Gou in the operating room to add some upgrades

Chapter 233 The surprise of the outpatient clinic

Monday was the time when Fang Xian was scheduled to go to the outpatient clinic.

First of all, Fang Xian's current professional title recognized by the Medical Association is that of attending physician. With such a level, he can regularly attend outpatient clinics in the Affiliated Hospital of Xiangnan University, let alone Cixian People's Hospital?

After Fang Xian's multi-site practice application was received, he went to the outpatient clinic as a routine, which was nothing special.

Fang Xian is a counterpart support doctor. On outpatient days, he can go directly to the outpatient clinic, which is not considered an overstep. However, Fang Xian still went to the department to report in advance. After greeting the ward director Huang Bohang, at eight o'clock Before that, I rushed to the outpatient clinic.

Huang Bohang had taken Fang Xian to see the outpatient clinic before and told Fang Xian his own clinic in advance.

At this moment, a sign with his picture and the name of an expert from Shonan University Affiliated Hospital is visible in the orthopedic clinic.

Fang Xian had never been to an outpatient clinic before, nor had he had the opportunity to have an outpatient clinic with a teacher. But after thinking about his current corresponding theory, he felt that there would not be much of a mistake, as long as he read the films and inquired about the medical history carefully.

However, when Fang Xian arrived at the door of the clinic, he discovered that there were two beauties standing there at the door, each wearing white coats.

One white coat looks good, the other looks even better.

There were some good-looking people whom Fang Xian didn't recognize, but the other one who was even more good-looking was Zhou Xiyin who was wearing a mask.

Zhou Xiyin was walking towards Fang Xian at this moment: "Brother Fang, this is Dr. Du. He said that the medical assistant in the outpatient clinic was sent by the medical department to help you."

Fang Xian was wearing plain clothes at the moment, with his clean white coat hanging upside down on his elbows, and he scanned the other person up and down.

The person named Doctor Du's eyes suddenly lit up: "Teacher Fang, hello. My name is Du Rong."

"You can call me Xiao Du. Director Huang knew that Teacher Fang was visiting the clinic and asked me to come over and help." Du Rong's voice was charming, matching her figure.

But in the charm, there is an intelligence that Zhou Xiyin is absent.

Zhou Xiyin hesitated and said, "Senior Brother Fang, how about I go back to the ward first?"

Fang Xian's eyes flashed when he heard this, and he asked in his soul: "Dr. Du, do you know how to do a physical examination and write medical records in orthopedics? If so, Dr. Zhou can do the physical examination and you can record it."

"Do you know what Neer sign is?"

"Ah?" Where did Du Rong know where to go?

Neer's sign is part of the orthopedic sports medicine specialist physical examination.

Fang Xian said, "Thank you, Doctor Du. I'll write the medical records myself. You may not be able to write well for some specialist examinations in orthopedics."

"Please help me thank Director Huang."

Fang Xian refused directly. He must undergo a physical examination when visiting the outpatient clinic!Zhou Xiyin can do it, but the other party can't do it at all, so it's worth figuring out his purpose.

When the girl saw what Fang Xian said, she was stunned and nodded, and said, "Okay, Doctor Fang, let me help you maintain order."

Fang Xian said: "Doctor Du, I'm just a young doctor. I don't dare to act bigger than a professor."

"See the doctor first, let's talk about it next time."

After Fang Xian dismissed her, the time was about to reach eight o'clock.

When Fang Xian was sorting out his name tag and white coat, Zhou Xiyin said: "Brother Fang, there are many such arrangements in prefecture-level municipal hospitals, especially when I am in the trauma center of the No. 1 Civil Hospital in Chang City. After I left, there were a lot more young surgeons.”

Fang Xianxin said, regardless of your family background and connections, your appearance is a disaster.

But Fang Xian didn't say that if Zhou Xiyin wanted to go to the outpatient clinic, just follow him. After all, Zhou Xiyin majored in orthopedics and could help a little.

At eight o'clock sharp, Zhou Xiyin also let the first person in on time and said very skillfully: "Only one patient and one family member at a time. Everyone should line up regularly. Don't crowd."

“Everyone is crowded and everyone’s time is wasted.”

As soon as the patient came in, she closed the door, then sat down in the assistant's seat very actively, took the patient's medical record in front of her, and wrote the header very seriously and carefully: date, department of treatment.

"Old man, what's wrong with you?" Fang Xian was slightly startled by Zhou Xiyin's professional skills, but he didn't say much. Maybe Zhou Xiyin also knew that he had no experience in outpatient clinics, so he opened an opening first.

Be the first to show up, rather than pretending to be low-key.

Zhou Xiyin's basic skills were so solid that Fang Xian even doubted whether she was also a cheater. She asked questions very accurately and tactfully, and more importantly, her voice was also very sweet.

Moreover, when she was working seriously, an inexplicable smell from her body would hit her nostrils, which would occasionally make Fang Xian's consciousness slightly blurred.

"I have a lot of pain here. I have been in pain for a long time. I have been to many hospitals, but they all said it is incurable. I also came here last time, but Director Huang said that this week, an expert will come and let me I came here specifically to take a look." The old man, who was about 60 or [-] years old, pointed to his hip as he spoke.

Standing next to him was his son, who patiently waited for his father to finish speaking before adding anything.

"Dr. Fang, I took my father to the Shonan University Affiliated Hospital before. He was told that he had femoral head necrosis and that he needed surgery to replace the joint."

"I'll come and see, what's your opinion." He was standing, carrying a large bag of examination materials, which contained X-rays, CT, and MRI.

After Zhou Xiyin nodded to express his understanding, he asked: "Since the pain lasts for such a long time, the professor at the Shonan University Affiliated Hospital recommended joint replacement surgery. Why don't you do it?"

Zhou Xiyin did not touch the checklist, but Fang Xian focused his attention on the old man's X-rays and various examinations, and frowned fiercely.

With such a collapsed femoral head, how can this old man walk to the clinic?

Auxiliary examination is an important tool for judging the severity of the condition. From the tool, it can be roughly inferred the severity of the patient...

Fang Xian turned around, looked straight at Zhou Xiyin's inquiry, and listened to the answers one by one. At the same time, he assessed the approximate identities of the old man and middle-aged man through their clothes.

The middle-aged man was wearing a shirt, formal pants, and a watch that was probably valuable.

His tone of voice is polite and courteous, and his education is not bad. He is either rich or has read a lot of books, so his life will definitely not be burdensome.

But the implication behind the words is that he actually wants his father to solve the current pain through surgery or other methods.

The old man was probably in his 60s. When he heard this, he stepped back and shook his head like a rattle: "I don't do surgery, I don't do surgery. Surgery requires the bones to be replaced, so I won't do it." "

After shaking his head, he looked at Fang Xian with some disappointment in his eyes and said, "Doctor Fang, actually you don't have to be embarrassed. I know my own disease very well. You just need to prescribe something for me." Painkillers will be fine, but I won’t do surgery.”

Before Fang Xian could answer, Zhou Xiyin reached out and comforted her with a sweet tone: "Si Si, please don't get excited. Let's talk slowly."

"Your condition is very serious now. Every step you take is suffering. But your situation is not complicated. After the operation, you can return to normal. What are you thinking?" At your age, it should be time to take care of more children and enjoy family happiness."

Fang Xian was equally puzzled. Logically speaking, the old man's family background was not bad and his knowledge was not shallow.

However, Fang Xian knows that being in the outpatient clinic is not only a manifestation of medical technology, but also an experience of various aspects of life. He was absent from the early experience, and now that Zhou Xiyin is the first to stand up, he may be more objective.

When the old man heard this, he was obviously moved, but he still shook his head firmly.

"I don't want to have surgery, I won't do it."

The middle-aged man sighed slightly and explained in a low voice: "Dr. Fang, this is actually the case. It's mainly my fault."

"My mother died accidentally due to surgery, so maybe my father was a little afraid of surgery."

The old man stood up and was about to leave: "I don't want to do surgery, I don't want to do surgery."

He staggered out anxiously. Seeing this, the middle-aged man hurried over to help him, with a look of helplessness on his face.Zhou Xiyin didn't know how to respond, so he turned his head and looked at Fang Xian, probably asking whether he should stop him.

Fang Xian said: "Compile all the patient's examination information and return it to them."

Fang Xian was unable to understand the past between the old man and his son in just a short time at the outpatient clinic.

Or maybe the old man was afraid of his wife leaving, so he didn't dare to take risks. He had a kind of fear from the heart about the operation.

After Zhou Xiyin packed up, he was about to go out, but Fang Xian snatched the flat film from his hand and said, "I'll deliver it to you. You can lead the next patient to the consulting room."

Zhou Xiyin nodded and said yes.

Fang Xian pushed open the door and chased out, holding the registered number in his hand.

After catching up with the old man and the middle-aged man, Fang Xian smiled and said, "Your films have been left in the outpatient clinic. In addition, you should withdraw from this registration. I'm sorry that I can't help you."

The middle-aged man took Fang Xian's flat bag, said thank you, and explained: "Doctor Fang, it's okay."

"Dad, let's go home, no more surgery." The middle-aged man apologized to his father with red eyes.

He is full of helplessness. He is not short of money or time now, but he just doesn't know what to do to deal with his stubborn father at home...

Fang Xian saw that the old man's legs were still shaking slightly, which must have been caused by pain.

The necrosis of the femoral head has collapsed to such an extent that even being able to walk and stand occasionally is already enduring great pain.

The old man and his son walked resolutely towards the elevator, obviously not wanting to look back.

Fang Xian could only turn around and return to the consulting room.

When the doctor does not knock on the door and the patient has his own persistence and choices, he must not regard himself as the savior.

In fact, the treatment for this patient is very simple, a joint replacement, which only takes a few days.He can probably still play chess in the park for another 20 years, but?
After briefly ignoring the patient, Fang Xian returned to the consulting room.

The second patient was younger, about six or seven years old. He was a little boy. He was quite ignorant. When he saw Fang Xian and Zhou Xiyin in white coats, he was very scared and hid behind his father. Somewhat Timid.

The person who brought him here was a middle-aged man, very simple and honest, dressed plainly, caught the child out, and took the initiative to purse his lips and said: "Doctor, this is my son."

"I also took him to many hospitals, but found nothing, and they all said it couldn't be cured. I heard that another great expert came from the county, so I thought about taking him to have a look."

As he spoke, he exposed the wrists and feet of the child in long-sleeved trousers!
Then I saw that the child's right forearm and the middle of the thigh of the left lower limb were extraordinarily slender, and there was a curved deformity.

Seeing this, Zhou Xiyin felt a little better. She put on gloves, carefully held her right forearm, and looked at it carefully in front of her eyes: "Have there been any fractures?"

The middle-aged man nodded: "It's easy to fracture, and you can't even touch it. A little force will cause a fracture. I have fractured several times before."

"Osteogenesis imperfecta (brittle bone disease)!" Zhou Xiyin just thought for a moment and then said casually.

It can also be called porcelain doll disease. It mostly occurs in children. The bones are very fragile. A little external force can cause fractures. At present, there is no special treatment method...

Fang Xian said: "Let's take a look at the plain film first."

Zhou Xiyin took the initiative to stand up and spread out the flat film. It can be seen that the bones of the child's affected limb are like a bow, with a slender diameter, osteoporosis and a small medullary cavity.

After reading it, Fang Xian asked: "How old did this start? Which hospitals have you been to before?"

"Are you 4 years old? Every fracture is not serious, just put a plaster on it and it will be fine. I have been to Shonan University Affiliated Hospital and hospitals in Guangdong Province, and they all said that there is no specific treatment method. You can only pay more attention." The middle-aged man replied.

"Doctor Fang, there's nothing I can do about it."

Such a disease is prone to fractures, even spontaneous fractures, and fractures occur without doing anything.

However, most fractures are greenstick type, with less displacement, mild pain, and fast healing. They are completed by subperiosteal osteogenesis. Malunions are common, and the limbs are often bent or angled. Generally, after puberty, the number of fractures gradually decreases...

After searching through these knowledge reserves in his mind, Fang Xian nodded and said: "There is indeed no better way to treat such bones. If there are no fractures, most of them are to pay attention to care, and then let the child grow to adolescence and usher in the second generation. In the secondary growth phase, after bone remodeling, it will be better.”

"However, the bones are very fragile. Maybe the heavy schoolbags you carry at school will cause fractures. It is quite troublesome for you to take care of them, but parents still need to be careful."

The middle-aged man nodded: "Yes, that's how it is. I kept him with me all the time and didn't dare to go out. Once before, on the way to school, his grandfather broke his bone while walking with him. Now it's me Send him to the classroom with his schoolbag on his back."

"Then the teacher set up a special cabinet for his schoolbag to store, and he didn't dare to bring his homework home, and he didn't dare to let him play with other children, so he was very withdrawn."

In fact, it's not that he is withdrawn, the main thing is that he also confessed that the child should not play with other people, and other parents also confessed to their children to stay away from this porcelain doll.

The child did not speak, but looked at Fang Xian with a little fear. However, his eyes actually showed a kind of ignorant curiosity, and a kind of longing. This longing look made both Fang Xian and Zhou Xiyin move in their hearts.

But Fang Xian hasn't spoken yet.

Zhou Xiyin suggested: "It is difficult to treat this disease, but there are some special auxiliary tools. Do you want to try it? It is to customize a set of braces for the child, which can assist and protect his activities, so that you can also I can feel a little more at ease.”

"There is just one problem. This brace may need to be replaced every year, and the cost is not low. If your family can afford it, I can give you a suggestion. It may be useful, but if there are certain difficulties, forget it. ." Zhou Xiyin's voice was not loud.

Fang Xian glanced at Zhou Xiyin in surprise, thoughtfully.

This week Xiyin, what kind of brace are you thinking of?Why don’t I know the basic theory of trauma surgery at Level 5?

(End of this chapter)