Gou is practicing medicine in the clinic

Chapter 310: Bad luck only seeks out the poor, the fear of the second patient
The patient's sister immediately agreed.

Coming to Sunshine Clinic for treatment must be based on trust.

Whatever tests the doctor tells us to do, patients and their families will basically agree as long as their financial conditions allow.

Unless it is some risky invasive examination that scares them, they may refuse it.

After taking a chest X-ray of the patient, Li Jingsheng found that the patient's lungs had global atelectasis and even nodules.

Pulmonary interstitial fibrosis is also relatively serious.

No pleural effusion or infiltration was found.

In his experience, this patient's condition was much more severe than expected.

It's just that his small clinic has limited conditions and cannot conduct further examinations.

At first, he just suspected that the patient had chronic respiratory failure, so he wanted to take a X-ray to see the condition of the lungs.In fact, the best way to diagnose respiratory failure is to look at arterial blood gas analysis.

He couldn't do this test here, so he could only diagnose it through other methods.

Imaging examinations, whether X-ray or CT, are intended to help doctors clearly diagnose the cause of respiratory failure.

For example, in this patient, the cause of respiratory failure has basically been discovered.

Whole lung atelectasis, pulmonary nodules, and interstitial pulmonary fibrosis are the main causes of respiratory failure.

Taking the patient back to the consulting table outside, Li Jingsheng looked at the patient's sister.

"I just took a X-ray and found that there are nodules in the lungs. The condition is a bit complicated. Our clinic's conditions are limited. I suggest you go to a large hospital for further examination."

Li Jingsheng said it more tactfully.

In fact, doctors generally speak tactfully in front of patients.

Especially if the condition is serious, patients are generally not told directly.

Some patients are not in good health to begin with. If their mental endurance is poor, they will not be able to bear the news that there is a big problem with their body, especially cancer or serious diseases.

It could collapse on the spot.

It is even possible to pick up lunch boxes directly on site.

Especially some patients with poor heart conditions, high blood pressure, or severe intracranial arterial and cardiovascular sclerosis, are really unable to bear such severe stimulation.

The same goes for older people.

"It's too expensive to go to a big hospital for treatment. Can you treat it here?"

The patient held his chest and gasped hard.

My body has become like this when I was only 30 years old. Fortunately, I am not married, otherwise my wife and children would have to suffer along with it.

"Let's go to a big hospital first. If you need medicine, injections, etc. later, you can come directly to our clinic."

Li Jingsheng said to the patient.

Finally, the patient's sister helped him go.

After a few minutes, his sister came in again.

"Doctor Li, my brother was here just now, so it may be inconvenient for you to say something. Can you tell me the truth now? My parents are old and sick now. I can only take care of my brother's affairs."

It's very good that a sister like her can do this.

"I would like to ask, are you married?"

"It's over! The child is over 17 years old."

She would obviously be mistaken.

"Your brother's illness may be serious. When I took the X-ray, the nodules I saw were not very good in terms of shape, size, or density. Because he has been suffering from this disease for many years. If it is just ordinary chronic respiratory failure, You can come to my clinic for treatment. Even if it is a lung tumor, you will need further examination at a large hospital to see the nature of the tumor and whether it has spread.

There are some things I shouldn't say, but I still have to tell you that malignant lung tumors can be cured by surgery in their early stages.If you are in the middle or late stages, you need to consider whether your family's finances allow it.

The situation I see most is that there is no talent left. "

Li Jingsheng could only remind him tactfully.

It can be seen that the elder sister has great affection for her younger brother and takes care of her younger brother like a parent.

This is also the tragedy of parents who pampered their sons too much when they were young.

I dare not say that this patient's lung disease must be caused by the bad habit of snorting. At least it is related to the overindulgence of his parents.

Excessive pampering makes him less competitive in society and makes him easy to indulge himself in every possible way.

Smoking, staying up late playing games, etc. may induce lung tumors.

"Thank you!"

The patient's sister had tears in her eyes. When she walked out of the reception hall of the clinic, she saw her taking out a tissue and wiping her eyes.

Maybe the tears came out just after they were wiped away. She continued to wipe her eyes with a tissue at the door for more than ten times before she adjusted her mood and walked out.

Looking at all this, Li Jingsheng also sighed.

The disease is ruthless. It does not distinguish between men and women, old and young, rich or poor, and will attack humans mercilessly as long as there is an opportunity to attack.

Misfortune only seeks out the poor.

The poorer you are, the more likely you are to be targeted by some diseases.

For example, if the financial situation is not good or average, seven out of ten people will be very frugal.

Being frugal in itself is not a bad thing.

But crises can also lurk in seemingly good frugal practices.

Many people are reluctant to throw away leftover food.

Especially middle-aged and elderly people over 50 years old have survived that difficult era.They think it is a pity to throw away the leftovers, and wasting food is unacceptable to them.

People who grew up in that era had a very special affection for food.

As everyone knows, now that people's living conditions have improved, eating leftovers has become a hazard.

According to scientific research, many nitrosamines may appear in leftovers and leftovers after they have been left for a long time.

Such substances are highly carcinogens.

This also leads to a certain potential risk of cancer from eating leftovers and rice.

Including pickles, pickled vegetables, cured fish and bacon, which many people like to eat, will increase the risk of tumors.

Li Jingsheng encountered such a real-life incident when he was training in the First Hospital.The patients are a couple, both of them are young, the husband is 38 years old, and the wife is one year younger, 37 years old.

They don't have any bad habits, they just like to eat pickles.

If you don't eat for a day, you will feel unhappy.

In this way, the two of them have been eating since they got married until they became unwell and went to the hospital for examination.

As a result, both of them were diagnosed with malignant tumors.

The husband has stage II colon cancer, and the wife has advanced gastric cancer.

This is a tragedy.

No one can be sure that the couple's simultaneous cancer was caused by eating pickles, but eating pickles does increase the risk of cancer.

"Boss, did the patient just now really have a lung tumor?"

Wang Zongxiao asked.

"Probably yes."

Li Jingsheng made a comprehensive diagnosis based on experience, imaging examinations, the patient's symptoms, and course of the disease, and could basically determine which patient had a lung tumor.

The possibility of malignancy is extremely high.

And it is probably already in the middle to late stages.

"I'm only 30 years old. It's such a shame."

Wang Zongxiao shook his head.

"Didn't he check it out once in the hospital before? Why wasn't the problem found at that time?"

"Haven't you also worked in a big hospital for many years? Are you still asking me this?"

Li Jingsheng rolled his eyes at him.

"Even with lung CT, some tumors may not be able to be detected. Maybe the tumors haven't occurred at that time, or they are still very small. It's possible."

Tumors smaller than 1cm are difficult to detect with ordinary imaging examinations.

Mainly, it was five years ago when patients went to the hospital for check-ups.

Some patients who are at high risk of developing cancer, or those who have been diagnosed with cancer, generally need reexamination every three months or six months.

Instead of ignoring it for several years.

While the two were talking, the next patient sat next to Li Jingsheng's consulting table with a look of horror.

He is also young, looking to be in his early 40s.

A man of this age is considered to be in his prime.

The man in front of him seemed to have fairer skin, with a darker complexion and a slimmer figure.It shows that he rarely does physical work and lacks physical exercise.

The bodies of these patients are much weaker than those who often do physical work.

"Dr. Li, I've been out of breath recently and my cough has been a bit severe. I even saw bloodshot eyes yesterday. Could it be lung cancer?"

There was panic in the man's tone.

Apparently, the previous patient was diagnosed with a possible malignant tumor, which made him extremely frightened.

Because his symptoms were very similar to the previous patient.

Even more serious.

Because the sputum he coughed up was already stained with blood.

"Don't be nervous, the chance of getting malignant tumors is not high. If you don't smoke and live in an environment where you seldom inhale second-hand smoke and dust, it's very difficult to get lung cancer. The probability is basically the same as winning a lottery ticket. .”

Li Jingsheng comforted the patient.

Han Siying stood nearby with her lips pursed and a secret smile.

Sometimes, some of the patient's behaviors are really cute.

"I don't smoke, but I usually play games. When I was young, I often went to Internet cafes to play games. There were many people smoking there, so I may have inhaled a lot of second-hand smoke." The man was quite upset when he talked about second-hand smoke. .

"Listening to what you said, you should know the dangers of second-hand smoke!"

Li Jingsheng asked.

"I've been coughing a lot recently, and I'm a little out of breath. I'm afraid that I have a bad disease. I didn't dare to go to a big hospital for a check-up, so I searched for some relevant information on the Internet. I also asked doctors on the Internet , they told me that I must go to the hospital for examination as soon as possible, and also introduced me to two good hospitals. I told a friend about this yesterday, and he told me that most doctors online are not trustworthy.

It's a bit similar to a medical nurse, that is, people go to their hospital for examination and treatment.

Let me not be gullible, it is best to find a reliable hospital.

I just saw on the Internet a few days ago that many people said that your clinic is good, and Dr. Li Jingsheng has won many awards in medical skills competitions.I came here early this morning.

Sure enough, I found that there are a lot of people here. I heard some comments from patients waiting in line, and they all said that your medical skills and medical ethics are good.

I arrived relatively late, and now I'm finally in line. "

The patient recounted his medical experience in one breath.

"The main symptoms are coughing and difficulty breathing, right?"

"Yes. The phlegm has been stained with blood for the past two days."

He added another sentence.

"Siying, measure his basic physical signs."

After Li Jingsheng finished speaking to Han Siying, he looked at the patient again.

"How long have you had these symptoms?"

"It's been almost two or three months! Or a little longer. I didn't pay much attention to it at first. It wasn't until recently that the condition seemed to have worsened, and I thought about going to the hospital for a check-up."

"I'll listen to your heart and lung sounds. Just relax and breathe normally."

Li Jingsheng listened to his heart and lung sounds.

Brow wrinkled slightly.

This patient did have a problem with his lungs.

There is obvious wheezing, poor breathing or even cyanosis when coughing.

"Can we take a video and see?"

"can!"

The patient came alone. He probably trusted Li Jingsheng and readily agreed to the examination.

Li Jingsheng took X-rays for him.

A round lesion with clear borders can be seen on the chest X-ray.

The patient's lung lesions were located in peripheral areas and showed lobulation.

It was basically determined to be a single lesion, and the diameter was quite large, close to 4cm.

There was uniform calcification distributed in the center of the lesion.

He felt that this film was very diagnostic.It was filmed on the spot with a mobile phone.

"Dr. Li, how are you? I don't have a tumor, do I?"

The patient didn't even button his clothes, so he climbed up and asked nervously.

There are still many patients who are afraid of death!

"Uh... the situation should be pretty good. When I took the X-ray, I found a calcification lesion. The diameter is quite large, almost 4cm."

Li Jingsheng told the patient his diagnosis tactfully.

This patient's lesion is most likely a tumor.

But based on the feeling, it doesn't seem to be vicious.

He didn't dare to determine the nature of the lesion before doing a pathological examination.

Also, this patient's disease must require surgery to treat it.

There are often some fake doctors who deceive patients, saying that tumors will shrink or even disappear on their own.It can be cured by taking medicine or injecting medicine into the tumor.

No incision, no surgery.

There are still some patients who believe it.

The result can be imagined.

Currently, a variety of methods have been developed for tumor treatment, including targeted drugs and even a few specific drugs targeting certain cancers.

But the most mainstream treatment is surgical resection.

Then radiotherapy or chemotherapy is supplemented to achieve radical cure.

This is also the most mature traditional treatment method since the discovery of tumors in humans.

Has accumulated considerable treatment experience.

It’s much more reliable than what those fake doctors said about injecting drugs into it.

In addition, the recently invented treatment method of freezing tumors to death at extremely low temperatures and then crushing them has also achieved certain breakthroughs.It is expected to be applied in clinical treatment in the near future.

In general, there are more and more ways to treat tumors.

The experience also becomes richer.

"It's fine if it's a calcified lesion, but I'm afraid it's a tumor! It's okay, it's okay, it's a blessing among misfortunes."

After hearing this, the patient looked happy.

This is really a bit dumbfounding.

Li Jingsheng couldn't bear to tell him the truth.

He was afraid that he wouldn't be able to bear it and would get sick.

Han Siying, who worked as Li Jingsheng's assistant next to her, had a strange expression, and Li Jingsheng glared at her.

She had little work experience, and being young, she had no idea what the consequences of a small move might be.

After receiving Li Jingsheng's warning, she turned away and did not dare to say another word.

"Can you treat it here?"

The patient asked again with some urgency.

"Let's go out and talk!"

Li Jingsheng took the patient back to the clinic.

"The ideal treatment for your lesion is surgical resection. If you are willing to go to the Second Hospital for this surgery, I can help you arrange it."

"Is the Second Hospital a regular hospital? You can't cheat me!"

When the patient heard that he was going to have surgery, his expression became a little heavier.

Overall it was pretty easy.

"The largest hospital in the south of the city is the Second Hospital. It is a public hospital. There is no need to worry about whether it is legal or not. I also see that you trust me so much, and then I am worried that if you go online to ask those online doctors, you will be deceived and have problems. hospital. I just thought of making arrangements for you. You decide this matter yourself."

Li Jingsheng explained seriously.

The patient hesitated for a moment and finally agreed, "Okay, I'll listen to you. I'll leave this to you. When I cure the disease, I will definitely come over and thank you."

"You can just go directly to the Cardiothoracic Surgery Department of the Second Hospital to find Director Zhang. If his number is gone today, you can go to the outpatient clinic and tell him that I asked you to find him. You should be given a new number."

After Li Jingsheng gained a certain status in the Second Hospital, it became easier to arrange for patients to be hospitalized.

The second hospital itself also needs patients.

Director Zhang of the Department of Cardiothoracic Surgery has been interested in recruiting Li Jingsheng for a long time.

When the two met, they would chat warmly.

Director Zhang should be very happy to introduce a patient now.

And after the hospital leaders find out about this, their concerns about Sunshine Clinic will turn into a favorable impression.

Because Li Jingsheng introduced the patients received by the clinic, this was a sign of loyalty to the Second Hospital.

The patient left happily.

Li Jingsheng didn't write any note to him.

I am not familiar with the patient, so it would be inappropriate to be too enthusiastic.

Many patients and family members are quite suspicious. Sometimes they feel that doctors treat them very well, but they always feel that they have some agenda.

In fact, what can the doctor do?
Watching the patient go out, Han Siying couldn't help but ask, "Master, why didn't you tell him that he had a tumor? I looked at the X-rays and found that the chance of a tumor is very high."

"You are usually so smart, but why are you so uneducated? The patient is afraid that he has a tumor. Did you tell him that he had a tumor, and did you deliberately want to scare him?"

Li Jingsheng taught her a lesson.

She stuck out her sweet tongue and nodded with a sudden look on her face, "I didn't think about it. You often teach me not to deceive patients and their families, so I just wanted to tell him the truth. And looking at the movie, benign tumors are very likely to be big."

Her medical talent is very high.

He has strong understanding and learning ability.It also has a good theoretical foundation.

In addition, I met a master like Li Jingsheng, and my progress was rapid.

"Aren't you dogmatic? Just because you can't deceive patients and their families, doesn't mean you can't speak tactfully! As a doctor, you must not be stubborn, otherwise you will be complained by patients and family members every day, and you may get into trouble."

Li Jingsheng thinks she is good at everything, but she has a bit of a good student mentality.

She learned how the teacher taught her and did not dare to question what the teacher taught.

When many medical students first engage in clinical work, they are basically like this, walking on thin ice, trembling with fear, and strictly following the operations taught by the teacher.

Or follow the textbook.

As a result, in the fierce competition, they are often defeated by other medical students who are brave enough to diagnose or treat outside of the rules.

However, there are very few medical students who are bold and do not follow the rules.

Because it often requires the support of strong true skills to dare to act boldly.

It's definitely not possible to operate blindly.

(End of this chapter)