Gou is practicing medicine in the clinic

Chapter 224 Is this drunk?Director Zhang personally called

"Orthopedic surgery rarely studies urological cases. Doesn't this patient have pain in the right waist and lower limbs? Has the pelvis been checked?"

Li Jingsheng thinks that starting from pain should lead to some different discoveries.

"I haven't checked it! It has little to do with the pelvis. It is likely to be the pain caused by the compression of the enlarged kidneys. I have encountered many cases of this situation in clinical practice."

Dr. Tan Shuilin has his own opinion.

Doctors prescribe examinations based on their own diagnostic ideas.

Those who feel that they have reference value and have diagnostic significance will apply to patients.

Don't ask indiscriminately, directly formulate a lot of examinations, either for novice doctors, or for medical ethics problems, or for the above-mentioned task indicators that have not been completed.

The conversation room between the two has come to the ward.

Since it was already past twelve o'clock in the middle of the night, the lights in the ward had already been turned off, and the patient and accompanying family members were already resting.

"37 beds Chen Guixiang!"

"Doctor Tan, are you going to give me an examination or an injection?"

The patient is less than 40 years old, probably because of physical illness, sleep is very light.

As soon as they entered the ward, the female patient woke up.

Her husband was resting on the edge of the bed.

In fact, the accompanying bed next to the hospital bed can be taken out after scanning the QR code and paying the fee.

The accompanying bed in the Second Hospital is 15 yuan/night.

Family members may not know about this service, and they may be reluctant to spend the money.

Seeing the doctor coming, her husband quickly stood up and moved out of the way.

"Let's check it out for you! How do you feel now?"

"After you helped me with the medicine, I stopped vomiting, but my stomach was still very distended, and the whole side of my right leg and buttocks hurt like a needle prick."

The female patient showed obvious shortness of breath when speaking.

Her lung infection doesn't seem to be under control!

Li Jingsheng's respiratory diagnosis level is very high, and he can know the condition of her lungs just by standing by and listening.

"Can you lie on your side? Let me check your pelvis and leg bones!"

Li Jingsheng knew that there was no way to persuade Dr. Tan Shuilin to prescribe a pelvic examination for the patient.

You can try the bone touching technique now.

"Husband, help me turn over."

It shouldn't be a big problem for a woman to turn over, but her waist and kidneys are swollen, which will bring her pain and discomfort.

The male family member came over to help her turn over and lie on her side.

You could tell she was in pain as she turned over.

"If it hurts during the examination, just remind me."

If Li Jingsheng hadn't seen the patient's husband as an honest person, he wouldn't have dared to perform this bone palpation examination on her.

The examination started soon. Li Jingsheng touched the side of the patient's pelvis first.

The bones of the hip are most palpable.

"How long have you been feeling pain on the right side?"

"It's almost a month!"

"Did you have a slight pain a month ago?"

As soon as Li Jingsheng touched it, he immediately noticed that there was something wrong with her pelvis.

This feeling like a dead tree is deep in his memory, and it is undoubtedly a malignant bone tumor.

"It seems to be true! It may have been a long time ago. It used to be just an occasional pain, and it will recover soon. And it's not as painful as it is now."

The female patient said after careful recollection.

"Let me see your leg bones again!"

Li Jingsheng didn't touch her hip joint, but skipped directly to touch the patient's kneecap and femoral head.

Still the same dead wood.

"Okay, the examination is all right, and Dr. Tan will tell your husband about the results. You should have a good rest!"

Li Jingsheng signaled Dr. Tan to speak outside.

Tan Shuilin looked at him and didn't do much examination, just touched the patient's hip, knee and part of the femur.

The inspection is over so soon?

This Dr. Li said he was here to increase his knowledge, and it looked a bit like he was flying around!
After the two walked out of the ward, Li Jingsheng had basically sorted out the diagnosis in his mind.

"Dr. Tan, I suggest that you immediately apply for a pelvic and femoral examination for this patient. It is likely to be a malignant tumor."

Just when Dr. Tan Shuilin felt that this doctor surnamed Li was superficial and unreliable, Li Jingsheng spoke.

"Malignant tumor?"

Tan Shuilin was stunned.

"Shouldn't it be possible?"

It was hard for him to believe the result.

Moreover, Li Jingsheng did not enter the ward for more than 3 minutes, and the examinations he did were very limited.

"It's very simple, just check it out. The patient's pain is neither pain caused by kidney compression, nor sciatica, but cancer pain. I suspect that her lungs may also have spread of malignant tumors. It may even be the cause The focus of the disease was in the lungs, and it gradually moved to the kidneys, pelvis, etc."

Regarding this, Li Jingsheng was not too sure.

But when he found out that the patient's bone was like a dead wood bone, and then thought of the patient's right buttock, severe pain in the lower limbs, lung infection, and enlarged kidneys, etc., the combination of these is the possibility of cancer. Sex is extremely high.

"This... Dr. Li, first of all, thank you for coming to consult this case late at night, but I am very surprised that you said that the patient is a malignant tumor. I will report to the superior doctor tomorrow and see if I can apply for the patient according to your wishes. A pelvic X-ray examination. If you can write down the general diagnosis idea, it will be easier for me to report to the superior doctor! Is it convenient for you to read it?"

Tan Shuilin felt that this young orthopedic surgeon was simply fooling around.

A doctor's diagnosis is not a child's play.

You suspect it is a malignant tumor, but you can't confirm it just by touching it twice with your hands?

"No problem, I will borrow paper and pen from you."

Li Jingsheng readily agreed.

Write down your thoughts on diagnosis.

"I strongly recommend that patients get a pelvic X-ray as soon as possible, preferably a CT or MRI of the lungs."

"The lungs have been checked once, and it is currently confirmed to be a lung infection, and is already being treated with anti-infection drugs."

Dr. Tan Shuilin really wanted to roll his eyes when he heard that.

Lung CT, or even MRI, do you just do it?
Lung CT costs more than 200 yuan, which is a very expensive price for poor families.

Don't even think about MRI, the patient's family will never agree.

Moreover, the patient has been hospitalized for almost four days, and his condition has not improved significantly, and his trust in the doctors of the Second Hospital is declining.

He smelled a trace of alcohol when Li Jingsheng was speaking, and seriously suspected that the orthopedic surgeon had drunk too much, and then went to the hospital in the middle of the night to show his presence.

"Let me write down my phone number too! I won't go to work tomorrow. When you report to the superior doctor, if you have any questions, you can call me at any time."

Li Jingsheng is a steady person.

After thinking about it, I wrote my personal mobile phone number on the back.

"Excuse me, Dr. Tan, goodbye!"

Li Jingsheng was relieved to have diagnosed both difficult cases.

Since it was already a little late at night, it was not easy to get a taxi on the road.

He didn't even think about the one at the entrance of the hospital.

Usually the maximum fare is 50 yuan, and they ask for 10 yuan.It is only less than three kilometers away, and it takes about [-] minutes to walk.

Fortunately, an ordinary Volkswagen Bora slowed down beside him.

"Take a taxi?"

The driver is a 37-year-old elder brother.

"How much is it to Chengnan Old Street?"

"I'll charge you ten dollars, okay?"

"Brother, it usually costs eight yuan to take a taxi."

Li Jingsheng opened the car door and got in.

"Eight yuan is eight yuan, but you also said that it is normal. Now do you see what time it is? Just treat it as an extra two yuan to buy me cigarettes!"

"Hehe, the elder brother is right."

Li Jingsheng happened to have change in his pocket, so he took out a ten-yuan bill.

Now the daily income is more than [-] yuan, and the front matter has been successfully resolved, and it is quite stable after moving to the new location.Naturally, he didn't care about the two yuan fare.

"Oh, it's hard to make money now! I used to be a white-collar worker in a big company, and I was promoted all the way to be a supervisor. My monthly income was never less than [-] yuan, and I got nearly [-] yuan when I was high. Kick me out, the capitalists are so fucking ruthless. I have worked hard for the company for many years, even if the salary is reduced, just fire me, you say you are not disappointed."

The eldest brother was afraid that he finally caught a person who was suffering, and told Li Jingsheng about his misfortune.

"That should have cost you a sum of money?"

"Excuse me! My current boss is better than the other. Every day, I wear small shoes, pick on my faults, and then deduct all kinds of fines. I have to pay the company 8 yuan for last month's shift. Do you think I can stay here?" ?”

"Is that why you resigned yourself?"

"Yes, I got the salary slip and slapped it on the boss's face. I quit. I also paid [-] yuan for medical expenses for this matter."

The driver brother is really a fierce man.

That slap hit the boss's face, I'm afraid it was not a light hand.

"Young man, as someone who has experienced it, I would like to advise you that when you are young, you must save more money and not be in too much debt. Because you never know whether you will be able to get that high salary next month. I am the lesson of blood, Now I can only make some money by online car-hailing, housing loan, renovation loan, plus car loan, more than 8000 a month. Fortunately, I sold the BMW X1 last month, and the car loan is gone. "

With a loan of nearly [-] a month, this big brother is really a ruthless person.

6000 a month, and it takes more time to get this amount. After deducting the tax, there are only more than [-] left.

Then according to the minimum social security payment, individuals must pay at least 600 more.

Coupled with medical insurance, you can get more than 5000.

If you can maintain this income level every month, then there is no problem.

Otherwise, unless his wife can have a higher income to fill the gap.

"Why do you want to buy a BMW when you owe a mortgage and a renovation loan?"

Li Jingsheng asked.

"It's a good face! At that time, I thought, I am the director of the company anyway, and I can be regarded as a middle-level manager. What does it look like to drive a scooter? I gritted my teeth and took out a loan to buy a BMW. If I talk too much, I will cry. Let me tell you, don't take out a loan to buy a car, it's full of pitfalls. I paid off the loan for more than a year, but I couldn't afford it last month. I couldn't handle that BMW. After the calculation, I had to find out 2000 diverse.

The car dealer saw that I was pitiful and the car was in good condition, so he just said forget it. "

Second-hand car dealers even when their relatives go to the car, they will definitely cut down the price when they collect the car!
But buying a car with a loan is a bit tricky.

It will be even worse if you encounter a darker credit company.

Li Jingsheng also tasted the days of being in debt, and the past is unbearable.Let him take out a loan to buy a luxury car in order to save face, without even thinking about it.

He wouldn't do such a stupid thing if he was killed.

After the driver sent him to the place, he paid ten yuan for the fare.

Watching the driver brother drive away, Li Jingsheng shook his head, life is full of ups and downs, just get over it.

He came out of the trough, and his current achievement is actually less than three months.

These three months of hard work and good luck changed his fate and allowed him to stand up again.

Silently in my heart, I wish that brother driver can get out of the trough of life as soon as possible.

After returning to the clinic, he soon fell into a deep sleep.

No more sleeping in that cramped, stuffy attic.

Now that there are so many rooms, just find a bedroom that is very spacious.

……

When he woke up the next day, it was already around 40:[-] in the morning.

There are buns and soy milk at the door, packed in plastic bags and placed on the window.

The phone received several text messages.

Tang Ping bought the buns and soy milk for him.She knew that sometimes Li Jingsheng didn't have time to go out to buy breakfast when he was busy, so she brought him a copy.

She didn't call to wake him up at such a late hour, which showed that she was sympathetic to his hard work and deliberately let him sleep for a while.

Ou Qinglan also sent him a WeChat message, saying that she came to find Li Jingsheng after get off work tonight.

It is estimated that this little girl misses him.

A man and a woman in love can't see each other every day.

Last night, she was supposed to come over for a dinner together, but she didn't want to come because of social fear.

The two did not see each other for a day.

It must be another busy day for the two of them today.

Send her a message back and go to the bathroom.

I hurriedly brushed my teeth and washed my face, and after breakfast, I hurried to work in the reception hall downstairs.

When they came to the reception hall, the patients saw a doctor in an orderly manner.

"Boss, these patients are all waiting for you to come over and take care of them yourself. Siying has already measured the body temperature and heart rate of some patients. The medicine sales department is busy, so she ran over to help."

Now that drug sales have become shelves, it will be much more convenient for old customers to buy drugs.

New customers need to explain and give them membership cards, which are time-consuming.

Fees are fairly convenient, and now the intelligence is relatively high.

And Tang Ping can also support.

Li Jingsheng began to consult patients one by one.

"Doctor Li, I came here specifically for you. My old father broke his leg, and he asked several hospitals in his hometown for surgery. Last time you were very good at grafting my wife's wrist. This time I came here specially Take a look."

From the accent, it should be around Jiangli City, not too far away.

The old man with a broken leg was sitting in a wheelchair, humming non-stop, with a pained expression on his face.

They've had filming done at a local hospital.

Li Jingsheng took the film for examination, and found that the tibia of his leg was broken, which is not difficult to treat.

The age of the patient is actually not as old as imagined, only 56 years old.This age is considered young and middle-aged.

"Didn't you get any treatment at the local hospital?"

"I heard that there was going to be an operation, and I happened to know that your technique is very good at bone-setting, so I rushed back overnight to take my dad over."

"Thank you for your trust in me. I will check him first. Judging from the film, the fracture of the tibia is quite serious."

When Li Jingsheng encounters this kind of 'hardcore fan', what else can he say, try to help him.

Limb fractures, as long as they are not particularly complicated or serious, he can basically treat them.

After touching the patient's bone, he was already confident.

The fee is [-] yuan.

In fact, it is not expensive, because the cost of bone setting, splint, and bone extension paste are all included.

With Li Jingsheng's current level of bone-setting techniques, it really didn't take much effort to reset the leg bones for others.Put on plaster, fix it, and let the patient go home and take good care of it.

Come back in a month for another checkup.

While explaining the precautions to the patient and his family, a young man ran in from the outside, only 25 or [-] years old, looking flustered.

Holding a crying child in his arms, he was only two or three years old.

"Doctor, doctor, my child accidentally cut his finger, can it be treated here?"

"Let me see!"

Li Jingsheng hurried over to check.I saw that the first section of the child's left index finger had been cut deeply, and only a layer of skin was left.

"I will give the child a simple bandage, and you should send it to a big hospital as soon as possible, and you should be able to pick up the job."

Li Jingsheng's clinic couldn't eat this kind of severed finger replantation even if he wanted to.

Large hospitals can handle it, but the charges will definitely not be cheap.

As long as you can pick it up, it's good.

What I am most afraid of is that if I connect it, I will not be able to survive. At that time, I will have to amputate the limb, which is equivalent to paying twice, and the finger has not been kept.Doctors can only do their best, and no one dares to guarantee it.

Li Jingsheng now only has Tang Ping as a good nurse, plus himself, even with Han Siying as a medical assistant, it is still a third-rate surgical team.

He can do ordinary minor surgery, but he may have to work hard for two or three years before he can do this kind of high-precision and complex surgery involving nerve, blood vessel, and tendon anastomosis.

It's not even close yet.

After bandaging, the child's bleeding became much smaller and basically stopped.

Li Jingsheng's bandage to stop the bleeding came in handy.

"How much does this bandage cost? I'll scan it for you."

"I won't charge you, go to the big hospital quickly! The child is so young, it's too much to suffer."

At this moment, Li Jingsheng began to show a trace of the demeanor of a great doctor.

Earn as much money as you deserve, not too much.

But when encountering such a small matter, it is only one who can help.

And it's volunteer work.

"Thank you, thank you so much!"

After the man thanked him, he quickly took a taxi to the big hospital with the child in his arms.

These things are just the daily routine of the clinic, which can be regarded as small episodes, and he continues to diagnose and treat patients one by one.Each one is handled with great care.

He found that after improving the immune diagnosis last night, it was helpful for the diagnosis of almost any disease.

It was almost ten o'clock when Li Jingsheng's cell phone rang.

It was a call from an unfamiliar number.

"Hello, who are you looking for?"

"Doctor Li? I'm Dr. Zhang Zhongsheng, Department of Urology, Second Hospital!"

"Oh! Hello, Director Zhang!"

Li Jingsheng had heard of Zhang Zhongsheng's name, and he was considered a general in the Department of Urology of the Second Hospital with a very high level.

I heard that the surgical skills are particularly superb.

"I have seen the diagnostic idea you wrote last night. I have performed a pelvic X-ray examination on the patient and found that the structure of the patient's right ilium is blurred, with uneven density and insect-like bone destruction, and there is no bone in the local area. There was no abnormality in the left pelvis. A metastatic bone tumor was found in the right pelvis, with osteolytic destruction. It seems that your diagnosis is correct, and the patient is likely to have a malignant tumor."

Zhang Zhongsheng's tone was both praiseful and a bit heavy.

"I have long heard that the Orthopedic Surgery Department recruited an excellent young doctor. I didn't think there was anything wrong with it before. Now I know how high your level is. At present, the patient has been arranged for a lung CT scan. Just now the pelvic X-ray examination When the report comes out, I just want to tell you the result in time."

This is not the chief physician talking to a small resident doctor, it is clearly the tone of equal treatment.

And no matter how you listen to it, there is a hint of gratitude and goodwill.

"Thank you for taking me so seriously. That patient's lung infection is probably a malignant tumor!"

Li Jingsheng sighed.

He was not surprised by this result.

When I felt the bone of the female patient yesterday, I could already conclude that it was a bone tumor.

And bone tumors tend to occur in children and adolescents.Bone tumors generally occur in adults, most of which are caused by cancer cell metastasis.

That is to say, the bone tumor is not the primary lesion.

"Hey! If that's the case, I can persuade her to eat and drink! The patient is only under 40 years old, what a pity."

Zhang Zhongsheng also sighed.

When a doctor encounters such a situation, he will feel heavy.

But helpless.

I just hope that human medical science and technology can progress faster and overcome malignant tumors as soon as possible.The good news is that foreign countries have developed targeted drugs that can eliminate a variety of cancer cells.

It is more advanced than existing chemotherapy drugs, and the side effects are relatively much smaller.

At the same time, it has one of the biggest advances, it is no longer just targeting a single type of cancer cells, but can target multiple types of cancer cells.

This is really worth looking forward to.

Perhaps within a few years, treating cancer will really be as easy as treating a cold.

(End of this chapter)