Gou is practicing medicine in the clinic

During the conversation with this person, Li Jingsheng was already secretly observing some of the patient's conditions.

In addition to finding the patient's scleral jaundice, he also found that the patient's palms also had obvious liver palm symptoms. Obvious red patches can be seen on the thenar and hypothenar areas of the patient's palms.

But the palm is white.

This is a typical clinical manifestation of liver palm.

"Your ideas are quite advanced. Now let's talk about your symptoms. Have you had any obvious symptoms such as loss of appetite, bloating, and diarrhea recently?"

Li Jingsheng asked the patient.

"I often have this symptom when I lose my appetite. My stomach occasionally feels a little bloated, but it's okay. I never have diarrhea."

The patient's symptoms are not particularly obvious.

This indicates that the disease is probably still in its early stages.

The liver is a silent organ. When something goes wrong with it, it is a little different from other organs. In the early stages, there are generally no symptoms or the symptoms are not obvious.

For example, occasionally you feel uncomfortable in your chest or feel a little bloated in your abdomen.

Malignant lesions in these two organs, the liver and pancreas, are the most terrifying.

The pancreas is a small organ, the liver is large, but it has almost no nerves, and it knows no pain. As long as problems with these two organs are detected, it is often already at an advanced stage.

As for some people who say that gastric cancer is also very scary, that is because patients are not very vigilant. When they experience stomach pain and discomfort, they think it is a minor problem and put it off for a while.

Eventually a minor illness turned into a serious one.

Li Jingsheng took the patient's temperature.

37.6 degrees.

About 1 degree higher than normal body temperature, low fever.

It's this damn low fever again.

Li Jingsheng already had a bad feeling in his heart. This patient's problem is likely a big one.

"Are there any strange bloody moles on your body?"

he asked the patient.

"Not found."

The patient shook his head.

Spider nevus is generally an obvious sign of liver disease.

Spider nevus is more likely to appear after liver problems.

Rheumatism, rheumatoid syndrome, and Cushing's syndrome are also prone to this nevus.

"Go and lie down on the examination bed inside, and I'll examine your abdomen."

After the patient lay down on the bed inside, Li Jingsheng felt a moderately obvious swelling in the patient's right upper abdomen.

Palpation results in other areas were fair.

Maybe he has been doing physical labor for a long time. The patient has obvious abdominal muscles and is in good shape.

At least compared to those middle-aged and elderly men with potbellies, he is considered very healthy.

"No big problem, right?"

The patient sat up and asked Li Jingsheng.

"I suggest you go to a major hospital to have your liver checked as soon as possible. The problem may be serious."

Li Jingsheng did not require patients to take X-rays in the clinic.

He definitely can't cure this patient's disease here. The characteristics of liver disease are very obvious, so just go to a large hospital for examination.

There is no need for patients to spend an extra hundred dollars here.

"Is there something wrong with my liver? I thought it was something wrong with my stomach."

The patient seemed relatively calm after listening.

At forty there is no confusion, at fifty one knows destiny.

Patients who are almost fifty years old may already have a relatively indifferent view of life and death.

"I'm not sure if there's something wrong with my stomach. There's probably something wrong with my liver. You can't delay this illness. If you delay it for a long time, something big will happen."

Li Jingsheng said seriously.

"Is it okay to go back in a few days? I have a lot of stuff in the scrap shop. I need to at least finish it before going to the hospital for treatment. In those larger hospitals, as long as you go in, there are all kinds of queues and various inspections. Spending money is like paper. To be honest, I really don’t want to go.”

Patients seem to be resistant to big hospitals.

"Uncle, how much money can you make by disposing of the waste in the store?"

"Uh...it's hard to say. If the market is good, it's no problem to make two to three thousand yuan."

"Then I can responsibly tell you that your disease may still be in the early stages. But if you don't pay attention, every day you delay, the cost of treatment may increase several times. It only costs a few thousand yuan to treat it, but you delay it for a few days. , there may be tens of thousands of dollars, but no hospital may be willing to accept it. Then make your own calculations and see if it is more cost-effective to go to the hospital after disposing of the waste, or is it more cost-effective to go to the hospital now? "

Li Jingsheng can only settle the account for the patient in this way.

"Is it so serious? Then I'd better go now! There are two children still studying. If I collapse, their tuition fees will not be covered."

The patient has been doing business for a long time and is not good at anything else. He is quite good at settling accounts.

His expression changed when he heard that if it took a few days, the treatment fee might double.

Without saying anything, he hurriedly left Li Jingsheng, probably rushing to the hospital for a check-up.

"Master, you still have a way to persuade people. If you hadn't persuaded him like this, I estimate that the patient had to stay at home for ten days and a half, which is a long time."

Han Siying looked at the patient's back as he hurriedly left, covering her mouth and snickering.

"Nine times out of ten, he has liver disease. If it's cirrhosis, it's probably liver cancer. If he delays going to the hospital for examination and treatment, he will really die. When you practice medicine in the future, as long as it's for As long as the patient is good, the process is not important.”

Li Jingsheng appropriately instilled in her some concepts of medical benevolence.

The disciples who have been taught must avoid formalism or acting too rigidly.

Can be flexible when dealing with different patients.

As long as it is beneficial to the patient's condition, scaring the patient or some white lies are advisable. Just as the patient was sent away, Li Jingsheng's cell phone rang again.

I took it out and glanced at the screen. It was Director Tian from the Gastroenterology Department of the People's Hospital calling.

The two usually don't have much contact.

Even if Director Tian recommends business to Li Jingsheng, it is basically through Lian Tao.

Because he knew that Lian Tao and Li Jingsheng had a close relationship and were good friends.

I called suddenly today. Is there an important colonoscopy patient you want to recommend to Li Jingsheng?

"Hello, Director Tian, ​​I guess you must have something good in mind for me."

Li Jingsheng greeted half-jokingly.

"There is really a special patient I want to recommend to you. A tumor was detected in the patient's ascending colon, which is basically a malignant tumor. The diameter is quite large, close to three centimeters. His situation is quite special and he may not be able to tolerate traditional Laparotomy. And because the tumor is large, it can only be removed piece by piece. The disadvantage of this surgical method is that it cannot ensure clean removal.

According to my personal medical experience, the possibility of postoperative recurrence in such patients is very high.

Your colonoscopy skills are excellent, and you often have some fantastic ideas. I want your help to think of a way to see if there is an innovative surgical solution that can solve this problem.

The patient is familiar with me, and his family is not short of money.

He also admitted that as long as he could cure his disease and avoid recurrence, he would be completely willing to spend tens of thousands or hundreds of thousands more. "

Director Tian introduced a big job to him.

Li Jingsheng is naturally interested in making money.

Buying a house and purchasing various equipment to build an endoscopic laboratory requires a lot of money.

A colonoscopy surgery costs tens of thousands, and the profit is conservatively estimated to be over 30,000.

As long as I can eat this job, I will definitely eat it.

"Must I give an answer now?"

Li Jingsheng asked.

"It's best to give a definite answer today, because the patient's tumor is already very large and he is very worried about metastasis. The sooner it can be removed, the better."

"Do you think this is okay? You send me the patient's information first, and I will give you a reply before seven o'clock in the evening. There are still dozens of patients who have not been seen, and I really don't have time."

"No problem, I'll send you the information and try to get a reply as early as possible. I'll communicate with the patient again."

Director Tian agreed.

Li Jingsheng is very interested in this high-end medical business.

As long as he opens up the situation, he can not only make money every day, but also quickly complete the initial accumulation of funds. You can also take the opportunity to build an elite team.

At present, we are still only making small progress in the field of endoscopy.

There are only four team members.

……

At about five o'clock in the afternoon, Yao Lu came again.

Still wearing the same outfit.

He was just carrying two bags in his hands, probably going to the mall to buy clothes.

She is still the same as before, buying and buying.

A materialistic woman who worships money is full of vanity and pleasure.

It was close to 6:20, and Li Jingsheng finally finished seeing the last patient. This man is a diabetic and has high blood pressure. He comes to Li Jingsheng to get checked out and get some medicine.

The patient's blood pressure was somewhat uncontrollable.

Because the patient already had a history of hypertension for nearly thirty-one years. Long-term use of antihypertensive drugs has caused certain harmful effects.

The patient's arterial atherosclerosis should also be severe.

In order to lower blood pressure, I started taking other antihypertensive drugs, and now I need to take them in combination.

In other words, he now needs to take multiple antihypertensive drugs at the same time.

Fortunately, the patient never became his own doctor and did not take antihypertensive drugs blindly. Maybe he also knows the dangers of taking antihypertensive drugs indiscriminately.

After all, you already have diabetes, and if you cause further damage to the kidneys, it will really make things worse.

Although diabetes is caused by a problem with the beta cells of the pancreas, it leads to elevated blood sugar.

But if you ignore it, or treat it incorrectly, it will soon progress to diabetic nephropathy.

This is a type of glomerular disease dominated by diabetic microvascular disease, which can eventually affect renal function and gradually develop into renal failure.

Many people think that diabetes will at best lead to skinny skin, and they simply don’t understand why diabetes can cause kidney failure.

In fact, diabetes is not treated promptly and correctly, leading to the progression to diabetic nephropathy.

This patient's situation is actually quite difficult, and it is difficult to prescribe antihypertensive drugs.

Fortunately, Li Jingsheng's current medical skills of medicinal efficacy and medicinal metabolism have reached the level of proficiency. According to the actual condition of the patient, it does not take much effort to prescribe the medicine.

After sending away the last patient, Yao Lu walked over directly.

"What's uncomfortable?"

Li Jingsheng asked calmly.

"I bought this dress for you. Thank you for being willing to add a number to me."

Yao Lu put the bag in her hand at Li Jingsheng's feet.

"I still remember your dress size. I saw it while shopping after dinner just now. I thought it would look good on you, so I bought it."

"If you come to see me for medical treatment, I welcome you. You can just take the clothes back and return them, I won't accept them."

How could Li Jingsheng accept the clothes she sent?

They are not children of two or three years old.

She wanted to use this method to please Li Jingsheng, which was too low-level. (End of chapter)