Gou is practicing medicine in the clinic

"Have you been to the hospital for examination or treatment?"

Li Jingsheng asked the patient.

It stands to reason that after a patient breaks his leg, as long as the pain persists, he will definitely go to the hospital.

No matter how naive you are, you will go to the drugstore to buy safflower oil, bone-setting water and the like.

It shouldn't be possible to have been in pain for more than a month and still be very calm and ignore it as if nothing was wrong.

"I saw it in the drugstore and bought it for more than 100 yuan. I'm still using it now! It just doesn't work very well. Plus I'm quite busy at work, so I keep putting it off."

"It's been hurting for more than a month, and you've just been dragging it out?"

Li Jingsheng asked him.

"There is nothing I can do. We have children to raise at home, and with the mortgage and car loan, my wife and I can't even make enough money together. Although I can earn 9000 yuan a month, when the market is good, I can earn around [-] yuan. , but the child went to a foreign language school and learned piano, dance, and calligraphy, which was very expensive."

The man complained to Li Jingsheng.

There are many patients who like to complain to medical staff.

Many of them are suffering in their hearts and simply want to find someone to talk to and get some comfort and sympathy.Some people deliberately talk about their difficulties and ask doctors to prescribe less medicine and try to use substitute medicines.

After all, doctors have a lot of decision-making power when it comes to how much treatment a patient will have to spend when he enters the hospital.

Just two random tests, such as 24-hour blood pressure monitoring, are enough to cost hundreds of dollars in bleeding.

The second hospital charges 24 yuan for 240-hour blood pressure monitoring.

This kind of similar inspection is actually very flexible.

Unless the patient's situation is special or the condition is serious, this examination may be necessary.

Otherwise, you can do it or not.

Anyway, from the doctor's perspective, as long as it meets the indications for a certain examination, it can be prescribed.

Doing more tests can reduce misdiagnosis and misdiagnosis.

But from the patient's perspective, 240 yuan is a considerable expense if all is paid for out of pocket.

In addition to some other laboratory tests and examination fees, the disease has not been cured, and the cost is more than 1000 yuan.

This man's monthly income can reach [-], [-], or even more than [-], which is considered a high income.

But looking at the clothes he wears, they are indeed quite simple.

"How many children do you have?"

"There are still a few, but just this one, I feel a little unable to support it."

The man replied.

"Is the foreign language school that kind of private aristocratic school?"

"Yes! Isn't it important for children to learn foreign languages ​​from elementary school? We also sent her to a foreign language school that costs 13 yuan a year. The teachers there are basically foreign teachers, and they usually communicate with each other. Communicate in a foreign language and have a good language learning environment. Alas, it’s a bit expensive, but as long as the child has a future, it’s worth it.”

The mentality of men is the voice of many parents.

All for the children.

In Li Jingsheng’s view, investment in education is definitely very important.But you also have to act within your capabilities.

Private aristocratic schools are very expensive and cannot be afforded by ordinary families.

There are also some expensive extracurricular trainings, many of which are proper IQ taxes.

Some people spent more than 70 yuan to hire one-on-one private tutors to help their children with their homework.As a result, the child only scored more than 30 points in the exam.The parents were furious and took the personal trainer to court.

There are quite a few cases like this.

Not to say that all personal trainers are useless, at least the ones that are particularly expensive have a higher probability of IQ tax.

In addition, this patient has enrolled his child in three specialty tutoring classes. Will the child be able to learn from it?
No specialty tutoring class is cheap.

Of course, this kind of thing is a family matter, so Li Jingsheng will naturally not comment on it.

"Where was the left leg injured when you fell?"

Li Jingsheng asked briefly and quickly changed the subject.

Otherwise, this bitter father would be able to chat for an hour or two without any problem.

"Here, this is where the ankle is."

The man lifted his trouser leg up a little and pointed it out to Li Jingsheng.

"Where does it hurt now?"

Li Jingsheng asked.

Just now I saw a man walking and he could hardly use his left leg.

It means the pain is very severe.

"It seems like this whole area hurts. Especially when I stand on my left leg, it feels like there are pins and needles."

"The pain is so severe, why don't you let your wife or other family members come with you? It's very dangerous if you fall."

Li Jingsheng had already squatted down and began to examine the patient's left leg.

"My wife earns 7000 yuan a month, which is a pretty good income. Even she usually works a lot of overtime. I saw that she was very busy, and the pain was really bad today, so she came here by herself. The main reason is that we both have a lot of time off. At least it’s the same day.”

The man explained.

Li Jingsheng found that there was no abnormality in the injured area of ​​the man's ankle, and there were no hematomas or bruises.Just a little above the ankle bone, a remnant of faded pigmentation is seen.

It shows that this was the location where the injury occurred.

"Pull the trousers up a little further, and I'll show you the whole calf."

He couldn't tell yet whether the bones in his ankle were injured, causing pain in his entire left leg, or if there was another problem.

One thing is certain, no matter how injured the left leg is, it will not cause pain in the right hand.

When the man rolled up his trouser legs, he showed a pained expression with his right hand.

It shows that there is also something wrong with his right hand.

What could be the problem?

Based on Li Jingsheng’s clinical experience, I really can’t figure out why my right leg hurts when my left leg is injured?
As a result, he just pinched the patient's calf.

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

The patient was a 37-year-old man. If the pain hadn't been severe, he wouldn't have been so squeamish.

Li Jingsheng tried to pinch the patient's ankle bone again, especially to check the ankle joint.

He found that the bone position and bone quality of the ankle joint were normal.

The possibility of ankle joint displacement can basically be ruled out.After carefully touching the bones, there seemed to be no obvious fractures in the ankle bones.

This is strange.

The injury was obviously on the ankle, so why did it turn into calf pain instead?
"Do you still remember the specific day when you fell?"

"On the 12th of last month, I remember that the company paid wages on the 15th. At that time, I was still thinking that if there was any problem, I would wait until the wages were paid before going to the hospital for treatment. If that didn't work, I could borrow it from someone and I could pay it back in three days. "

This eldest brother's life is really hard.

Obviously I have eight or nine thousand a month, and my wife has six or seven thousand. After deducting taxes and social security, the total is [-].

But the family didn't have any savings.

This family financial situation must be very unhealthy.

After all, they are already 37 and eight years old.

Li Jingsheng really wanted to say that the cultivation of children is very important, but it is best to do what you can.

For any family, the adults are the most important.

When buying insurance, give priority to adults.

Because if an adult has an accident, becomes ill, has no money for treatment, and leaves the child behind, the consequences will be unbearable for the child.

On the contrary, if you give priority to buying insurance for the adults, even if the child does get seriously ill unfortunately, there will not be unbearable consequences.At worst, it's not about debts and fundraising, but it's also possible to treat children's illnesses.

Li Jingsheng did the math and found that the patient fell and was injured on the 12th of last month, almost fifty days ago.

This has been well over a month.

"Does your thigh hurt?"

Li Jingsheng asked the patient.

"It seems to be a little painful."

"Then let me check it for you!"

When he pinched the patient's thigh and femur, the patient screamed in pain without even applying any force.

In addition, he also found that the patient's left lower limb seemed a little swollen.

When pinching, the blood vessels inside feel a bit hard.

Can't tell.

In short, the legs of normal people must feel softer in a naturally relaxed state.

But this patient's muscles are a bit hard deep inside.

It indicates that there is probably a problem with the blood vessels.

"Do you have any pain in your waist or abdomen?"

"No pain!"

Go lie down on the examination bed inside and I'll give you some pressure on your abdomen.

Li Jingsheng asked the patient to go inside and lie down.

Patients' judgments are sometimes inaccurate.Especially when there are multiple pains in the body, they may be relatively insensitive to some less obvious dull pains.

The patient's waist, abdomen, chest and other trunk areas were examined, and no abnormalities were found.

No obvious tenderness or the like was found.

There was no swelling of lymph nodes in the patient's armpit or groin.

It indicates that the problem should be concentrated on the left lower limb.

"Does your right leg hurt?"

"It doesn't hurt, only my right hand hurts."

The patient shakes his head.

Out of caution, Li Jingsheng examined the patient's entire right lower limb.

There was no pain in the right leg.

"Let me show you my right hand."

Have the patient remove his coat and examine his right hand.

There were no obvious signs of trauma, but the patient had faint redness in the veins of his right elbow.

This is a very special representation.

Superficial veins in normal people are cyan and not red.

"You fell and injured your right hand?"

"Probably not. It was about a month after the fall that my right hand started to hurt. In the past two days, the pain has become more and more painful. Do you think this is strange? Even if you really hurt your right hand, it will only hurt the next day at most. It will hurt. How could it take a month for it to start hurting?"

Even the patient himself found this symptom very strange.

"Let me check the muscles and bones of your right hand."

Li Jingsheng tried to squeeze it, and the patient screamed again.

Very similar to the pain in my left leg.

And there is also the phenomenon of muscle contraction.It feels hard, but it is somewhat different from the muscle contraction caused by spasm.

Muscles in spasm may feel as hard as stone.

This patient's situation is really strange.

"In this case, you go and take a vascular color Doppler ultrasound first. When it's finished, just come in and see me with the results."

Li Jingsheng gave the patient an application for color ultrasound examination.

Color Doppler ultrasound is quite useful for checking blood circulation.

Generally used as a primary examination method, it is often used in clinical practice.

The fees are also relatively low.

Patients may not be able to accept CT right away, or even enhanced CT.It also doesn't comply with regulations.

Based on the initial examination of this patient, Li Jingsheng believed that there was the greatest possibility of a blood vessel problem.

But if there is a problem with the blood vessels, why does it cause pain in the right hand?

Moreover, the veins on the inside of the right elbow are red. What is the cause? (End of chapter)