I Can See Health

Latest website: "If the patient is pretending, if he urinates immediately, he will definitely have to go to the toilet later." Fan Zhiping said.

"Well, that's a good idea." Cheng Peng nodded.

Lu Chen frowned, "I think there might be something wrong."

"What could be wrong with this?" Fan Zhiping asked doubtfully.

"There must be indications for using furosemide." Lu Chen said, "We are currently considering that the patient is in a pseudo coma, but we are not 100% sure, so we cannot use the drug casually. Because once the patient takes furosemide, symptoms will appear. Any problem, such as malignant arrhythmia, etc., is our responsibility, and the consequences may be serious. "

"Then what should we do?" Cheng Peng glanced at Lu Chen helplessly, "Just wait until the patient loses patience and wakes up on his own?"

Lu Chen smiled and said, "No, have you forgotten that comatose patients have certain operations that must be done according to the treatment principles?"

Fan Zhiping frowned at first, then suddenly realized.

"You mean urinary catheter and upper gastric tube?"

"Yes!" Lu Chen smiled.

Cheng Peng and Fan Zhiping looked at each other.

It turns out that Lu Chen is the "bad" one...

…

"What expressions are you looking at..." Lu Chen glanced at the two of them angrily, "I'm just going to give it a try. If I'm really unconscious, according to the treatment principles, a urinary catheter must be inserted. If I'm pretending to be unconscious, listen. When it comes time to insert a urinary catheter, he will definitely wake up..."

"Then give it a try." Cheng Peng said.

A person who is pretending to be unconscious can grit his teeth and endure it even if you pinch him.

Because most people have psychological expectations for the pain of pinching, they know what is going on and can be mentally prepared.

But when the gastric tube and urinary tube were inserted, he couldn't bear it.

Because the feeling of inserting a gastric tube and a urinary tube is something that most people have never experienced before, and they cannot make psychological expectations to endure it.

…

Come to the bedside.

Lu Chen was fully armed, wearing gloves, a hat and a mask.

Cheng Peng stood next to him on the platform, holding a catheterization bag in his hand.

On the hospital bed, a middle-aged woman was lying on the bed with a very calm face.

Lu Chen saw her health clearly - 74.

It seemed that as Fatty Cheng said, the patient was pretending to be comatose.

"Doctor, what are you..." The patient's accompanying family member is a young woman, probably the patient's daughter.

Cheng Peng said quickly: "We all need catheters for comatose patients."

The patient's daughter's face changed.

"This...should not be necessary."

Cheng Peng shook his head, "A urinary catheter must be inserted. For all comatose patients, this is the basic treatment principle. We cannot violate it. Moreover, after the urinary catheter is inserted, you can take better care of the patient."

The young woman still waved her hand to refuse, stood up, and stood in front of Lu Chen.

"Doctor, if you don't wait a little longer, my mother might wake up soon."

Lu Chen pretended to be confused and said: "We can't guarantee when we will wake up. If the condition changes and we don't have time to react, it will be terrible."

"No, it won't." The young woman seemed to be very resistant to the insertion of a urinary catheter.

Since the family members did not agree to insert a urinary catheter, Lu Chen and Cheng Peng would not force the operation.

"Then we will observe for another twenty minutes. If the patient does not wake up, a urinary catheter must be inserted, otherwise this will not comply with the treatment principles."

Lu Chen's voice was so loud that he believed the middle-aged woman lying on the bed could "hear" it.

"This, this... okay then."

The young woman looked back at the woman on the bed and could only nod silently.

…

Lu Chen and Cheng Peng returned the same way they came without even opening the catheterization pack.

Back to the doctor's office.

Cheng Peng said hesitantly: "Lu Chen, is this really useful? Why don't you try Dr. Fan's method? I think it should be useful!"

"Don't worry." Lu Chen said with a smile, "I'll give her twenty minutes, and she will definitely wake up later. Pushing furosemide seems to be a good method, but it does not comply with the treatment principles. If the patient If you cause trouble for us, it will be difficult.”

"Yeah." Cheng Peng nodded.

All we can do now is wait.

Wait for the patient to wake up on his own.

…

Ward eight in the heart.

"Mom, if you don't wake up, the doctor will insert a urinary catheter into you!" The young woman looked around, and then whispered to the woman on the hospital bed, "I heard that urinary catheter insertion is very painful, and there are many complication……"

The middle-aged woman on the hospital bed had her eyes closed tightly and her eyelashes were trembling slightly, as if she might wake up at any time.

"Mom, it's almost done...I've scared others. The neighbors won't dare to quarrel with you in the future. They've already paid the medical expenses."

As the young woman finished speaking, the middle-aged woman on the hospital bed slowly opened her eyes, her voice sounded extremely weak, "Then I will give you a few more expensive bottles to replenish qi and blood!"

"Okay, then I'll go talk to the doctor." The young woman breathed a sigh of relief. She was really afraid that her mother had gone too far.

…

While Lu Chen and Cheng Peng were chatting, Nurse Liu walked into the doctor's office.

"Dr. Cheng, your comatose patient is awake!"

Cheng Peng looked happy and stood up quickly: "Great! I'll go see her."

Lu Chen smiled and joked: "Go quickly, otherwise you will be unconscious again later."

Cheng Peng came back within five minutes of going to the ward.

"Hey, the patient needs an injection to replenish qi and blood. We don't have any Chinese patent medicine here, so we can't give it!" Cheng Peng said helplessly.

Chinese people, especially the older generation, are very superstitious about Chinese patent medicine preparations.

It cannot be said that Chinese medicine preparations are useless, but the ones that really work clinically are Western medicine preparations.

Many Chinese patent medicines are just placebos.

"Fat man, just give her a bottle of amino acids and a bottle of vitamins." Lu Chen suggested.

"That's all we can do." Cheng Peng nodded.

Amino acids, albumin and other drugs have special magic power for people of the older generation.

Many patients, no matter what the disease or which department they are in, will come up and ask if they can take amino acids or albumin.

For treating diseases, amino acids are useless and can only be regarded as nutritional medicine.

If the albumin is not low, albumin infusion will not only be of no benefit, but will also increase the burden on the heart and lead to heart failure.

After Cheng Peng negotiated with the patient, most of the problems were solved.

Everyone turned a blind eye and didn't point out the fact that she was pretending to be asleep.

After the middle-aged woman finished the intravenous drip, she asked to be discharged from the hospital.

Compared with Fan Zhiping's "promoting furosemide", Lu Chen's "inserting urinary catheter" is more in line with clinical diagnosis and treatment thinking.

Otherwise, if the condition really changes during the administration of furosemide, the gain will outweigh the loss.

After the incident was over, Lu Chen also received a thank you from Cheng Peng.

"Congratulations, I received a +1 thank you from Cheng Peng!"

…

After solving this incident, Lu Chen continued to prepare his case report.

He flipped through the medical records he had encountered before.

The more interesting cases are oleander poisoning and the recent heart transplant case.

Other cases are either too simple and common, or too out of touch with clinical practice.

Lu Chen temporarily listed the two cases of oleander and heart transplant as candidate cases.

…

After get off work, Lu Chen had dinner in the cafeteria and returned to his dormitory very early.

As soon as he opened the bedroom door, he received a call from his uncle Lu Wenjun.

During the phone call, Lu Wenjun thanked Lu Chen again.

His father-in-law was already in good condition and was preparing for surgery. This time he came to ask Lu Chen for his opinion.

Lu Chen patiently explained it to Lu Wenjun.

After hanging up the phone, Wang Zihao and others also returned to the dormitory.

"Zihao, can you do ppt?" Lu Chen looked at Zihao.

Wang Zihao shook his head and walked to Lu Chen's side.

"I can do the simple ones, but I can't do the too complicated ones. What's wrong, do you want to give a ppt lecture? Or do you do it for the boss?"

"I use it myself. I'm not familiar with some functions in ppt yet." Lu Chen said, "Time is tight, so learn slowly. It may be too slow. I want to find someone to guide me."

"Well, I remember that Lao Gu seems to know how to do it. He is an experienced driver." Wang Zihao thought for a while and said, "When he was an undergraduate, he gave speeches on stage several times. The ppt was very nice."

"Gu Xinyue?" Lu Chen asked doubtfully.

"Yes." Wang Zihao nodded, "He and I are both undergraduates from Jinghua Medical University, so we know him well."

"good."

Lu Chen found Gu Xinyue on WeChat.

…

"Do you want to make a ppt?"

"Well, after I finish the first version, can you help me review and proofread it?"

Lu Chen's words appeared in the dialog box, and a smile appeared on Gu Xinyue's face.

He was finally able to surpass Lu Chen in one field.

Lu Chen thought Gu Xinyue was unwilling and was about to say forget it, but he didn't expect Gu Xinyue to make an "ok" gesture.

Lu Chen was overjoyed, "Thank you so much. I will send you the first version in two days. You can help me review it. I will treat you to dinner next time."

"Okay, I'll remember it."

Gu Xinyue didn't say much, but she readily agreed.

After solving the problem of ppt production, Lu Chen devoted himself to the screening of cases.

On the other side of the Guipei Building dormitory.

After Gu Xinyue accepted Lu Chen's request, she received a letter from Jinghua Electrophysiology Association.

He is now an ordinary member of the Electrophysiology Society.

"Dear members, next Sunday, the Jinghua Electrophysiology Association will report an academic exchange meeting. Members are welcome to participate enthusiastically. You will be responsible for your own travel expenses and food reimbursement!"

"Electrophysiology exchange meeting?" Gu Xinyue touched her chin, "I must go and have a look."

This kind of academic exchange meeting is generally an exchange of cutting-edge academic knowledge.

For Gu Xinyue, this is definitely a good opportunity to gain knowledge.

He had to go.

…

…

A night of silence.

The next day.

Lu Chen is working the night shift today.

So after he finished checking the room in the morning, he could go back to his dormitory to rest.

Recharge your batteries and prepare for the night shift.

Arriving at the department, Sun Guoguo led everyone to check the room.

As soon as he returned to the doctor's office, Lu Chen saw people coming to the hospital's charity meeting.

The purpose of their trip was mainly to investigate the patient with aortic dissection.

If the patient's case is true, then they will waive part of the patient's fee.

Fortunately, the entire review process went relatively smoothly.

The information of patients with aortic dissection is very detailed. After the charity association’s investigation is passed, the fee can be reduced by about 30%.

This should be considered a large proportion for the cost of surgery, which can easily cost hundreds of thousands.

However, in the end, it still depends on whether the patient’s family can come up with the rest of the surgery fee.

As long as family members can get it together, the patient can be transferred to another department for surgery immediately!

…

Finished solving the charity issue.

Lu Chen was just about to leave the department and return to the dormitory to have a good rest.

Suddenly, Li Yao came to the department again.

She has been coming to the department much more recently than before.

She walked into the doctor's office and looked at the people working.

"District 3 of the Heart has invited a hospital-wide conference. Lu Chen, please accompany me to attend."

After saying that, Li Yao walked away.

Lu Chen was about to leave, but after hearing this, he could only stay temporarily.

It seems that I have to wait until I finish attending the general consultation before I can go back to my dormitory.

"Junior brother, go quickly, this is a good opportunity to learn." Sun Guoguo whispered from the side, "The whole hospital has a general consultation. There are eight districts in the heart. People from each district will come, and other related departments in the hospital will also come. people."

Lu Chen was thinking in his heart, "What kind of intractable and complicated patient is this that actually mobilizes so many people?"

While thinking about it, Lu Chen followed Teacher Li Yao downstairs.

…

The hospital's general consultation is held in the demonstration classroom on the fourth floor.

This demonstration classroom can accommodate more than 200 people and is specially used for cardiology departments to prepare various meetings.

The entire fourth floor is very large and is mainly divided into two areas, the cardiology CCU ward on the right and the cath lab on the left.

Between the CCU and the cath lab, there is a large classroom, which is the large presentation classroom of the Department of Cardiology.

Lu Chen put on his shoe covers and hat and followed Li Yao into the demonstration classroom.

There are already many people in the classroom, and everyone's chatter can be heard.

Lu Chen also met Gu Xinyue, who was sitting in the second row.

Li Yao said hello to the teachers in other districts in her heart.

People have almost arrived.

Director Yang from Xinnei District 3, who presided over this hospital-wide conference, slowly walked onto the stage and began to speak.

"Thank you all for taking time out of your busy schedule to attend this hospital-wide general consultation. This case is very difficult. The patient has been admitted to the hospital many times and has a recurring condition. The current diagnosis is not clear and involves multiple disciplines. I have to think about it again and again. , I just invited this general hospital consultation.”

"I hope everyone can brainstorm and come up with a feasible diagnosis and treatment idea for this patient in our department!"

"The patient's bedside doctor, Wang Peng, is below and will introduce the patient's medical history to everyone."

A young doctor walked onto the stage.

He is thin, about 1.7 meters tall, and has a light beard at the corner of his mouth.

The patient's medical history information was displayed on the screen on the stage, and Wang Peng's voice also sounded.

Patient, female, 54 years old.

Admitted to the hospital due to "sudden chest tightness for 4 hours".

Three months before admission, he had undergone thrombolytic treatment in a local hospital for "inferior wall myocardial infarction" (the specific diagnosis and treatment process is unknown), and emergency coronary angiography later showed occlusion of the proximal anterior descending artery.

Three days after the operation, the patient had abdominal pain during hospitalization and developed about 200g of tarry black stool. UU Reading www.uukanshu.net showed occult blood in the stool (+++), and the hemoglobin was tested at 97g/l. The patient was discharged after the symptoms improved.

Two months later, the patient was admitted to the gastroenterology department of our hospital again because of "black stool twice". The patient began to experience headache, vomiting, and blurred vision on the 9th day after admission. Magnetic resonance imaging showed hemorrhagic cerebral infarction in the right occipital lobe and hippocampus.

…

"From a monistic perspective, what are the possible causes of this patient's multiple arterial embolisms and gastrointestinal bleeding?"

After listening to Wang Peng's description, Lu Chen felt that this patient was not simple.

Sometimes there is embolism, and sometimes there is bleeding.

Two symptoms that seem completely contradictory.

No wonder we need to invite the entire hospital for a consultation!

Anyway, Lu Chen couldn't think of any possible diagnosis or treatment methods for a while.

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