Chapter 650: Hearing-impaired patients, the impact of blood circulation changes on nerves
However, because of Zhou Can's appearance, the two were forced to communicate.
Because some neurological diseases require the joint efforts of internal medicine and surgery to overcome them.
Zhou Can had no choice but to act as a messenger between the two top neurosurgeons in order to get them to consult together. It was impossible to get them to sit in the same consultation room for a consultation.
The two of them might start fighting if they disagreed.
In terms of physique, Wu Baihe from the outside world is short and strong, while Director Yin Hua from the inside world is much taller, but lacks physical exercise and is rather thin.
If a fight really breaks out, Director Yin Hua will probably suffer.
After Zhou Can came back from the Song family, he never received a reply.
There's no point in being anxious about this matter. If the patient's family members don't agree to treatment, there's nothing anyone can do.
What's more, the Song family is not an ordinary family.
Zhou Can's diagnostic skills are already very close to the seventh level. In order to be more confident in treating Mr. Song, he simply set aside a lot of time to focus on various difficult cases.
Even the emergency department's routine rounds were changed from twice a day to once a day.
Later, it was changed to once every two days.
He had long intended to let other doctors do this matter.
Because it's the same in any department, after you reach the deputy director level, you basically don't care about these trivial matters. You must learn to let go when it's time to let go.
Otherwise, you will end up exhausted like Zhuge Liang.
You have to do everything yourself and bow to reality.
The director usually makes ward rounds once a week, and Monday is basically the time for the directors of each department to make ward rounds.
There is a reason for this setting.
After freeing up time, Zhou Can has more time to study difficult cases and learn relevant medical knowledge.
After only about six days, his diagnostic skills were successfully promoted from level six to level seven.
At the moment of breakthrough, he was both excited and thrilled. All these years of hard work had finally borne fruit.
Seventh-level diagnostic medical skills, and almost all general diagnosis, this is probably unprecedented and will never be repeated in the medical field.
[Pathological diagnosis, level 7, current experience value 1/10000000. Level 1 expert.] Specializes in diagnosing cases in the fields of pediatrics, cardiothoracic surgery, general surgery, acute and critical illness, neurosurgery, neuroendosurgery, gastroenterology and surgery, and orthopedics.
It can be seen that he is good at many areas.
It can be said that there are fruitful results.
After being promoted to level seven, you will reach the expert level.
The level is higher than that of chief physician.
Diagnosis of various diseases is almost easy.
Especially when it comes to diagnosing diseases in areas of expertise, some of them don’t even require X-rays or tests. Just taking a look at the patient and asking about the symptoms can give a pretty accurate diagnosis.
After successfully upgrading his pathological diagnosis to level seven, Zhou Can could clearly feel the invincibility of a master whenever he saw patients.
Some of the cases he saw were quite difficult, but when they came to his hands, he was basically able to cure them all successfully.
And it’s effortless to diagnose.
Difficult and complicated diseases that previously required a lot of brainstorming and even required consultation with experts from other departments can now be diagnosed more easily on one's own.
The tests prescribed for patients are becoming fewer and fewer and more targeted.
Internal medicine diagnosis usually starts with a blood or urine test, and then looking at the results, the location of the lesion can be basically determined. Then a film of the lesion can be taken to confirm the cause of the disease.
There are also some cases that require puncture to obtain pathological specimens for testing, and a pathology check will be enough.
After a morning of seeing patients, Zhou Can found that the seventh-level pathology diagnosis was really cool.
And it should be more efficient when diagnosing patients.
When an experienced doctor sees a patient, he usually does a physical examination and asks questions first, and then has a preliminary opinion in mind, that is, determines the direction of diagnosis. Then he will write a corresponding examination application for the patient, and then make further diagnosis based on the examination results.
The less experienced a doctor is, the more tests he or she will prescribe.
This is also a necessary phenomenon.
Because the current medical environment is very poor, giving patients more examinations can not only increase department revenue, but also minimize the possibility of misdiagnosis.
In fact, if the level is not high enough, even if the patient undergoes a complete body examination, there is still a possibility of misdiagnosis or missed diagnosis.
There must be a reason why expert appointments are so expensive yet so popular.
Zhou Can looked at the time and it was already past noon.
Added more than twenty numbers.
There is no way. He is very famous now. As long as he sees patients, there will be patients from all over the country coming to see him.
Some patients arrived a few days earlier, stayed in hotels, and had to be accompanied by at least one family member.
This is not easy at all.
Zhou Can could sympathize with their hardships.
Seeing these patients come from thousands of miles away, suffering from illness and pain, and having to bear a large amount of expenses every day, it is really unreasonable not to add a number for them.
People are all made of flesh and blood.
To put yourself in others' shoes is to have the heart of a Buddha.
It is precisely because Zhou Can is particularly compassionate to patients and can empathize with their suffering that his reputation is getting better and better.
At least eight out of ten patients and their families who have seen him praise his superb medical skills and noble medical ethics.
"Director Zhou, there is a patient outside who says he has hearing problems and would like you to take a look. I explained to the family that Director Zhou's appointments for today have been filled, but they still insisted on asking you to help take a look."
The nurse came in and said to Zhou Can.
"Give them a number!"
Zhou Can wrote a note and gave it to the nurse.
The plus sign must be issued by a specialist in attendance.
Because the staff at the registration window does not have this authority.
If they dare to add more numbers, they will be scolded to death by the specialists sitting in. No girl is that stupid.
Zhou Can’s appointment fee has increased to 16 yuan because he has been promoted to attending physician.
The deputy director's number is 21 yuan.
Specialty appointments are the most expensive, the cheapest is 50, which is the worst. The slightly better ones are 300 and up.
Zhou Can was not short of money, and he was born with a compassionate heart as a doctor, so he repeatedly rejected the hospital's proposal to upgrade him to a special expert.
It is obvious that his level is better than that of special-need specialists, but he only charges patients 16 yuan.
This was after I was promoted to attending physician and was forced to upgrade to the level of attending physician.
Otherwise, the charges are cheaper.
The patient with the plus sign finished his registration and walked in quickly.
There are three people in total.
The patient is a young man in his twenties, and the other two family members should be the child's parents.
Zhou Can thinks he is not good at diagnosing and treating hearing impairment.
This usually refers the patient to an ENT specialist for treatment.
"Please take a seat! Is your hearing completely lost?"
Zhou Can motioned for the patient to sit down.
The young man can understand lip reading.
Many hearing-impaired people can guess what the other person is saying by observing their lip movements.
This can be considered a special ability that was developed through forced training.
"Yes, my child was fine when he was born. But when he was two years old, he climbed onto the table and fell down when we weren't paying attention. He was fine at the time, except for a bruise on his head. Later, we gradually discovered that there seemed to be something wrong with his hearing. At the beginning, we had to speak to him very loudly so that he could hear.
Later, even yelling in his ear was useless.
I really regret it. If I had watched him more closely and not let him climb onto the table, it would have been great! Over the years, we have been seeking medical treatment everywhere. His studies, work, and life have all been seriously affected.
Now we are at the age of finding a partner. We have introduced several girls to us, but as soon as they heard that our child has hearing problems, they immediately shook their heads and refused to even meet him.
Sad! "
The young man's mother sighed and recounted the whole story.
Children are young and ignorant and have no idea what is dangerous. Parents must take good care of them.
Many tragedies happen in a moment.
Like this couple, they are probably in their forties, and both of them have gray hair.
After their son fell, he developed hearing problems, which have affected their lives.
The parents have been living in regret, worrying about their son's illness every day. Let alone living a happy life, this family must be suffering every day.
"Have you seen an ear doctor?"
"We have been to all the ENT, neurology and neurosurgery departments in big hospitals. We have seen all of them. The doctors said there is nothing they can do. We later heard that we could get a cochlear implant, but after testing, it turned out that it was not possible. The doctor said that my child has completely lost his hearing."
At this point, the boy's mother burst into tears.
"Don't worry, I'll take a look at him first. Has he been examined in all aspects?"
"I've done a lot of examinations! I have several bags of films. The old ones are all at home. I only brought the latest films and examination results taken in the past few years."
The male family member raised the white plastic bag in his hand.
You can see that it contains thick inspection materials.
"Okay, let me see. If the tests you've done are diagnostic, you don't need to do it again."
Zhou Can saves money for the patient's family.
After taking the information bag, he began to examine it carefully to understand the patient's brain and ear conditions.
I lost hearing in both ears at the same time, and I could hear at first after the fall, but then I couldn't hear anymore.
This shows that the disease does not occur immediately, but has a progressive process.
There are nerves in the brain that are specifically responsible for hearing.
Based on his clinical experience, Zhou Can initially inferred that the auditory nerve was most likely injured in the fall, but was not promptly treated, which eventually led to the complete loss of function of the auditory nerve.
Specifically, it must be based on imaging, nerve signals, and ear examinations.
After examination, the patient's head CT scan did not reveal any abnormalities.
Even two large hospitals performed high-definition MRI examinations on the patient, and also found no problems.
No wonder so many hospitals say it can’t be cured.
Zhou Can also felt that this case was quite tricky.
"Okay, let's do a head ultrasound so I can check the blood flow in your head."
After a moment's contemplation, he discussed this with the family members.
"Okay, we'll follow your instructions."
The family has taken their child to so many hospitals and has long learned how to cooperate with doctors.
Because many doctors, when faced with uncooperative family members, will adopt defensive medicine or "persuade the patient to quit."
This couple must have encountered this before and learned their lesson.
Zhou Can decided to start with the blood circulation in the head, which was another diagnostic approach.
Because the patient was injured when he fell when he was two years old, he is now in his twenties. Nearly twenty years have passed. Ordinary injuries have healed long ago and it is difficult to leave any traces.
It is very difficult to examine nerve damage.
It is not like bone, muscle or blood vessel injuries. If there is any problem, you can immediately see it by taking an X-ray.
Neurological problems usually need to be examined through nerve electrical signals and electromyographic signals.
The patient had an EEG, a brain neurological test.
The nerve signals in the hearing line are gone.
According to Zhou Can's experience, falls generally do not directly break nerves.
Because the brain has a hard skull and is protected by the dura mater, and there is a thin cerebral cortex and a small amount of subcutaneous tissue on the outside to cushion it.
Plus the head is round.
The possibility of breaking a brain nerve by falling off a table is extremely small.
Zhou Can suspected that there might be a problem with the blood vessels.
However, we could not find any problems from the CT and MRI images. The main reason was that too much time had passed and the "evidence" had disappeared.
After prescribing a color ultrasound of the head for the patient, Zhou Can personally took the patient to the color ultrasound room for examination.
"Doctor Xing, please help me work overtime!"
Zhou Can asked for the door of the color ultrasound room to be opened and said to the doctor inside with a smile.
"No problem. Director Zhou has spoken. Not to mention one overtime shift, even ten overtime shifts are necessary." Doctor Xing agreed readily.
"Really? That's great. I was just about to discuss with you about letting you work a few more shifts!"
Zhou Can said happily.
"Ahem... Director Zhou, I was just joking. I can work one overtime, but if you really ask me to work ten overtimes, my husband will probably make trouble with me every day."
Doctor Xing, who was in his thirties, immediately looked miserable.
Doctors in the ultrasound room have a heavy workload, but the good thing is that they can leave on time.
You don't have to be called by the hospital to work overtime after work .
It is common for doctors and nurses in clinical departments to be called back to the hospital in the middle of the night to rescue or deal with emergency conditions.
Also, the salary in the medical technology department is decent.
Neither high nor low.
The key is that there is no major liability risk.
The boy's head ultrasound scan started soon. Zhou Can stared at the screen with a sharp gaze like an eagle.
"Don't move, don't move, this is the spot. The blood path here seems to have changed, don't you think?"
Zhou Can asked Doctor Xing.
The latter stared at the screen carefully for a while, then smiled bitterly and said, "Please don't scold me for telling you this. Although I do color Doppler ultrasound for patients every day, I really don't know the subtle changes in the blood flow of the head. With my level, I can only sit in the color Doppler ultrasound room and get a fixed salary. I can't compare with top-notch experts like you."
Doctor Xing looked at the patient for a long time but couldn't find any problems.
"You have to have some ambition. Doctors in the ultrasound department can also be very good. When you examine patients in the future, study more carefully."
Zhou Can said a few words to him.
It's not criticism, but more like encouragement and advice.
"Printing this out, I feel like there must be something wrong. The blood flow to his head has changed, and it's probably related to a fall when he was a child."
Zhou Can seemed to have found the reason for the young man's hearing loss.
However, the specific details still need to be carefully considered and then a treatment plan can be come up with.
Changes in blood flow are neither common nor rare.
