Chapter 465: The surgery was done poorly. People are very different.
"It's nothing. I just looked at the patient's preoperative films and barium contrast. I guess you performed a total gastrectomy on her."
Zhou Can explained with a smile.
Barium angiography is used to examine the cardia and digestive tract. Usually, the patient is asked to swallow barium directly, which is medically referred to as a barium meal.
Some patients may have great concerns when taking it, but you can rest assured that there is basically no harm.
The barium meal used for gastrointestinal examination is a suspension of medicinal barium sulfate. It is insoluble in water and lipids, so it will not be absorbed by the gastrointestinal mucosa and is basically non-toxic to humans.
If you say that it is not toxic at all, I certainly cannot guarantee that.
After all, it is a chemical agent.
It’s just that the vegetables, fruits, and various processed foods we eat on a daily basis contain far more additives than we imagined.
The toxicity of a barium meal test may be less than eating a spicy stick or chewing a betel nut.
This check is not done frequently, only once when necessary, so there is no need to worry too much.
Our body's detoxification, defense, self-cleaning, and recovery abilities are far beyond our imagination. Many toxic and harmful substances will be quickly broken down by our liver after entering the body.
If the liver cannot process it, the kidneys will cooperate to excrete the toxins out of the body.
At the same time, our sweat glands also have detoxification functions.
If the food you eat is highly toxic, don't worry, your body will immediately activate a dual protection mechanism of vomiting and diarrhea, vomiting out the toxic contents in the stomach, and then quickly excreting the toxic contents in the intestines through diarrhea.
It can also be seen from here that our bodies love ourselves more than we love ourselves.
"Yes, I did perform a total gastrectomy on her. My idea is that losing the stomach organ is better than losing her life. Even if it can only help her live five years longer, I think this operation is of great significance. Under normal circumstances, if there is no recurrence, her life span can even be extended by ten, twenty years, or even longer."
Director Le is considered a veteran in cardiothoracic surgery.
In terms of surgical skills, he is quite excellent.
Any surgery will cause some harm to the patient's body. If the attending physician, after evaluation, feels that the benefits of the surgery far outweigh the harm, then it is worth it.
Losing the stomach, a digestive organ, will definitely have a negative impact on the body.
From now on, you can only eat liquid food.
It also brings a lot of inconvenience. Without a stomach to store food, patients must eat small and frequent meals. In addition, food reflux also makes patients suffer.
Losing the stomach not only reduces the digestion and food storage capacity, but also reduces an important protective barrier when eating through the mouth. There is gastric acid in our stomach, which can eliminate most bacteria and viruses.
Without it, there would be no barrier.
Therefore, you must take good care of every organ in your body. If you find any problems, seek medical attention in time.
If you keep delaying, it is easy to miss the best time for treatment.
The body is like a house. When a fire breaks out in a room, put it out quickly, and the damage to the items in the room will be minimal. For the whole house, there will be almost no impact.
If you wait until the fire is big and all the items in the room are burned before putting out the fire, at least the room will be damaged.
Each organ in the body is equivalent to a room and has its own unique function.
It is difficult for other rooms to replace its functions.
For example, if the kitchen burns out, then I won’t be able to cook and I’ll have to eat takeout every day.
"After you removed the stomach, did you pull the jejunum over the diaphragm and anastomose it end-to-side with the esophagus?"
Almost everyone is from the same lineage as Director Hu Kan, and they can guess some of the surgical methods.
"Great! That's exactly how it works."
Director Le nodded in acknowledgment.
"The feeding tube was placed in the distal jejunum, right?"
Zhou Can asked again.
"That's right." Director Le really admired Zhou Can. He could accurately deduce the surgical plan after just a few glances. "Doctor Zhou must have found the cause of the patient's illness. Don't keep me in suspense. Just tell me! You know I'm impatient."
Director Le couldn't help but urge.
Based on his understanding of Zhou Can, he was certain that Zhou Can had already reached a diagnosis.
It’s just that Zhou Can has always been low-key and won’t speak easily unless he is absolutely sure.
"Hey, I won't hide it from you. We do have a preliminary diagnosis. But whether it's as I thought, further testing is needed." Zhou Can smiled. The first thing he said was not the answer, but he emphasized that the treatment plan could only be determined after examining the patient.
Medication and treatment are rigorous matters.
No matter how experienced a doctor is, unless it is an emergency life-saving situation, he or she should never treat the patient based solely on the doctor's subjective judgment.
Even in emergency life-saving situations, some necessary examinations are still needed.
You ask, what should we do if it is an emergency or critical illness such as sudden chest attack or cerebral hemorrhage?
Even for such critical illnesses, the most they can do is some basic rescue measures, such as cardiopulmonary resuscitation, and then urgently perform relevant examinations on the patient. Before the examination results come out, absolutely no doctor dares to use thrombolytic drugs or perform surgery on the patient.
If we have to set a cruel rescue condition, the patient is unconscious when he is admitted, and the doctor knows from experience that the patient has cardiovascular blockage. The doctor can even infer which coronary artery is blocked by virtue of his superb medical skills and rich experience.
At this time, emergency intervention to clear the thrombus can save the patient's life.
If the patient has to wait until a CT scan or even angiography is completed before deciding on the surgical plan, the patient will definitely die.
At this time, should I rely on the doctor's experience and perform surgery to save the patient, or should I wait for the test results to come out?
Unfortunately, even though we know that the patient will die while waiting for the test results, we still have to wait.
It's not that doctors don't want to save patients, but no doctor dares to gamble with his or her future and house. If the patient can't be saved and the family takes the case to court, the doctor will most likely be finished.
In order to protect himself, the doctor could only wait for the test results.
During the waiting process, only some basic rescue measures can be taken, and no surgery or interventional surgery is dared to be performed.
Even the use of medication is done with extreme caution.
This is the cruel reality.
It's not that doctors are unsympathetic, but they must strictly follow relevant procedures.
"This patient underwent anastomosis of the jejunum and esophagus. Based on her symptoms and surgical plan, I boldly inferred that the cause of her illness was most likely a serious postoperative complication, with reflux of bile and pancreatic juice."
Zhou Can gave the diagnosis conclusion.
After hearing this, Director Le fell into deep thought.
"Reflux fluid is mostly alkaline. Without the neutralization and buffering of gastric acid in the stomach, it is more invasive to the esophageal mucosa. Therefore, whenever reflux occurs, the patient will feel unbearable pain behind the sternum and naturally lose appetite. If this continues for a long time, the physical condition will definitely deteriorate seriously."
He made further analysis based on Zhou Can's conclusion.
Zhou Can just smiled and nodded, indicating that was exactly the case.
"So how do we solve this problem?"
Director Le humbly asked him for advice.
The cause of the disease has been found, and it is not immediately fatal, giving doctors plenty of time to treat the patient.
What we need to do now is to find ways to treat and change the patient's current situation.
"This has already been done, so I'm afraid it's a bit troublesome. If it hadn't been done before, there would have been a way to solve it."
Zhou Can's expression turned serious.
He is not a god, and some postoperative complications are almost unsolvable.
A good cook cannot cook without rice.
The previous surgeon had already removed part of the patient's tissue, so even if he knew how to treat the patient, there was nothing he could do .
“Did I mess up the surgery?”
Director Le is also a smart man. Even though Zhou Can didn't say it explicitly, he already understood some of it.
A competent doctor generally will not criticize other doctors for not performing the surgery well.
At most, it would be like Zhou Can, who just gave a slight nod.
It is basically impossible to hold the last surgeon responsible because the family members of the patient signed the consent form before the surgery. They were fully aware of the situation and agreed to the surgery.
Even though we know that signing before surgery will bring huge risks, there is basically no solution.
You have to sign when it’s time to sign.
If the family members don’t sign, the surgery cannot be performed.
You can only change the hospital.
Moreover, the family members' professional level is definitely not as good as that of the attending physician. It is ridiculous to use the medical knowledge from Baidu, Zhihu and other popular science websites to teach the doctor how to decide on the surgical plan.
As long as a family member dares to do this, the attending doctor will give up after failing to explain and ask the family member to find someone else.
Nowadays, some smart patients and their families like to ask several hospitals before surgery and dare to make multiple comparisons of the surgical plans formulated by doctors. This is actually a safer approach.
Of course, the prerequisite for doing this must be a chronic disease, and you need to have sufficient time, money and energy to visit several hospitals.
If the hospitals you choose are large ones, you can basically avoid some potential risks.
Zhou Can really had no way of giving a direct answer to Director Le's question.
Even if the two had a good relationship, it would be extremely stupid for him to admit in front of Director Le that he had messed up the operation.
Even if people don't have any opinions to your face, they will definitely have some thoughts behind your back.
If you meet a doctor who is arrogant and conceited, it is possible that you will become enemies with him.
"Doctor Zhou, is there any way to solve this patient's postoperative complications?"
Director Le asked the question in a different way.
"Show me your surgical plan and surgical records. Then, during this period of time, you can do a 24-hour bilirubin monitoring test on the patient. If possible, it is best to supplement it with a gastroscopy, mainly to observe the bile reflux and clarify the cause of the disease."
Zhou Can did not rashly "give advice to others".
It can be seen that as he has been practicing for a longer time and his medical skills have improved, he has become more cautious in what he does and says.
This is also the common manifestation of all doctors after evolution.
The higher the level of the expert, the more cautious he is during diagnosis and treatment.
It is not entirely because they are afraid of being slapped in the face, but rather they look at the problem more comprehensively. In-depth comprehensive evaluation and judgment have gradually been integrated into their diagnosis and treatment habits. Therefore, they have become more and more cautious in practicing medicine.
By doing this, the probability of capsizing will also be reduced.
Director Le gave all the surgical records and the surgical plan discussed before the operation to Zhou Can for review and study.
On the other hand, he has arranged for the patient to undergo a second examination to observe the patient's reflux condition in order to determine the cause.
Half an hour later, Zhou Can had completed his research and had a plan to improve the surgery.
Director Le’s examination results will probably not be available until tomorrow.
Zhou Can called Director Le and told him to wait until the test results came out tomorrow before consulting with him. Then he rushed to the pediatric department.
There is a difficult case waiting for him there!
When he arrived at the pediatric department, he went straight to Director Tang Fei's office.
He knocked on the office door and found that Director Tang Fei had not yet left work and might be waiting for him to come.
Because when she saw Zhou Can coming in, she felt very happy, and immediately put down the pen in her hand and got up to make tea for Zhou Can.
You know, this is the director of pediatrics.
Zhou Can was just a resident doctor, but he was treated with such courtesy by a director whose status was second only to that of the vice president. This was the benefit of being powerful.
Ordinary residents would feel extremely honored and happy to be able to enter Director Tang Fei’s office for a private chat.
It is estimated that there will be standing room only throughout the whole process.
Looking at Zhou Can, he was treated exactly like a doctor of the same level. Even an ordinary deputy chief physician who came to see Director Tang Fei might not be treated this way.
"Doctor Zhou, please take a seat! Why are you being so polite when you are here?"
Director Tang Fei smiled and asked him to sit down, and then closed the office door.
Zhou Can's expression immediately looked a little unnatural.
Being misunderstood by Director Xueyan's husband has left him with some psychological trauma. He has become more cautious when dealing with these younger and prettier female doctors and nurses.
Especially when you enter someone else's office and are alone with each other, try not to close the office door if possible.
Otherwise, if it causes misunderstanding, it will not benefit anyone.
"Don't be shy, Doctor Zhou. This isn't your first time here."
Director Tang Fei saw that Zhou Can looked nervous and uneasy, so she immediately smiled and tried to comfort him.
"Uh... I'm not shy! Could you please open the door of my office? I've been feeling a bit tight in my chest lately."
Zhou Can made up a lame excuse.
Puff!
Who is Director Tang Fei? You can tell from his expression that he is not telling the truth.
I couldn't help laughing on the spot.
Zhou Can suddenly felt even more embarrassed.
"Dr. Zhou, what's wrong with you today? You seem strange. Did something happen to you?"
Women's sixth sense is too strong.
She could easily tell that something must have happened to Zhou Can.
"Well...well..." Zhou Can hesitated.
"You're treating me like an outsider! If you have any problem, you can tell me without worry. I might be able to give you some advice and help you solve it! Of course, if you don't want to tell me, you don't have to force me."
Director Tang Fei has always been kind to Zhou Can and values him very much as a super talent.
Zhou Can hesitated, but finally said honestly, "I was not paying attention when I was with a female doctor in our hospital. I closed the door of the office and discussed the patient's condition with her inside. As a result, her husband misunderstood me. This morning when I was at work, her husband found me and warned me not to associate with his wife anymore. I am not afraid, but I am afraid that I will harm you female comrades, which would be a big sin."
He felt depressed when he mentioned this matter.
“Cluck, cluck, cluck!”
After hearing this, Director Tang Fei burst into laughter.
"I thought it was something else, but it turned out to be this! You should be careful with other female doctors and nurses, but you should be at ease with me. My husband never asks me about my relationship with other men. He trusts me very much. Besides, he is busy doing research in the laboratory all day long and has no time to care about me. In his words, as long as I don't cause trouble for him, it's fine."
Director Tang Fei explained to Zhou Can.
"You are so beautiful, he never worries about other men snatching you away?"
Zhou Can couldn't help but ask.
He found that there were huge differences between people.
Director Tang Fei's husband and Director Xueyan's husband are simply two extremes.
"If he really cares about this one day, I'd be happy. But for him, his scientific research data is obviously more attractive to him." Director Tang Fei is in her forties and has a sweet look. Her husband doesn't worry at all that she might be targeted by .
It's really interesting.
