Chapter 326 Everyone has a different way of living. Whatever you fear will come true. Dr. Zhou panics.
After seeing so many café au lait spots on the patient's body, Zhou Can had basically confirmed the diagnosis.
This disease can actually be detected through an eye examination.
Ophthalmologists can see small, brown-yellow, miliary nodules on the iris through a slit-gland lamp.
Zhou Can picked up the patient's ultrasound examination report again and was able to see a subcutaneous mass.
Multiple neuromas will appear in the peripheral nerves at the site of the disease.
If not treated promptly, it will spread further.
This is also the main reason why the adjacent fingers are affected and subsequently develop lesions.
There is currently no specific medicine for treating neurofibromatosis macrodactyly. The best way is surgery, supplemented by some medication. The main treatment idea is to ensure the patient's quality of life and reduce tumor recurrence.
And work to reduce complications.
There is currently no cure for this disease.
Zhou Can's treatment ideas were very clear. He took into account the patient's family difficulties: the child's father died in a car accident, the child's grandmother was a sanitation worker, and the mother worked outside to earn money.
Try to save treatment costs for this family and reduce recurrences.
Of course, the first priority is to restore the patient's hand function as much as possible. The child is still so young, and once the right hand is taken out, it immediately looks like a monster, which will cause great damage to the child's mind.
He will naturally be excluded and isolated by other students in school.
The current primary treatment goal is to restore the child's right hand to its normal appearance and normal function through surgery.
After communicating with the child's grandmother, the child was arranged to be hospitalized for surgery.
Surgical treatment includes soft tissue reduction, epiphyseal fusion, bone tissue reduction, amputation of part of the finger, carpal tunnel decompression... It seems that the treatment area is only two fingers, but it is much more complicated than imagined.
And it requires high technical skills from doctors.
There is no need to worry about this.
Tuya’s surgical capabilities are among the best in the province, with multiple teams capable of performing surgeries of this level.
Around eleven o'clock in the morning, the little boy who had had a fever for more than two years, chest pain, and had not eaten for two days came back after doing a routine blood test and B-ultrasound.
After the child's mother handed the test results to Zhou Can, she checked them frequently on her mobile phone.
If you don’t know, you might think she is in a hurry to go to work.
Zhou Can, however, was furious. The child's father was a gambler and the mother was not a good person either.
The child only eats two meals a day. If the mother was a little more responsible, this wouldn't have happened.
"The blood test results show that the patient's total white blood cell count and neutrophil ratio have increased significantly, and there are symptoms of anemia. The hemoglobin level is low." Zhou Can frowned slightly after checking the blood picture.
Long-term fever and increased total white blood cell count, these two together, in most cases indicate that inflammation, viral invasion, etc. have occurred in the patient's body.
The patient also has long-term chest pain symptoms, and the pain is actually located in the upper abdomen, which is the area where the liver is located.
After checking the B-ultrasound results, Zhou Can was shocked.
"Your child may have an abscess or tumor in his liver! And it's very serious!"
No wonder children always complain of chest pain.
The area of the liquid dark area in the liver was very large. Zhou Can judged that the possibility of a liver tumor was small and a liver abscess was likely to have occurred.
B-ultrasound is quite accurate in diagnosing the size and range of abscesses.
These parents really make me want to take off my shoes and slap them in the face.
If the child had been brought to the hospital for treatment when he first developed a fever, his condition would not have become so serious.
"I know it's very serious. Doctor, how can you treat it?"
The woman looked nonchalant.
Maybe she thought Zhou Chan was trying to scare her on purpose.
"It is recommended to do a liver puncture first and extract some pus samples for further testing. After the specific cause is confirmed, further treatment can be carried out."
Zhou Can gave diagnosis and treatment advice.
At present, it is only a preliminary suspicion that there is a liver abscess, but it cannot be confirmed.
I don't even know what the disease is.
"Hasn't everything been found out? We still need to do another checkup! You've also seen the attitude of the child's father. It's simply impossible for him to spend a lot of money to treat the child."
When the woman heard this, she immediately became unhappy.
I don’t know if she really doesn’t care about her child’s life or if she doesn’t realize how serious her son’s illness is.
"The child's father is unwilling to spend money on treatment. You are also the child's parent, so you can treat him!"
Zhou Can said to the woman.
The child looked at his mother pitifully.
"I don't have any money, how can I treat him?"
She felt the child's gaze and seemed to finally have a change of heart.
The attitude is somewhat sincere.
"You don't have a job?"
Zhou Can asked curiously.
"No! My child's father and I play cards and mahjong every day. When we win, we order takeout. When we don't have money, we cook noodles at home."
The woman's answer really refreshed Zhou Can's three views.
Some people can actually live like this.
"You and your wife don't work, and you don't have much savings. What if you encounter something big that requires money? Just like right now, your son's condition is so serious that the treatment will cost at least 10,000 yuan. If you don't have money for treatment, won't you delay the birth of your child?"
The people Zhou Can comes into contact with on a daily basis are probably positive people in this society.
His colleagues and friends are at least doctors or nurses with decent jobs. They have stable incomes and decent social status. His parents, Li Lao, Mr. Cui, and his girlfriend Su Qianqian are already in the upper-middle class of society, the elite class.
It is basically patients who make up the lower classes of society that he comes into contact with.
Just like the sanitation worker who brought her grandson to treat macrodactyly, and the young father who brought his child to treat hair dryer hand deformity, they all belong to the bottom of society. But even if they are at the bottom of society, they still work hard and don't want to rot at the bottom.
I can’t imagine this gambling couple sleeping on the poker table every day and not working.
The most pitiful ones are their children.
"What did you say? My son's treatment will cost more than 10,000 yuan?"
The woman seemed frightened by the high cost of treatment.
Ten thousand yuan may be only half a month or a month's salary for some people, but for people like them who make a living by gambling, it is already a huge sum of money.
"It would cost at least 10,000 yuan. If the child is brought to the doctor when he or she first becomes ill, he or she might be cured with around 3,000 yuan."
Zhou Can said seriously.
"I'll call his father first."
The woman’s cell phone didn’t seem to be bad, it must have cost at least two or three thousand yuan.
Different people have different ways of living. People like her typically live day by day.
"Hey, husband, the doctor said that our son's illness will cost at least 10,000 yuan to treat. What should we do?"
"I'm playing cards now! Even if you sell me, I'm not worth ten thousand. You decide!"
“I don’t have any money!”
"You have no money, but do I have money? It cost me 120 yuan to check up that loser this morning, I have to win it back. That's it, I'm hanging up now."
"Hello, hello..."
The woman looked dejectedly at the phone whose call had ended.
"Doctor, you've seen the attitude of the child's father. I told him he wouldn't care. I still have over 300 yuan on me. Why don't you get some medicine? I'll take the child home for treatment."
At least this mother still behaves like a human being at this moment and can take out all the money she has to buy medicine for her child.
But the child's condition is so serious that he will definitely need puncture and drainage, or even surgery to cut open the abscess, and then use medicine. Three hundred yuan is probably not even a fraction of it.
Zhou Can looked embarrassed.
"Your son's condition cannot be cured by simply taking medicine. He needs puncture and drainage. The cause of the disease is not clear yet, so there is no way to prescribe medicine. Also, his treatment cannot be delayed any longer, otherwise his life will be in danger."
Zhou Can could only try his best to persuade the family members with his earnest words.
"It costs ten thousand yuan. Where can I get so much money?" the woman looked helpless.
"As a mother, you can't just ignore your child when he's seriously ill, right? Ask relatives and friends to lend you some money to save your son's life first. When your son recovers, you can find a job and make money to pay off the debt. If you give birth to a child, you have to be responsible for him. Even the law clearly stipulates that parents have the obligation to raise their children until they reach adulthood."
Zhou Can had no choice but to give the woman some advice.
No matter what, saving the child's life is the most important thing.
"Okay then, I'll call and borrow it and try."
The woman went out with the child.
Zhou Can was still a little worried when he saw her attitude.
It is hard to imagine that for the sake of ten thousand dollars in medical expenses, parents can be so cruel as to ignore their child's life or death.
This matter was beyond Zhou Can's experience in handling, and he felt it necessary to report it.
Seeing that the child was still so young, he couldn't bear it.
This is a life!
I called Director Tang Fei on the spot. She is the director of the pediatric department, so it would be right to report this matter to her.
The call was connected quickly.
"Hello, Director Tang, I'm Zhou Can!"
"Hello, hello! It's Dr. Zhou's first day as a doctor. What happened?"
Director Tang Fei's voice is gentle, slightly low, and steady.
"It's like this, I received a patient..." Zhou Can briefly reported what happened.
"It's useless to call the police in this case. Give me the patient's address and the identity information of his or her father or mother. Then we will directly contact the local Women's Federation and the Street Office, and they will come forward to resolve the issue."
Tang Fei has much more experience in handling this than he does.
Parents are the first guardians of their children. If parents are unwilling to treat their children, doctors will usually persuade the grandparents. If that still doesn't work, you can contact the street office and the Women's Federation to mediate. With the help of social forces, help children successfully get medical treatment.
It is definitely unrealistic to ask the hospital or the doctor himself to pay for this.
Doctors also have their own families to support and their abilities are limited. Even if Zhou Can is a tycoon with a net worth of tens of millions, if he is too compassionate and pays for the treatment of patients with slightly difficult conditions, he will become a pauper within a year.
There was no way he would do such a stupid thing.
At this time, the door of the clinic was pushed open, and another patient came back after the examination.
"I have another patient here, so let's leave it like this for now!" Zhou Can said to Tang Fei.
"Well, go ahead and do your work! If the child's parents don't want treatment, just send me the name, phone number, and address of the patient and his family, and I'll handle it."
She finished her instructions and hung up the phone.
Zhou Can put away his phone and looked up at his family members.
It was the grandmother who brought her granddaughter to see the doctor.
"Doctor Zhou, we have finished the examination. Please take a look at the results."
After receiving the medical examination form, Zhou Can asked the patient and her family to sit down and rest. This eight-year-old girl definitely did not have a cold.
As for what the disease is, it needs to be diagnosed and analyzed step by step .
One thing is certain, the disease this little girl suffers from must be a difficult and complicated one.
Check her blood picture first.
The white blood cell count was 1.7×109/L, which was significantly decreased and far below the normal value.
Normal white blood cell counts are (4-10)×10^9/L for adults and (5-12)×10^9/L for children.
This little girl is only 8 years old this year and is a child.
Logically, her white blood cell count should reach 5×10 to the power of 9 or above to be considered normal.
Now it's only 1.7, which is frighteningly low.
Her neutrophil ratio and lymphocyte ratio are slightly lower than normal, but still normal.
However, when Zhou Can's eyes swept across the platelet column, he found that there was only 37.5×10 to the ninth power/L.
This is obviously much lower than normal.
At the same time, the white blood cells and platelets have dropped significantly, which is definitely a serious illness. It is definitely not a cold.
Zhou Can became more certain of his initial inference.
What kind of disease could that be?
He also had the patient do a urine routine test.
When I looked at the results, the urine protein was 4+.
The girl's grandmother watched the young doctor's face change every time he checked an examination report, and her heart was hanging in the air.
"Doctor Zhou, what disease does my granddaughter have? Is it serious?"
She asked anxiously.
"Based on the current test results, I am sure she does not have a cold. Her white blood cell and platelet counts are far below normal, and her urine test results are also very bad, with 4+ urine protein."
Zhou Can wanted to say that it was probably a serious illness.
Seeing that the old lady's face had turned pale, he didn't dare to say anything more.
What if the little girl's illness hasn't been diagnosed yet and the family members are scared into having problems? That would be really troublesome.
Many retired elderly people work in offices.
Their bodies are prone to multiple underlying diseases, and when they get older, they cannot withstand the storms.
People with high blood pressure and heart disease are very afraid of being stimulated.
"Doctor Zhou, please save my granddaughter! Her parents are not around, and they entrusted her to me to take care of. What should I do if something happens to her?"
The old lady was very smart. Even though Zhou Can didn't say anything else, she still guessed that the result might be very bad.
"Don't worry, don't worry. Once she's here, we will definitely do our best to treat her. We've only done a blood test and a urine test, and we can see that some indicators are obviously abnormal, but we can't confirm what the disease is. We may need your cooperation in doing some biochemical tests."
Zhou Can noticed that the old lady's hands were shaking, so he took out a pack of tissues from his bag and wiped the sweat from his forehead.
Moreover, the old lady's face became paler and paler, which looked particularly scary.
I’m just worried that something might happen to this old man and I won’t be able to explain it when the time comes!
"Yes, we will definitely cooperate with the doctor to do the examination. Does the biochemical test require an X-ray?"
"No need for an X-ray. All we need to do is collect blood and other specimens and send them to the laboratory for some specific tests, such as lactate dehydrogenase and aspartate aminotransferase. Do you feel any discomfort in your body?"
Zhou Can asked with concern.
At this moment, he especially wished he had a nurse by his side.
What if the old lady faints in the clinic? It will be hard to explain!
"I just feel a little weak all over, my head hurts a little, and my chest feels like there's a stone pressing on it, it's very stuffy!" She already needed to support herself on the table with her hands, which showed that her physical condition was very bad.
Chest tightness, especially when the elderly experience this symptom after being stimulated, immediately made Zhou Can highly alert.
I'm really unlucky today. The more I fear something, the more likely it is to happen.
Symptoms of chest tightness and difficulty breathing will appear before myocardial infarction or various heart attacks.
The elderly also have symptoms of headaches, and if high blood pressure comes along, it will be even worse.
"You don't have heart disease or high blood pressure, do you?"
Zhou Can asked nervously.
"I have high blood pressure. I have been taking medicine and my blood pressure is well controlled. I, I seem to be feeling a little uncomfortable. The figure in front of me is shaking..."
As the old lady was talking, she laid down on the table, opened her mouth and gasped.
"Grandma, grandma... woo woo..." When the little girl saw that her grandma was sick, she was so scared that she burst into tears on the spot.
Zhou Can quickly stood up, opened the door of the clinic, and shouted to the nurse outside, "I have a family member here who may have been stimulated and suddenly fainted. Please quickly notify other doctors and nurses to come and help save him."
"Ah...I'll go get someone right away!"
When the nurse heard about this, she became a little panicked.
Zhou Can returned to the clinic and quickly examined the old lady.
First make sure the old lady's airway is not blocked, then measure her blood pressure.
It's very strange. The blood pressure is normal but the heart rate is too fast, the same symptom as the little girl.
She said she didn't have any heart disease and her blood pressure wasn't high, so it was definitely not an attack of hypertension.
