came just now, his wife had severe stomach pain and had already run to the toilet because of diarrhea. I suggested that she get a check-up and receive formal treatment, but she refused to listen. You can persuade her again when you see her later. This disease is just a precaution."
Zhou Can mentioned the patient's wife to her again.
He really spoke with great sincerity, all for the sake of that old lady.
"I've already tried to persuade her. But it didn't work! Don't worry, I'll keep a close eye on her condition during my ward rounds. If her condition worsens, I'll persuade her to get treatment again, and then she might listen."
When Yu Xin mentioned that old lady, she looked helpless.
"Okay, I'll go to the office to finish writing the medical records, hand over the work, and then I'll be leaving get off work. Bye."
Zhou Can no longer cares about this matter.
He has a lot of his own things to do.
I went back to the office to finish the medical records of several patients and prepared to leave work.
As soon as I went out, I ran into Director Shang who was walking out of the director's office. Looking at his face, he seemed not to be in good health.
"Director Shang, I'm off work!"
"Well! Be careful on the road. Tomorrow morning, the patient in bed 71 will undergo an endoscopic surgery. When you come in the morning, remember to make arrangements for him."
Director Shang spoke very gently to Zhou Can.
"Okay! Can the patient with the parasites in his brain have surgery tomorrow?"
Zhou Can asked casually.
"I'm afraid it won't be possible tomorrow. I just called the general surgery department to coordinate, and they said that intracranial surgery should be performed by a neurosurgeon. Then I contacted the neurosurgery department and asked them to conduct a joint treatment, but the nurse who answered the phone spoke in an official tone, which really pissed me off."
Director Shang must have been really angry, otherwise he would not have told his doctors about this.
