Come on, Dr. Wu

Chapter 408 I have no money

Take out the toothpick, and the operation is almost done.

After all, this was the source of all the patient's recent symptoms, including the abscess he had developed.

Because the surgery has been performed, the abscess can be cleaned under a microscope, and then anti-inflammatory drugs can be used for a period of time after the surgery to basically clear the abscess.

"Come on, I'll leave the rest to you."

Wu Xiaofu handed over the position of chief surgeon to Peng Xia. Peng Xia has grown rapidly because he often performs surgery with Wu Xiaofu.

Peng Xia is basically proficient in many surgeries.

Cheng Shi took over Peng Xia's position and started to hold the mirror.

After Wu Xiaofu left the operating room, Cheng Shi smiled and said to Jiang Bei.

"Congratulations, we can fight side by side again in the future."

Jiang Bei couldn't help but smile when she heard this, "I said that Northeastern women wouldn't have bad luck. Look, the boss is a soft-hearted god."

The other people in the operating room also laughed at this time. They saw it more clearly than Jiang Bei. Jiang Bei was lucky to have a teacher like Wu Xiaofu who valued talent and was energetic. But it was also true that there was a shortage of people in area F. Otherwise, Jiang Bei would not have had a chance.

Since Area F was newly established, there are not many staff. You know, the ratio of doctors to patients in a department should be at least three to one, that is, five patients to one doctor.

Now the number of patients in Area F often exceeds fifty, and even if some are discharged, the transition is almost seamless. Under such circumstances, ten doctors are not enough.

The doctor I'm referring to is the regular doctors in the department, not including trainees, interns, graduate students, and the like.

Because these doctors are here to help, they won't tell you when they'll leave, and they won't keep all their hearts with them.

Excluding these, how many doctors are left in the department?

Chen Zhendong, Zhang Xuewen, Zhao Xin, Feng Lingling, Yuna, Peng Xia, even if Wu Xiaofu is included, there are only seven of them.

Now that Cheng Shi has arrived, there are eight people in total, and these eight people are divided into four groups.

Wu Xiaofu is in the general practice group of hepatobiliary medicine, and he receives the most diverse patients. Chen Zhendong is now mainly engaged in minimally invasive surgery and new technologies, while Zhang Xuewen is more responsible for trauma.

Zhao Xin was responsible for intervention, just like when Wu Xiaofu first introduced him.

Interventional surgery, relatively speaking, does not require so many people. Just two people can do it, and the other one does not need to have too high requirements.

So two interns who were willing to learn interventional therapy were assigned to Zhao Xin's group. Of course, since Wu Xiaofu wanted to develop interventional therapy, he couldn't just leave it like this.

So Wu Xiaofu asked Zhao Xin to keep an eye on it, and if there were any good seedlings, dig them up and focus on cultivating them. If there were any that looked usable, he could just take them and use them right away.

Eight doctors in total is really a bit too few. Wu Xiaofu has always wanted to recruit people, but there is no suitable one. Now Jiang Bei comes to him, even if Jiang Bei wants to go back, he has to persuade her.

Now that Jiang Bei wants to stay, we can’t let her go.

After leaving the operating room, Wu Xiaofu changed his clothes and went straight to the physical examination building.

The First Affiliated Hospital is responsible for part of the physical examination business. To be honest, the most lucrative business department in the hospital is the physical examination department.

Real doctors are civil servants who have a normal work and rest schedule, have Saturdays and Sundays off, do not work overtime, and if they do work overtime, they will receive triple overtime pay.

And because there is regular cooperative business, there is no need to worry about performance, so the bonuses are not small.

Many business departments envy these physical examination doctors.

This time, it was the director of the physical examination department who called Wu Xiaofu and asked him to help look at a case. He said that a little girl was found and the case was a bit special, so he asked him to take a look.

In fact, Wu Xiaofu was also very surprised when he received the call. After all, this was the first time he received a consultation invitation from the physical examination department.

The physical examination department is not a nosy department. Basically, they will not care about anything else after the physical examination. If the patient really has any illness, they will send him to a professional department for diagnosis and treatment. They will not do it personally.

However, Wu Xiaofu did not ask any further questions, thinking that he might be a relative of the director of the physical examination department.

After all, it was the first time he called, and he is the director of the physical examination department, so he had to give him face. After all, he had to come for a physical examination every year, or he would come for a physical examination if he knew him. Maybe he would need the director of the physical examination department's help or something.

In a hospital, it's normal for us to help each other.

When he arrived at the physical examination department, Wu Xiaofu went straight to the director's office. The door was open, so Wu Xiaofu knocked on it directly.

"Sister Zhang, I'm busy."

Director Zhang of the Physical Examination Department is a general practitioner by training. He started out in the day ward and later took over the Physical Examination Department. He is now in his fifties.

Maybe it’s because he doesn’t have to work the night shift, but Director Zhang looks very healthy and people would believe him if he said he was in his forties.

Director Zhang's eyes lit up when he saw Wu Xiaofu. "Director Wu, you're here. Don't be busy. This is the patient I told you about. She's a 19-year-old girl named Huang Rui, whom I saw this morning."

As he spoke, he pointed to a pretty girl next to him. Literally, she was just like a flower, as young as a flower, with a face as beautiful as jade.

She is the kind of girl that you will fall in love with at first sight, especially when there is a hint of sickness on her face, which makes people feel distressed and want to protect her.

This liking has nothing to do with gender, it really is true: everyone loves beauty.

Huang Rui, who was originally sitting next to Director Zhang, stood up at this moment and looked at Wu Xiaofu somewhat nervously.

"Director Wu."

Wu Xiaofu nodded, walked into the office and sat down, "Is it your liver that's bothering you?"

Director Zhang was not surprised to hear Wu Xiaofu point out the essence of the disease without any inquiry or basis. This was Wu Xiaofu's strength. Otherwise, she would not have invited Wu Xiaofu over.

Director Zhang began to explain the specific process calmly.

It turned out that Huang Rui came to the hospital in the morning for a physical examination and abdominal color ultrasound. The doctor in the ultrasound department asked about her medical history as usual: Why did you come to check your liver, gallbladder and spleen?

You should know that the Physical Examination Department of the First Affiliated Hospital, in addition to cooperating with some units on physical examination matters, is also open to the public. If someone wants to come for a physical examination, they can also make an appointment for the examination.

It doesn't matter whether it's a full set of examinations or a single one, Huang Rui just came for an abdominal color Doppler ultrasound. Based on experience, these patients all have underlying medical conditions.

Asking in advance will help with inspection so that you can focus on the issues when checking.

However, when Huang Rui was asked at first, she just said that she was here for a physical examination. When the ultrasound doctor was scanning the liver, she suddenly asked, "Doctor, how is my liver fibrosis?"

Liver fibrosis!
This word will not be mentioned during a normal physical examination because it is too professional, and normal people will not have liver fibrosis. Only elderly patients with liver disease will pay attention to this aspect.

It's like some patients with hepatitis and cirrhosis, and Huang Rui is only 19 years old, it shouldn't be like this.

So the ultrasound doctor paid more attention and scanned her liver carefully. At first glance, the echo was uniform and nothing special. But a closer look revealed that the liver was full of low-echo nodules of varying sizes.

This made the ultrasound doctor a little frightened. What was going on?

They are not like ordinary hepatitis patients. They have liver fibrosis and appear in young patients. The physical examination department has also seen some of them, and most of them are suffering from hepatitis.

There are fewer people now, but before, many people were infected with hepatitis for various reasons.

However, the physical examination ultrasound department is different from the outpatient building. Most of the patients they examine are normal people, so their experience is actually lacking compared to the outpatient building.

You can only report what you see.

The specific diagnosis is less clear.

However, the ultrasound doctor was also a little curious, but more of a heartache. She was only 19 years old and so beautiful, so how could her liver be in such a condition?

So I asked more questions, "Have you ever had an ultrasound before? Has your doctor ever told you that you have multiple nodules in your liver?"

Huang Rui was not surprised to hear this, and just continued, "Doctor, I have Wilson's disease."

Wilson's disease!
To be honest, when the ultrasound doctor heard the word, he reacted for a moment and felt familiar with it, but he couldn't remember the details. After all, it was not a diagnostic department, so the aspects of memory were different.

You can't ask the patient what disease it is. You can only remember the word in your mind and prepare to go back and have a look.

Of course, in order to report more carefully, the ultrasound doctor still asked some other questions, "Have you diagnosed this disease?"

Huang Rui also had these sad eyes at the time. She said that this was hereditary. Her sister also had it. It was her sister who was diagnosed first and later died of liver cirrhosis. It has been several years since she was diagnosed and she has been undergoing regular check-ups since then.

Wilson's disease!
Wu Xiaofu was also surprised when he heard this. It was indeed rare.

Wilson's disease, also known as Wilson's disease, was first reported by Wilson in 1912, so it was named that way. It is an autosomal recessive copper metabolism disorder that mainly affects adolescents.

That's right, it's a genetic disease.

Even in this day and age, genetic diseases are synonymous with "difficult" because once such a disease occurs, treatment is not as simple as just addressing the specific organs, but also requires addressing the genes.

This disease is caused by genetic influence, which leads to the deposition of excess copper ions in the liver, brain, kidneys and cornea, causing liver and kidney damage, extrapyramidal symptoms, psychiatric symptoms and corneal pigment rings.

Well, this disease can affect the mind, and neurological related diseases are even more difficult when it comes to this aspect, but there is also good news, which is that this disease is one of the few neurological genetic diseases that can be treated so far.

The most important thing is early diagnosis and early treatment. Once the treatment is delayed until the late stage, it will be basically ineffective.

The clinical diagnosis of Wilson's disease is relatively complicated.

Director Zhang from the physical examination department was a little surprised after hearing what the ultrasound doctor said, but after seeing the patient, he felt even more sympathy.

Director Zhang is not an expert in this area, but he has some knowledge about it. After knowing that the child is currently only undergoing regular checkups and no intervention has been performed, he felt that something was wrong.

But she didn't have any good suggestions, and she didn't want to watch this beautiful child continue like this, because if she dragged on, she would probably die at a young age like Huang Rui's sister.

Director Zhang’s youngest daughter is about the same age as Huang Rui. Her maternal instinct took over, so she called Wu Xiaofu to see if he could help Huang Rui.

“In fact, the diagnosis of Wilson's disease is still difficult.

When it comes to diffuse nodular lesions in the liver, the most common thing we think of is nodular cirrhosis.

There are many factors that lead to nodular cirrhosis, such as hepatitis, parasites, Wilson's disease, chronic hepatic congestion, etc.

The diagnosis of Wilson's disease is actually very important when we ask about the medical history. A positive family history and medical history can help us rule out and diagnose the disease.

Huang Rui's sister was diagnosed with Wilson's disease, and after family screening, she was also diagnosed. For this disease, liver ultrasound often shows bright spots of thickening of the liver parenchyma and even nodular changes.

Combining the images and family history, we can diagnose that Huang Rui is indeed a case of multiple intrahepatic nodules caused by Wilson's disease.

There is currently no effective way to cure this disease. The current treatment is basically symptomatic and causal treatment.

But from what Huang Rui said, she has only been doing regular checkups until now and has not carried out any intervention, which is not acceptable.

Fortunately, it is not too late now. She only has some liver symptoms and no neurological symptoms yet."

For patients with Wilson's disease, nineteen years old is really a sensitive age, because from the age of nineteen, the chance of neurological symptoms will increase.

This is related to the accumulation of pathogenic factors in the body, that is, copper overload.

Therefore, the key to treating Wilson's disease is to inhibit copper overload.

Treatment for copper overload generally includes two stages: one is to remove or detoxify the copper that has been deposited in the tissues, and the other is to prevent the re-accumulation of copper.

This is very important for Huang Rui, because she has not received treatment for such a long time, and the copper accumulation in her body has become serious. The nodules in the liver are a manifestation of this.

The basic principles of treatment are actually not that complicated.

In fact, it is to reduce copper intake through a low-copper diet, and then use drugs to reduce copper absorption and increase copper excretion.

This kind of treatment should be started as early as possible, and should be started before the disease occurs, because once the damage occurs, it will be difficult to correct it. Just like Huang Rui's liver is already damaged, it will not be so easy to recover.

Speaking of which, it was still delayed. Wu Xiaofu couldn't understand why no intervention was carried out since the disease had been diagnosed long ago.

"Grandma Liu only said to have regular checkups, she didn't say anything else."

Wu Xiaofu really wanted to call the doctor a quack, but he couldn't say it out loud. He just couldn't understand why a doctor who could diagnose Wilson's disease should have some skills and didn't know how to treat it.

Fortunately, Director Zhang called him over today, otherwise, the child would have developed liver damage and might die from liver dysfunction within a few years.

Just like the patient's sister.

"Grandma Liu?"

"Yes, she's the doctor in our town. She's the one who's been treating me all along, and she's the one who asked me to come to the city for regular checkups."

In town?

Wu Xiaofu didn't think much about it this time. Maybe Grandma Liu really only knew one side of the story. No wonder, even the ultrasound doctor didn't know, and Director Zhang didn't know much, not to mention the old doctor in the town who was obviously old.

"You need to be hospitalized for a systematic examination and then start systematic treatment. If you have no objection, I will arrange it for you."

"I have no money."

(End of this chapter)