Chapter 306: Terrible weight loss method, black face and red heart
"That shouldn't be the case! The child's grandmother never mentioned anything about this, and we see the child almost every day and have never seen him hurt." The man still didn't quite believe that the child had been stabbed by a rusty sharp object.
This is also out of trust in the elderly.
After all, it is his mother who takes care of the child at home.
"Husband, call mom and ask her! The doctor will definitely not speak nonsense!"
The woman has begun to persuade her husband.
The man trusts his mother. After all, there is a layer of distance between them and the daughter-in-law. It is very good if they can get along well with each other.
Now that this has happened, she dares to doubt her mother-in-law.
After hesitating for a few seconds, the man met his wife's gaze and finally took out his cell phone to make a call.
The child himself was already very ill.
Finding out the problem early will be helpful for the doctor's diagnosis.
"Mom, you're home!"
…
"We are taking Xiangxiang to the hospital! Let me ask you something. Has Xiangxiang been pricked by anything recently? The doctor asked us to ask if the child has been pricked by rusty objects."
He was afraid of upsetting the old man, so he explained it again.
After hearing these two sentences, the man's face changed slightly.
"Ah... you really got stabbed by a rusty angle iron! Okay, okay, I get it. I still need to get back to the doctor, so I won't tell you now! We definitely won't be back at noon, so you don't have to wait for us, just eat by yourself!"
It can be seen that the man is not very old, only about 27 or 28 years old, but he is very filial.
Zhou Can, who was standing nearby, had heard it all clearly, so there was no need for him to repeat anything.
I directly opened a second inspection form.
"I initially suspect that the child has sepsis, which is a very dangerous disease. Go check the procalcitonin first. After the results come out, I will formulate a corresponding treatment plan for the child based on the situation."
Zhou Can saw that the child's mother looked unhappy, and wanted to advise the family to be more careful when taking care of the child in the future, and it would be best to put away sharp objects such as nails and knives.
Some tranquilizers and blood pressure-lowering drugs for adults should also be kept out of the reach of children.
Children are full of curiosity and exploration about everything in the outside world.
The first sensory organ that babies use to explore the outside world is not their hands, but their tongues. For all animals, eating is an instinct from the moment they are born.
When babies eat, they first use their tongue to lick the food to get a feel for its taste.
It's the taste they like, so they suck and swallow it.
Therefore, the tongue is the earliest organ used by humans to explore the outside world, not the hands.
Human hands and feet were originally organs used for crawling.
Even in adulthood, the main function of the hands is not to perceive things in the outside world, but to grasp objects.
Children under the age of three have almost no ability to distinguish, and they will instinctively put anything they think is edible into their mouths. The little girl was only scratched by a sharp rusty object, which is a blessing in disguise.
At least it leaves the doctor a chance to save him.
Watching the little girl's parents rushing to take the child for examination, Zhou Can was already thinking about the next treatment plan.
Asking the patient to undergo a second examination is only to confirm the diagnosis.
In fact, based on his experience and medical knowledge, he was 80% sure that the child had sepsis.
"Doctor Zhou, you look young, but I didn't expect your diagnostic skills to be so high! The little girl was stabbed by a rusty sharp object, and even her parents didn't know about it, but you were able to deduce it just by looking at the blood test results. You're really amazing! I've learned a lot today!"
A woman with a very bad complexion and an abnormally obese body sat down in front of Zhou Can's consulting table.
When looking at Zhou Can, he was full of admiration.
Not only her, but also the family members and patients who were watching the excitement just now, also admired Zhou Can very much.
With the support of the news interviews, his image as an "expert" has improved significantly.
However, this kind of fame increase has certain limitations and is very small in scope.
Only the dozen or so patients and their families knew how powerful he was.
It is not easy for a famous doctor to accumulate knowledge.
All things are difficult at the beginning.
Other famous doctors are like him, accumulating popularity little by little and eventually becoming well-known medical experts.
In addition, famous doctors can not only improve their reputation by treating patients, but also publish scientific research results and academic papers, which have a certain bonus effect. Then there are the senior honorary titles such as senior professional titles, excellent young scholars, outstanding young scholars, Yangtze River scholars, and academicians, which one has a greater bonus effect.
As for titles such as professor and expert, in the eyes of people in the industry, they are actually common titles.
Chief physicians who are successful can basically reach the level of professor in medical schools.
"You are too kind! Are you feeling unwell?"
Zhou Can looked the obese woman up and down and asked her about her condition directly.
Looking at her complexion, there must be something wrong with her health.
After she sat down, she placed the registration note in front of Zhou Can.
"I just feel a little heartburn, can't eat, keep vomiting, and it feels very painful when I eat!" the woman described her symptoms.
Zhou Can glanced at Deputy Director Shi at the nearby desk.
Judging from the symptoms described by this woman, it should be a digestive tract disease.
At this moment, Deputy Director Shi was checking the medical records of a patient, frowning. Judging from this situation, he probably encountered a difficult case again.
It’s good enough that he didn’t ask Zhou Can for help.
If Zhou Can pushed another patient over there, Deputy Director Shi would probably be furious.
Zhou Can calmed down. He had been in gastroenterology for more than two months, and he could easily handle common digestive diseases. Even if it was a difficult digestive disease, as long as it didn't happen to touch on his knowledge gap, he could probably diagnose it.
"How long has this symptom lasted?"
“It’s been almost a month!”
"Did it appear suddenly, or gradually?"
“It slowly started to appear after I used a special weight loss method on the Internet.”
She lowered her head a little embarrassedly and answered.
"What's the special method?"
Zhou Can asked.
There are many ways to lose weight on the Internet, many of which are fabricated and packaged by unscrupulous merchants. Some are just made up by non-professionals, which may be effective for the parties involved, but not for everyone.
There are also some methods that can only be written by charlatans who have gone crazy.
For example, do not eat whole grains, and only eat a little water and low-calorie food to maintain basic life.
Some are even more exaggerated, saying that they are fasting, and that the amount of food they eat will gradually decrease day by day, eventually achieving the so-called Qi-eating therapy. This is something they learned from Taoists, who say that they swallow purple air in the morning and clouds in the evening.
Normal people definitely don’t believe this.
However, some obese people are desperate and will try all kinds of medical treatments, and they actually believe whatever others say.
After a lot of tossing and turning, he almost killed himself and was finally carried to the hospital by his family for emergency treatment.
Zhou Can has treated similar cases in both the Department of Gastroenterology and the Department of Surgery.
I don’t know what kind of weight loss method this woman used?
Seeing how weak and sick she looks, I'm afraid she's been through a lot.
"I, I use a medical slimming device called the Fairy Tube to lose weight. When I bought the Fairy Tube online, the seller provided excellent service and even invited a medical expert to give us a lecture on how to use it. He also told us that we don't have to worry about the side effects of taking slimming pills."
The woman hesitated and took out a plastic bag from her bag, which contained a transparent plastic tube with an astonishing diameter.
It is estimated to be at least half a meter long.
The inner diameter of the tube wall should be no smaller than a nickel.
How can you lose weight with such a thick tube?
"How do you usually operate it? No need to demonstrate, just explain it."
Zhou Can considered himself a professional and had never heard that a plastic tube could help lose weight.
"After eating, about half an hour later, the tube is inserted from the mouth into the esophagus and pushed all the way in until it reaches the stomach. Then the patient bends over and draws out the food in the stomach."
She explained it again using both words and gestures.
After listening to this, Zhou Can couldn't help but stroke his forehead with one hand. These days, anyone can dare to call themselves a medical expert.
Doctors who perform gastroscopy on patients are definitely professionals, right? They have to ask patients to fast beforehand and make adequate preparations. They are even more cautious during the gastroscopy and take all kinds of protective measures.
I can’t imagine that the patient was holding such a thick plastic tube and sticking it directly into his stomach. It’s so scary.
Aren’t those illegal businesses afraid of causing loss of life?
For the sake of money, criminals will do anything. As long as the food is not deadly, they will sell it, regardless of whether the pesticide residues exceed the limit or the food is spoiled and has a risk of cancer. Anyway, it is the consumer's own business.
"May I ask how many times have you used this tube?"
"I can't remember exactly, but it should be 20 to 30 times!"
"As a professional doctor, I can tell you responsibly that you should never use this method of weight loss again. It is very easy to damage the esophageal mucosa and stomach wall during the operation. It may also cause bacterial infection and lead to tracheitis and bronchitis. In more serious cases, refluxed food may enter the trachea and suffocate to death."
"Using this extreme method to make food vomit out is also very harmful to the body. The stomach contents contain a lot of gastric acid, which will seriously burn the esophagus, trachea, throat, vocal cords, etc. when refluxed."
Zhou Can could only persuade her earnestly.
As for people not listening, there is nothing we can do.
Doctors cannot restrict patients' thoughts and behaviors and can only fulfill their obligation to persuade them.
"Let me prescribe two tests for you first to see the specific conditions of your esophagus and stomach! Judging from the symptoms you've reported, your esophagus and stomach may have been damaged to some extent. And judging from your hoarse voice, your vocal cords may have been damaged as well."
Zhou Can wrote her an application for an examination and asked her to make an appointment for a gastroscopy first.
"I really don't understand, if you care so much about your figure, why don't you control your diet and exercise more?" Ji You sighed deeply as he watched the fat woman leave.
"In the final analysis, there are only two reasons. One is to satisfy the desire for food and want to eat when seeing delicious food. The other is not willing to exercise and have a slim body. Do you think there is such a good thing in the world that can satisfy all three?"
Zhou Can saw it clearly.
Unscrupulous businesses take advantage of the patients' desire for pleasure and a beautiful figure.
At this time, the little boy who sprained his ankle came back after taking the X-ray.
"Doctor Zhou, this is the X-ray I just took. Please take a look."
The little boy's grandfather sat down holding the child.
After taking the X-ray, Zhou Can found that there was an obvious fracture line on the child's right navicular bone, but no fracture line could be seen on the front or side of the talus.
The boy suffered only minor fractures.
The hematoma in the ankle is not a problem. There will be pain for a while, but it will disappear after two days.
The body's self-healing ability and its ability to absorb local hematoma are both very strong.
"His ankle is sprained pretty badly! Look, the navicular bone is broken."
Zhou Can took the film and showed it to the family members.
Theoretically, the navicular bone, talus, first and second cuneiform bones are all prone to fracture during the sprain process.
However, the most vulnerable bone to fracture is the scaphoid bone.
It has something to do with the location where it is located.
It is an important link between the heel and the toes. When the ankle is sprained, this part often bears the strongest external force.
Moreover, most of the sprains occur outwards.
When the foot lands, the center of gravity is unstable and the foot is tilted to the outside of the foot. In this case, the body's own weight plus the unbalanced force are superimposed, which can easily exceed the bearing capacity of the bones.
This results in a fracture.
The most serious case Zhou Can had seen was a direct comminuted fracture.
There is no way to reduce the fracture with external fixation, and the only option is surgery.
Even with surgery, it is difficult for patients to regain their previous athletic ability.
"Well, what should we do? His father and mother are divorced, and his father is working outside. His grandmother and I are taking care of the grandson. Doctor, you have to help me think of a solution!"
The grandfather didn't expect his grandson to be so seriously injured, and he became anxious when he heard it.
The first reaction of many family members at this time is to cry bitterly.
Zhou Can has gotten used to it.
"Don't worry, don't worry. I'll try to put a plaster cast on him and do external fixation and reduction treatment. But you must follow the doctor's orders and never let the child do whatever he wants. If he doesn't recover well and becomes disabled, that would be a problem."
There is a certain element of intimidation in these words.
Zhou Can also had good intentions. His face was black, but his heart was red.
The boy's parents are divorced, his father is not at home, and he lives with his grandparents. Usually, it is difficult for grandparents to control their grandchildren, and it is the most real portrayal that they are spoiled from childhood.
Zhou Can now performed external fixation on the little boy's fracture, but the little guy was naughty and removed it after two days.
Then the corrective treatment effect cannot be achieved.
It is really possible to cause disability.
After recovery, I can walk again, but I limp.
"Okay, okay, we will listen to you!" Grandpa couldn't help but use honorifics to address Zhou Can. He lowered his head and glared at his grandson fiercely, "Boy, did you hear what the doctor said? If you don't listen this time, your legs will be crippled."
He may sound fierce in words, but his eyes are full of love.
"Yes! I'll listen to you!"
The little boy promised very readily, but it .
Zhou Can performed external fixation of the fracture on the little boy.
To put it simply, it is plaster.
After finishing, he carefully checked it and observed it for more than ten minutes. He was relieved when he found that the bandage was not tied too tightly to block the blood flow.
Plastering seems to be a very simple thing, but novice doctors often get nervous and either tie the bandage too tight or too loose.
If it is too loose, the ideal fixing effect cannot be achieved.
If it is too tight, it may easily cause ischemic necrosis of the patient's lower limbs.
Such a thing had never happened in a big hospital like Tuya, but he had heard colleagues in the orthopedic surgery department mention it. A patient had a broken foot and, in order to save money, had a plaster cast applied at a small clinic. Later, because the bandage was wrapped too tightly, the blood flow to the lower limb was blocked, which directly led to necrosis of the lower limb.
When he was sent to Tuya Hospital, amputation was the only way to save his life.
Many operations that seem extremely simple in large hospitals often lead to medical accidents or even deaths in small hospitals or clinics.
This is because large hospitals have a heritage and a three-level responsibility mechanism.
Many bloody lessons have become experience and passed down from generation to generation, so the probability of accidents in large hospitals is much lower.
Zhou Can gave some instructions and sent the grandparents and grandchildren away.
There are only a few patients who come to see him.
Some people also come to him with the results after completing the examination.
More than an hour later, the little girl whose palm was scratched by the rusty angle iron came back after checking the procalcitonin level. As Zhou Can expected, the test result was abnormally high.
It has now been basically confirmed that the patient has sepsis.
Since the patient reported anuria and oliguria, Zhou Can inferred that there must be something wrong with the patient's kidney function.
Now that the cause of the disease has been confirmed, the process of hospital admission begins.
Before that, kidney function must be checked.
Urine test is one of the important examinations. The patient has anuria and oliguria, so the only thing we can do is let the child drink more water, and finally squeeze out some urine sample for testing.
In addition to this method, doctors have other methods for patients who truly cannot urinate.
For example, inserting a urinary catheter.
If it still doesn't work, it means there is no urine in the bladder, and the situation is serious. At this time, CT scans, ultrasound and other examinations can be done to further clarify the condition of the kidneys.
Some patients with renal failure may even experience severe kidney atrophy, with the kidneys being almost invisible in imaging examinations.
This little girl obviously hasn't reached that stage yet.
After a series of examinations, the little girl was finally diagnosed with sepsis and acute renal failure. Zhou Can admitted her to the hospital for emergency treatment.
This was also the first patient he admitted to the hospital alone.
