Chapter 466: The rich and powerful are all treated the same. Some diseases may be "diseases of affluence"
"Since Director Tang has said so, I have nothing to worry about."
Zhou Can sat down with peace of mind.
It is common for male and female colleagues to spend time alone together to discuss work. For example, a subordinate reports to his superior, or Zhou Can comes to consult a doctor.
"Haha, we are not afraid of slander if we are upright! Let's get down to business. This is the patient's medical records. We have basically done all the necessary tests. He was treated in another hospital for a long time, but the effect was not satisfactory. I organized relevant experts from the department and even invited experts from the Department of Gastroenterology to consult together, but we still couldn't find the real cause of the disease."
Director Tang Fei gave the child’s information to Zhou Can for review.
In medicine, patients under the age of 14 are usually referred to as children. This patient is a male who has turned 14 this year. The main symptoms of the first visit were lower limb edema for more than half a year and abdominal distension.
Symptoms such as nausea and vomiting were also mentioned during hospitalization.
"This child's parents are really careless. Their lower limbs have been swollen for more than half a year, but they never took their child to the hospital for a checkup."
After reading the medical history, Zhou Can shook his head and sighed.
Many incurable diseases are caused by delaying treatment. It is really like raising a tiger to harm you.
"You can't blame the child's parents entirely. The child's father is an official, and the mother is the CEO of a large company. The family is rich and powerful. They only have one child, so they naturally treat him like a treasure. I heard that they hired several tutors for the child, and also provided a special nanny. The only downside is that the child's parents are very busy and don't have much time to accompany the child."
No wonder Director Tang Fei is so concerned about it.
Every country in the world is a society based on personal relationships, and this has been the case since ancient times. Whether it is the feudal dynasties of the past or the modern society ruled by law, personal relationships are always the unspoken rules of social rules.
In feudal society, if the sons of nobles or the children and relatives of officials got into trouble or committed crimes, would the county magistrate dare to arrest them?
Even if they really arrest someone due to public outrage, it is difficult to withstand pressure from all sides and eventually release the person secretly.
The county magistrate probably didn't even know the noble son who committed the crime, nor did he know his family. So why did he risk violating the law by letting him go?
The young man's uncle is the prefect, a much higher position than the county magistrate.
This alone was enough for the county magistrate to release the person.
The young master's uncle was also a wise man. He secretly gave the county magistrate a sum of money and told him that he would take care of him if he had any problems in the future. As long as the county magistrate was not stupid, he would most likely "gladly" accept it.
Currying favor with the powerful is an instinct that humans have developed to survive in society after thousands of years of evolution.
It's a bit similar to seeking good fortune and avoiding misfortune, but it's more complicated and advanced.
The parents of this patient may have already contacted Director Tang Fei, and even informed the dean or hospital-level leaders. In this case, Director Tang Fei needs to actively treat this patient.
It’s cured, great job.
Even if the disease cannot be cured, you must still be positive.
Zhou Can nodded and continued to check the patient's medical records and medical history.
After the child showed symptoms of nausea and vomiting, the nanny was worried that something had happened to the child and quickly informed the child's parents, who then took the child to the hospital for treatment.
The first hospital for consultation was the Provincial Children's Hospital, and I made an appointment with a specialist.
Look at the children from wealthy families. Their treatment is almost no different from that of the sons of the powerful in ancient times.
In ancient times, when the princes and kings fell ill, they would directly ask the imperial physician to diagnose and treat them. They would use the best doctors and the best medicines.
The children of modern dignitaries go to the province's top hospitals to see experts.
The expert performed three routine examinations on the child, namely routine blood tests, routine bowel and urine tests, and then also did an abdominal ultrasound examination.
The blood routine test showed that the WBC result was 3.3*10 to the power of 9 per liter.
PLT189*10 to the 9th power per liter, normal stool.
Abdominal ultrasound showed an enlarged spleen.
The child presented with fatigue, a flat and soft abdomen, no tenderness or rebound pain, and the liver was not palpable below the ribs. The spleen was about 3 cm below the ribs and was soft, and shifting dullness was heard.
Then it was discovered that the child had mild edema in both lower limbs, which was not serious.
When the expert examined the child, he could not feel the liver under the ribs. I don't know if he did not dare to examine it because he was worried that the child would be disgusted or resist, or what was going on.
Anyway, from the examination, it can be seen that it is very regular.
Quite conservative.
It can also be inferred from this that the experts at the provincial children's hospital were under certain pressure when they treated this child.
Are the parents of the child difficult to talk to?
Because the child's father is an official, his mother is the president of a large company, they are rich and powerful, and they only have this one son. Now that they find their son is sick, they can't help but feel anxious.
It is possible that the words and attitude may cause certain pressure on the attending doctor.
In short, the specialist who received the patient only performed a few basic examinations and did not dare to order any more tests.
The treatment is even more interesting, as the children are asked to fast for two days.
I didn't prescribe any targeted treatment drugs, but just asked the child to fast for two days. Then a magical thing happened, the child's condition improved significantly.
Experts are experts, their level is really high.
No medicine was used, the child was just asked to fast for two days and his illness was cured.
Unfortunately, the good times didn’t last long. Less than two weeks later, the child fell ill again. The doctor was consulted again, and this time the doctor diagnosed the child with duodenal ulcer. The doctor asked the child to fast for two days again.
This expert is truly a god-like expert.
After two days of fasting, the child's condition improved again.
Zhou Can was overwhelmed when he saw this. It had been a long time since he encountered such a bizarre and difficult case. He intuitively knew that this case was definitely a rare disease of hellish difficulty.
No wonder Director Tang Fei consulted so many experts but to no avail.
The expert at the Provincial Children's Hospital even tried fasting therapy twice but failed to cure the child. After each fasting, the child's condition would improve significantly, but then relapse.
Zhou Can was wondering if there was something wrong with the child’s diet.
Some wealthy people are willing to spend money on food, eating all kinds of delicacies from land and sea, meat and fish, and supplements until they get sick of them.
Could this child be suffering from food accumulation disease?
Next, when the child's condition relapsed for the fourth time, the family may have felt that the specialist was unreliable and changed doctors. However, the child was still treated at the Provincial Children's Hospital. The new specialist could not withstand the pressure and began to treat the child with drugs.
The drugs and methods used for treatment are in accordance with the standard treatment plan for duodenal ulcer.
However, after treatment, the child's condition did not improve significantly.
This is really interesting.
Not taking medicine, just fasting for two days, the condition can actually get better. Now serious medication, on the contrary, has no effect.
I guess the new expert is cursing the sky in his heart, it’s so weird.
The previous expert did not use any medicine, just fasting could achieve significant improvement. Why did I take over and carefully prescribe medicine for symptomatic treatment, but there was no effect?
The expert cursed his own bad luck and prescribed new tests for the child.
It's just those few things.
The blood routine showed that the WBC had risen to 5.62*109 per liter, LY was about 51%, and HB was about 104g/L.
Considering that the child has always had edema in his lower limbs, it is not serious.
In addition, the condition did not improve after treatment, so I began to suspect that there was something wrong with my kidneys.
Under normal circumstances, the kidneys of a 14-year-old boy are at their best stage in life. Boys at this age generally do not have sex, and may not even have their first nocturnal emission.
The kidneys are as clean and intact as a piece of uncut jade.
After checking urine, the 24-hour urine protein quantity was normal. Note that the 24-hour urine protein quantity was checked.
This indicates that the child's renal function is normal.
Considering that the child had symptoms such as nausea and vomiting, a routine stool test was performed.
This time there was a new discovery, the stool OB was intermittently positive.
What does it mean?
Stool OB means fecal occult blood. Intermittent positive test means that the child sometimes has blood in the stool.
There are many reasons for blood in the stool, the main one being gastrointestinal bleeding.
And it is likely to be intermittent bleeding.
The second expert was extremely excited after making this discovery. Finally, there was some new progress.
Based on this clue, another stool Sudan stain was performed, and this time the result was negative.
Seeing that the result was negative, the expert probably breathed a sigh of relief.
Because if the stool Sudan stain is positive, it is likely to be a malignant disease.
Sudan staining results in normal subjects are negative.
When excessive neutral fat is excreted, Sudan III staining results will be positive, which indicates that the patient has liver decompensation, pancreatic lesions, acute diarrhea, and fatty dysentery.
It is commonly seen in acute and chronic pancreatitis, pancreatic head cancer, malabsorption syndrome, small intestinal absorption dysfunction, and pediatric diarrhea.
Based on the clues of intermittent positive fecal occult blood results, the second expert began to focus on the digestive tract.
The child was first given a full gastrointestinal tract radiography.
Zhou Can could infer that the expert must be full of confidence at this time, holding back a strong desire in his heart, I will definitely find the cause of this child's illness. And I will find it soon and make a great contribution.
The whole gastrointestinal tract radiography was not in vain, as it was found that the child's duodenal mucosa was significantly thickened.
Such a young child, at the age of a flower, has thickening of the duodenal mucosa, which means that the disease has occurred for a long time.
Just like our palms, if we only do heavy physical work for one or two days, it is impossible to form calluses.
Only by doing hard labor for a long time can you get calluses.
The more and thicker the calluses are, the longer you have been doing hard labor.
The roughening of the duodenal mucosa often means that the patient has long-term chronic inflammation , which is related to factors such as long-term irregular diet and lifestyle, and lack of attention to exercise.
This is not a big problem, at least in Zhou Can's opinion, it is not a big problem.
If the duodenal mucosa is just rough and there are no other symptoms, there is no need to treat it. Just pay attention to observation and regular check-ups.
If you are organized, you can stick to soothing and gentle exercises and eat light and easy-to-digest food.
For example, eating porridge, noodles, lotus root powder, milk, soy milk, oranges, etc. As long as you eat on time and have a regular life, there will generally be no problem.
The situation can also be improved quickly.
The second expert went to great lengths to perform a full gastrointestinal radiography on the child, but ultimately only obtained this little finding. It is conceivable that he must have been extremely unwilling and disappointed.
It’s like we see a fish pond with deep water and a large area, and we can even see fish jumping out of the water from time to time.
I thought to myself, there must be a lot of fish in this fish pond. I might not catch tens of thousands of kilograms, but at least a few thousand kilograms.
Then they drained the water and after a lot of effort they caught a few buckets of small fish and shrimps.
This expert from the Provincial Children's Hospital originally wanted to catch a 'big fish', but ended up catching only a 'small fish'. It would be strange if he wasn't disappointed.
This is sometimes how doctors diagnose a disease: they lock on to the target with full confidence, and then after going through all the trouble to find nothing.
The expert must be unwilling to accept that he failed to find the problem, and he would not be able to explain to the family.
So the next inspection began.
What are you checking?
gastroscopy.
Intermittent occult blood in the stool means there are definitely bleeding spots.
Zhou Can once solved a similar case. The patient also had gastrointestinal bleeding, but the cause could not be found. Later, after Zhou Can's unremitting efforts, he finally found that the patient was infected with a rare parasite.
Because of this case, he also wrote a paper with Dr. Shi from the Department of Critical Care Medicine, which was first published in a core domestic medical journal.
Later, it was also included in the SCI medical journal.
Dr. Shi was also successfully awarded the title of associate senior professional.
Zhou Can also gained a lot of benefits. With his conditions and knowledge, he could reach such a high level in his first paper, which was something he never dared to think about. It also greatly increased his potential points.
Later, when he was working at Xinxiang Maternal and Child Health Hospital, he was selected by the hospital into the reserve talent list of famous doctors, and that SCI paper played a certain role in his contribution.
Since its invention, gastroscopy can help doctors accurately detect many diseases of the upper digestive tract.
Gastroscopy can detect lesions that are difficult to detect with CT, ultrasound, and even MRI .
After the expert performed a gastroscopy on the child, he actually made a new important discovery.
The child had atrophic gastritis and duodenal mucosal edema.
It's a bit like gyrus edema.
During the gastroscopy, a random sample of the duodenum was taken for pathology.
To be honest, after checking this far, I started to suspect whether it was cancer.
It is very necessary to do a pathology.
Because I had been treated for duodenal ulcer in the early stage, it had no effect at all.
According to clinical experience, if a disease is clearly present but the medication used to treat the disease is ineffective, it often indicates that the outcome may be very bad.
After pathological examination, it was determined that the child suffered from severe acute and chronic inflammation, and also had villous atrophy.
At this time, a disease name popped up in Zhou Can's mind: celiac disease.
Celiac disease, also known as gluten-induced enteropathy and non-tropical steatorrhea, has a relatively high incidence in developed countries abroad, but is rare in my country.
All Zhou Can could think of at this time was that rich people have their own sufferings, such as "rich people's diseases".
