My Medical Skills Give Me Experiences Chapter 278

After listening to the family members' complaints, Dean Tian began to have serious doubts about Du Leng's ability.

It's just that in this kind of public occasion, she will definitely not show it.

Right now, family members and patients must be appeased and the situation calmed down.

It was not easy to invite Tuya's expert team to carry out this expert consultation activity, but there were twists and turns, and troubles continued.

Tuya Hospital didn't know how to send some reliable young doctors over.

Thinking of the reliable young doctor, Dean Tian couldn't help looking at Zhou Can.

For example, young doctors like Dr. Zhou are very reliable.

"My family member, calm down first! Maybe your wife's condition is really 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 more Joint consultation with experts. We must try our best to find out the cause of your wife's illness, so that you will not run away in vain."

Under Tian's reassurance, the family members looked much better.

"Director Zhang, this patient's condition is a bit complicated. Can you discuss her cause on the spot?"

Dean Tian is almost putting pressure on Director Zhang.

After all, it is related to whether the expert consultation at Xinxiang Maternity and Children's Hospital can achieve good results.

You can't spoil the good situation because of such a small matter.

"Okay, after I've dealt with the patient in hand, I'll immediately organize a discussion with the experts present." Director Zhang Bihua readily agreed.

Maybe they are also worried that the family members will be impatient to wait again and feel dissatisfied.

After scanning the other experts, she happened to catch a glimpse of Deputy Director Shi and Director Jiang, who was inside of him, being idle.

"Director Shi and Director Jiang, one of you is good at gastroenterology and the other is good at neurology. The patient's symptoms are related to the digestive system and the nervous system. Please help me first!"

Zhang Bihua led the team to Xinxiang Maternity and Children to carry out expert outpatient activities. She is the captain and has the right to arrange other experts to work.

Of course, at her level, she spoke very politely.

He used a negotiating tone.

Instead of using that offensive bossy tone to order other experts to work.

"No problem! Bring the materials here, and Director Jiang and I will study together!"

Deputy Director Shi answered more positively than anyone else.

It caused Zhang Bihua, Dean Tian and others to look at him in surprise.

We are all human beings. Looking at Deputy Director Shi's positive attitude, I am afraid that I am somewhat confident!

As everyone knows, Deputy Director Shi and Zhou Can have discussed it long ago, and even planned to take the initiative to cut off the bullshit.

If Du Leng hadn't quarreled with his family members, Deputy Director Shi might have offered to 'help' a long time ago.

The family members turned against Du Leng, and they were eager to find other experts to help his wife see a doctor.

"Honey, let's go, let's find another expert to see a doctor!"

The family members took the materials and brought their wife to Deputy Director Shi's consultation table.

Director Jiang also got up and walked over. Gao Jian followed closely.

Zhou Can quickly stood up and offered to sit down.

"Director Jiang, please sit down!"

This kind of humility and courtesy greatly increased Director Jiang's affection for Zhou Can.

"Thanks!"

Director Jiang nodded friendly to him, and sat side by side with Deputy Director Shi.

Zhou Can and Gao Jian stood together for the first time.

The two looked at each other and smiled, but Gao Jian's eyes were full of fighting spirit.

"Doctor Zhou, after nearly two years, how about we take this rare opportunity to compare?"

"Hehe, I don't care!"

Zhou Can was never afraid of anyone.

He also wanted to see what level Gao Jian's medical level had reached after nearly two years?

He felt that Gao Jian was much more pragmatic than Du Leng.

The strength must be much stronger than Du Leng.

The woman's disease is biased towards internal medicine, and the main direction of the high-sighted training is internal medicine. Therefore, Gao Jian has an advantage over Zhou Can to a certain extent.

Because Zhou Can spent the previous year and a half rotating in various departments of surgery.

It has only been about two months since I officially entered the regular training of internal medicine.

The four began to study the woman's examination data and condition.

The woman had uterine bleeding a year ago and had a curettage and curettage at the local county hospital. Pathology showed that the scraping was endometrial tissue. Since then, the woman has not had menstruation again.

Less than half a year later, the woman developed obvious symptoms such as polyuria, thirst, polydipsia, and fatigue.

Drink up to 20,000 milliliters of water a day.

I have to get up to urinate almost every hour or two at night.

And patients gradually like to drink cold water.

In the Provincial People's Hospital, a steamed bun meal test was done and the diagnosis was diabetes.

Doctors at the Provincial People's Hospital prescribed reggenac and acarbose to treat the patient. After taking the medicine for a period of time, the patient feels that there is no effect, so he stops the medicine on his own.

In this way, he stayed at home for several months and did not control his diet during the period. The patient reported that there were always urea bubbles in his urine, but he did not have symptoms of urgency or painful urination.

About a few months ago, there was genital itching and increased secretions.

More than two months ago, there was a disturbance of consciousness, unresponsiveness, and occasional symptoms such as inability to communicate. Sometimes even urine is pulled on the body because of the disturbance of consciousness.

The husband worried that if the delay continued, his wife's condition would become more serious, so he hurriedly took his wife to the hospital for treatment again.

The first thing I went to was the Provincial People's Hospital.

In the minds of many people, the People's Hospital is a good hospital serving the people, with affordable prices and guaranteed medical quality.

This time, they were linked to a urology expert number of the Provincial People's Hospital.

After the expert's diagnosis, the patient was given a water deprivation test and a saddle area MRI test. It suggested that the patient's pituitary stalk was thickened and blood prolactin increased, so he was diagnosed with type 2 diabetes and hyperprolactinemia.

Then there was a diabetes insipidus?

It is estimated that the expert only suspected that the patient had diabetes insipidus, and it is not easy to jump to conclusions about the specific type of diabetes insipidus.

Experts from the Provincial People's Hospital gave the woman rosiglitazone, acarbose, and glipizide controlled-release tablets to control blood sugar.

At the same time, desmopressin and fentin were prescribed to control urine output.

After the woman took desmopressin, the urine output decreased significantly, but the good times did not last long. After only a few hours, the patient reappeared the symptoms of increased urine output.

After returning home from the Provincial People's Hospital, the patient insisted on taking desmopressin and other drugs for treatment.

They were all prescribed by the expert from the Provincial People's Hospital.

The condition has improved obviously.

Due to taking desmopressin for a long time, the patient developed symptoms of 'gaining weight', so he stopped the drug himself. At the suggestion of a relative, I found a local Chinese medicine doctor and switched to traditional Chinese medicine for treatment.

Results After taking the traditional Chinese medicine, the symptoms of polyuria and polydipsia were aggravated. And feel extremely tired.

Two days ago, the patient was talking nonsense and had a disturbance of consciousness, and even her husband couldn't recognize her. Limb paralysis and tremor symptoms also appeared. The phenomenon of pulling urine on the body occurs frequently.

Now I have to change her to a large diaper every once in a while.

In desperation, the husband took his wife to Xinxiang Maternity and Children's Hospital for treatment.

Zhou Can realized the complexity of the condition after understanding all the condition of the female patient.

"May I ask if your wife hasn't had menstruation since she underwent dilatation and curettage for more than a year?" Zhou Can asked the woman's husband.

The female patient has become like a fool, and there is no way to communicate normally.

"Yes!"

The family members frowned tightly.

At this moment, Yang Chan also came over by herself to help with the diagnosis.

"Yang Chan, the patient hasn't had a period for more than a year since she underwent curettage. What do you think is the most likely cause?"

Zhou Can took the initiative to communicate with her.

There is a specialization in surgery, and Yang Chan has already received a lot of true biography from Director Zhang Bihua for obstetrics and gynecology diseases.

Although the study time is still short, less than two years, she must be better than Zhou Can in this field.

"What about your doubts?"

Yang Chan didn't answer the question instead.

"The patient's imaging examination showed that the pituitary stalk occupied space, so I think the possibility of hypothalamic or pituitary lesions is the greatest."

When Zhou Can diagnoses such difficult and miscellaneous diseases, he always looks for a breakthrough first, and then conducts comprehensive syndrome differentiation and analysis.

He tried this diagnostic technique time and again, and it worked.

"There are many reasons for the patient's amenorrhea. Lesions in the uterus, hypothalamus, pituitary gland, and ovary may cause amenorrhea. She has undergone curettage and curettage, and the uterus should also be listed as a key object of investigation."

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Yang Chan made a supplement after listening to Zhou Can's diagnosis opinion.

The corner of Zhou Can's mouth twitched, this chick is deliberately establishing the authority of the monitor!

The possibility of uterine disease is very small, and she insisted on pulling it out, just to tell Zhou Can that she is still the monitor and knows a little more than him.

However, considering that the patient also has symptoms of diabetes insipidus, the uterus should indeed be checked.

Zhou Can took the patient's examination data and checked it carefully again. Soon, he ruled out the possibility of uterine disease.

The reason is that the patient's pituitary stalk is thickened, which may also cause diabetes insipidus.

"Director Jiang, please tell me, is the enlarged pituitary stalk likely to cause central diabetes insipidus?" Zhou Can couldn't help thinking of a similar case based on his experience in neurosurgery.

That patient had a lesion in the pituitary gland, which caused central diabetes insipidus.

"Doctor Zhou's level is very high, no wonder Director Tan of our Department of Internal Medicine values ​​you so much! I'm also doubting in this direction. Since you also brought it up, I think it is necessary to do water deprivation and pressurization for patients." Test, review sellar mri."

Director Jiang in God was still a little uncertain.

Hearing that Zhou Can also suspected that central diabetes insipidus was caused by pituitary disease, he immediately made up his mind to conduct an investigation on this aspect for the patient.

"Several experts, my wife checked the saddle area at the Provincial People's Hospital last time. Just now, Dr. Du also said that the results of the saddle area can be used. Look, can you not check it?"

When the family members heard that they were going to be checked again, and they were still checked, they couldn't help showing a bitter face.

What patients and their families are most afraid of are various examinations.

This is all caused by excessive inspections in many hospitals.

Regardless of whether the patient is sick or not, first do the checks that should be done before talking.

"I think it is very necessary to review it once."

Director Jiang said seriously.

The family member frowned and hesitated for ten seconds, and finally agreed, "Okay, I will take my wife to check again. I believe that your experts will not deliberately order more checks to earn my two check fees."

In fact, these words already contain the meaning of warning the doctor.

I can also feel that after being messed with by Du Lenghu, the family members have become very difficult to speak.

Several doctors looked at each other, but did not answer.

Director Jiang issued an examination application for the patient.

"Go! Don't worry, we doctors have to find a way to find out the specific cause of your wife even if we work overtime today. However, some tests and examinations, as well as the efficacy of medication, need a certain amount of time to observe. If you trust our doctors, It is necessary to be prepared for hospitalization. The ugly thing is above, her condition is extremely complicated, and it is unrealistic for us doctors to say that it will be cured. We can only assure you that we will do our best."

Director Zhang Bihua also came over after dealing with the patient in hand.

The affinity of female doctors is much stronger than that of male doctors.

Especially for an elderly female doctor like her, who has rich communication experience with family members and patients, she can gain the trust of family members and patients better and faster.

"Okay! Thank you, Director Zhang, thank you!"

After listening to Director Zhang's words, the family members looked much better.

Even rarely squeezed out a grateful smile.

A good doctor not only has superb medical skills, but also needs to have excellent communication skills with patients.

After watching the family members take the female patient for an examination, Zhang Bihua picked up the female patient's information and began to study it carefully.

At this time, Du Leng seemed to have a problem again.

"Did you spend money to buy this doctor? You can't find out her cause, and we can't find out the cause of the disease. It's too late for us to waste time."

The fat woman's father was yelling at Du Leng.

Du Leng was embarrassed.

At this moment, it is estimated that there are ten thousand mud horses galloping in his heart. It's cool for a while, but be careful with the crematorium afterwards.

He pretended to be b all morning, earning enough attention and admiration.

Now bad luck ensues.

Three patients who are extremely difficult to diagnose, to be honest, he has no idea about any of them.

At that time, I was surrounded by many patients and their family members, just wanting to have fun for a while, so I ordered a checkup for them. Coupled with the overestimation of his own strength, when the inspection results came out, he still couldn't figure it out.

Don't know where the cause is?

If it's a regular consultation, it's not a big problem.

There are many cases where the cause cannot be found out.

Especially for such intractable diseases, it is normal that they cannot be found out.

But at this moment, he was sitting in the clinic in public, and the cause of the previous patient could not be found out, so the family had a big fight with him.

Now there is another case where the cause cannot be found out, which is really worse.

Du Leng has clearly noticed that many people are casting strange glances at him.

Under such circumstances, being surrounded by people and making a fool of himself in public made him feel extremely ashamed and even a little scared.

"Mister~www.mtlnovel.com~ Don't be angry. Bring your daughter here, and some of us doctors will diagnose her together."

Director Zhang Bihua rushed to mediate.

Can't fight anymore, otherwise, what do other family members and patients look like?

It will make the doctors and nurses of Xinxiang Maternal and Children's Hospital laugh.

The family members came with their super obese daughter.

Zhou Can is very interested in this sleep apnea syndrome patient.

This kind of disease should actually be linked to the special needs expert number of the respiratory department.

Usually it is difficult to meet, but today there is a case, which is a rare opportunity to exercise.

After several chief physicians had read it, Zhou Can picked up the patient's examination data to check.

He always felt that the patient's neck seemed a little asymmetrical.

The rich diagnostic experience accumulated in general surgery gave him a lot of help at this time.

"Upper airway myxedema should be a diagnostic direction."

After reading it, Director Zhang Bihua took the lead in giving a diagnosis opinion.

"The enhanced CT didn't reveal any tumors. Her upper respiratory tract edema is a bit strange. I have diagnosed many obese patients, but rarely found respiratory myxedema."

Deputy Director Shi provided a little experience of his own.

There are many people, and these experts gather together for joint consultations, and the advantages of combining the strengths of everyone are indeed much more obvious than fighting alone.

"Sas disease is divided into three types, namely obstructive type, central type, and mixed type. I think she should belong to mixed type sleep apnea syndrome."

Director Jiang was also unwilling to lose his reputation as a neurology department, and also gave some substantive opinions.

Gao Jian, Zhou Can, and Yang Chan, three young doctors, stood behind and did not speak.

All three of them are working hard and want to achieve something.

Chapter end