Chapter 9 Why is Half Missing?
Boom boom boom!
The knock on the door sounded so pleasant to the ears.
It's almost time to get off work, so the probability that this is a follow-up patient is very small.
Generally, patients who come for follow-up visits are concentrated in the morning or early afternoon.
Zhou Can was on high alert, waiting to earn experience points.
"Come in! "
Dr. He's voice is always so gentle and powerful.
The door of the clinic was pushed open, and a man walked in, supported by his family. He pressed his abdomen with one hand, his expression painful.
"Ouch, ouch... Doctor, my stomach hurts so badly, please help me!"
The man's face turned pale with pain and his forehead was covered with cold sweat.
“Sit down first!”
Dr. He appeared very calm and composed.
"When did the pain start?"
"It's been two days. It's been painful for two days. Ouch..." The man kept groaning in pain.
To cause such pain to a middle-aged man, the pain must be very severe.
"You didn't eat anything poisonous, did you? For example, poisonous mushrooms, toads, vegetables and fruits sprayed with pesticides."
"No, definitely not. I've been eating at home these days, and my wife and children are fine."
"Do you smoke or drink?"
"Um."
“Are there any family members with similar medical history?”
"No!"
"Come, help him lie flat on the bed, I'll do a physical examination."
After Dr. He instructed the family to help the patient lie flat on the bed, he began the examination.
Zhou Can also stood up and went over to take a look.
Based on the patient's description and the symptoms he exhibited, he had begun to make pathological inferences.
However, due to the lack of examination data and his insufficient clinical diagnostic experience, it was difficult to determine the patient's pathological mechanism.
There are so many reasons that can cause abdominal pain.
Many diseases can cause severe abdominal pain, including peritonitis, gastroenteritis, gallstones, appendicitis, etc.
Doctor He pressed the patient's abdomen with his hands.
"Oh...gently, gently..."
The patient screamed immediately.
"That's the only area that hurts, right?"
"My right shoulder and right back hurt, but not as bad as my stomach."
After hearing this, Zhou Can immediately understood that this was radiating pain caused by severe pain in the upper abdomen.
Just like throwing a stone into a pond, ripples will form in circles, spreading outwards from the point where the stone falls into the water.
The same goes for pain.
It is transmitted to surrounding areas via nerves.
This phenomenon is medically known as radiating pain.
It can now be basically concluded that the initial area of pain is in the right upper abdomen.
"Did your abdominal pain suddenly start two days ago, or has it been developing gradually?"
"It came on suddenly. There were no signs. It just started to hurt all of a sudden, in waves. And every time it hurt, the pain got worse. Later on, the pain became unbearable and I even vomited a few times."
The patient provided another clue.
So, medical consultation is still very important.
Don't be afraid of trouble and ask for more relevant information.
"Since the pain is so severe, you can't have waited until now to seek medical treatment? Have you been to other hospitals for treatment?"
Dr. He has extensive experience in diagnosis and treatment. He was able to immediately infer some facts that the patient had not revealed based on the patient's description.
"Well... I did go to a small clinic. They gave me an IV, saying it was for inflammation. It didn't work. The owner of the clinic was afraid something might happen, so he advised me to go to a big hospital."
Those small clinics often give patients intravenous drips.
Small clinics are most responsible for the overuse of various antibiotics.
For some minor colds or minor symptoms, intravenous infusion and the use of antibiotics do work quickly.
Little do they know that this is a bit like drinking poison to quench thirst.
You may get better quickly this time, but your body's immune system is disrupted and weakened, making you more susceptible to getting sick next time. And your illness may be more serious.
This cycle repeats itself, eventually forming a vicious cycle.
When patients really need antibiotic treatment, they will sadly find that there is no medicine available.
Because the virus in the patient's body has developed serious drug resistance.
Even a random cold could turn into a super virus.
"Besides abdominal pain, pain in your right shoulder and right back, do you have any other symptoms? When I touched your abdomen, it felt a little hot!"
A physical examination is the first thing your doctor does after seeing you.
This is very important.
It can help doctors discover some hidden diseases of patients.
Some patients may feel embarrassed or think that it is insignificant and may deliberately conceal some symptoms. This requires doctors to have a keen eye.
"I feel feverish and have chills."
"Well, let me take your temperature, heart rate, and blood pressure first. Relax a little and don't be nervous. Once we get here, we will definitely do our best to treat you."
After Dr. He comforted the patient, Zhou Can quickly rushed to measure the patient's blood pressure, heart rate and body temperature without waiting for his instructions.
How can senior doctors do these basic tasks themselves?
Be more diligent, Dr. He will definitely be happy to see it.
Next time you ask to take him with you to see patients, the probability of him agreeing will increase a lot.
"Temperature 39.6, pulse 98/min, blood pressure 120/mmhg. Percussion of both lungs showed no abnormalities, no chest murmurs during breathing, and breathing was about 25 times/min."
Zhou Can performed a series of measurements on the patient.
The range of 39.1 to 41 degrees is considered a high fever.
This patient's condition was more serious and complicated than expected.
"Go do a routine blood test and ultrasound imaging first. If the results are not ideal, you may need a further CT scan." Dr. He said this to both the patient and Zhou Can.
Zhou Can quickly ran to the computer to apply for a medical examination.
"Because your condition is complicated, the outpatient department will be closed soon. Before your test results come out, the cause of your illness is unclear and you cannot be admitted to the hospital. I suggest that after you have completed the examination, you can go to the general surgery department of the inpatient department to see Dr. Fang. I will explain the relevant situation to him."
The patient's condition may deteriorate further at any time.
Doctor He did not dare to take it lightly.
If the condition is not serious, the patient is usually asked to come back the next day.
After the patient left, Dr. He stood up and prepared to go off work.
"Xiao Zhou, how is it going? Have you gained anything from following me for an afternoon?"
"I have gained a lot. I have benefited a lot from your procedures and treatment methods for various patients, especially your medical ethics and style. You have set a very good example for me."
"Haha, you are such a sweet talker. Okay, the nurse at the reception desk should come over and close the door. Let's go."
After Zhou Can followed Dr. He out of the clinic, he was still thinking about what disease the last patient he saw had.
He is only 1.4 experience points away, and he is unwilling to give up!
The patient had severe pain in the right upper abdomen, which radiated to the right shoulder and right back. He was also addicted to smoking and drinking. In addition, he had a high fever and chills. All these symptoms combined made it seem like there was something wrong with the bile duct.
Could it be common bile duct stones?
Zhou Can seemed to have grasped something, and his eyes became as bright as stars.
Every time a doctor diagnoses a patient, it is like doing a math word problem.
After calculating the results, you will feel a special sense of accomplishment.
【Pathological diagnosis experience value +0.4.】
The experience points that I had been looking forward to appeared again .
It’s just a little too little!
It only increased by 0.4.
Under normal circumstances, for clinical diagnosis, as long as the answer is correct, 1 experience point will be added.
Why is it more than half missing?
