I run a clinic in the United States

Chapter 387 Why are so many people here?
Iris Clinic, Internal Medicine Clinic.

Suddenly, a large group of people rushed in, and Rachel and Yennad were startled.

Behind those people, Jin Jizhen followed closely, shrugging apologetically at the two doctors in the clinic to express her apology. Because she couldn't stop it just now.

"What's wrong? Dear Rubio... family." Dr. Yenard asked.

Because there were eight people from the other party's family, including Rubio and his wife, Rubio's grandparents, two Rubio children, and the children's grandparents.

The day before yesterday, Mrs. Rubio had a regular physical examination at Dr. Yenard. Dr. Yenard received the report in the morning, but had not had time to read it. Because these days are too busy.

Yernard believes that Mrs. Rubio has always been in good health and energetic. Her previous physical examinations were quite normal, and there should be no major problems this time.

Therefore, Dr. Yenard did not rush to see Mrs. Rubio, but first read the reports of several other clients.

"Dr. Yenard, I'm going to die, I'm going to collapse, please help me quickly!" Mrs. Rubio looked frustrated, her eyes were red and slightly swollen, and there were still tears on her face. It was obvious that she had just died not long ago. Cried loudly.

"Don't be anxious, don't be anxious, sit down and talk slowly." Jenard was also panicking, not knowing what was going on, and quickly asked the other party to sit down.

Zhou Qiao explained with a smile: "In fact, in clinical practice, tumor markers are just a monitoring indicator, which does not mean that they are equated with tumors. In addition to tumors, there are many other diseases that can cause these indicators to exceed the standard. of."

Even the "chronic disease" type of cancer is quite troublesome. The quality of life in the future is absolutely different from that before the disease.

"Dr. Zhou is here. Come on, I'll take you to his clinic."

It's not that they can't trust Rachel and Jenard, but that this matter is too urgent and important. Now that they are here, they should go directly to the best doctor here.

During the physical examination, the other party screened for some cancer indicators. Because here in the United States, early cancer screening is relatively common.

With Zhou Qiao's comfort and invitation, the Rubio family walked out and came to the rest area, finally breathing a sigh of relief.

The report shows that there are two abnormalities in Mrs. Rubio's indicators. One is that the carcinosaccharide antigen 125 is elevated to 50U/mL (normal value should usually be <35U/ml), while the carcinoembryonic antigen (CEA) is elevated. to 16ng/mL (normal value should usually be <5ng/mL).

"Wait a minute, let me take a look at the report. I'm sorry, Mrs. Rubio, I've been too busy these days and haven't had time to read your report. I think you've always been in great health..." Dr. Yenard explained, and then, without waiting for her, After calling up the electronic version of Mrs. Rubio's report, Mrs. Rubio took the initiative to hand over the paper report.

Since Mrs. Rubio has no particularly obvious symptoms for the time being, there is no treatment for uterine fibroids. It is only recommended that fibroids be checked every 3 to 6 months. If the fibroids are found to be enlarged or symptoms appear, treatment should be considered. It can be treated with medication or surgery.

Other diseases can be delayed, but this cancer cannot be delayed.

The results came out, and sure enough, there were no major problems, except for relatively small uterine fibroids and intestinal inflammation.

Although many types of cancer have become "chronic diseases" in the United States and their mortality rates are not that high, there are also many tumors, especially in the middle and late stages, that can kill people. The kind with extremely low survival rate.

"Of course, follow-up investigations will definitely be carried out, but you don't need to be so nervous, you can just relax."

Rachel said: "This needs to be investigated carefully."

Then, Jin Ji really wanted to invite the rest of the Rubio family to sit outside because the clinic was too crowded, but they all shook their heads.

Although there is still a possibility of tumor, seeing how Dr. Zhou is chatting and laughing, it seems that the possibility is relatively small.

"Doctor Zhou, it's like this..." Yernard briefly explained what happened, and then handed the paper report in his hand to Zhou Qiao.

The moment Mrs. Rubio got the report in the morning, she almost collapsed, and then quickly called her husband. Then, the husband notified his parents and his wife's parents. Everyone was anxious.

"Come on, Jin Jizhen, let's make coffee and black tea for everyone, and some donuts."

Such an important indicator was suddenly exceeded. It's no wonder that the other party's entire family mobilized their troops and immediately came over for consultation.

Dr. Yenard took it and took a look, and was also surprised. Indeed... something was wrong.

As for intestinal inflammation, it should disappear after taking medicine for a week.

However, the black girls saw that they were not here to cause trouble, but just for consultation, so they all retreated.

While talking, Zhou Qiao appeared at the door.

He didn't bother to make an appointment, since it was so close anyway, so the whole family just came over.

If it is in the late stage, then the sky will really fall.

Jin Jizhen also wanted to hear what was going on here, so she didn't force herself and stayed.

Not only him, several other free doctors also came over to see what was going on.

Everyone else was watching Zhou Qiao closely, especially the Rubio family, who were quite nervous.

Suddenly a large group of people rushed in, and the whole clinic was alarmed. A black girl from the laundry next door also appeared at the door.

"I think I have a tumor. I don't know if it's early stage or late stage. If it's late stage, it's really..." Mrs. Rubio said with a sad face.

"Huh?" The Rubio family was confused, thinking to themselves, could Dr. Zhou have misdiagnosed? If this drags on seriously, it will be terrible.

Zhou Qiao was right.

"Rachel, what do you think?" Dr. Yenard was unsure for a moment and asked Rachel.

Unexpectedly, Zhou Qiao flipped through the report and said with a smile, "It's okay, it's not a big problem."

And they also came to their senses at this time, taking a step back, even if it was a tumor, it was not detected in the previous physical examinations. If it was detected this time, it must be in the early stage, right?
In the end, Zhou Qiao personally arranged a series of investigations on these two indicators for Mrs. Rubio.

The Rubio family are also regular customers of the clinic and are serious residents of the nearby community. The kind from a good family.

Early detection means early treatment.

Dr. Zhou is one of the top doctors in North America. His opinions are very important and more convincing.

"For example, the cancer carbohydrate antigen 125 may be related to uterine fibroids or some gynecological diseases, while the carcinoembryonic antigen CEA may be related to intestinal polyps or inflammation."

"Is Dr. Zhou here? Can Dr. Zhou look at it for us?" Mr. Rubio said.

Sure enough, a recheck a week later showed that the carcinoembryonic antigen (CEA) was already within the normal range. It’s just that the cancer carbohydrate antigen 125 is still high, which is normal because this indicator is caused by uterine fibroids.

As long as uterine fibroids are present, this indicator will exceed the standard. Unless surgically removed. But the fibroids are smaller and less common now, so there is no need.

"Dr. Zhou, thank you. You really scared us to death this time." Mrs. Rubio patted her chest and was very happy. She was finally able to return to normal life and work.

……

The third national "Crescent Cup" Young Doctors Cardiac Minimally Invasive Surgery Formula Competition has begun.

This event was previously rumored to be held every four years, but after the first competition, everyone found that the effect far exceeded expectations, especially in terms of economics. The sponsors made a lot of money, so at the strong request of the sponsors, Next, it will be changed to once a year.

In fact, this is also a valuable communication opportunity for doctors. If you get the honor, its significance to your future career is self-evident.

So, everyone is still quite positive.

Since it is a formula competition, it is the same as before, the rules remain unchanged, there are still six spells and three forms.

The six surgical procedures refer to the participating events, which are three types of small incisions: cardiac surgery through right thoracic small incision or thoracoscopic surgery, small left thoracic incision or thoracoscopic cardiac surgery, upper sternal small incision cardiac surgery, and cardiac intervention. There are three types of surgery: mitral valve clipping (MitraClip), Watchman left atrial appendage closure, and transcatheter aortic valve replacement (TAVR or TAVI).

The three forms are the methods of competition, namely simulated confrontation, surgical video and live broadcast.

This time, not only Zhou Qiao served as a judge for the national finals, but also Zhou Qiao, Murphy, and Stephanie became judges in the California division.

Although the judges in the sub-division are not as valuable as those in the National Finals, it is still a rare honor.

When the news came out, many doctors in California were talking about it.

"Wow, Dr. Zhou and the others are actually the judges."

"Yes, Iris Clinic has three judges from each division. Dr. Zhou is also a judge for the finals. Sitting with those top academicians, my God, I can't even imagine it."

"Well, tell me, will Dr. Zhou give me some water?" "Then I have to make it to the finals!"

"Forget it, I'm just talking casually." The doctor was not interested because he had participated in the competition for two consecutive years and received the participation award.

"This time, I will not sign up and leave the opportunity to others."

Many doctors gave up this time. Mainly, he was hit by Zhou Qiao.

Two years ago, although Dr. Zhou was great, everyone was in the same "camp" and were all in the contestant area. But now? Dr. Zhou has transcended and become a judge.

How can everyone compete? In particular, some older people are more concerned about face.

I usually call Dr. Zhou a brother, but now I call him "teacher"? No, no, no, I won’t compete. Give opportunities to young people.

Because of the variable Zhou Qiao, the organizing committee discovered that almost all the contestants in this competition were junior doctors.

This is also a good thing. As for young doctors, naturally the younger the better.

Zhou Qiao, Murphy and Stephanie have all received many surgical videos from players in the past few days, watched them together in the conference room, and then rated them.

Of course, everyone fights for himself.

It is relatively rare for three judges to work together, because most of the others, even if they are from the same organization, watch the videos alone and score individually.

On this day, the three of them were watching videos together. Suddenly, a message popped up on Stephanie's computer.

It turned out that a clinic transferred a schizophrenia patient. The patient's condition was a bit complicated. Stephanie was very knowledgeable in the field of psychiatry and had published many related academic papers. Moreover, she was also a well-known patient in San Francisco. psychiatrist.

Later, Stephanie also received a call from the patient's parents and made an appointment for diagnosis and treatment.

At ten o'clock in the morning on Wednesday, the patient's parents came with their children.

This is a high school girl. The patient's parents told about their child's condition, which started about two months ago.

At that time, the patient had conflicts with his classmates at school, had several quarrels, and the friendship boat capsized, so he was a little depressed.

Then, sleep abnormalities appeared, and I woke up easily after falling asleep. Sometimes I had hallucinations, and my temper became increasingly irritable.

The patient's mother felt that the child's state was wrong, so she tried to enlighten her, but it was of no use. The child not only quarreled with friends, but also quarreled with his parents at home.

About a month later, the child's mother couldn't bear it anymore and felt that continuing like this was not an option, so she took the girl to a clinic near her home and asked a psychologist for counseling.

The doctor diagnosed it as "schizophrenia"!
The family members were shocked and quickly cooperated with the treatment.

However, after taking the medicine as prescribed by the doctor for a month, there was no improvement, and the child became more and more "nagging".

The psychiatrist there couldn't figure it out, so he suggested that Stephanie come to see a doctor and referred her over.

After Stephanie understood the situation, she arranged for the other party to have his liver function checked.

"Doctor, we are here to see a mental illness. Why do we check liver function?" The girl's mother was full of doubts.

Originally, the psychiatrist there praised Stephanie very much, saying that she would most likely get better soon if she came here. However, after arriving, the well-known psychiatrist did not immediately provide psychological counseling. Instead, he immediately arranged for a liver function test.

What the hell is this?

Seeing that the girl's family was confused, Stephanie explained: "You have been taking medicine for so long, but your condition is not getting better. It's probably because the medicine is not right. Let's not talk about whether it is schizophrenia. This medicine alone is not good for you." After taking the medicine for a month, I suspect that her liver function has been damaged. If this happens, I will first help her regulate her body and repair her liver function. "

"Ah?" The girl's family was stunned.

But since Dr. Stephanie was so serious, they had no choice but to cooperate.

The results made them dumbfounded. The report showed that the transaminase was extremely high and the liver function was actually damaged.

OMG!

Mental illness has not been cured, and new illnesses have appeared.

"Doctor Stephanie, what should we do now?" The girl's family was extremely anxious.

At the same time, I admire Stephanie even more. Xin said that famous psychiatrists are different.

That's because Stephanie is not only a psychiatrist, but also a very powerful surgeon. She is proficient in many kinds of surgeries and can be considered an all-rounder. Her focus is naturally different from that of ordinary psychiatrists.

"Immediately stop taking the previous drugs and then perform liver-protective treatment." Stephanie admitted the girl to a community hospital and asked Chiba Nanako to help repair the girl's liver function.

On the other hand, Stephanie took the disease process information and went to chat with Zhou Qiao. Because she thought this girl's condition was a bit strange.

The report showed that the girl's liver function was impaired, but there were no related manifestations of biliary damage.

Liver and gallbladder, there is a Chinese idiom called "the liver and gallbladder are in harmony with each other". These two organs have extremely similar anatomical positions and closely related functions.

Usually, when liver function is damaged, biliary function will be affected to some extent. Especially the bile duct.

Stephanie is a medical genius, and of course she knows it.

That's what's strange.

Some doctors may ignore such a small problem and think it is normal, but in Stephanie's opinion, this is anything but normal.

When Zhou Qiao heard this, he also became interested and called Murphy and Chiba Nanako to discuss the girl's condition.

The girl is blessed to have so many top doctors helping her to consult.

Then, a series of investigations began.

There are many "weird" results in the results obtained.

For example, the girl was thin, with a body mass index of only 13. However, during liver puncture, her liver was found to have infiltration of fat cells.

At the same time, the girl's liver pathological tissue test found that she had chronic liver damage, which did not support acute drug-induced liver damage.

Not only that, Iris Tiantuan also discovered that a special protein was severely missing in her liver tissue. This situation is generally considered a hereditary disease - progressive familial intrahepatic cholestasis type 3. However, subsequent surgery The results of related genetic testing were not supportive.

At this time, the girl had been undergoing liver function repair treatment at the community hospital for more than a week. What surprised Nanako Chiba was that the effect was not good.

Because Chiba Nanako is very clever in using medicine, and her medicine always cures the disease, it is impossible that the effect is not good.

Obviously, this is another contradiction.

Liver damage, liver care treatment is not very effective.

Everyone fell into deep thought for a while.

Stephanie: "Looking at it this way, her liver function damage should be due to another hidden reason, rather than drug-induced liver function damage caused by taking too much medicine as I had expected. I'm sorry, I made a wrong judgment before. ”

Zhou Qiao waved his hand: "I can't blame you."

In fact, even if Stephanie's judgment is wrong, it will not be harmful to the patient, because liver function is damaged, and symptomatic liver function repair treatment is beneficial.

For example, if the pool is short of water, is it wrong to add water to it?

That's right.

But the current situation is that no matter how much we make up for it, it won’t be enough.

What does this mean?
It means there is still some leakage underneath!

(End of this chapter)