Gou is practicing medicine in the clinic

After doctors have been engaged in clinical work for a long time, as their diagnosis and treatment experience becomes more and more abundant, they are fully capable of diagnosing whether the patient is sick through some typical signs of the patient.

Nails have vertical lines, white spots, and half-moon marks disappear. Generally, there is no direct scientific basis to prove that these are manifestations of disease.

However, clubbing of fingers, unless it is congenital, is most likely a manifestation of lung, heart and other diseases.

The simplest and easiest way to check whether you have clubbed fingers is to bend the two fingers of your left and right hands with the nails back to back.

Then observe whether there is a gap between the two fingers.

The thumb is the easiest to observe.

Because normal people's thumb pairs are close together, the prismatic gap in the middle is the largest.

Li Jingsheng continued to diagnose other patients.

"Doctor, can you help my husband look at this mass on his chest?"

The patient was in his mid-twenties and looked very young.

The woman next to him who is called the patient's wife looks a little older, and she should be around thirty years old by visual inspection. Probably several years older than the man.

It is common for older men to marry a wife who is several years younger than him.

But it is relatively rare for a man to marry a woman who is several years older than him.

At most, the girl is a few months older than the boy, about one or two years old.

Because as women age, their aging will continue to accelerate. A man in his forties may still be very young and look like a flower. Forty-year-old women often look old without makeup.

"Come inside and I'll check it out for you!"

Considering the patient's privacy, Li Jingsheng took the patient into the examination room at the back.

If possible, it would be better to set up a separate outpatient room like a hospital and let patients wait outside.

Sunshine Clinic now connects two rooms to create a large reception hall.

All patients waiting in the waiting area sit in the rest area or stand in line in front of four consultation tables. When there are many people, you may even need to queue outside.

This also has some advantages.

Every waiting patient can clearly see whether the doctor is treating the patient.

I won’t complain because I waited too long, wondering if the doctor was scrolling through his phone again or doing other things. They didn't call a new number for half a day.

Also, a large number of patients waiting in a hall can increase the popularity.

I believe that the vast majority of patients come here for treatment. Seeing the busy and crowded scene, they will subconsciously think that the clinic's medical skills are good. Otherwise, it would be impossible for so many people to come to seek medical advice.

Having a good first impression is conducive to mutual trust between doctors and patients.

Doctors' diagnosis and treatment work has great benefits.

Things that impressed Li Jingsheng deeply, such as asking patients to take a X-ray for 100 yuan, required a lot of ideological work.

In the end, some patients are still unwilling to undergo this examination.

But now there are many patients waiting in line for treatment. Basically, as long as the doctor requests an examination, the patient will agree.

The doctor doesn't need to say anything at all.

Li Jingsheng took the patient into the examination room at the back and asked him to lie down on the bed. After unbuttoning, you can see that the patient's left breast is significantly larger.

If you are an obese man, your breasts will develop to a certain extent.

There's more fat in it.

This male patient is not obese. After all, he is only twenty-four or five years old, very young.

"Does it hurt?"

Li Jingsheng tried to press it. The texture was hard and had a wooden feel.

And it can move slightly.

The diameter of the mass was roughly estimated to be over four centimeters. This is already a relatively large package.

Clinically, 0.5cm, 1cm, and 5cm are the most commonly used diameter classification grades for masses.

A mass or polyp of 0.5cm is generally considered to be a tiny mass. As long as the edges are clear and there are no signs of malignancy, treatment is usually not performed.

A mass that reaches 1cm in diameter is still just a small mass.

At this time, it depends on the situation to make a decision.

At least it will attract the doctor's great attention, and the patient will be asked to review it every six months or one year.

If the mass reaches 5cm in diameter, unless it is in the abdominal cavity or chest cavity. Otherwise, the patient himself can easily touch it and feel very scared.

If such a large mass is in the chest, even if it cannot be touched, it will cause obvious discomfort to the patient.

Because it will squeeze other organs, such as the pericardium, lungs, liver, etc.

"It doesn't hurt or itch."

the patient replied.

"But when I wear less clothes in the summer, I feel quite embarrassed. My colleagues will give me strange looks."

There is such a big lump on his left chest. He is a young man with a standard body shape. He wears few clothes, so it is indeed easy for others to look at him curiously.

"How long have you had this lump?"

Li Jingsheng asked.

"It's been almost two years. At first it was only about the size of a peanut, but recently it seems to be growing very fast, and it feels like it's getting bigger and bigger. Doctor, I checked on Baidu online, and they said it's possible for breast development in females. It’s caused by excessive hormones. Is that what it is?”

the young man asked.

There are many younger patients because the Internet is now highly developed.

When they have physical abnormalities, they often choose to check online. If you really have a problem, it is recommended to make a call and go to the hospital to ask the doctor.

A lot of popular science content on the Internet is written by professional medical professionals. The content is correct, but it may be wrong when applied to different potential patients.

Moreover, the symptoms of many diseases are highly consistent, and even professionals, let alone non-professionals, may misdiagnose them.

"Have you ever gone to the hospital to check your estrogen levels?"

"No!" The young man shook his head and continued.

"My wife was worried that it was a tumor. She found out that your clinic is responsible for patients, and because it is very close to your place, she forced me to come here."

"Just be content with a wife who cares about you so much! The mass is already so big. If it's something bad, wouldn't it be dangerous if you drag it on any longer?"

Li Jingsheng thought it was good for this young man to marry a wife who was a few years older.

At least the wife knows how to take care of people.

"How about I give you a B-ultrasound first? It doesn't feel good. It's probably not breast hyperplasia."

Li Jingsheng knows very well that breast hyperplasia usually causes pain, and even the patient cannot lift his arms.

And it happens more often in women.

Especially women in their forties and fifties are at high risk.

This patient is a male and only in his twenties, so the possibility of breast hyperplasia is relatively small.

"Don't scare me, okay? I don't feel any pain or itching. It doesn't affect my eating, sleeping, etc. How could it be a bad thing?"

The man didn't care much about the lump.

Now it has affected his Xia Tian image, otherwise, he would probably not even bother to see a doctor.

"Every word our Dr. Li says is for the benefit of your patients. If I didn't think it was very risky, I wouldn't say this to you. I suggest you take a X-ray to see."

Han Siying was standing by to help the master speak.

After several months of internship at the clinic, she made great progress.

It’s not just about improving medical skills.

There has also been significant progress in communicating with patients and family members.

Like now, she knows how to help Li Jingsheng speak at the right time.

"Okay then, let's take a video and see."

The young man agreed.

Sure enough, women are very efficient at breaking the ice when dealing with men.

Especially when young and beautiful girls interact with men, men tend to become particularly cheerful.

After going out, the young man told his wife the situation.

He didn't care, but his wife turned a little pale.

"Doctor, we will definitely listen to you. Please take the trouble to check my husband. Please."

The woman almost begged.

"Okay, okay, you sit down and have a rest first and drink a glass of water. I will definitely check it carefully for your husband."

Li Jingsheng can feel that the woman cares about her husband's health very much.

Take the man to the medical technology room for a B-ultrasound.

The boundary of the mass is not clear, but it is not the typical unclear shape.

Overall, it looks okay.

The shape of the mass is quite regular, oval.

No hypoechoic lesions were present.

Li Jingsheng couldn't help but wonder. Could it be that his judgment was wrong?

Except for the slightly unclear boundary of this mass, everything else is fine.

He touched it again and checked carefully. The wooden feeling was still there. The mass is hard, and the texture does not look like inflammatory hyperplasia. It is slightly similar to the pimples that usually appear in breast hyperplasia.

Li Jingsheng also has a unique trick, which is to touch the bones.

I tried touching the nearby ribs and found no obvious lesions. The bone quality is pretty good. This is healthy.

"Okay, put your clothes on."

Li Jingsheng said to the patient.

"Doctor, what's going on? Is this mass serious? What is it?"

"It feels a bit like a hard lump due to breast hyperplasia. The B-ultrasound results are okay, but I still recommend that you go to a major hospital for a checkup."

Li Jingsheng must fulfill his obligation to remind.

This phenomenon was also the first time he encountered it from Doctor Cliff.

If the mass is really something bad, but after the patient is examined by him, he will tell the patient that the examination result is normal.

The patient didn't care much about the mass in the first place, and he will only care less about it when the time comes.

It's really a malignant tumor, and that's a disaster.

The five-year survival rate for breast cancer is very low.

However, if discovered in time and surgically removed, the risk of death will be greatly reduced.

Just like cervical cancer, many women become angry when they hear about it.

In fact, it is considered a very friendly cancer.

Liver cancer and pancreatic cancer are much more terrifying.

In addition, the mortality rate from esophageal cancer is also extremely high.

Basically, cancers that tend to metastasize and relapse have a very high risk of death.

After coming out of the medical technology room, the patient's wife stayed outside the door and did not wait in the reception hall.

She looked anxious.

"Doctor, are my husband's test results okay?"

"The B-ultrasound results are pretty good, and no obvious lesions were found, but I am still worried that this mass is something bad. Because my clinic has limited conditions, I suggest you go to a large hospital for a biopsy. Because if it is malignant, I am worried If you delay it for a little longer, you will directly lose the chance of surgery." (End of Chapter)