Chapter 278: The competition among the young generation, you, a doctor, must have paid for it.
After listening to the family members' complaints, Dean Tian began to have serious doubts about Du Leng's ability.
But she would definitely not show it in such a public occasion.
Right now we must appease the family members and patients and calm the situation down.
We finally invited Tuya's team of experts to carry out this expert consultation activity, but it was full of twists and turns and troubles.
Tuya Hospital doesn't even know whether to send a few reliable young doctors over.
Thinking of the reliable young doctor, Dean Tian couldn't help but look at Zhou Can.
For example, young doctors like Dr. Zhou are very reliable.
"Family member, please calm down! Your wife's condition may be complicated. But don't worry, we have invited many experts from Tuya Hospital this time. One expert may have limited knowledge, so we will invite multiple experts to jointly diagnose. We will try our best to find out the cause of your wife's illness and make sure you don't come here in vain."
After being comforted by Dean Tian, the family members looked much better.
"Director Zhang, this patient's condition is somewhat complicated. Can you hold an on-site consultation to discuss the cause of her illness?"
Dean Tian is almost putting pressure on Director Zhang.
After all, it is about whether the expert consultation of Xinxiang Maternal and Child Health Hospital can achieve good results.
We can't let such a small thing ruin such a good situation.
"Okay, after I finish treating this patient, I will immediately organize a discussion with the experts present." Director Zhang Bihua readily agreed.
They may also be worried that the family members will become impatient and dissatisfied again.
After she glanced at the other experts, she happened to see Deputy Director Shi and Director Jiang of Shennei who were idle.
"Director Shi, Director Jiang, one of you specializes in gastroenterology and the other specializes in neurology. The patient's symptoms are related to both the digestive system and the nervous system. Please help take a look first!"
This time, Zhang Bihua led a team to Xinxiang Women and Children's Hospital to carry out expert outpatient activities. She is the team leader and has full authority to arrange work for other experts.
Of course, at her level, she speaks very politely.
The tone used was consultative.
Instead of using that offensive and condescending tone to order other experts to do their work.
"No problem! Bring the information here, Director Jiang and I will study it together!"
Deputy Director Shi answered more actively than anyone else.
This caused Zhang Bihua, Dean Tian and others to look at him in surprise.
We are all smart people. Looking at Deputy Director Shi’s positive attitude, I think he is quite confident!
Little did they know that Deputy Director Shi and Zhou Can had already discussed it and were even preparing to take the initiative to intercept it.
If Du Leng hadn't quarreled with the family, Deputy Director Shi might have offered to "help" a long time ago.
The family members had a falling out with Du Leng and were eager to find other experts to treat their wife.
"Wife, let's go find another specialist!"
The family member took the information and brought his wife to Deputy Director Shi's desk.
Director Jiang also stood up and walked over, followed by Gao Jian.
Zhou Can quickly stood up and gave him a seat.
"Director Jiang, please take a seat!"
This kind of humble and courteous behavior greatly increased Director Jiang's favorability towards Zhou Can.
"Thanks!"
Director Jiang nodded to him in a friendly manner and sat side by side with Deputy Director Shi.
Zhou Can and Gao Jian stood together for the first time.
The two men smiled at each other, but Gao Jian's eyes revealed a strong fighting spirit.
"Doctor Zhou, it's been nearly two years since we last met. How about we take this rare opportunity to compete?"
"Haha, I don't care!"
Zhou Can has never been afraid of anyone.
He also wanted to see how advanced Gao Jian's medical skills had become after nearly two years.
He felt that Gao Jian was much more pragmatic than Du Leng.
His strength must be much stronger than Du Leng.
The woman's disease was more related to internal medicine, which was Gao Jian's main training area. Therefore, Gao Jian had an advantage over Zhou Can to a certain extent.
Because Zhou Can had been rotating in various surgical departments for the previous year and a half.
It has only been about two months since I officially entered the regular training program in general internal medicine.
The four began to study the woman's examination records and medical condition.
The woman had uterine bleeding a year ago and underwent a curettage at a local county hospital. Pathology showed that the scraped material was endometrial tissue. Since then, the woman has not had her menstrual period again.
Less than half a year later, the woman developed obvious symptoms such as polyuria, thirst, polydipsia, and fatigue.
The most water I drink in a day is up to 20,000 ml.
I have to get up to urinate almost every one or two hours at night.
And the patient gradually likes to drink cold water.
A steamed bread meal trial was done at the Provincial People's Hospital and the patient was diagnosed with diabetes.
The doctor at the Provincial People's Hospital prescribed regorafenib and acarbose to the patient. After taking the medicine for a period of time, the patient felt that there was no effect and stopped taking it on his own.
The patient stayed at home like this for several months without controlling his diet. He reported that there were always bubbles in his urine, but he did not have symptoms of urgency or pain when urinating.
About a few months ago, she developed vulvar itching and increased discharge.
More than two months ago, he developed symptoms such as impaired consciousness, slow reaction, and occasional inability to communicate. Sometimes he even urinated on himself due to impaired consciousness.
The husband was worried that if he delayed any further, his wife's condition would become more serious, so he hurriedly took his wife to the hospital for treatment again.
The first place we went to was the Provincial People’s Hospital.
In the minds of many ordinary people, the People's Hospital is a good hospital that serves the people, with affordable prices and guaranteed medical quality.
This time, they made an appointment with a urology specialist at the Provincial People's Hospital.
After the expert diagnosis, the patient was given a water deprivation test and an MRI of the sellar region was performed, which indicated that the patient had an enlarged pituitary stalk and elevated blood prolactin, so he was diagnosed with type 2 diabetes and hyperprolactinemia.
There is also a diabetes insipidus written at the end?
I guess the expert just suspected that the patient had diabetes insipidus, but it was difficult to jump to conclusion as to what type of diabetes insipidus it was.
Experts from the Provincial People's Hospital gave the woman rosiglitazone, acarbose, and glipizide controlled-release tablets to control her blood sugar.
Desmopressin and bromocriptine were also prescribed to control urine output.
After the woman took desmopressin, her urine volume decreased significantly, but the good times did . After only a few hours, the patient began to experience increased urine volume again.
After returning home from the Provincial People's Hospital, the patient insisted on taking desmopressin and other medications.
All of these medicines were prescribed by the expert from the Provincial People's Hospital.
The condition has improved significantly.
Due to long-term use of desmopressin, the patient developed symptoms of "weight gain", so he stopped taking the medicine himself. At the suggestion of a relative, he found a local Chinese medicine practitioner to switch to Chinese medicine treatment.
As a result, after taking Chinese medicine , the symptoms of polyuria and polydipsia worsened, and I felt particularly weak.
Two days ago, the patient began to talk nonsense and had impaired consciousness. She even failed to recognize her husband. She also had limb paralysis and tremors. She frequently urinated on herself.
Now I have to change her diapers to larger ones every once in a while.
In desperation, the husband took to Xinxiang Women's and Children's Hospital for treatment.
Zhou Can learned about the entire condition of the female patient and realized the complexity of the illness.
"Excuse me, has your wife not had her menstruation for more than a year since she had a curettage?" Zhou Can asked the woman's husband.
The female patient has become almost mentally retarded and is unable to communicate normally.
"Yes!"
The family members frowned.
Just at this time, Yang Chan also came over and helped with the diagnosis.
"Yang Chan, the patient hasn't had her period for more than a year since she had a curettage. What do you think is the most likely cause?"
Zhou Can took the initiative to communicate with her.
Every profession has its own expertise. When it comes to obstetrics and gynecology diseases, Yang Chan has learned a lot from Director Zhang Bihua.
Although her study time is only short, less than two years, she is definitely better than Zhou Can in this field.
"What are your doubts?"
Yang Chan did not answer but asked instead.
"The patient's imaging results showed a mass in the pituitary stalk, so I think the most likely possibility is a lesion in the hypothalamus or pituitary gland."
When diagnosing such difficult and complicated diseases, Zhou Can always looks for a breakthrough first, and then conducts comprehensive diagnosis and analysis.
He has used this diagnostic technique many times and it works perfectly.
"There are many reasons for the patient's amenorrhea. Diseases in the uterus, hypothalamus, pituitary gland, and ovaries may all cause amenorrhea. She had a curettage, and her uterus should also be listed as a key target for investigation."
After listening to Zhou Can's diagnosis, Yang Chan made some supplementary comments.
Zhou Can raised the corner of his mouth. This girl was deliberately trying to establish the class monitor's authority!
The possibility of uterine disease was very small, but she had to bring it up, just to tell Zhou Can that she was still the squad leader and knew a little more than him.
However, considering that the patient also has symptoms of diabetes insipidus, the uterus should indeed be examined.
Zhou Can took the patient's examination records and examined them carefully again. Soon, he ruled out the possibility of uterine disease.
The reason is that the patient's pituitary stalk is enlarged, which may also cause diabetes insipidus.
"Director Jiang, may I ask, is it possible that thickening of the pituitary stalk can cause central diabetes insipidus?" Zhou Can, combining his experience in neurosurgery, couldn't help but think of a similar case.
The patient had a pituitary gland lesion that caused central diabetes insipidus.
"Doctor Zhou is very good. No wonder Director Tan of our Department of Internal Medicine thinks so highly of you! I also have this suspicion. Since you brought it up, I think it is necessary to do a water deprivation test on the patient and recheck the sellar MRI."
Director Jiang of the Department of Neurology was originally a little unsure.
Hearing that Zhou Can also suspected that pituitary lesions caused central diabetes insipidus, he immediately made up his mind to check this aspect for the patient.
"Experts, my wife had a test for the sellar area M last time at the Provincial People's Hospital, and Dr. Du just now also said that the test results of the sellar area M can be used. What do you think, is it okay not to check it?"
When the family members heard that they had to do another examination, and it was an examination that they had done before, they couldn't help but look bitter.
What patients and their families fear most are the various examinations.
This is all caused by excessive examinations in many hospitals.
Regardless of whether the patient is sick or not, do the necessary examinations first.
“I think it is very necessary to review it.”
Director Jiang said seriously.
The family member frowned and hesitated for 20 to 30 seconds, and finally agreed, "Okay, I'll take my wife to have another checkup. I believe your experts will not deliberately order more tests just to earn my two examination fees."
This statement actually contains the meaning of warning to doctors.
It can also be felt that after being fooled by Du Leng, the family members have become very difficult to talk to.
The doctors looked at each other and didn't respond.
Director Jiang wrote an application for examination for the patient.
"Go quickly! Don't worry, we doctors will find a way to find out the specific cause of your wife's illness even if we have to work overtime today. However, some tests and examinations, as well as the efficacy of the medication, require a certain amount of time to observe. If you trust us doctors, you need to be prepared for hospitalization. Let me be frank, her condition is extremely complicated, and it is unrealistic for us doctors to say that we can definitely cure it. We can only assure you that we will do our best."
Director Zhang Bihua had just finished treating the patient and came over.
Female doctors are much more approachable than male doctors.
Especially for older female doctors like her, who have rich experience in communicating with family members and patients, they can gain their trust better and faster.
"Okay! Thank you Director Zhang, thank you all!"
After hearing what Director Zhang said, the family members looked much better.
He even managed a rare smile of gratitude.
A good doctor not only needs to have superb medical skills, but also needs to have excellent ability to communicate with patients.
After watching the family members take the female patient to the examination, Zhang Bihua picked up the female patient's information and began to study it carefully.
At this time, there seemed to be problems with Du Leng again.
"You paid for your doctorate, didn't you? You can't figure out the cause of her illness, and neither can we. Why didn't you tell us earlier? You've wasted our time."
The fat woman's father was yelling at Du Leng.
Du Leng looked embarrassed.
At this moment, I guess there are a thousand horses galloping in his heart. It's fun to show off for a while, but be careful of the crematorium afterwards.
He acted cool for the whole morning and attracted a lot of attention and admiration.
Now bad things are coming one after another.
There were three patients who were extremely difficult to diagnose, and to be honest, he had no idea how to diagnose any of them.
At that time, I was surrounded by many patients and their families, and I just wanted to make myself feel better, so I ordered tests for them. In addition, I overestimated my own ability, and when the test results came out, I still had no clue.
Don’t know the cause of the disease at all?
If it is a normal consultation, there is no big problem.
There are many cases where the cause of the disease cannot be found.
Especially for such difficult and complicated diseases, it is normal that no diagnosis can be made.
But at this moment, he was seeing patients in a public place, and the cause of the previous patient's illness could not be found out, so the family members had a big argument with him.
Now there is another case where the cause of the disease cannot be found, which is really adding insult to injury.
Du Leng had clearly noticed that many people were looking at him strangely.
Being watched by so many people and making a fool of himself in public in this situation made him feel extremely ashamed and even a little scared.
"Sir, please don't be angry. Bring your daughter over here and we doctors will help diagnose her."
Director Zhang Bihua quickly mediated.
We can’t start arguing anymore, otherwise, how will the other family members and patients look at us?
It will also make the medical staff of Xinxiang Maternity and Child Health Hospital look like a laughing stock.
The family came with their super obese daughter.
Zhou Can was very interested in this patient with sleep apnea syndrome.
For this kind of disease, you should actually see a special expert in the respiratory department.
It is rare to encounter such a case at ordinary times, but there is one today, which is a rare opportunity for training.
After several chief physicians had looked at it, Zhou Can picked up the patient's examination records and looked at them.
He always felt that the patient's neck seemed a little asymmetrical.
The rich diagnostic experience he had accumulated in general surgery was of great help to him at this time.
"Upper respiratory tract myxedema should be a diagnostic direction."
After examining the patient, Director Zhang Bihua was the first to give a diagnosis.
"The enhanced CT scan didn't reveal any signs of a tumor. The edema in her upper respiratory tract is a little strange. I've diagnosed many obese patients, but rarely have I seen anyone with respiratory myxedema."
Deputy Director Shi offered some of his own experience.
There is strength in numbers. When these experts gather together for joint consultation and draw on everyone's strengths, they have obvious advantages over working alone.
"SAS is divided into three types: obstructive, central, and mixed. I think she has mixed sleep apnea syndrome."
Director Jiang was unwilling to let the reputation of the Department of Neurology down, and also gave some substantive suggestions.
Three young doctors, Gao Jian, Zhou Can and Yang Chan, stood at the back without saying anything.
The three of them are trying their best to achieve something.
