I run a clinic in the United States

Chapter 415 Surprise Little Treasure Box

"My son was diagnosed with heart disease when he was 6 years old. At that time, after the doctor listened to his heart, he felt that something was wrong and suggested that we do an echocardiogram."

"So we went, and then the nightmare began." The child's mother sighed.

In Zhou Qiao's clinic at Iris Clinic, Zhou Qiao and Grace listened to the story of the patient's mother. As for Chiba Nanako, she is busy with other things and cannot come for the time being.

However, this case is quite special. Afterwards, Zhou Qiao will bring Chiba Nanako in to discuss the details together.

Real progress is achieved when everyone makes progress together.

Zhou Qiao listened to the mother of the patient and looked through the examination reports they brought.

There are both previous and latest ones, showing the progression of the disease and medication history, which are of great reference value.

The echocardiogram report showed that the child's ventricular septum was significantly thickened, and the peak flow velocity of the left ventricular outflow tract was 1.7M/S.

This is typical of hypertrophic obstructive cardiomyopathy.

To be honest, when the diagnosis was first made, the parents of the child had never heard of this disease at all. They had heard of coronary heart disease, myocarditis, heart disease caused by hypertension, etc. This hypertrophic obstructive cardiomyopathy was really not It's a common disease, and almost no one around me has it.

It's like a sword of Damocles hanging above your head, ready to fall at any time. Don’t mention how worried the parents of the children are.

Hypertrophic obstructive cardiomyopathy is a type of hereditary primary cardiac hypertrophy. The hypertrophy of myocardial muscle fibers causes the heart chambers to become smaller. The main manifestations are obstruction of left ventricular blood flow, causing pulmonary congestion, poor systemic circulation perfusion, and ultimately myocardial ischemia.

Grace couldn't help but look forward to it, and secretly said in her heart: "I must participate in the whole process of this operation, and try to let Zhou Qiao teach me more."

However, the doctor also said that although this disease usually has no symptoms, it is a serious problem once it occurs, and angina pectoris or cardiac arrest may occur over time.

The parents of the child don't want to take any more risks. They really want to help their son get rid of this "disease" completely.

Zhou Qiao wanted more detailed data he needed.

Even if it was detected four years ago, what happens next?

"Thank you Dr. Zhou."

Cardiac ultrasound is different from ordinary B-ultrasound. Both the examination fee and the equipment purchase fee are much higher than ordinary B-ultrasound. Cardiac ultrasound has many functions that cannot be satisfied by ordinary B-ultrasound.

Afterwards, Zhou Qiao thought for a few seconds and suggested that the child do an exercise test to evaluate the working condition of the heart during exercise.

Zhou Qiao said softly: "As much as you can help me, we will definitely do our best. As for the surgery, although it is risky and difficult, it is not impossible."

The condition was very complicated. The doctor told them at the time that the operation was very difficult and there was no indication for surgery. Conservative treatment was recommended.

Through changes in these indicators, we can determine whether there is heart valve stenosis and insufficiency, and we can also evaluate the status of cardiac function.

Doctors are not saints. Physical examinations are divided into price points and items. They are not omniscient and omnipotent. Missed diagnosis and misdiagnosis are common.

I have gone to the hospital many times and consulted with many well-known hospitals. The doctors all said that considering that the child has not shown any symptoms of discomfort and has no indication for surgery, it is recommended to use medication first.

"Let's do this. Arrange hospitalization first for further examination and evaluation. Then we will discuss it and come up with a proper surgical plan." Zhou Qiao said.

This medicine lasted for four years. Unfortunately, the crisis was not resolved.

It can be said that for the past four years, there has not been a day when I was not in this kind of helplessness and fear.

She came from the Massachusetts General Hospital Heart Center and knew the risks of the procedure.

For example, echocardiography can display the direction of blood flow. Blood flow in different directions also has different colors. In addition, it can also measure the speed of blood flow.

Because different doctors have different levels of expertise, some of the details and parameters obtained will naturally be different.

Since hypertrophic cardiomyopathy is very hidden and requires high ultrasound diagnosis, Zhou Qiao thought about it and decided to go to the ultrasound room of the community hospital in person.

Grace also followed, thinking that Zhou Qiao is also good at ultrasound examination? Does this mean you don’t trust the doctors at that community hospital?
In fact, it's not that he doesn't believe it, but that Zhou Qiao doesn't feel at ease if he doesn't go over to take a look. This is a responsible performance.

"Thank you so much."

At the same time, a series of inspections began to be arranged.

As the disease progresses over time, patients are very likely to suffer from angina or cardiac arrest, which can be life-threatening.

However, she knows Zhou Qiao. This guy is often very "humble". Generally speaking, this means he is 70% or 80% sure, or even higher.

In addition, hypertrophic obstructive cardiomyopathy has its own peculiarities and is usually asymptomatic.

Although cardiac arrest has not been encountered yet, once encountered, wouldn't it be a test of life and death?
Doctors once told them that after entering puberty, the structure and function of the human heart will change greatly, and some risks often appear at this time.

Grace was frightened when she heard this, because if she were to do it, she would probably fail.

"Dr. Zhou, experts from the University of California Medical Center say you are a top leader in the field of heart disease. Can you help us? Please!" the child's mother begged, wiping away tears.

Now that the child is ten years old, if one day he suddenly "loses control", it will be... unimaginable and unbearable.

The children's parents seemed to see hope, with excitement on their faces. It’s not easy. After so many years, I finally found a famous doctor willing to take action.

This disease is characterized by cardiac hypertrophy and can be divided into obstructive and non-obstructive hypertrophic cardiomyopathy based on the presence or absence of left ventricular outflow tract obstruction.

In fact, it is because the general physical examination package does not include an echocardiogram.

When he came to the ultrasound room, the doctor on duty performed a routine review on the child. Zhou Qiao looked at it for a moment, gave some of his own opinions, and asked the other party to add a few data that were "not usually needed."

Therefore, I was a little confused after learning about the disease. My son was usually fine and there were no abnormalities in regular physical examinations. Why did he suddenly develop this disease?

Instead, as children grow older, angina sometimes develops.

Every detail is related to the life safety of the child, and also related to his golden signature, so he has to pay attention to it.

Immediately, Zhou Qiao called Jin Jizhen and asked her to take the patient's family to the cardiac surgery ward of the community hospital to go through the hospitalization procedures.

This "exercise test" is usually done relatively rarely. There are certain risks, but with Zhou Qiao on site and inside a general hospital, this risk is controllable.

The doctor on duty was slightly startled, but he followed his instructions.

Grace nodded secretly on the side, thinking that Zhou Qiao was a professional.

This kind of "professionalism" is more professional than "professional doctors".

It was this exercise test that brought to light the true condition of the child's heart. The data showed that the systolic flow rate of the child's left ventricular outflow tract was 5 M/S and the pressure difference was 117, which was far higher than the normal standard. This shows that children with severe left ventricular outflow tract obstruction due to hypertrophic obstructive cardiomyopathy must undergo surgical treatment as soon as possible, otherwise the risk of sudden death is extremely high.

The child's parents were also present. Zhou Qiao explained that under normal circumstances, the thickness of the ventricular septum of a child around ten years old is 0.8-1.0 cm, while the hypertrophy of the ventricular septum in children can reach 39 mm, which is nearly 5 times that of normal people. Ventricular outflow tract obstruction is obvious, and various data show high risk!

The faces of the child's parents suddenly changed, and their hearts beat faster.

The two of them looked at each other and felt a little lucky. They really came at the right time. If they delayed for a while, maybe... it would be a sad story. This is a burden they cannot bear.

They only have this one child. Even if there are several, one death is not something a parent can bear.

"Dr. Zhou, please arrange the surgery as soon as possible. Thank you!" The child's father stepped forward and bowed deeply to Zhou Qiao.

Zhou Qiao nodded: "I will try my best!"

Grace's heartbeat was also pounding, not because she was moved by Zhou Qiao, but because through this examination, she understood the urgency of the matter more clearly.

On the one hand, the operation is very difficult and risky, and on the other hand, the child is in critical condition, and there is a risk of myocardial ischemia and cardiac arrest at any time. Truth is a dilemma.

Zhou Qiao, on the other hand, nodded without any hesitation.

This man... is so fascinating!

However, it must succeed.

If Murphy or Stephanie were here, even Chiba Nanako would not have such thoughts.

After all, Grace had not been following Zhou Qiao for too long, and she was not 100% confident in Boss Zhou's skills. Because Grace knows deeply that the risks of surgery exist objectively.

She hasn't fully realized how powerful Zhou Qiao is.

After sending the patient and his family back to the ward, Zhou Qiao said a few words of comfort and hurriedly left with Grace. They need to further discuss the details of the operation, formulate plans to deal with various emergencies, and conduct simulation drills in advance to ensure that the operation process is foolproof.

Zhou Qiao also called Chiba Nanako over, still "one for two".

Grace sighed softly, when will it be Zhou Qiao's turn to teach me alone.

Grace and Chiba Nanako are both studying very seriously. In other hospitals, there is no such opportunity. Because after entering the workplace, people have no obligation to teach you.

Even if a superior doctor comes to teach you because of the boss's orders, they may not try their best, and some scheming people may even hide their secrets. This is human nature.

Of course, Grace is different at Massachusetts General Hospital. Her father is the director of the heart center. This kind of "second-generation medical" treatment is not something ordinary doctors can enjoy.

While rehearsing the operation, Grace glanced at Zhou Qiao secretly and said to herself that this man treats me no better than my father treats me.

She confessed her love to Zhou Qiao, but Zhou Qiao declined her politely, indicating that she was not necessary to Zhou Qiao, and they would never covet her beauty.

It is really rare to be so "generous" and like a teacher or a father without coveting beauty.

Grace herself feels a little guilty. She earns such a high salary here and learns other people's skills. It really doesn't make sense not to reciprocate.

"Dr. Zhou, when will you take me?" Grace secretly resented in her heart.

Of course, these distracting thoughts were just fleeting thoughts, and Grace quickly immersed herself in the training of medical skills again.

"Self-discipline" and "concentration" are the basic attributes of genius. Without this attribute, true genius cannot be achieved.

Whether it is Murphy, Stephanie, Chiba Nanako, Grace, or Yang Xuejun, once they seriously devote themselves to it, they can enter that state of selflessness.

Both girls have first-class learning ability. They don't need a heavy hammer to play the drums. They often draw inferences from one instance and learn from small things. Zhou Qiao also finds it easy to teach.

Everyone likes to teach good students.

Zhou Qiao is naturally rewarded for performing "teaching tasks". Just like teaching Murphy and Stephanie before.

However, if the system prompts too frequently, it will disturb his usual work and life. Therefore, Zhou Qiao has set the "message do not disturb" mode for some unimportant "information".

But for some important and uncommon ones, the system is required to remind them in time.

He was teaching these two girls so much that they were enjoying themselves. Suddenly, the system popped up a golden virtual panel in his mind: "Congratulations to the host for once again achieving the 'Little Mentor' achievement X2! As a reward, a small surprise treasure box can be opened. Randomly obtain the following items: male charm +2, a scroll of superb medical skills, a magical medicine, and a fragment of the key to the Temple of Medicine.”

Zhou Qiao was idle now anyway. He watched the two girls rehearsing the operation, and silently gave an instruction in his heart: "Open the treasure box immediately."

Suddenly, the lid of the virtual treasure box in his mind popped open. Countless ribbons were floating, and golden light shone. A reward suddenly appeared in his mind: "Male Charm +2."

Zhou Qiao was immediately pleasantly surprised. If he remembered correctly, it was difficult to improve this male charm, and it would require a system upgrade before it could increase again.

Unexpectedly, you can also draw it from the treasure chest.

However, he would be equally happy if there were several other rewards, all of which were also very precious.

After Chiba Nanako and Grace finished their practice, when they looked back at Zhou Qiao, the two of them suddenly felt that Zhou Qiao was more charming.

Grace tightened her legs slightly, a seductive blush inadvertently flashed across her pretty face, and she felt slightly confused and infatuated.

In fact, Zhou Qiao did not waste time teaching the two people how to operate, because there was still some pre-operative preparation work to be done.

Elena and Ava couldn't rest and returned to their old jobs. When encountering such a major operation, they would come to help.

Of course, during normal minor surgeries, or when Chiba Nanako and Grace perform the surgery alone, they leave the opportunity to Park Soo-joo, Kim Hee-jin and Zhang Mengjing.

When everything was ready, the surgery officially began.

Although they have not been in the operating room for a long time, Elena and Ava still behave like "masters" and perform all operations impeccably.

Ava touched the audio equipment in the operating room of the community hospital. It was still the same old equipment that had not been replaced yet, but she felt very familiar with it.

Although this speaker is old, it is extremely durable. Even after more than ten years, the sound quality is still excellent.

I used to think about asking the community hospital to replace equipment, but now I feel that the old equipment is better.

To be honest, although Elena and Ava have now become princesses of the Nordic royal family, they still miss the busy times before, especially the difficult years in the clinic they spent with Zhou Qiao.

Ava played a popular song "Young Friends Come to Meet".

(End of this chapter)