Gou is practicing medicine in the clinic

Chapter 168 High-risk dismantling, not easy for adults
When it comes to the neck and lumbar spine, Li Jingsheng is still afraid to do it.

If the strength or angle is not grasped properly, and the person is disabled or even killed directly, the responsibility will be great.

How dangerous is the neck?

Even a normal kiss between lovers can easily kill.

The neck is not only densely covered with blood vessels, lymph, and nerves, but also has important large blood vessels and some special 'structures'.

A 'strawberry' mark can form when a couple kisses on the neck with even a little force.This is actually because the capillaries in the neck can't bear the pressure and burst and bleed.

When the neck feels the stimulus, the carotid sinus responds, sending the message to the heart.

The heart will stop beating.

At this time, the kissed party will appear in a coma and die suddenly.

Even superficial stimulation can easily cause death. Li Jingsheng was naturally apprehensive to restore the dislocated cervical intervertebral disc to this patient.

"There are only two cervical intervertebral discs prolapsed, and the difficulty of this reset is not particularly high. You can push, pull, press, pull, and massage. You can just help him reset. Otherwise, he will have to go back to the People's Hospital for surgery. Pain!"

After Dr. Xu read it, he casually handed over the task to him.

"But... the patient's reset risk..."

"Which practical operation is not risky in clinical practice? As long as the operation is strictly followed the process, the risk can be controlled!"

Doctor Xu didn't give him a chance to speak at all.

Force this healing task on him.

"Okay then, I will strictly follow the procedure and ask the teacher if I don't understand."

Li Jingsheng looked at the patient.

The two family members exchanged glances, obviously reluctant.

The old lady immediately said with a bitter face, "Doctor, I'm just such a son, what can I do if something goes wrong! Do you think I can ask you to help me directly? The young doctor can learn more before operating!"

The family is not stupid.

The conversation between master and apprentice can be heard clearly.

Li Jingsheng twice emphasized the risk of resetting, which already made them tense.

"I've been sick recently, my body is weak, my hands will tremble involuntarily, and I can't do it at all. This Dr. Li looks young, but his level is very high. When I was away, he was the one who reset the patient's bone and never came out. If you really don’t want to, and you don’t force it, then you’d better go back to the People’s Hospital for surgery.”

Doctor Xu said with a serious face.

After hearing this, the family members were in a dilemma.

Let's treat it here, I'm a little bit worried.Don't treat it here, get surgery at the People's Hospital.

"Auntie, the risk of surgery is actually greater. It needs to be cut from the back of the neck. If the nerve is cut, at least it will be paralyzed for life."

Li Li, a female nurse, was doing ideological work for the family members.

"Cure here! Come on, treat me!"

At this time, the patient made his own decisions and asked Li Jingsheng to treat him.

"Son, what if something goes wrong!"

The old lady was still a little worried.

"This is a regular large hospital, so accidents are not so easy. If something happens, the compensation they will give is enough for you and your father." In the eyes of the patient, it is really the kind of person who is poor and has no worries. indifferent eyes.

In my 30s, I am still not married, have no partner, and have no children, only two elderly parents.

The pressure on patients can be imagined.

If the disease is not cured, he will basically be useless for life.

Going to the People's Hospital for surgery is more risky and expensive.

So he went all out.

"Doctor, please treat me with confidence! I'm not afraid!"

The patient seems to be struggling to speak and unable to stand upright.

The neck is slightly lowered to the ground.

Physiological curve anti-bow performance is extremely obvious.

He is not afraid, Li Jingsheng is afraid!

This is not a joke.

An accident happened on the first day of work in the Second Hospital, and Director Hua tried every means to hire him here.At that time, Li Jingsheng's future will be ruined, and Director Hua and Dr. Xu will also be implicated.

"teacher!"

Li Jingsheng looked at Dr. Xu for help again.

"Let the patient sit on the chair first, then touch the bone for him, hurry up, there are still many patients waiting behind!"

Doctor Xu is really fearless.

Now that the senior doctor has said so, Li Jingsheng is no longer a mother-in-law.

After opening the clinic for a year, his courage has indeed become smaller.

Every day is like walking on eggshells.

"Come on, sit on this chair and try to relax your body."

Li Jingsheng guided the patient to sit down.

It can be seen that the patient's expression is very painful.

Moreover, the patient's right hand has already experienced the feeling of being unable to exert strength.

Cervical disc herniation, many are direct high paraplegia.

This dude is lucky.

"Doctor Chen, please help me support his head, I will remove his neck brace."

After Li Jingsheng let go, he was no longer intimidated, but went all out.

"All right, all right, I'm the best at this kind of layman's work."

Dr. Chen was so happy that he got a job supporting his head.

The family members saw their son's resolute attitude, although they were still a little worried, they didn't say anything more.Just watching nervously.

After carefully unfastening the neck guard on the patient's neck, Li Jingsheng could already observe with the naked eye that there was an obvious disc herniation in the patient's cervical spine.

"I'll check it out for you first, relax!"

He felt the bones of the patients, carefully feeling the joint structure of the cervical spine, bone position changes, bone quality, bone temperature, cartilage damage and local soft tissue swelling, etc.

After touching it, he had a bottom line in his heart.

The fourth and fifth intervertebral spaces in the patient's neck were obviously asymmetrical, wide on the left and narrow on the right, and the fourth spinous process of the neck was deviated.

When the bone was further palpated, the supraspinous ligament felt peeling.

The patient's neck is tilted forward more than 15 degrees.

The problem is basically identified.

A variety of bone-setting techniques will be used to perform bone setting for this patient, and the control of details needs to be quite strict.

The five advanced bone-setting techniques he has learned, as well as the basic bone-setting techniques, have all reached the proficient level or above. After repeated evaluations, he believes that he has the ability to challenge this case.

If the techniques of stretching and traction, swinging and touching can be raised to above the level of Xiaocheng, the patient will be more confident in reset.

Now he operates it, with a safe grasp of about 50%.

If these advanced bone-setting techniques can be upgraded to the Xiaocheng level, the safety factor will reach at least 80%, or even higher.

Now that he has officially joined the Second Hospital, Dr. Xu also intends to exercise his bone setting ability and give him some opportunities to practice mobile phones with a high risk factor.

I believe that the speed of earning life points will be very fast.

At that time, these bone-setting techniques will be improved one by one to a higher level, and within a month, his bone-setting level will be able to reach another big level.

"Have you figured it out?"

Doctor Xu asked him.

"I've figured it out. I'm sure I can reset him successfully."

Li Jingsheng was much more confident in his answer this time.

"Isn't it just a cervical intervertebral disc reset, not to mention only two cervical vertebrae have problems, even if there are three or even four cervical vertebrae, you can challenge it with your current ability. For safer reduction and less pain for the patient, I suggest You can reset him in three to four sessions."

Hearing what the teacher said, Li Jingsheng's eyes lit up slightly.

Dr. Xu dared to let him treat it, so it turned out that he had already made a safe arrangement.

It caused Li Jingsheng to worry for a long time in vain.

Staged treatment is not a novel approach clinically.When encountering a more difficult disease, or when there are multiple symptoms combined, doctors often adopt a staged treatment approach.

Treat the fatal ones first, wait until the most important problems are solved, and then solve those less fatal problems.

For bone setting and reduction, what Li Jingsheng came into contact with was all one-time operation in place.

Divided into three or four courses of treatment, manual reset is still the first time for the bride to get on the sedan chair.

"It's okay to divide it into four courses. We don't live far away anyway. As long as the treatment is safe, it doesn't matter if we go a few more times."

said the old lady.

"It takes nearly two hours to get here from Yanxia Lane in the north of the city by bus!"

The patient's father corrected him in a low voice.

This is because they are worried that the doctors don't know the truth, which really makes them go back and forth.

"You don't speak and no one treats you as dumb! You live in the city and it's not close? Really!"

The old lady was very upset when her husband told her the truth.

She glared at her husband angrily.

The husband shrank his neck in embarrassment and moved back.

The gazes of the two people stared at Li Jingsheng in unison.

Because of the rules of speaking, Li Jingsheng has already begun to implement bone setting techniques for patients.

"Relax, relax!"

While telling the patient, Li Jingsheng stood behind him, clasped the top of the patient's head with his right hand, and pinched the patient's neck with his left hand.

I saw him constantly adjusting his posture and bone-setting techniques.

Pushing, pulling, pressing, pulling, manual traction... He will use whichever bone-setting manipulation can be used to achieve a good therapeutic effect.

Dr. Chen next to him looked envious for a while.

Among these bone-setting techniques, he also knows many basic techniques, but he can't use them as skillfully and freely as Li Jingsheng.

As for some of Li Jingsheng's dark techniques and advanced bone-setting techniques, Dr. Chen couldn't understand them at all.

Among them, the technique of exerting force, as well as the angle of massage, two-way cooperation, etc., if the doctor who operates it does not explain it in detail, it will be difficult to learn it even if you want to learn it.

"Aw... it hurts, it hurts..."

The patient's sudden screams startled the family members.

In fact, since Li Jingsheng touched his bones, the patient has been gritting his teeth and enduring it.

His body was trembling non-stop, and his teeth were clenched.

Maybe the pain was too much at this moment, breaking his endurance limit, so he let out a cry of pain.

"Okay, okay, don't move, don't move."

Li Jingsheng has helped the patient correct the spinous process to the correct position, and the prolapsed intervertebral disc has recovered more than 90%.

He dare not force the remaining 10%.

Worried about something going wrong.

In fact, his palms were full of sweat.

In terms of tension, he is more nervous than the two family members.

"Teacher, now push him back to about 90%, and the remaining 10% will be slowly brought back to its original position by traction. Do you think it's okay?"

"absolutely okay."

Dr. Xu is very satisfied with his performance.

With just a little click, Li Jingsheng can directly formulate a reasonable treatment plan for the patient, which requires a high level of talent and a considerable level of understanding and mastery of bone setting techniques.

"Let me tell you, more than half of it has been reset now, but the next reset is extremely risky. The safest way is to be hospitalized here, put on traction, and let it slowly reset."

Li Jingsheng looked at the two family members.

"Going to the hospital! Can we do it at home?"

When the old man heard that he was going to be hospitalized, it must be the money that made him feel distressed.

"Even our professional doctors have to be cautious about this kind of high-risk operation. In order to save this hospitalization fee, do you do it yourself at home? In fact, his hospitalization fee is not very high, because there are not many medications, and the main reason is nursing expenses. It’s a bit more expensive. But it’s worth the money, and there are medical staff watching to ensure safety. And the traction can achieve the best effect.”

Li Jingsheng once opened a clinic, and now he is doing ideological work for family members, which is very efficient.

"How long will you stay in the hospital?"

the old lady asked.

"It depends on his recovery. If it is fast, it will be three or four days. If it is slower, it will be more than a week! You don't need to worry about the length of hospital stay. The beds in the hospital are very tight, and there is an evaluation system for the length of stay. Even if the patient doesn't want to be discharged, our medical staff will rush to discharge. The main purpose must be to cure the disease!"

After listening to Li Jingsheng's explanation, both family members agreed.

Just such a son, he must be cured.

Now being able to reset manually is already the best result.

"Here, put a pillow on him first, and I'll give you hospitalization. You go to pay for the formalities, and then come here to take the person to the inpatient ward. It can reduce the risk of his activities. Before he recovers, he still needs to Focus on rest.”

Dr. Xu made arrangements for the patients.

It is not complicated to apply for hospitalization. First go to the orthopedic surgery inpatient department to find the nurse at the nurse desk to complete the procedures, and then go to the inpatient window to pay and register.After paying the fee, the inpatient department will arrange a bed.

This process requires running upstairs and downstairs.

It is certainly the best option for patients to stay in the outpatient department.

After Li Jingsheng installed the pillow for the patient, he quietly checked the results on the attribute panel.

Level experience +10, general surgery diagnosis +1, bone palpation +10, common bone setting +10, pulling and stretching and traction +10, rotation flexion and extension +10, lifting and pressing +10, swinging and touching +10 , HP +11.

The harvest is really not ordinary.

Especially the proficiency of the six bone-setting techniques, each of which is +10.

This kind of high-risk operation is difficult, but it is of great help to the improvement of technology.

"Xiao Li, come in with me."

Dr. Xu called Li Jingsheng to the inner room.

"Teacher, is there something wrong with my handling of this patient just now?"

Li Jingsheng took the initiative to ask.

"There are two ways of traction, one is fixed traction, and the other is manual traction. How did you choose to hospitalize the patient for traction?"

Dr. Xu obviously intends to cultivate Li Jingsheng's ability to deal with affairs in an all-round way.

"Manual traction is time-consuming. Our outpatient clinic has a large number of patients every day. We can spare this time to treat more patients. In addition, the patient's cervical spine is not stable now, so it is not very safe to wear a neck brace. They live in the north of the city, very far away from here. Their family circumstances are probably not very good, and they are reluctant to take a taxi, preferring to take the two-yuan bus.

There are substantial risks to the patient in this process.

If something goes wrong, it will be a devastating blow to the patient's family.It is also not good for our hospital.

The cost of hospitalizing the patient should not be very high, and it is convenient for us to check the patient's recovery process at any time. Relatively speaking, the patient will be safer.After weighing all aspects, I think it is the best plan to let him be hospitalized for traction treatment. "

Li Jingsheng explained his considerations in detail.

After listening, Dr. Xu's expression softened a lot.

"It seems that you are more thoughtful than me. The hospitalization plan seems to increase the financial burden of the patient, but it is the safest one. It should also be the most affordable one. After the traction is done, what are you going to do?"

Some treatment options seem to be expensive, but they are stable, safe, and in place at one time.

Might be more economical.

In case the patient has a second displacement of the cervical spine on the way home, the increase in treatment costs is a trivial matter, and he is afraid of paraplegia or even disappearing.

"After the traction, I guess the cervical intervertebral disc should be basically reset. I'm afraid I'll have to leave the rest to you, for massage therapy. I haven't even mastered the art of squeezing and dividing the bones yet!"

Li Jingsheng's learning speed is amazing.

However, it is extremely difficult to learn and master all eight advanced bone-setting techniques.

He needs more time.

"Massage and massage are not difficult to learn. Once you have mastered pinching and dividing bones, coupled with the foundation of bone touch, you can easily master massage and massage."

Osteoarthritis allows doctors to grasp the patient's bone status at any time.

It can play a very good 'navigation' role whether it is bone setting reduction or massage and massage for patients.

Perhaps it is more appropriate to compare bone touch to a CT scan.

"At first, I was a little worried about your random admission of inpatients, but now it seems that I was too worried. You can make decisions on the next cases, and ask me if you really don't understand."

After Dr. Xu finished speaking, he led him out.

"Li Li, ask the new account to come in!"

The second patient couldn't wait a long time ago. He didn't need Li Li to call his number at all. He already came in in a wheelchair with a full face of excitement.

"It's me, it's me! My foot was broken, please see if it can be cured?"

The patient was 35 to [-] years old, and the wheelchair was pushed by a haggard middle-aged woman, about the same age as him.

Should be a couple.

The two are dressed decently, and their financial situation should be okay.

The man was wearing a pair of dark blue jeans, which were covered with mud and blood.The trouser legs have been cut off directly at the knee.

This is also the most common emergency treatment in clinical practice.

Take off the patient's pants, one is uncivilized, and the other is easy to cause secondary injury to the patient in the process of taking off the pants.

It can be seen that the patient's right leg has a relatively serious hematoma and some skin trauma.

With Li Jingsheng's professional eyesight, he could tell at a glance that the man's right calf was probably broken.

It's a little better than Liduan.

But the bones inside must have been broken more severely.

He took the information bag from the patient's wife and took out the film to check.

It was filmed at Qiaobang Hospital.

The two strongest hospitals in Lijiang City are People's Hospital and Qiaobang Hospital.

Patients who underwent examinations in these two hospitals went to the second hospital for treatment. What does it mean?
It shows that the orthopedic surgery in the Second Hospital is very famous!

No wonder Dr. Xu didn't even give Dean Jin face. If he didn't accept apprentices, he wouldn't accept them.No one can do anything to him.

And he was not afraid of the Second Hospital dismissing him at all.

Possessing a special medical skill is too popular.

"Ah, why isn't such a serious bone injury hospitalized for surgery?"

After watching the film, Li Jingsheng's face turned pale with fright.

The tibia was almost completely broken, and the fibula was also severely fractured.

The broken ends of the two bones had been squeezed together.

With such a serious bone injury, besides surgery, is there any other option?
"When I was doing an examination at Qiaobang Hospital, I accidentally heard someone say that your bone-setting technique is very good. Then I asked a friend who is a doctor, and he told me that if my bone injury can be treated with manual reset , it is definitely better to choose the conservative treatment method of manipulative reduction. Not only will the recovery time be shorter, but the damage to the body can be reduced a lot.

Furthermore, I was injured in an accident this time. The company learned that I might have to be hospitalized for more than two months, so they let me recuperate.

I guess my job must be lost.

I don't know how long it will take to get back to work, and the family is burdened with a large mortgage, and the car loan is still 13 months away.It will be very difficult for my wife to fight alone.I can save a lot of medical expenses if I can cure it here. "

The man is very honest.

Tell me all about your personal situation.

The purpose of doing this is to arouse the empathy of the doctor, so that he can do his best to help him.

Capitalists are ruthless.

Men's positions should be better.The accident caused him to be hospitalized for two months, so the company probably wouldn't fire him directly.

But let someone else take over his position, and then after he returns to the company, arrange a new garbage position, such as logistics and the like.It's like a soft dismissal.

The workplace is so cruel.

At that time, the situation of this male patient will be very bad.

Resignation was almost inevitable.

Finding a new job can be especially difficult for men and women over 35.

He is still sober, and has realized that the crisis of life is coming.Start now to find ways to save money on treatment and keep treatment time as short as possible.

"What you have to do now is to treat with peace of mind, and just leave the money-making to me."

The wife comforts her husband.

"Doctor, although I heard that manipulative reduction therapy can save a lot of treatment costs, but if it will cause disability or affect his future motor function, then we still choose surgery."

His wife looked directly at Li Jingsheng.

It can be regarded as giving him a bottom line.

(End of this chapter)