godfather of surgery

Chapter 100 The difficult patient

"Okay, let's go round the room!" Yang Ping said, and the question was almost the same.

For Director Zeng's subtle attitude, Yang Ping can keenly feel it, and he doesn't care about it for the time being.

Accompanied by Director Zeng, Yang Ping led everyone around the room.

There are 21 patients, in addition to the young man just now, there are [-] more.

Six patients with neck, shoulder, waist and leg pain were treated conservatively; fourteen surgical patients had two clavicle fractures, one humerus fracture, two ulna and radius fractures, one femur fracture, three tibia-fibula fractures, and three tendon ruptures. A finger fracture, a pelvis fracture, an external fixator.

Although he is a temporary director, he is not here for vacation, but to save people. Yang Ping is very serious about ward rounds.

When the last patient was checked, there was still a ward, the door was closed, it should be empty, and no one lived there, Yang Ping glanced at it.

Director Zeng said, "No more."

Suddenly, the door opened, and an old man about 70 years old with black-framed round glasses came out: "Zeng Xiaobao, I am not a patient. You have two brushes. Ask someone to drive me to the surgery. came back."

Isn't this ward called locked?Why did he move back?

Director Zeng was embarrassed now, his face seemed to be smeared with chili oil, which was hot.

"This, what's the situation?" Yang Ping asked in a low voice, he was already standing at the door, and he couldn't do it without asking.

"This patient has undergone surgery for more than a year, and now he is here to recuperate. Let's take a look together." Director Zeng said daringly.

Immediately, he went to the door to make a smile: "Where, Mr. Yan, there is a single room in the surgery department, so I arranged for you to go there. The patient will be admitted here soon."

"Humph!" The patient snorted coldly.

Yang Ping took everyone in.

"Who is in charge of this patient? Report the medical history!" Director Zeng shouted.

Before the doctor spoke, the patient spoke on his own: "The main symptom of lumbar disc herniation is numbness and pain in the right lower extremity. "

"Can you take a look?" Yang Ping had long seen that this patient was a patient with disputes.

Director Zeng said: "This is Director Yang from the provincial capital. He came here to help you take a look. Maybe there is a good way."

"Director Yang? From the provincial capital? Just right, I have to go to the provincial capital to petition and sue. The surgery was done by the professor in the provincial capital? Excluding the medical insurance reimbursement, I paid more than 2 yuan myself. It’s not working anymore.” The patient’s attitude was very bad, full of resentment.

"Zeng Xiaobao, let me tell you, when my legs get better, I will definitely go to petition and sue you. What are you doing, you're a waste of life, you think I don't know, you and the professor Zeng in the provincial capital are relatives, and you colluded. There must be something unspeakable in it, and I have written the letter of complaint." The patient cracked and talked in different ways.

Yang Ping took his hand and said, "What's your name? Let's calm down first, and tell me what the problem is, and I'll help you take a look?"

"Mr. Yan!" Director Zeng said, embarrassed.

Yang Ping said, "Mr. Yan, what is your problem? Let's talk about it."

The patient took out a notebook: "No. 17 in June last year, here, I did a CT in this hospital, and diagnosed lumbar disc herniation, L4/L5, L5/S1, spinal canal stenosis, and right nerve root compression. Conservative treatment for one month was ineffective. Zeng Xiaobao recommended Professor Zeng to perform the surgery in the provincial capital. The pain in my right lower limb did not get any relief. After the stitches were removed and I was discharged from the hospital, I was hospitalized again on September 28. Since then, I have been hospitalized and discharged, and discharged from the hospital. This has been repeated for more than a year. Now it is almost the end of the year, and there is no relief. , how do you solve it?"

The thick book, with saliva sticking to his fingers, turned page by page, and then took a pen and wrote again: "Today, today's date, let me write down, what is the name of Zeng Xiaobao with the provincial capital?"

The old man looked at Yang Ping's badge: "Yang Ping, Director Yang, do the rounds and write it down."

The old man closed the book and put it under the pillow.

This medical history does not need to be introduced. It is clearer than what is written in the medical record. If there is something on the medical record, he has it; if it is not on the medical record, he also writes down.

"Mr. Yan, you teach something before retirement, can I check it for you?" Yang Ping said.

He lay down: "Politics in high school, the examination is the examination, and I cooperate with it. Don't say that I do not cooperate with the doctor, so the effect is not good."

When the patient reported his medical history just now, Yang Ping also looked at the medical records. He had previously performed L4/L5 and L5/S1 lumbar discectomy + posterior decompression + intervertebral fusion + pedicle screw internal fixation.

Professor Zeng of the First Affiliated Hospital, Yang Ping does not know, but he knows, but there is definitely no problem with the level of surgery, and the province is first-class, so what is the problem?
He performed a straight leg raising test on the patient's right lower extremity, which was obviously positive. He couldn't lift it at [-] degrees. He checked the muscle strength and sensation. The muscles innervated by the sciatic nerve were slightly weaker, and felt a little worse, and the right calf muscle was atrophied.

The resistance abduction and external rotation test and the 4-figure test were both positive.

"No, no, it's numb and painful, I can't stand it." The patient shouted.

Yang Ping asked the patient to lie down, and he pressed the position of the piriformis muscle. The muscle part was harder than normal. When he pressed it, the patient cried out again, and the right lower limb was numb and painful.

Could this be piriformis syndrome?
Professor Zeng came down for surgery, and he was probably busy. He only watched the film, and the lumbar intervertebral disc herniated disc was pressing on the right nerve. The image was highly consistent with the symptoms.

"How is it, do you understand? You have nothing to do with this incident, I won't sue you, but Zeng Xiaobao, I must sue." The patient sat up.

After the inspection of the room, Yang Ping sorted it out in his heart. Except for the patient with chronic osteomyelitis in the left backbone, this patient also had problems in diagnosis and treatment.

Through this period of time, Yang Ping has read a lot in the system space, coupled with the original solid theoretical foundation, both in terms of knowledge and depth of knowledge, he has made rapid progress.

If these two patients want to come one by one, if they say it directly, it will naturally make Director Zeng lose face, although Yang Ping has only been here for two weeks, so there is no need to lose face.

There are two things you can't do as a man: cut off people's fortunes and lose face.

Yang Ping decided that it would be better to take a detour. First, he took out the patient in the dispute just now and said that this patient is estimated that Director Zeng is already overwhelmed. If he can give him an idea, why not do it.

"It's embarrassing, it's embarrassing!" Director Zeng wiped his sweat.

Yang Ping said easily: "It doesn't matter that any hospital has difficult patients."

Director Zeng said, "Director Yang! Look, what guidance do these patients have?"

"Not to mention guidance, Director Zeng has rich experience and has studied in the First Affiliated Hospital. These cases are handled very well. It seems that Director Pan has the confidence to separate the orthopaedics department." Yang Ping said in front of everyone.

Although Director Zeng made a fool of himself just now, after Yang Ping said this, he saved a little face.

"Director Zeng, let's sit in the office?" Yang Ping said.

Director Zeng knew that he had something to say and nodded immediately.

At the director's office, director Zeng poured tea.

Yang Ping said: "Director Zeng, I suspect that this person with lumbar disc herniation has piriformis syndrome. If we can mobilize him to do an MRI and EMG of the piriformis outlet, we can identify it. It is the piriformis outlet. Syndrome, do another operation to release the sciatic nerve, the problem can be solved."

If the problem can be solved, he is willing to kowtow a few times, this patient is his heart disease, it is too difficult, and half of the white hair on his head is caused by him.

The patient had made trouble several times, made trouble at the office, and was blocked on the way to and from get off work. Now he simply lives and does not leave. All the letters of complaint have been sent to the mailbox of the county magistrate.

"The hospital doesn't have an MRI, so I have to go to the Shipo People's Hospital for an MRI. The outpatient service can't be reimbursed. He will definitely not do it. Now he doesn't pay a cent for the hospitalization." Director Zeng was full of bitterness.

"It's okay to do a CT and an EMG, and it can be seen that there are both CT and EMG?" Yang Ping said.

"Yes, there are!" Director Zeng said.

"Then let's go see the patient together and talk to him?" Director Zeng said.

Yang Ping said: "No problem, I'll talk to him. It's better to call him here."

"I'll call!" Director Zeng wanted to go out.

Yang Ping stopped Director Zeng, asked him about the patient's family situation, and asked him to invite someone.

Not long after, the patient came over, limping on crutches.

　Thank you for your monthly and recommended tickets, thank you for your reward in the cold night and moonlight, thank you for your reward for playing badminton when you have nothing to do, and thank you for your reward!
　　
　
(End of this chapter)