Chapter 272 This young doctor is not ordinary, the obese woman's respiratory arrest
This young doctor gave her a big surprise. He was modest and low-key, yet decisive and generous. The key point was that this young man had a very high level of diagnostic skills.
It was so high that even she, a top expert in obstetrics and gynecology, couldn't help but cheer for him.
From the moment Zhou Can walked over to the moment the diagnosis was given, the whole process was thrilling.
It's neat and the diagnostic ideas are extremely clear.
It is many times more powerful than those fancy 'fancy punches and kicks'.
Compared with those young doctors who are boastful and vain, Zhou Can is a breath of fresh air, which makes people feel refreshed.
"I'm not sure. I can only infer it based on the patient's condition and my personal clinical experience. I believe that her primary lesion may be in the stomach, mainly from four aspects. First, the formation of a tumor does not take one or two days, but takes a long time to grow, breaking through the body's multiple immune protections to eventually grow into a tumor. Her ovarian tumors are not only numerous, but also small in size, which means that the possibility of tumor cells spreading from other places to the ovaries is very high."
Zhou Can calmly explained his dialectical thinking.
"Second, there are only a few types of ovarian tumors that are prone to occur in young women. For example, endodermal sinus tumor, dysgerminoma, and teratoma. But her ovarian tumor is not one of these types, and the probability of metastasis from other places is increased again."
"Third, the patient's pain area is in the stomach, and ovarian tumors generally only cause pain in the lower abdomen. According to the characteristics of tumor metastasis, metastasis from top to bottom or parallel metastasis is more common. Therefore, I think that if a tumor in the stomach is not detected in time, it is more likely to metastasize to the ovaries. For example, Krugenberg tumor is a metastatic tumor derived from a gastrointestinal tumor."
"Lastly, the patient had symptoms such as nausea, vomiting, and reflux, which indirectly confirmed that she had stomach problems. Gastric tumors are usually easily ignored by patients, are highly hidden, and have a low chance of being detected. Many of my patients with gastric tumors are already in the late stage once they are discovered."
Zhou Can stated the basis for his conclusion one by one.
After listening to him, Director Zhang Bihua would have wanted to applaud him if the occasion had not been inappropriate.
"I'm sure you've heard Dr. Zhou's diagnosis and analysis. If you're willing, I'll arrange a gastroscopy for you right away to check your stomach. If the primary lesion is really in the stomach, you need to be prepared for the worst."
Director Zhang Bihua first gave preventive measures to the family members and patients.
Even if the worst outcome comes out later, they will be mentally prepared.
"We agree to have a gastroscopy. Director Zhang, please save my daughter. She is so young and her child is not yet weaned..." As the girl's mother spoke, she choked up and could not continue.
Tears were welling up in my eyes.
Female patients are more frightened and panicked.
This kind of disaster would be too much for any patient to bear.
"Don't cry, don't cry. Disease is not scary. As long as we are strong, optimistic and brave, we have a chance to defeat it." Director Zhang Bihua quickly comforted the female patient's mother.
Yang Chan also took out a pack of tissues, took one out and handed it to the family member.
I made an appointment for the patient to have a gastroscopy and asked her to go for it right away without mentioning it.
Xinxiang Women and Children's Hospital has seen a sharp decline in its medical services, so there are very few patients. There is almost no need to queue up for any examinations. The examinations can be done quickly and the results can be obtained.
Dean Tian was not accompanying the experts from Tuya Hospital in the clinic hall at this moment, but was sitting in an office on the second floor observing the situation in the outpatient hall through the window.
To be honest, he was quite nervous about inviting the experts from Tuya Hospital to come and see the outpatient clinic.
Both nervous and expectant.
He is even more afraid that the higher the expectations, the greater the disappointment.
So far, the arrival of the experts has not brought the expected popularity. The outpatient hall is still deserted.
Any hospital director would feel bad if he saw a good hospital becoming worse and worse under his management.
Dean Tian has a deep sense of guilt in his heart. His biggest hope now is to restore Xinxiang Women's and Children's Hospital to its original level. However, it is easier to make a mistake than to do it well.
A bowl, it only takes a moment to break it.
To fire a bowl, dozens of processes are required, from selecting the clay to preparing the ingredients for the clay, then making the bowl blank, firing , glazing it, and firing it a second time.
Any mistake in any process may result in firing failure.
Xinxiang Women's and Children's Hospital has been built up over 70 years after the efforts of several generations. However, it is really sad that it is on the verge of bankruptcy due to a medical accident.
Dean Tian was eager to save the Xinxiang Maternity and Child Health Hospital, so Zhou Can's outstanding performance attracted his attention even more.
It's like seeing a ray of light in the darkness.
"Who is that young doctor? He looks quite capable."
The assistant standing behind Dean Tian shook his head and said, "I don't know this young doctor either. I only know the famous people in Tuya Hospital. There is also the overseas returnee doctor Du Leng. There were many hospitals that tried to recruit Du Leng, a special talent, but Du Leng went to Tuya Hospital. He is indeed a highly intelligent and educated person. It seems that his original choice was right. In less than two years, he has been promoted to attending physician."
Graduating from a prestigious overseas university and having a doctorate degree are enough to make Du Leng more famous than ordinary medical students.
There are many hospitals that pay attention to him.
But at this moment, he seemed somewhat inferior to Zhou Can.
Zhou Can actually diagnosed a more difficult case, while Du Lengling was still talking big without any substantial progress.
Although the patients and their families gathered around Du Leng's table with admiring expressions, these people did not come to the hospital to listen to the doctor's lectures. If Du Leng could not cure their diseases, they would soon be abandoned.
After helping the two chief physicians diagnose the case, Zhou Can prepared to return to his seat.
Yang Chan stared at him and blinked.
"I haven't seen you for over a year. I didn't expect your diagnostic ability to have improved to such a high level. I also discovered that your basic medical knowledge is much more profound than before. I remember that this was your weak point before."
Despite being praised by her, Zhou Can remained calm.
"Illusion, that's all your illusion, understand?"
Zhou Can spoke modestly, but he was extremely happy in his heart.
Basic medical knowledge has always been Zhou Can's weak point, but this time he could feel proud in front of her.
After hundreds of days and nights of hard study, I made up for the lack of basic medical knowledge, and the benefits gradually began to show.
Whether in the operating room, outpatient department, or inpatient ward, the application of basic medical knowledge is essential.
Any medicine you take must be supported by solid basic medical knowledge.
Otherwise, the prescribed medicine may not achieve the desired effect, or even cause trouble.
Yang Chan snorted and ignored him.
However, judging from her expression, she obviously did not believe what Zhou Can said.
After Zhou Can and Deputy Director Shi returned to their seats, they continued to be met with the cold shoulder.
This is how patients see a doctor, the head effect is obvious.
Given a choice, almost all patients would give priority to seeing a famous doctor.
At this time, Du Leng had completed the diagnosis of two patients.
It's not that he had found the disease, but he talked a lot to the patient, ordered tests, and asked the patient to do tests and examinations. At this time, a very fat woman came over with difficulty, accompanied by her family.
It really felt like the earth was shaking when she walked.
It seemed as if the ground was shaking slightly.
According to conservative estimates, this woman weighs at least 270 to 280 kilograms.
I guess she may not even be able to see her own hands while eating, let alone lowering her head to see her toes, which is even more of a luxury.
Anyone who is this fat, regardless of gender, must first look for the reasons within themselves.
Excessive pampering by parents, one's own indulgence in diet, and unwillingness to diet after being overweight will eventually lead to a child becoming super fat.
"Finally, a patient came to see us."
Deputy Director Shi stared at the obese woman with a hint of anticipation on his face.
Excessive obesity is actually a disease.
It is easy to go from frugality to extravagance, but it is difficult to go from extravagance to frugality.
It is relatively easy for an obese person to grow from a thin person to a fat person. If they eat and drink to their heart's content and lack exercise, they will quickly become fat. However, if they want to go back from a fat person to a thin person, they need to put in more than ten times the effort.
The process was very difficult.
This is also the reason why weight loss pills are so popular on the market.
People who take diet pills know that they are harmful to their health, but they still spend a lot of money to buy them and take them home, just to turn from fat to thin.
Especially for women, being too fat will damage their image, make them ugly, and cause setbacks in finding a job and falling in love.
"Dr. Du, please help our daughter. When she was sleeping, her breathing suddenly stopped. It's very scary." The fat woman did not walk to their table, but came to Du Leng's table.
For this kind of sudden respiratory arrest disease, it is actually better to see a respiratory doctor.
However, he came here just for the title of overseas returnee doctor, so Zhou Can and Deputy Director Shi could only envy him.
"The title of a returned overseas doctor is really popular."
Deputy Director Shi said in a low voice with a hint of sourness.
"Otherwise, why do so many people want to study abroad to make money?"
Zhou Can never thought that international students are necessarily good.
He treats overseas students with a normal attitude.
Those who are admitted to prestigious universities based on their real abilities, study hard overseas and obtain corresponding degrees, are truly talented and are world-class top talents.
If they want to return to their home country after completing their studies, the foreign immigration authorities will be very enthusiastic in retaining them.
Another way is to spend money to go abroad to gain experience. Some people only study for one or two years and get a graduate degree.
Because it is very difficult for this type of students to take the postgraduate entrance examination in the country.
Through this indirect way of improving academic qualifications, it is relatively easy to obtain a postgraduate degree. Then return to China to find a job, enter a large factory or a large state-owned enterprise.
The academic qualifications of such people are very watered down, and their abilities may even be worse than those of regular undergraduates in China.
Judging from Du Leng’s current performance, he should belong to the former.
He does have some real talent, but because he is too proud and has a strong sense of superiority after returning to China, he is not very pragmatic.
It feels more like a flower stand.
The extremely obese female patient glanced at the plastic stool in front of the examination table. She hesitated.
Standing for a long time takes a toll on her body. After walking such a long way, she wanted to sit down and rest.
But this thin plastic stool may not be able to withstand her "oppression".
"Find that woman a sturdy chair. If the stool is crushed, it's no big deal. But if she falls and gets hurt, several people may not be able to help her up!"
Dean Tian has been standing in the office on the second floor watching the situation in the outpatient hall.
When he saw the female patient wanted to sit on the plastic stool, he was immediately frightened.
Fortunately, the female nurse on the scene was very smart. She quickly persuaded the obese woman to stand for a while and immediately tried to find a chair for her.
Soon, the hospital nurse brought an iron chair.
It looks pretty solid.
The obese woman helped herself to sit down, and the people around her looked worried. They were worried about the chair, fearing that it would be broken by her.
In fact, the chair creaked when she sat on it.
This was the first time that Du Leng treated such a super fat man. He was obviously intimidated by the other party's "momentum" and seemed a little unconfident.
"Hello, can you tell me when did you start to experience breathing cessation while sleeping?"
"I don't remember exactly, it probably started about three or four years ago! I took her to a big hospital for a lot of tests and she took some medicine, but it didn't work."
The family members were a couple in their fifties. The man put the information bag in front of Du Leng.
There are various checklists in there.
Du Leng took it out and checked it.
"Her sudden apnea during sleep is most likely related to her obesity rather than a neurological problem. Excessive obesity will lead to a decrease in the cross-sectional area of the pharynx and a significant increase in the neck circumference. As fat accumulates in her neck, her upper airway will eventually become narrower and narrower. After falling asleep, the muscle tension of the pharynx will change, causing her airway to be blocked and apnea to occur."
After reading the examination data, Du Leng gave the patient another rough examination and then gave a conclusion.
It is undeniable that his medical knowledge is quite profound and his level is not bad.
The reasons given were so reasonable that even the medical staff around nodded repeatedly after hearing them.
But this time, the family members didn't seem to buy it.
"Dr. Du, the reason you mentioned is the same as what the doctors said when we were treated in other hospitals. And they have already performed surgery to improve her airway. My daughter's condition has improved to a certain extent, but she still has apnea sometimes."
Family members said.
"I don't see any surgery-related information and medical records in your file bag!" Du Leng just scanned the information in the file bag. If there were any patient's surgery records, he would have seen them long ago.
"Well... the operation was performed almost four years ago, and the relevant data has long been lost."
The woman's mother hurried over to explain.
"Is that so? Let me help her again!"
Du Leng fiddled with it for a while, but obviously couldn't find a second cause other than obesity.
"How about this? I'll prescribe an enhanced CT scan and bronchoscopy for her. We'll make further diagnosis after the test results come out. It's also possible that the surgical effect did not meet expectations, or that she continued to gain weight after the surgery, causing the airway to narrow again."
Out of trust in him, the family members readily agreed.
So I applied for an inspection and went for the inspection.
Zhou Can and Deputy Director Shi didn't have any patients to see, so they were bored and had just been watching Du Leng diagnose the woman.
Judging from the family's description of the condition, the woman's wheezing when she walked, and her thick neck, Zhou Can felt that the woman's sleep apnea was likely not related to her airway.
There are many reasons that can cause this symptom. If you are only confused by the superficial symptoms of obesity, it would be like holding a candle but not seeing the light.
Once she finishes the bronchoscopy, the results will be clear.
Whether it was the ovarian tumor patient who underwent gastroscopy or the obese woman who underwent bronchoscopy, they both needed to fast for four to six hours.
Bronchoscopy is usually performed under local anesthesia and has lower risks.
It is estimated that the results will not be available until the afternoon.
