Chapter 993 Oncology consultation
When he went to work after the holiday, Xu Zhiliang was obviously different from before. His hair was no longer like a chicken coop, but neatly combed. He was no longer wearing the same worn jeans and T-shirts that had been worn for ten thousand years. This time he was dressed very well. I don’t know. How long can this good image be maintained?
After Tang Shun came back, he was obviously a little haggard. From time to time, he would type quickly with his mobile phone. Sometimes his fingers might not be able to keep up with the speed. He would hide aside and use voice input instead of typing. Anyway, the researchers in the laboratory saw that he would take out his mobile phone from time to time. It was difficult to calm down and work for a while. After all, the big family had just separated, and it was inevitable that they would be a little bit inseparable.
Li Min said he was on vacation, but he actually underwent surgery at Guandu Hospital for a whole week. He was also invited by Director Zhang to the county hospital to help see several more complex cases. Of course, Li Min also gave a clear diagnosis of these complex cases on the spot. and treatment options.
The orthopedics department of the county hospital heard that Director Zhang had hired a talented person, so he gave Li Min several bags of bulging CT films and MRI films to help check. The radiology department was also unambiguous. How could the high-level resources that Director Zhang hired be wasted? , so he also selected a large number of difficult and complicated diseases and rushed to the general surgery department. Li Min was an honest man with no tricks, and he would not refuse anyone who came. He read the films one by one and provided unpretentious explanations, which actually solved many unresolved problems for doctors.
After Yang Ping finished chatting with Li Min, Song Zimo came in and said: "There is a consultation in the oncology department, and I want you to go to the consultation by name."
After finishing speaking, Song Zimo added: "It is really the consultation order issued by Director Jiang himself. He just called me."
There was a time when every department encountered difficult cases, and the doctor in charge would send a consultation sheet to the Institute of Surgery, with Yang Ping's name clearly written on it. This was the so-called roll call consultation. Yang Ping held a thick stack of I went through the hospital with thick consultation orders and found that some were not difficult cases at all. These consultation orders were issued by the doctor in charge and had not been reviewed by the department director.
In order to avoid wasting Yang Ping's energy, the medical office made a rule that consultation orders naming Yang Ping must be issued personally by the department director. This way, the chaos of spam consultations by naming Yang Ping can be eliminated. Otherwise, the lovely Professor Yang can only go to work every day. Do one thing - consultation, there will never be an end to the consultation.
Therefore, Song Zimo's supplement to this sentence is still necessary. Since the Medical Office issued the order, some cowardly guys have pretended to be the director to sign, and then privately issued consultation orders naming Professor Yang. In this case, the patient's condition is usually not serious, and the patient's condition is not serious. It's complicated, but the relationship with the doctor who issued the consultation order is quite special. At this time, the doctor will boldly take risks. If he succeeds, he will gain a lot, but if he fails, he will be criticized at most, so there will be such risk-takers from time to time.
Song Zimo handed the diagnosis sheet to Yang Ping. Yang Ping looked at the summary of the disease on it. There were a lot of symptoms and a lot of diagnoses, but they were all uncertain diagnoses. He might have encountered some troublesome cases, so Yang Ping decided to take the time to see what was going on.
It seems that this case is not simple. Although he is very busy at work, the condition is not trivial. Yang Ping decided to go and see it in person. Before departure, Yang Ping pulled up the patient's medical records from the computer to preview. This is a necessary step for consultation.
The Institute of Surgery is a single building, so the distance to the internal medicine building is still a bit far. Yang Ping picked up the consultation form, touched the Montblanc pen in the upper left pocket of his white coat, got up and walked to the internal medicine building, followed by two As a young graduate student, every time Yang Ping goes out for consultation, a doctor who is free and able to go out will definitely follow him.
The purpose of following these young doctors is very pure, they just want to learn something. Although there are some advanced things that they cannot understand or understand now, they will naturally understand them after they have been exposed to them for a long time.
Yang Ping's steps were very fast, and so was the doctor who was following him. However, the taller of the two students had a relaxed expression, while the shorter student was obviously very anxious and struggling, because even if he ran quickly, he still couldn't keep up with Professor Yang. speed.
Surgeons are like this. They come and go in a whirlwind. There is no time to take it easy with you. In fact, in the hospital, surgeons and physicians can be recognized at a glance without looking at the sign on the chest. If the expression is relaxed, walk forward quickly, and see If you are rushing from place to place to catch up on time, you must be a surgeon. If you walk steadily and have a thoughtful look on your face as you walk, you must be a physician. It is almost the same.
In the doctor's office of the Department of Oncology, Director Jiang is frowning, and there are several doctors surrounding him, who seem to be discussing cases. It is obvious that Director Jiang's mental state has not been very good recently. The circle of sparse hair around him is obviously less than before, and his face I always seem to be sleep-deprived and have been under a lot of pressure recently.
Seeing Yang Ping come in, Director Jiang immediately stood up to greet him: "Professor Yang!"
Although Yang Ping is very young, with his current status, as the head of the department, it is reasonable for him to stand up and call him Professor Yang.
"Quick, go get the medical records!" Director Jiang ordered his doctors, and then warmly greeted Yang Ping to take a seat. The flexible young doctor had already brought a glass of water.
Several doctors rushed out to get the medical records, as if it was an extremely honorable thing for Professor Hei Yang to take the medical records at this time. Soon, the medical records folder was handed over to Yang Ping. In fact, Yang Ping had already read the medical records on the computer in advance. Information, now using paper medical records, is just a formality. To the consulting party, it appears to be cautious, and to the inviting party, it appears to respect the consulting doctor.
When looking at medical records, it is not appropriate to put a glass of water next to it. This is the rule, so there is no need for Yang Ping to speak, someone has already helped to remove the glass of water.
Yang Ping looked through the medical records. Indeed, this patient was quite troublesome. The patient's name was Fu Xiaotao. He was very young, only twenty-four years old. He was studying at Jiaotong University in Shanghai and had just been admitted to the school's graduate school. He did not expect to find this disease.
I was hospitalized for 8 months due to repeated abdominal pain, obvious weight loss, general edema and generalized lymphadenopathy. When I was admitted to the hospital, I was in a coma and woke up alternately. After treatment, I am now awake. I have been hospitalized for two weeks, four of which were spent in the ICU. I was hospitalized. During this period, approximately 40 kilograms of ascites were extracted through repeated abdominal punctures.
According to the test report, when he was admitted to hospital, his liver, kidneys, etc. were already severely dysfunctional, and his immune function was seriously imbalanced. CT showed swollen lymph nodes throughout the body, but no obvious primary tumor lesions were found in the liver, lungs, etc.
After extensive hormone treatment, his condition is now improving, and his liver and kidney function indicators are also improving.
Fu Xiaotao is from Nandu Province. Because he studied in Shanghai, he has seen patients in major hospitals in Shanghai. Different hospitals consider different diagnoses. Some hospitals consider lymphoma, while others consider systemic lupus erythematosus. Some people consider monocytic hyperactivity disorder, others consider the metastasis of undiscovered malignant tumors to lymph nodes, and some even think it is a rare and unknown immune rheumatic disease. Those who made these diagnoses were all experts. Everyone had their own reasons, but the reasons were not sufficient. Therefore, these diagnoses did not become a definite diagnosis in the end, and there were no effective methods in treatment. A large number of drugs were used every time the disease occurred. Glucocorticoid therapy.
With Fu Xiaotao's current condition, it is impossible to continue studying, and the condition has not been understood in Shanghai. Therefore, the family has no choice but to take the patient back and find a solution.
Fu Xiaotao was in good health when he went to school. He was still an athlete in the school and the main force of the school football team. He also won the 5,000-meter championship in the school sports meeting. Now his limbs are as thin as tree branches and his feet are as swollen as steamed buns. There was no trace of an athlete at all on his body.
After taking Fu Xiaotao home, his parents didn't know what to do. They could only let him rest at home. If his condition became serious, he would be sent to the hospital for hormone treatment. Other than that, there was no other way.
But Fu Xiaotao himself did not give up. He searched for information everywhere on the Internet. He did not just search for bits and pieces of information, but used some professional journals and websites he had learned to look up the treatment of this disease. Although he found nothing, he got I got some information that Sanbo Hospital is very good, especially for these difficult cases, so I came to Sanbo Hospital for treatment.
"Let's see the patient!"
Yang Ping suggested that this is the basic process of consultation. Of course, there are doctors who come and go in a hurry. They do not see the patient during the consultation and write consultation orders directly based on the medical records. However, most doctors will not do such stupid things. After all, clinical practice The basic principle of a doctor is to reach the patient.
The atmosphere in the oncology ward is generally quite depressing. You can see patients wearing hats or covering their heads tightly everywhere because their hair has been lost due to radiation and chemotherapy. Some patients who love beauty, especially women, always like to wear hats to cover up the hair that has been lost. At the same time, their immunity has been destroyed by radiotherapy and chemotherapy, so they are more afraid of being infected by bacteria and viruses, being invaded by wind and cold, etc.
The windows and balconies of the oncology department are all locked, so the entire space is closed, which adds a bit of oppression to the atmosphere. Locking the doors, windows and balconies does not mean that the hospital does not give patients the freedom to go out and breathe fresh air, because the oncology department is very special. Patients often jump off the building because they can't think about it, so in order to avoid trouble, many hospitals simply lock the doors and windows, or open the doors and windows regularly under supervision.
Yang Ping came to the ward, and Fu Xiaotao was curled up on the bed. His limbs were really like dry firewood, and his abdomen was swollen like a six-month pregnant woman. It is said that he looked like an eight-month pregnant woman when he first arrived. His feet were swollen like steamed buns and his skin was thin. Wrinkles can already be seen, indicating that the swelling was more severe before and is now in the process of reducing swelling.
Sitting next to her were Fu Xiaotao's parents, who were looking sad. They had worked so hard to send their children to 985, and they had all been admitted to graduate school. This was a classic success story of chicken babies coming ashore. But now that it has become like this, the parents feel both distressed and confused. Uncomfortable, the kind of discomfort that makes dreams shattered all over the place.
Perhaps in many hospitals, Fu Xiaotao's parents were used to this kind of back-and-forth consultation. When Yang Ping and the doctor came in, Fu Xiaotao's parents made no move.
"This is our Professor Yang!" Director Jiang introduced him personally, as if it would be insufficient or impolite for other doctors to introduce Professor Yang.
When the patient's parents heard Professor Yang's words, they both stood up immediately, with a smile on their gloomy faces: "Hello, Professor Yang." They finally met the legendary Professor Yang.
The spread of a doctor's reputation depends on two things - word of mouth and papers. The spread of fame among ordinary people relies on word of mouth, while the spread of fame in the medical field relies on papers. Of course, appearing at academic conferences to give lectures is also a way to become famous in the medical field. In this way, if you appear more often and appear first, you will naturally be remembered by your colleagues. But in the final analysis, it still depends on the paper, because without excellent papers, doctors have no chance to give lectures on the stage, and can only serve as a doctor in the audience. A loyal listener.
Hearing the words Professor Yang, Fu Xiaotao immediately turned over and sat up as if he had been stimulated. He faced Professor Yang with his true face. Before Professor Yang was introduced just now, the patient had been lying on his side and curled up with his back to the teacher. He looked here without speaking. He was also used to doctors coming and going. Every time he came, the final conclusion was the same: "It cannot be diagnosed, and can only be treated with glucocorticoids for symptomatic treatment."
Presumably the result was the same this time, but after hearing the words Professor Yang, Fu Xiaotao seemed to have rekindled his hope. He also greeted Yang Ping respectfully: "Professor Yang!"
In fact, this time we also relied on a large amount of glucocorticoids to end intermittent coma and restore the patient to a conscious state. Glucocorticoids are a powerful and versatile weapon in medicine. No matter what the disease is, when there is no solution, doctors will often prescribe steroids. , this is the doctor’s last resort.
Although the medical records are very detailed, Yang Ping is used to asking about the medical history himself. Although the medical history is the same, different doctors ask different medical histories. This is for sure.
Yang Ping is also used to re-examining his own physical examination. Although the guest officer's physical signs have always been the same, whether he can detect it and how much he can detect is directly related to the doctor's level.
"Frequent awakening from sleep at night, with sweat all over the body, clothes soaked, repeated abdominal pain, fatigue, inexplicable swollen lymph nodes all over the body, and strange red bumps appearing on the skin -" The patient has already expressed his feelings about his condition. The condition is so familiar that I can name a lot without thinking.
It has been eight months since the onset of the disease. When Fu Xiaotao first became ill, he complained to his parents about his physical discomfort. Their parents thought he was under great pressure to take the postgraduate entrance examination, so they did not pay attention to him. They continued to give him chicken blood injections until the symptoms became worse. The more severe the condition became, the more severe it became unbearable. Fu Xiaotao went to the hospital alone. Since then, Fu Xiaotao has been seeking medical treatment intermittently for the past eight months. He was unable to get an exact answer every time. Finally, he relied on a large amount of hormone therapy to relieve the symptoms. .
Over time, Fu Xiaotao gradually lost confidence in hospitals and doctors. Every time he saw a doctor, he only got relief. He never expected to be able to figure out what the disease was, let alone cure it. Many diseases cannot be cured. This is the reality.