Chapter 254: Pharmacological Meridian, Patients with Continuous Upper Abdominal Pain
In addition to this patient who was successfully cured and discharged from the hospital, the gastric cancer patient has also been discharged. However, he still needs to come to the hospital regularly for chemotherapy and follow-up examinations.
The female lawyer who suffered from liver cirrhosis had obvious therapeutic effect after surgery.
He was discharged from the hospital three days ago.
However, cirrhosis is a common chronic progressive liver disease in clinical practice, which is diffuse liver damage caused by the long-term or repeated effects of one or more causes.
This damage is often irreversible.
The liver and kidneys have great similarities in this respect.
Once damaged, it is difficult to recover.
The best way is early detection and early treatment.
However, compared to the kidney, the liver has a strong regenerative capacity. If the liver is in good condition, even if 80% is removed, it can still recover.
Because the liver of a patient with cirrhosis has entered the compensatory stage of disease, its regenerative ability will definitely be affected and is far inferior to that of a normal liver.
If it develops to the late stage of cirrhosis, that is, the decompensated stage, the liver is basically useless at this time.
Not to mention removing part of the liver, even other surgeries require consideration of whether the patient's body can withstand it.
The female lawyer in bed 79 was lucky in misfortune. Her liver cirrhosis was still in the early stages. After the real cause of the disease was found, the hidden danger was eliminated through surgery.
From now on, she only needs to take long-term medication to protect her liver, and her life will not be affected too much.
By the way, Zhou Can wrote discharge instructions for the female patient and successfully earned a reward of 100 pharmacological differentiation experience points!
This was also the first time he issued discharge instructions to a patient with liver disease.
His pharmacological differentiation has now been successfully promoted to level four, with a current experience value of 227/10000, the lower level of attending physician.
This level is not as good as the best, but it is more than enough compared to the worst.
Not to mention among the trainees, even among the group of resident doctors, he definitely stands out from the crowd.
All doctors know that pathological diagnosis and pharmacological differentiation are the two most difficult medical skills to advance in, which is comparable to the promotion of anesthesia. Many doctors have studied medicine for their entire lives, but they always remain at the attending physician level.
It is not simply because medical papers block their path to promotion to associate chief physician. It is indeed because many doctors have limited understanding, are lazy and slack after work, and are unwilling to study and learn as hard as they did when they were studying.
In the end, he worked until retirement without ever having mastered high-level pathological diagnosis and pharmacological differentiation.
If it is traditional Chinese medicine, in addition to pharmacological differentiation, there is a more difficult medical skill called the determination of drug efficacy by meridians.
It is equivalent to the advanced medical technique of using medicine.
Even if you have learned pharmacological differentiation, you can only treat the disease according to its cause, understand what medicine to use for what disease, and have precise control over the compatibility, dosage, and usage.
However, compared with the real masters of traditional Chinese medicine or internal medicine, there is still a clear gap.
Because they all understand the medical skills of the meridians.
It is also referred to as meridians.
For example, Director Tan of the Internal Medicine Department once studied the theory of traditional Chinese medicine and even learned from many old Chinese medicine practitioners in order to learn more about the efficacy of medicines.
The fact that he was able to become a first-class professor, be selected as an academician, and firmly sit on the top position of director of the Department of Internal Medicine is certainly not a false reputation.
Director Tan's medical achievements in the field of internal medicine are among the best among internal medicine experts across the country.
It's just that he is usually low-key and doesn't pursue fame, so he is not as famous as Wu Baihe.
Even Director Yin Hua of the Department of Neurology is more famous than Director Tan.
But Yin Hua was usually as respectful as a student in front of Director Tan.
Like Director Tan, many scholars have specialized in studying Chinese medicine after achieving certain medical achievements. Almost all famous internal medicine experts have taken this path, just like all famous scientists have finally embarked on the path of theology.
Newton, Einstein, Edison... these people all turned from scientific research to theology in their later years. No one can explain why.
People speculate that perhaps they believe in the existence of God because they know too much and find that many things cannot be explained by science.
According to this logic, after achieving certain achievements, Chinese physicians began to conduct in-depth research and study of traditional Chinese medicine, and it seems that they also discovered that many medical phenomena could not be explained by Western medicine theories.
Instead, the answer can be found in the theory of traditional Chinese medicine.
Therefore, they naturally began to explore traditional Chinese medicine.
Although Western medicine has developed rapidly in pharmacy, Western medicine still suppresses traditional Chinese medicine and is the mainstream of the market.
But when it comes to meridians, foreigners shake their heads like rattles and can only say NO, NO.
Because there are no such things as meridians and acupoints in Western medicine.
They don't even know what meridians are. If you talk to them about the efficacy of drugs and their meridians, isn't that like talking to a cow?
Zhou Can's pharmacological differentiation is currently at level four, and his understanding of pharmacology and medicinal properties has reached a new level. However, compared with medical giants such as Director Tan of the Department of Internal Medicine, his level is still far behind.
Therefore, his concept of the efficacy of drugs and their meridians is still very vague.
But he is much better than foreigners. At least he knows some basic knowledge about meridians and acupoints.
On this day, Zhou Can came to the ward early as usual to check on the patients under his care.
The number of patients assigned to him by Director Shang has increased from 7 to 11. During these seven days, some of the patients he was in charge of had been discharged, and some were newly admitted.
So far, all the patients he has treated have received effective treatment, and he has not encountered any difficult or complicated diseases that he cannot cure.
If endoscopic surgery is necessary, then surgery should be performed; if interventional treatment is necessary, then interventional treatment should be performed; if medication is necessary, then medication should be used.
Without exception, all the patients he cared for were able to receive formal treatment within two days of admission.
It is precisely because he does an excellent job in management that Director Shang keeps adding responsibilities to him.
Zhou Can never refuse anyone who comes.
Especially after his pharmacological diagnosis and treatment skills were upgraded to level 4, his ability to prescribe various medical prescriptions for patients was significantly improved. He could be more precise in the selection, compatibility, and dosage of drugs.
For example, for reducing fever, there are many kinds of drugs to choose from, such as ibuprofen, aspirin, acetaminophen, indomethacin, nimesulide, celecoxib, etc.
When using medicine, his previous resident doctor level only focused on pursuing the effect of reducing fever.
Now that he has been promoted to the level of attending physician, he will take into account many factors such as the patient's age, gender, underlying diseases, cause of fever, etc.
It is obviously more thoughtful and detailed than before.
The advantage of doing this is that it can better reduce the harmful effects of drugs and truly treat the disease according to its cause.
From this perspective, the prescribing skills of attending physicians and resident physicians are really not at the same level.
"Doctor Zhou, could you please help me check on the patient in bed 65?"
Zhou Can was checking the beds in the ward when Yu Xin, a female trainee in the group, came over.
"What's the matter?"
Zhou Can turned his head and asked.
Since he joined the Department of Gastroenterology, all the patients under his care have received effective treatment, which is a fact witnessed by all.
Many people don't say it, but they admire his abilities in their hearts.
Not to mention Yu Xin in the group.
"That's the old lady who was infected with salmonella last time. She has just been transferred back from the intensive care unit. I think her condition is still very scary. My expertise is limited and I'm worried something might happen. If you can help check it out, I can feel more at ease."
Yu Xin explained.
Whenever she encounters a patient she can't handle, or a situation she is unsure of, she will ask Zhou Can for help.
It is much easier to ask Zhou Can, who is also at the regular training level and has better ability than the attending physician, for help than to ask Director Shang or Huang Xinggui.
There is no psychological pressure either.
"Oh, that lady is really a fool. It would have been great if she had been diagnosed and treated right away when she was infected with salmonella! She had to wait until it became a serious illness before seeking medical treatment. It's lucky that she survived."
Zhou Can shook his head and sighed.
Follow Yu Xin to the ward where bed 65 is located.
The aunt’s husband was discharged from the hospital a long time ago.
Instead, it was she, the nurse, who, out of ignorance and a mentality of taking chances, ended up getting herself into the intensive care unit.
"Auntie, can you talk now?"
Zhou Can felt complicated as he looked at the sick and thin old lady lying on the hospital bed.
When the aunt saw him, she almost cried.
"Doctor Zhou... If I had listened to your advice, I wouldn't have stepped half a step into the gates of hell. I feel so upset and regretful. I have ruined my family..."
The old lady's voice was sobbing and her tears could not stop flowing.
Her daughter, who had taken a special leave to take care of her, quickly wiped her tears.
"Money is only a thing outside of one's body. Saving one's life is the best outcome. Isn't there a saying that those who survive a great disaster will have good fortune in the future? I believe you will live a happy life in the future. Look, your daughter is so filial that she took a leave of absence to take care of you at your bedside."
Zhou Can is not very good at comforting people.
I can only say a few words to comfort the aunt.
"I'll take your physical examination first. If you feel uncomfortable, please tell us immediately. Also, there's no need to dwell on or regret what has already happened. If you stay cheerful, you can be discharged a few days earlier. If you feel depressed and suffocated, it will be very detrimental to your recovery."
Zhou Can continued to persuade the old lady.
There's nothing we can do. The patient has already been so unlucky. As a doctor, we should try our best to help the patient.
"Mmm...I'll listen to you. I won't be so self-righteous this time!"
After suffering a loss once, the aunt never dared to act willfully again.
I actually stopped crying and tried to calm down.
Her daughter also took the opportunity to comfort her mother.
"Mom, the doctor told you to stay in a good mood, so please stop blaming yourself and worrying about this!" She sincerely hoped that her mother could live a happier life and untie the knot in her heart.
"I have good news for you! Dad was discharged from the hospital two days ago! He is recuperating at home! He kept saying that your mom is not at home, and he always feels like something is missing! My sister-in-law and I laughed at him because he felt like he had lost his soul when he didn't see you."
The aunt, who was originally immersed in self-blame and regret, actually smiled after hearing this.
"He never said these nice words to me. When I am discharged from the hospital, I will make him a pot of chicken soup so that he can recover sooner after eating it."
The old lady suddenly remembered that she and her husband were infected because they drank the problematic chicken soup, so she quickly asked Zhou Can, "Doctor Zhou, can we eat the chickens we raise at home?"
She was once bitten by a snake and became afraid of ropes for ten years. Even drinking "poisonous chicken soup" has left her with a psychological trauma.
"Of course you can eat it. As long as it's a healthy chicken and it's cooked thoroughly, there's absolutely no problem. Chicken has a mild tonic effect and is very suitable for nourishing the body after recovering from a serious illness."
Zhou Can said with a smile.
Yu Xin, who was standing next to her, couldn't help but smile at this moment.
This lady also has a lovely side.
Zhou Can measured the old lady's temperature, blood pressure, heart rate and other basic signs, and then learned about her physical symptoms at the time.
"Auntie's current signs and symptoms are all good. I believe that as long as she actively cooperates with the treatment, she will be able to recover and be discharged from the hospital soon." Zhou Can's words reassured Yu Xin, the aunt, and the family members.
There was joy on the faces of several people.
It is the common pursuit of patients, their families, doctors and nurses that patients can recover and be discharged from the hospital.
"Doctor Zhou, could you please help me look at the patient's medical instructions again? Is there anything that needs to be revised?" Yu Xin was probably worried that Zhou Can would think she was too nosy, so she explained. "Director Shang said that Duan Zifu and I can ask you for advice when we encounter something we are unsure about in the medical instructions."
"Director Shang really flatters me!"
Zhou Can gave a bitter smile. He was just a trainee and not as powerful as Director Shang thought.
Fortunately, his pharmacological differentiation has been promoted to level four, and he can basically handle it as long as the disease is not too complicated.
I read the patient's medical instructions carefully and there was nothing wrong.
"The doctor's instructions are very consistent with her current treatment and symptoms, so she can continue to use the medicine. However, we still need to closely observe the patient's medication response. If any abnormal reaction occurs, we must immediately seek treatment from a senior doctor."
The aunt had just been transferred out of the intensive care unit and was still very weak.
According to Zhou Can's training experience in the Department of Critical Care Medicine, these patients are the key nursing targets.
Zhou Can was talking to Yu Xin when Huang Liang, a senior resident doctor under Director Zheng Hongtao, walked quickly into the ward.
He walked straight towards bed 67.
It seems that the patient in this bed is under his care.
When Huang Liang saw Zhou Can, he was stunned for a moment, his expression somewhat unnatural.
Because seven days ago, the patient with acute gastroenteritis almost died due to his misdiagnosis, misjudgment, and procrastination.
The situation was extremely dangerous.
If the patient was sent to the gastrointestinal surgery department two or three hours later, he might have gone into shock or even died.
Zhou Can discovered in time that the patient might have intestinal perforation, which not only saved the patient, but also saved Dr. Huang Liang and Director Zheng Hongtao.
However, their attitudes towards Zhou Can are very different.
After Director Zheng and Director Shang shook hands and made peace, their attitude towards Zhou Can has become very warm and friendly.
When they meet, he would even greet Zhou Can with a smile on his face.
This shows that Director Zheng Hongtao is a very grateful person.
"morning!"
Huang Liang nodded to Zhou Can and greeted him.
"morning!"
Zhou Can knew that he was still upset, so he didn't argue with him.
Huang Liang has a high status in the gastroenterology department and is well-known. He is one of the best residents.
The fact that he took the initiative to say hello to Zhou Can at least shows that he is a reasonable person. It's just that he attaches too much importance to face and is arrogant, so he acted so unnatural when greeting Zhou Can.
To put it bluntly, I just don't want to appear too weak in front of Zhou Can.
But Zhou Can saved him once, and the favor was there. When he met his benefactor, he still couldn't act like a stranger.
At this time, an intern under Director Zheng also quickly walked into the ward.
"Good morning, Doctor Huang! I came here as soon as I heard you were admitted to the ward. This patient was admitted yesterday. He had unbearable pain in his upper abdomen when he was admitted. It was paroxysmal and lasted for more than 10 hours. After the emergency department received the patient, a blood test and B-ultrasound were performed, and the patient was given anti-inflammatory treatment, but there was no effect. So he was transferred to our gastroenterology department."
The intern on duty quickly reported the patient's condition.
The upper abdominal pain is extremely severe and hospitals generally take it very seriously.
At the beginning of the emergency department, it is definitely suspected that the patient has eaten unclean or irritating food, which has caused gastritis or enteritis. Therefore, the patient will be given anti-inflammatory treatment.
It now appears that the patient's condition is more complicated than imagined.
Huang Liang listened carefully and picked up the patient's information to check.
His frown deepened.
This indicates that the cause of this patient's illness is not easy to diagnose.
