Chapter 480: Fake pregnancy, surgeon for a bad patient
"The fetal heart rate is consistent with the mother's heart rate, which is very rare!"
Although we are not obstetricians, we usually work in the emergency department and often have the opportunity to see all kinds of pregnant women. Usually, the heart rate of pregnant women is much lower than the fetal heart rate.
"Doctor Zhou suspects that the fetal heart rate is actually the mother's heart rate?"
Yang Chan asked as if she had realized something.
"It should be! I have encountered a case of this before, which is a case of false pregnancy. The fetal heart rate you just measured is most likely just the pregnant woman's pulse."
[Pathology diagnosis experience value +1, reward pathology diagnosis experience value +100. ]
The harvest was quite good, and he was awarded 100 pathology diagnosis experience points.
It is quite difficult to earn experience points in pathology diagnosis.
Fortunately, he often receives some consultation tasks, and as long as he makes a successful diagnosis, he can basically get good experience points as rewards.
At present, his pathological diagnosis skills are advancing towards level six at a steady pace.
Pharmacological differentiation is much behind, but in fact, there are many prescriptions issued every day, and there are many opportunities to use medicine.
However, the medications used were basically conventional ones, and a doctor's prescription would only add one or two pharmacological differentiation experience points at most. It was rare to get a large reward like pathological diagnosis.
It was really not easy to successfully diagnose this pregnant woman as having pseudopregnancy.
This kind of thing is so weird that most people have never heard of it.
Zhou Can heard that a hospital had once received a pregnant woman who had already had an attack and her water broke. There was no time for examination and she was sent directly to the delivery room. Later, the pregnant woman only leaked a large amount of bright yellow liquid, but the baby was never born.
Upon investigation, it was found that the mother's body was only simulating the pregnancy process and there was no fertilized egg.
Later, the family believed that the hospital had stolen the child, so they called the police, reported it to the higher authorities, and even sued in court. The hospital was also very upset about this matter.
The mother's water had already broken at that time, and it was a bit inhumane to insist on sending her for a prenatal check-up.
Based on the principle of emergency treatment, we only drew blood from the pregnant woman and then sent her to the delivery room for emergency delivery.
At that time, blood was drawn to test the pregnant woman's blood type and whether she had any blood-borne diseases.
Later, it became the key evidence for the hospital to prove that the woman was not pregnant.
In fact, whether a woman is pregnant can be diagnosed not only by B-ultrasound or color ultrasound.
By testing the hcg content in the blood, it is also possible to accurately diagnose whether a woman is pregnant.
After a woman becomes pregnant, the level of human chorionic gonadotropin in her blood increases rapidly.
HCG examination can not only diagnose whether a woman is pregnant, but also find out whether she has an ectopic pregnancy.
Because ectopic pregnancy is also a condition after pregnancy, but the test results of blood hcg will be different from those of normal pregnant women. Doctors with a little experience can find problems through blood test results.
"What fake pregnancy? Could my belly be fake?"
Although the pregnant woman had multiple injuries and even a fractured right leg, she was still very aggressive.
When she heard Zhou Can say that she was faking her pregnancy, she immediately questioned Zhou Can angrily.
"Doctor, you must be mistaken. My girlfriend vomited a lot during the first three months of her pregnancy. Her belly is so big now, how could it be a false pregnancy?"
The woman's boyfriend was also there, denying Zhou Can's diagnosis.
"If you have any doubts, you can test the human chorionic gonadotropin in your blood. And then do an abdominal color ultrasound." Zhou Can said to the two.
Because it was a car accident, both men were migrant workers.
The family members have not yet arrived at the hospital.
"Just do it. If you find out that I'm pregnant, you must apologize to me."
The woman was particularly vicious.
Faced with such fierce female patients, Zhou Can always keeps his distance.
"Captain, if there is nothing else, I will go back to the operating room. Do not admit this patient to the delivery room until the cause of the disease is fully understood."
Zhou Can also gave her a piece of advice.
Because the pregnant woman was seriously injured, if she had uterine contractions or something like that and was pushed into the delivery room, it would be hard to tell what would happen.
In Zhou Can's eyes, Yang Chan is a novice doctor.
It is very easy to do something that is too considerate of the patient in an emergency. Soft-hearted doctors and nurses are actually not suitable for survival in the current harsh medical environment.
"Go get busy!"
She looked at Zhou Can with resentment, obviously dissatisfied with his hasty departure.
With her intelligence, she should have noticed that Zhou Can was deliberately avoiding her.
But love is something that no one can explain clearly.
Especially as she got older, the pressure to get married became greater and greater. But the men she met were no match for Zhou Can.
When she was in school, Zhou Can pursued her, but she looked down on this rich second-generation from the bottom of her heart.
Now that I'm older, have some social experience, and am more mature, I realize how regrettable it was to miss Zhou Can.
Today, Zhou Can is not only rich, but also has .
And the reputation of medical ethics is also very good.
There was also the time when Zhou Can stood up for all the frontline clinical medical staff in the hospital and protested against the inaction of the security department and the hospital's disregard for the personal safety of clinical medical staff, which left an epic heroic image in her mind.
Her family forced her to go on blind dates, and if she were to look for a partner based on Zhou Can's standards, she would probably find it difficult to find one that suits her.
…
After Zhou Can finished the operation at noon, he went to the cafeteria to eat and heard Ma Xiaolan talking about the pregnant woman.
"Did you know? A pregnant woman who was injured in a car accident and received treatment in our emergency department this morning was actually not pregnant. The nurses said that this was the first time they had seen such a thing. And it was our doctor Zhou who first diagnosed it!"
Ma Xiaolan often tries to please Zhou Can intentionally or unintentionally.
To put it bluntly, she should be considered a scheming bitch.
Of course, her mind is quite decent. She seems to be very aggressive and sharp-tongued towards other doctors and patients, but she is not a bad person. At least Zhou Can secretly observed her at work and found that she sometimes has a caring side in some specific matters.
"Which nursing group? Am I in it?"
This was also the first time that Qiao Yu heard of this strange story, and she was immediately filled with curiosity.
"It's our emergency department's nursing group 1. You must be in the group."
Ma Xiaolan answered as she scrolled down through the messages in the group.
After Qiao Yu opened WeChat, she saw that the nurses were all talking about this matter.
"It's true! Looking at the pregnant woman's belly, I can't believe it's a false pregnancy. The world is so big that there are all kinds of strange things. Doctor Zhou, please share with us how you made the diagnosis!"
Qiao Yu looked at Zhou Can with her bright eyes.
"It's nothing, actually. The female victim had an ultrasound, which showed a shadow object with a diameter of more than ten centimeters, which was suspected to be a gestational sac. But the fetus was not seen. The doctor from the obstetrics and gynecology department and our emergency doctor both measured it and said that there was a fetal heartbeat. Later, I found that the fetal heartbeat was consistent with the mother's heart rate, so I suspected it was a false pregnancy."
Zhou Can smiled and shared the diagnosis process with several people.
It can also help them gain some diagnostic and treatment experience.
"Did you finally get it cut out?"
Yang Zhi is a middle-aged man who doesn't talk much and is rather dull.
Unlike many married men who were unfaithful, he never took the initiative to flirt with young female colleagues in the department, whether they were doctors or nurses.
Don't ever think that he is a man who doesn't understand romance.
On several occasions, Zhou Can brought everyone together for dinner, and at the dinner table, Yang Zhi told dirty jokes to Ma Xiaolan and Qiao Yu, all in a set format.
"They didn't do a cesarean section. They didn't believe our hospital's diagnosis and directly asked to be transferred to another hospital for treatment."
Ma Xiaolan replied.
The female victim herself had syphilis and AIDS. I hope the medical staff in other hospitals who treated her will not be careless.
The patient took the initiative to request to be transferred to another hospital, and Tuya Hospital had no power to stop it.
It is the patients' right to choose which hospital to receive treatment.
…
After getting off work in the evening, Zhou Can went to the cafeteria to eat and then hurried to the cardiothoracic surgery department.
I don’t know if it’s because I’m too tired that I have this illusion.
He always felt that someone was watching him secretly.
I haven't offended anyone recently, but there is no way to avoid offending family members or patients at work.
Some family members ask weird questions and make requests that are impossible to meet, and there is definitely no way to satisfy them.
Then some patients have obviously been cured after surgery or have achieved significant therapeutic effects, but they still think that the doctor did not cure them and even caused other diseases.
There's no point in explaining this kind of thing.
Basically, this type of patients have one common characteristic: they are stubborn and like to get stuck in a rut.
Sometimes Zhou Can encounters such particularly difficult patients. When he gets annoyed by the questions, he will just say, "If you feel that our hospital has treated you badly, you can apply for a medical evaluation. As long as it is our responsibility, we will never shirk it."
There is really nothing we can do when we encounter this kind of patient but to fight back.
If you don't say anything, the patients will think you are weak and wrong, and they will dare to make trouble in the ward. All kinds of complaints make the medical department very worried.
As for the purpose of this type of patients, sometimes some new symptoms may indeed appear after surgical treatment.
Or maybe he did this on purpose in order to avoid paying the medical bills.
So, no matter what the situation is, it’s impossible to reason with them.
There is a famous saying: You can never wake up a person who pretends to be asleep.
When Zhou Can was doing his regular training, he encountered patients who were particularly noisy. After the hospital agreed to reduce some of the treatment costs, they immediately calmed down.
On his way to the cardiothoracic surgery department, he always felt like there was a thorn in his back, but he didn't look back.
If someone was really following him, he would be more likely to alert the enemy if he turned back to check.
If I have some free time tomorrow, maybe going to the Security Department to check the surveillance video would be a good option.
After Zhou Can arrived at the cardiothoracic surgery department, the first thing he did was to go into the ward to check on the patient with hemothorax.
The situation is not bad, and there has been obvious improvement in all aspects.
The bubbles coming out of the water-sealed bottle were even weakened a lot.
The bleeding seemed to have stopped gradually.
There was still some bleeding though.
The patient's left lung breathing sounds have become stronger, which is a good thing.
As long as the current trend continues, this patient should be able to recover and be discharged from the hospital soon without the need for open-chest surgery.
After leaving the ward, he returned to the doctor's office and logged into his personal account on the intranet.
Director Xue, Deputy Director He and others recommended several difficult cases to him. There were seven in total, which was considered a good case. At the most, Zhou Can received eleven difficult cases.
These include new patients admitted to the cardiothoracic surgery department, patients with postoperative complications, and patients for whom surgical options are difficult to decide.
There are mainly three categories.
Zhou Can both enjoys and has a headache about these difficult cases.
Cases that stumped the chief and deputy chief physicians must be extremely difficult. He was also a human being. Even though he had some talent and had received instruction from Chief Hu Kan, it was still very difficult for him to solve difficult cases.
And sometimes he can't solve it.
In this case, we have to gather the strength of the entire department, and even invite experts from other departments to come for a joint consultation.
Solving these difficult cases will bring many benefits to Zhou Can.
Improve his personal diagnosis and treatment capabilities, increase diagnosis and treatment experience, and earn large experience value rewards.
It must be pointed out that not every difficult case solved will be rewarded with a large amount of medical experience points.
Some difficult cases are difficult for other doctors.
But for Zhou Can, it was relatively easy.
This kind of case can only bring him 10 extra medical experience points at most. Sometimes there is no reward at all.
It was around 7:20 when the nurse came running over to urge him.
"Doctor Zhou, please go to the operating room quickly. The anesthesia has been completed and the operation will begin soon."
"Okay, I'll be right there!"
There was no other choice, Zhou Can could only rush to the operating room.
Enter the operating room, change clothes and go into the operating room. Director Xueyan and other medical staff are ready.
The first surgery today was for the patient who was transferred from Xinxiang Hospital with chest incision and sternum infection.
It is necessary to remove artificial materials, clean the wound, and reconstruct the chest wall.
This is a big project.
There are many technical difficulties involved.
If the surgeon is not strong enough, he or she may even need to perform the surgery in conjunction with an orthopedic surgeon.
"Zhou Can, we're just waiting for you to take charge of the cooking!"
Director Xueyan said with a smile.
It can be seen that she is recovering quickly from the shadow of divorce. I really hope she can find a good man for the rest of her life.
Sometimes marriage is just so fucked up.
A good woman meets a scumbag or a bad guy, and a good man meets a scumbag or a gold digger.
Only when you meet the right person at the right time can you hold hands for a lifetime and both parties achieve true happiness.
In recent years, the divorce rate has been increasing, which is not necessarily a bad thing.
It can make both men and women cherish their hard-earned marriages. The country with the highest divorce rate should be the United States.
Just leave if you feel you can't live anymore.
Even a small conflict like the placement of toothbrushes can lead to divorce.
Compared with these developed Western countries, the domestic situation is considered good.
"It's no problem for me to be the chef. Sister Yan and the directors can help me check it." Zhou Can smiled and nodded. Then his eyes fell on the anesthesiologist. "Oh, Teacher Feng is here too!"
"Director Xue was afraid something might go wrong, so she asked me to come over and keep an eye on it."
Director Feng did not come alone, he brought two apprentices with him.
He has more than one apprentice. Compared with these professional anesthesiologists, Zhou Can can only be regarded as an amateur.
"Hurry up and do the surgery, and try to get off work early. I know that your surgery speed is comparable to Xu Yidao's back then."
"Yes, sir!"
Zhou Can smiled and nodded.
After washing his hands, he put on sterile gloves and took the lead position. Zhou Can quickly cut the sutures of Xinxiang Hospital.
His current suturing skills are at the junior level of a director, and he can tell at a glance that some of the sutures of the doctors at Xinxiang Hospital were not done properly when closing the chest. Of course, he wouldn't say anything.
The patient's sternal incision was infected with osteomyelitis and did not heal for a long time. The best way to deal with this was surgical resection and reconstruction of the chest wall.
