This doctor is not short of money

Chapter 776
The speed under Director Su's feet is very fast, it can be seen that he is very anxious now.

Hearing Du Heng's question, his speed still didn't slow down at all, and he replied while walking, "The pregnant woman is a type [-] diabetic, and the delivery was two weeks earlier than the due date. I didn't expect this to start."

Premature?

How is it a premature birth again?
But none of that matters.

"Diabetes? Is the blood sugar high? The fetus is too small, or is it huge?" Du Heng also frowned at this time.

Diabetes is troublesome, but it can be controlled and treated.

But for pregnant women with diabetes, this is beyond description.

First of all, during pregnancy, pregnant women with diabetes are much more likely to have premature birth, low birth weight babies, dystocia, macrosomia, and congenital deformities than normal pregnant women.

The other is postpartum recovery. If it is a cesarean section, the recovery of the incision can kill a person in a hurry.Of course, if it is a normal delivery but requires a side cut, it is also troublesome.

As soon as Director Su heard Du Heng's question, he knew that Du Heng was knowledgeable, and then he said a little breathlessly, "The weight of the fetus is normal, but the fetal position has been abnormal.
But there are still two weeks left. If you move more, the position of the fetus may be adjusted.

But who would have thought that it would start suddenly, and the blood sugar of the parturient would directly explode. "

Director Su brushed his face and entered the delivery room, and began a series of pre-operations, "Even if the fetus is not in the right position, it will be possible to have a section at that time.

But it's so hard to die. Now that the blood sugar of the parturient is soaring, who would dare to use a knife?It's not about killing people. "

Du Heng also sighed in his heart. His blood sugar exploded before giving birth. This situation, whether it is for pregnant women, fetuses, or doctors and nurses, is a terrible thing.

"Can't you take medicine?"

"I have used it, but the blood sugar has not dropped much."

Du Heng was silent, and he did not continue to ask the question of whether the dose was increased.

Under Director Su's guidance, they arrived at a delivery room after three turns and two turns.

And in this delivery room, Du Heng also saw the doctor Zhang who brought Wu Shengnan in.

At this time, everyone in the ward was discussing in a low voice, and all of them looked ugly.

Du Heng's face was also pretty, but he couldn't go anywhere.

Pregnant women are very fat, either due to the problem of a big belly during pregnancy, or simply very fat. Just visually estimate that the pregnant woman is more than 1.6 meters tall, and her weight is at least two hundred catties.

With this weight and shape, they are actually going to cut it?
Is the surgical ability so strong?

Du Heng glanced at Director Su from the corner of his eye.

At this moment, Director Su couldn't care about Du Heng beside him, and he turned a deaf ear to the mother's groans, so he walked to the mother's side in two or three steps to check the situation.But the more he checked, the uglier his face became.

"What's the situation now?" Director Su asked quickly.

"I've already thought about what I should do, but my blood sugar hasn't come down." A female doctor next to me quickly replied.

"Is there any chance of success?"

"No." The female doctor's answer was not muddled, "Although the mother's cervix is ​​fully dilated, the fetus is in a transverse position, so..."

Needless to say, everyone knows what's going on.

Director Su's face contorted for a moment, but he tried his best to control his temper, "Don't you know the dangers of gestational diabetes? You didn't explain it clearly to pregnant women and their families?"

The female doctor who spoke sighed, "I said it, and I emphasized it repeatedly. Every now and then, I will call the patient and his family to find out the situation. The whole pregnancy is fine."

"Then..." Director Su pointed at the pregnant woman with a cold face, "Then this is now?"

The female doctor's complexion also became ugly. When speaking, Du Heng felt that she gritted her teeth and said the following words, "The parturient began to have regular contractions three days ago, and was admitted to the hospital after seeing redness."

When Director Su heard this, he immediately turned his head and looked at the female doctor coldly, "Have you been hospitalized for three days?"

Du Heng also looked at the female doctor.

If the blood sugar rises during hospitalization, the attending doctor and nurse are inescapably responsible.

But looking at the action of the female doctor biting her back molars, Du Heng felt that it might not have much to do with doctors and nurses.

Sure enough, as soon as Director Su finished speaking, the woman raised her head angrily, stared at Director Su and said, "Everything is fine, but after all, it is still far away from the expected date of delivery, so I want to let the pregnant woman persist for a few more days. It is also good for fetal development.

When the pregnant woman can't hold on anymore, I'm going to have a section on her.

Although it is difficult, it is not impossible. "

When she said this, the female doctor was confident, but the anger in her eyes also soared, "But because of the severe contractions these days, the mother has not eaten well.

When I couldn't hold on until early in the morning and was about to send to the delivery room, the mother-in-law and her mother were afraid that the mother would not have enough food and energy, so they gave the mother a few pieces of chocolate and an energy drink. "

Director Su stiffened slightly, and Du Heng also widened his eyes.

Caesarean section, you let the mother keep her strength, it's useless.

Director Su took a deep breath, "Didn't you explain clearly?"

"It's clear, it's very clear." The female doctor couldn't hold back her anger.

Director Su gently closed his eyes at this moment.

Diabetics eat chocolate and drink energy drinks, hey~~~~
My own doctor has done everything that should be done, and the rest is left to fate.

For this wayward family member, he has no energy to judge.

After taking a breath, Director Su opened his eyes and turned to look at Du Heng, "Director Du, look at this situation, is there any way for Chinese medicine to control the blood sugar of pregnant women?"

The corners of Du Heng's eyes twitched slightly.

He did not answer Director Su's question, but said softly, "The parturient is too fat, and it is really too difficult to use external inversion now."

After a slight pause, Du Heng continued to ask, "Now that the amniotic fluid has broken and the cervix has been fully dilated, I think it is feasible to adjust the fetal position with internal inversion.

Have you not considered this method? "

Internal inversion?
Director Su smiled wryly, "Why did you already say that, since the cesarean section, this kind of internal and external inversion has gradually been used by no one, and not many people know it now.

I have learned a little external inversion technique, but it is limited to what I have learned and known. "

Director Su sighed heavily, "Moreover, the internal inversion operation is also very risky. If you are not careful, problems such as uterine rupture and internal bleeding will occur. The risk is too great.

As for the current situation of pregnant women, Director Du, you have also seen it.Blood sugar remains high, as long as there is a little accident, that's really it. . .

Hey, so I called you, Director Du, and asked if there is any way for Chinese medicine to deal with the current situation. "

Du Heng shook his head lightly, and said slowly, "High sugar is not far away from fire, and hypoglycemia is not far away from cold. This is the general rule of diabetes, so to reduce sugar, you need to use bitter cold medicine.

And in view of the current situation of the parturient, it is necessary to quickly lower the blood sugar, so heavy medicine must be used.

But the bitter cold medicine is burdensome to the human body, and it is also harmful to the fetus in the mother's stomach.

This is the same reason that you dare not use large doses of drugs. "

Director Su shook his head in disappointment. After sighing again, he turned to look at the female doctor, "Issue the critical illness notice and go talk to the family members. Besides..."

After a sudden pause, there was a moment of silence. After three to five seconds, Director Su continued, "Continue to take the medicine, and continue to take the medicine while the fetus can persist, trying to suppress the blood sugar."

What does the director do?
In addition to checking for deficiencies and making up for omissions, most of the time, it is to help doctors and nurses make up their minds.

Now there are only so many treatment methods and treatment methods. What the director knows, in fact, all doctors know.

What they lack, apart from a small amount of knowledge reserve, is more experience and the control of dangerous and critical situations.

Of course, there is also the assumption of responsibility.

Now, this is what Director Su is doing.

The female doctor breathed a sigh of relief, and turned around to leave the delivery room, but Du Heng reached out and stopped her, "Wait."

Um?
Everyone looked at Du Heng suspiciously, not understanding what he was going to do.

"What happened to Director Du?" Director Su turned his head and asked in doubt.

But Du Heng hesitated again at this time.

It's very strange, when I entered Wu Shengnan's delivery room before, I had nothing to do with myself, except that I was a little excited, I didn't feel any other feelings.

But after entering this delivery room, the feeling that I hadn't seen for a long time reappeared - the corners of my mouth began to burn and hurt.

Gan!
Du Heng thought of the quintessence of nationalism.

He has not felt this kind of situation for more than a year, and this has made him forget that he still has such an annoying problem.

But the feeling at this moment tells him once again that he is still the same person as before.

In the delivery room and confinement room, he will still get sick. '

Thinking of the position, posture, and steps of the 'internal inversion technique', Du Heng began to retreat.

But at this time the mother's constant groans made him feel like he was sitting on pins and needles.

Seeing that Du Heng didn't speak, Director Su could only ask again, "Director Du?"

huh~~~
Du Heng let out a long breath, and looked at Director Su seriously, "Director Su, I know the inversion technique, let me try it?"

"You can?"

"Internal inversion?"

Hearing Du Heng's words, Director Su short-circuited for a second.

What the director of obstetrics and gynecology of my profession can't do, but he can do it as a doctor of internal medicine of traditional Chinese medicine?
It is true that there is some knowledge of gynecology and obstetrics in TCM internal medicine, but such a professional technique as internal inversion should not be something a TCM internal medicine should know, right?
Du Heng saw Director Su's doubts, and also saw the doubts of the surrounding doctors and nurses, and explained with a sigh, "Director Su, before I came to our hospital, I was the director of Jinzhou Women's and Children's Hospital. It's not difficult, is it?"

Hearing Du Heng's explanation, Director Su slowly returned to his senses, but he shook his head immediately, "Director Du, that's not what I meant."

As he said, he looked back at the parturient, "You have seen the current situation of the parturient, and you understand the situation, this is not a joke.

You should also know the risks of internal inversion, right? "

Du Heng made up his mind, let it be uncomfortable, it's not like he hasn't felt it before, a few blisters at the corners of his mouth, burning pain, tight mouth for a few days, "I know."

Upon hearing Du Heng's clear answer, Director Su began to hesitate, "Then...then...Did Director Du do similar...hand...operations before?"

For a while, Director Su really couldn't find a suitable word to modify "internal inversion", so he could only call it "surgery".

Du Heng shook his head, "I have never used internal inversion, but I have used external inversion for a woman with dystocia."

It's okay if Du Heng doesn't say it, but Director Su himself can make up some pictures in his brain, and he thinks Du Heng is trustworthy.

But this was only done once, and it was still an external inversion technique. Director Su didn't even hesitate anymore.

Can this allow Du Heng to do it?
Who dares?
If this is allowed to be done, isn't it being used for practice.

Director Su opened his mouth to refuse.

But the groans of the mother behind her not only hit Du Heng's ears, but also hit his nerves.

Obviously, if the internal inversion operation is not performed now to allow the fetus to be born naturally, the only risky caesarean section will be taken.

But for diabetic patients, if the blood sugar is properly controlled, the risk of surgery is that the recovery of the incision is slower.

But now that blood sugar is so high, the risk of postoperative infection soars, and the wound healing time is lengthened again.

And this is not the biggest problem, the biggest problem is in the operation.

Because surgery during high blood sugar period will increase the body’s stress response, make it more difficult to control blood sugar after surgery, increase inflammation, and increase acute complications of diabetes such as ketoacidosis, starvation acidosis, hyperosmolar coma, etc. These complications can be fatal.

How to do?
Director Su opened his mouth, but couldn't say any words of rejection.

Of course, he can also be ruthless now, follow the conventional treatment, issue a critical illness notice, and continue to lower blood sugar.

If the fetus in the womb is alive and can wait, and the blood sugar of the pregnant woman drops, then the pregnant woman will suffer a little, and the fetus will survive.

If you can't wait, and the blood sugar of the pregnant woman can't drop, then I'm sorry, the fate between the fetus and the family is not enough.Similarly, at that time pregnant women suffered some crimes, but their lives were not in danger.

Can the fetus wait?
Director Su gently closed his mouth again.

The amniotic fluid of the parturient is broken and the cervix is ​​fully dilated. If you don’t wait 1 minute longer, the fetus is actually at risk of suffocation. If the suffocation and hypoxia lasts for a long time, even if it does not die, the damage to the brain will be enormous.

The 'brain hypoplasia' caused by hypoxia, that is, the appearance of a child with 'cerebral palsy' also began to appear in Director Su's mind.

Director Su was silent, and so were the doctors and nurses in front of the pregnant woman. They all knew what was happening to the pregnant woman.

But there is nothing they can do now, they can only wait for the director to make the final decision.

And the decision is risky, and it is a big risk.

Du Heng succeeds, so everyone is happy, Du Heng has made a name for himself in the obstetrics department, and his reputation in the hospital has risen to a higher level.

If it doesn't work, then the one who takes the responsibility is the one who makes the decision.

(End of this chapter)