This doctor has a system

Chapter 230 218. Unknown Premonition

Many doctors hate this kind of money, but many Chinese people have this problem. When they go to do something, they don't give others money, and they feel uncomfortable all over.

The patient was escorted to the bronchoscopy room by his family early in the morning. He was actually in good condition and had no problem walking on his own.

The nurse in the bronchoscopy room carefully helped the old man onto the flat car, "Old man, don't be nervous, you can just take a nap in a while."

The patient nodded.

"In a while, the anesthesiologist will put a mask on you. Don't be afraid. There is oxygen in it. You can just breathe normally."

The patient nodded.

It's quite easy to communicate, and the nurse is very satisfied. Some elderly people scream when they come in, and she can't understand what they say, which is very energy-consuming.

"What did you tell him? He is almost deaf and can't hear." Wu Xingfeng, the anesthesiologist who went to prepare things, said after he came back, "If you have anything to explain, you have to speak to him loudly and close to your ears."

"No!" The nurse was stunned for a moment, "Old man, can you hear me?"

The patient nodded again.

"I can hear it," the nurse said. "Look."

Wu Xingfeng was also puzzled, "No, what's your name, old man?" Could it be that he was the wrong person?

The patient nodded.

"Look, he just can't hear and can only nod randomly." Wu Xingfeng said.

Sure enough, the patient nodded again.

"Old man, did you hear what I just said?" the nurse yelled in the patient's ear.

"No," the patient said.

"Then why are you nodding?" The nurse was numb.

"I'm usually like this. Nodding can avoid a lot of trouble." The patient said, "I realized this when I was not deaf before."

The uncle lives a very transparent life, no wonder he is so popular with his family.

The tracheoscope went smoothly, and obvious mucosal infiltration could be seen under the microscope. Dong Qianqian clamped several forceps under Gao Feng's guidance. Her current medical level is improving in all aspects.

The pathology results came out three days later, and the results showed squamous cell carcinoma, a type of lung cancer closely related to smoking.

Three days later, Gao Feng took Li Youliang, Director Xin Guoyu, and Director Qu Mengqi on a plane to the United States.

"Gao Feng, how is your spoken English?" Xin Guoyu asked, "If not, I can guest translate the old songs, and his spoken English will be no problem for simultaneous translation."

So awesome?Li Youliang was shocked. These directors were not only excellent in medical treatment, but also outstanding in other aspects.

"That's not necessary, my spoken English is okay." Gao Feng smiled. Thanks to his strong mental strength, he had made great progress in learning English some time ago, and now he has no problem with basic oral communication.

The plane is flying at an altitude of [-] meters, and the patchwork clouds outside the window flicker in and out, giving people an ultimate sense of beauty.

It should be a banquet held again in the Heavenly Palace, and thousands of taels of gold will fall into the world.Let's go by boat in Huaguang, hoping to catch a glimpse of the beauty through the gaps in the clouds.Immortal Yun Yan sent the breeze to lift me up like a cloud, inviting me to meet you.Bowing one's body, speaking modestly, and speaking softly, the human world is better than the nine heavens.

Gao Feng suddenly became inspired by poetry. He thought for a long time and finally composed a poem.

"The plane flies so high, I feel like I'm floating on the clouds. How does it feel to fly in the sky?"

"Youliang, what do you think of my poem?" Gao Feng asked.

"It's wonderful. In just 28 words, it vividly and completely describes the feeling of flying on an airplane. The key is that it's still catchy to read!"

"Cow, that's awesome!"

"It still has to be you."

"Hahaha." Gao Feng was very happy, "If not, why don't you also sing a song?"

I'm not worthy, Li Youliang said in his heart, but the leader asked him to come, so it wouldn't be appropriate for him not to make a song.

"Then I am ugly!"

"Today I sat on the big iron bird and felt good in the sky. When I stretched my head and looked down, the houses were smaller than ants."

You've really made a fool of yourself, Xin Guoyu thought to himself.

The Cleveland Clinic specially sent two pick-up personnel, one was a driver and the other was an accompanying translator. She was also a blond girl with long legs. Li Youliang stared at her for a long time.

"Do you like people with long legs?" Director Qu Mengqi asked.

"Don't you like it?" The two looked at each other and smiled narrowly.

"Professor Gao, we can go to the hotel next door first. After settling in, it's not too late to go to the hospital." Virginie said, "I see that you don't have any luggage."

Gao Feng came empty-handed, and Li Youliang brought him two changes of clothes and some commonly used medicines.As for Director Xin and Director Qu, they both have shriveled backpacks.

Men, you don’t need anything complicated to go out.

"Welcome!" Professor Ivor came to the door to greet them in person. Many people around him showed surprised expressions. They originally thought that Xin Guoyu was an expert from China, but they didn't expect that he was a legitimate and handsome person. young people.

"You arrived at the right time today." Professor Ivor led four people to the cath lab. "We have recently been specifically looking for a group of patients with indications. You can find out in advance."

In fact, there are not many patients who usually undergo transcatheter aortic valve replacement at the Cleveland Clinic. Even the middle class here can’t afford the high cost. However, for this surgery, the Cleveland Clinic recruited patients in advance across the United States. The cost of the surgery is free, and the patient also receives a substantial sum of money.

It has become a reality for hospitals to pay for medical treatment for patients.

"Most of these patients are between 65 and 90 years old, and some of them are in very poor general condition," Professor Ivor said. "Professors Sugimoto Genji and Professor Scopi Hartmann have been doing this in the past few days. I have had several patients and everything is going well so far.”

It seems that these two competitors are very capable, Gao Feng thought to himself.This is inevitable, otherwise the Cleveland Clinic would not specially invite the two people here.

In fact, Professor Marcin of the Mayo Clinic is also very famous for doing this, but as a direct competitor, it is impossible for the Cleveland Clinic to invite him.

Someone was performing surgery in the cath lab, "It's Professor Sugimoto Genji." Ivor took a look and said, "The patient is an 84-year-old man suffering from severe chronic obstructive pulmonary disease."

"This little Ridaozi is pretty good." Xin Guoyu whispered. As the saying goes, a layman can only watch the excitement, and an expert can watch the door.

It can be seen from the other party's skillful operation and relaxed and casual expression that he is able to perform this operation with ease.

Not bad, Gao Feng thought, I can do it too. "There are two more patients below. Do you want one?"

"Of course." Gao Feng replied, this was the purpose of his trip.

Genji Sugimoto had a slight smile on his face, and he was very happy inside. He had been performing well these days, and the British guy Scopi Hartman was suppressed by him.If nothing else happens, the qualification of the surgeon this time is guaranteed.

While changing his clothes, he saw a handsome young man walking in.

Sticks from kimchi country?He was curious, why hadn't he seen it in the cath lab before?While thinking, he saw this young man standing in front of the operating table.

Gao Feng brought Xin Guoyu in to familiarize himself with the environment. Each hospital was different, including the models of equipment and machines, which were sometimes quite large.When professors with relatively high status perform surgeries, they always bring a complete team with them, and they even need to bring equipment that is convenient for them.

"Who is that?" Sugimoto Genji asked Professor Ivor.

"Professor Gao Feng from China."

In fact, Sugimoto Genji has realized the identity of the other party, but he can't believe it. He looks too young. He and the other party are obviously not of the same generation.

At such a young age, how good can his skills be?Unless he started practicing from the womb!

Thinking of this, Sugimoto Genji felt relieved. He went to the bathroom and sat down outside the catheter room when he came back.

"How about it?"

"It's almost the same as ours." Gao Feng took a closer look and signaled to the nurse on the side to send the patient in.

This patient is relatively young, only 67 years old, somewhat thin, and works as a wandering entertainer, singing and singing in squares.He suffered from tuberculosis when he was young, and one lung was damaged. Coupled with a large amount of aortic valve regurgitation, the patient's quality of life was not high.

"You can do it all." Xin Guoyu was very self-aware. He was afraid of holding Gao Feng back, "I'll just hand you something."

"Is there anything I can do?" asked the nurse on the side. Genji Sugimoto had a nurse on duty.

"No, my colleagues are enough."

Gao Feng whispered a few words to the patient and signaled Xin Guoyu to start.

The first is the puncture and cannulation of the femoral artery. This operation can be performed under the guidance of fluoroscopy or color ultrasound. The surgeon needs to be familiar with the anatomy of the femoral artery, which is extremely important for creating a safe vascular access and preventing complications.

As a continuation of the external iliac artery, the femoral artery bifurcates below the inguinal ligament into the superficial femoral artery (SFA) and the profunda femoral artery (PF).In the majority of cases (77%), the furcation was located below the level of the femoral head.

Gao Feng uses real-time ultrasound guidance. Real-time ultrasound can see the femoral artery bifurcation and provide information on lumen size, presence of calcification and arteriosclerosis.Except for patients with high bifurcations, the intubation rate of CFA guided by color ultrasound was no different from that of traditional methods.

Ultrasound guidance also improves first-time puncture success rates, reduces the number of puncture attempts, reduces the risk of puncture into the vein, and shortens the median time to establish access.

In addition, ultrasound-guided puncture is particularly beneficial for patients with PAD, obesity, and blood vessel wall scarring or fibrosis caused by frequent punctures in the past.

Of course, it is also possible to perform puncture without the help of ultrasound. The puncture point is generally 1.5 to 2.0 cm below the most obvious place where the pulse of the femoral artery is most obvious on the right femoral artery, inguinal ligament. In reality, it is definitely better to have instrument assistance. Only a fool would touch it with his hands for a long time. .

And if you encounter a fat man with a thick layer of fat, you will be blind.

Gao Feng skillfully took the ultrasound probe and looked at it, and quickly made the mark.

Insert the 21G needle 30-45 cm below the arterial puncture point at an angle of 1-2 degrees.Insert the needle 1-2 cm below the ultrasound probe to avoid high puncture.Once the needle is close to the artery, the ultrasound will show the tip of the needle.At this time, the anterior wall puncture can be confirmed with real-time ultrasound examination.

Seeing Gao Feng's quick operation, Sugimoto Genji had an ominous premonition in his heart, something was wrong!
Next, Gao Feng easily inserted an interventional catheter through the femoral artery and inserted an intraoperative balloon to dilate the narrowed valve.

Xin Guoyu on the side quickly handed him the replacement valve, and then the replacement valve was passed through the hollow catheter and placed in the aortic valve area.

As Gao Feng operated, the balloon on the tip of the catheter began to inflate. He adjusted the angle at will and pressed the new valve into the expected position.

The operation is over.

Sugimoto Genji outside was stunned at this time. It was so fast that he didn't react for a while.

Is the angle so easy to adjust?How can valve compression be so easy and casual? ! !

Is my transcatheter aortic valve replacement a fake?
idiot!

Professor Ivor on the side also had the same idea. Could it be that the old man was holding back on me?

"It may be luck. I have had such a highlight moment before." Sugimoto Genji said, "Isn't there another one down there? Let Professor Gao Feng do it again."

His proposal was exactly what Professor Ivor had in mind.

"is it okay?"

"Of course." Gao Feng smiled. The surgery just now was like an appetizer, and he was very excited now.

Soon, another patient was pushed over, a big fat man.

It is relatively difficult to puncture the femoral artery in obese patients. The thick fat layer will interfere with the ultrasound. But in Gao Feng's case, there is no difference between the two. He quickly found the positioning point.

Sugimoto Genji, who is inside and outside the catheter, really wants to walk in at this time and ask, why are you positioning so quickly?It always feels like perfunctory.

But as the catheter was successfully placed into the femoral artery, his heart sank completely. This young man from China had something, and a lot of it.

He always felt like he was going to overturn.

It won't be a waste of time, right?Sugimoto Genji was filled with unwillingness.

"Great God Yamata, please let this Chinese man's next operation fail. I will kill a pig for you when I return to China." He prayed silently in his heart.

But it was obvious that Master Yaqi did not like his three melons and two dates. Gao Feng's subsequent operation was as smooth as the last time. The biological valve was pressed in quickly, and the operation was officially declared over.

"Wow, that's great!" Professor Ivor gave Gao Feng a big hug. "It's an honor for us to have you here."

"It seems to be stable." Director Xin Guoyu was very happy. "I have inquired and found out that Professor Scorpius Hartman is not Xiaodaozi's opponent at all. He was eliminated a long time ago."

It seems that I am going to show off my skills, Gao Feng thought to himself.

At around 9 p.m., there was a knock on the door, "Who is it?" Gao Feng asked in English.

"Hello, I am Sugimoto Genji from the island country." A voice rang outside the house.

"What are you doing here on this island?" Xin Guoyu asked. Several people were playing cards in the room at the moment.

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(End of this chapter)