Chapter 121 Five Hundred and Four
Soon, the patient got his medical card and came back.
Xiao Wu entered the computer outpatient system and prescribed a check list for the patient: anteroposterior and lateral radiographs of the left knee joint (standing position), and a plain MRI scan of the left knee joint.
The computer showed that the queue for magnetic resonance examination was a week old, and the patient was very anxious. Xiao Wu canceled the examination order and told the patient to go to a private imaging center called Quanying to have it done. They can expedite it there and get the results on the same day. .
The boss of Quanying is a doctor of imaging who returned from studying in the United States. He is smart and has a strong family background. After returning from overseas, he became a boss instead of a doctor.
Invest in an imaging examination center in G city, called the All-in-one Medical Imaging Center, which offers the best CT, MRI, and PETCT. Business has been booming since its opening.
It takes a week to get an examination in a large hospital, and another week to get the report. Come to Quanying and do it as fast as you want.
If it’s urgent, add money! The report is issued within two hours; normally within 24 hours; for delayed reports, the price is cheaper and there are discounts, and the report is issued after 24 hours, but it is faster than large public hospitals.
As long as you are willing to pay, the results can be obtained on the spot after the procedure. The price is very high, and a dedicated person will accompany you throughout the entire inspection.
Yang Ping has visited this imaging center and it is indeed good. The experience of waiting for the examination is also very good. It has online TV, a full range of newspapers and magazines, free coffee and drinks, and there are toy prizes for children who cooperate with the examination.
It is said that the patient can be discharged from the hospital in a day or two after the procedure. The patient is eager to have the examination done immediately and be hospitalized for surgery immediately. The family members push the patient to have a full imaging examination without saying anything.
There were no new patients yet, so Song Zimo took Zhang Lin and Xiao Wu to the laboratory to practice arthroscopy, and several trainees and interns also followed.
Yang Ping began to study Mr. Ning's condition again. All the puncture angles he imagined were not working, nor was the puncture path to complete the transforaminal scope. Either the tumor was blocking it or it was blocked by bone tissue.
The target is like an enemy hiding in the blind spot of the sniper's ballistics, and there is nothing you can do about it.
Since the envisaged path cannot be completed when puncturing from soft tissue, what about puncturing from bone tissue? Yang Ping used his imagination.
If the enemy is hiding in a thick corner and you can't hit it, just open a hole in the wall and let the bullet pass through the hole and hit the enemy.
This idea is very interesting. Yang Ping thinks it is feasible and the safest method, because as long as the puncture needle remains inside the bone before reaching the target, there is no need to worry about damaging the tumor's blood vessels.
Yang Ping tried to simulate the puncture process in his mind. The nerve roots come out from the intervertebral foramen formed by chest 1 and chest 2. It is best to puncture from the pedicle of chest 1, diagonally downward and inward, and pass through the bone of the pedicle. The tissue finally breaks through the bone tissue at the end and penetrates into the nerve sheath. As long as it enters the sheath, the difficulty of subsequent operations is much lower.
After Yang Ping perfected the plan, he went to the director's office to find Director Han and told him his thoughts.
When Director Han heard this, he was amazed! This plan is very good, and it coincides with what I just thought. Although the puncture is very difficult, it is safe. Even if it fails, it will not cause too much side damage.
As soon as he had this idea, Yang Ping had already come up with a mature plan, including the angle, location, depth, precautions, and puncture techniques.
This brat is very imaginative. Director Han said happily: "You will come with me for the afternoon general consultation. However, Director Kong just called. The family has invited Professor Su Qingyun through entrustment. Professor Su will probably bring someone over." , if it is determined that the plan is highly selective nerve root block, the operation may be completed by the people he brings. Your idea is very good and very mature, but the puncture is very difficult, but the puncture path is all bone, so it is safe. It has improved a lot, and even if it fails, it will not have much impact. Unlike soft tissue puncture, if you make a mistake, it will damage the blood vessels and cause bleeding, which is troublesome. You will also have to speak, exercise, and see the world during the next conference. ”
"I won't speak anymore. I'll go with you to listen." Yang Ping felt that this kind of scene was all about the senior director, and it was inappropriate for him to speak.
Director Han said with a straight face: "If you are asked to speak, just speak. If you are verbose, just tell me what you just thought. Don't be afraid. If you sit next to me when the time comes, you will represent me."
Yang Ping spent the whole morning thinking about the patient's plan. By lunch time, he would have forgotten about it if Su Yixuan hadn't called.
She had already packed the food and was waiting in the canteen. Yang Ping quickly went to the canteen after get off work.
Still in a relatively remote corner, Xiao Su handed Yang Ping chopsticks and said: "I heard that there is a patient in Huaqiao Building who will have a general consultation in the afternoon?"
"Yes, liver cancer is in the advanced stage and has metastasized throughout the body. The tumor has invaded the 2nd thoracic nerve root, causing severe pain in the chest. We need consultation and an analgesic plan. I have been thinking about this patient this morning and forgot to check your WeChat account." Yang Ping Talk while eating.
Xiao Su didn't care about Yang Ping's remarks: "It's okay. I know you must be busy. I'll get food first. I'll call you after I finish."
"We also invited several experts from other hospitals to come over. I will also attend a consultation in the afternoon." Yang Ping reported on the work situation.
Xiao Su smiled: "They are all directors, are you a young doctor?" "I don't know, Director Han asked me to go, I will go and have a look. There is a professor attached to the first one, who is the chairman of the Orthopedics Department of our province, I will go Feel the style of a great professor." Yang Ping devoured it.
"Slow down, don't choke, is that enough? I'll give you some more." Xiao Su said distressedly.
Yang Ping took the tissue from Xiao Su and wiped his mouth: "That's enough. I'll eat quickly and go back to study the plan for this patient. It's really a bit difficult."
"It's not difficult. We won't invite experts from other academies. Director Han is well-known in the country, but we still want to invite experts from other academies. This shows that it is not only difficult, but also risky." Xiao Su Bang analyzed.
"Have you forgotten about the weekend?" Xiao Su smiled and had two nice dimples.
Yang Ping was so embarrassed that if he didn’t mention it, he would have really forgotten it.
"Why are you nervous? Don't be afraid of forgetting. As long as I haven't forgotten." Xiao Su knew from his expression that he might have really forgotten.
Xiao Su put away the two metal dinner plates, cleared away the garbage on the table, and wiped it with paper towels several times, as if no one had eaten at this table.
"I'll do it!" Yang Ping picked up the dinner plate, and Xiao Su followed.
"I'll take a call." Xiao Su's phone vibrated.
"Well, I'm busy in the afternoon and I don't have time. Um, um, um, I understand -" After saying a few words, Xiao Su hung up the phone.
When I was putting the dishes on the table, I met Dr. Jin and he said excitedly: "Do you still remember the case of metal ion-reactive synovitis last time?"
Yang Ping said: "Remember."
"I came back for a follow-up visit. It's fine. Now the joints in my limbs are not swollen or painful, and I can play football. The patient's family was very happy and sent a pennant. This pennant should be given to you," Dr. Jin said.
"It's not for me, it's for the department, for everyone!" Yang Ping corrected.
After chatting with Dr. Jin for a few words, Yang Ping and Xiao Su returned to the department.
I didn't fall asleep during the lunch break. I entered the system space and dissected dozens of experimental subjects to strengthen anatomy knowledge training. Now the brain's ability to compose pictures is still in its infancy. It can form pictures, but it is more difficult to create complex graphics.
Yang Ping tried to reproduce the graphics he constructed in the morning, and he was able to reproduce them, which shows that his memory has improved very quickly, especially his memory of graphics.
In the afternoon, the patient came back from the full imaging examination. This patient was followed up by Xiao Wu.
Xiao Wu hung up the X-ray, and when everyone saw it, their scalps went numb.
It is densely packed with large and small particles, round, oval, at least hundreds of them, which are still visible, and there are some that are not visible on X-rays, because cartilage is not visible on X-rays.
Xiaowu hung up the MRI film. Everyone was now numb all over. The patient's son almost vomited and retched. He immediately ran to the trash can and squatted down to retch several times.
On the magnetic resonance film, not even a doctor can clearly see that there are hundreds of them densely packed throughout the entire knee joint cavity.
Synovial chondromatosis! Super severe synovial chondromatosis! If you have trypophobia, step aside.
Xiaowu took out his mobile phone to take photos, collect data, take photos of patients, and also take photos of images.
"Schedule surgery tomorrow, synovial chondromatosis, large and small, 504!" Yang Ping said.
The patient covered his eyes.
(End of chapter)