Chapter 548: The sneaky mechanism of the heart, I suggest you check your liver
Tuya is different from those small hospitals that survive on examination fees.
If the patient has already had a checkup done in another hospital, as long as that hospital is also a tertiary hospital, the doctor will basically not ask the patient to have a repeat checkup. The doctor will only ask the patient to have another checkup if he/she thinks the result is wrong or inaccurate.
The purpose of all examinations is to diagnose the cause of the disease and cure it.
If the purpose is just to earn money from the examination fees, then it would be a violation of medical ethics and the original meaning of the examination would be lost.
However, this matter needs to be viewed from multiple perspectives.
Some small hospitals have small business volumes, and doctors in their departments have tasks to accomplish, such as how many inpatients to admit this month, how many B-ultrasounds to order, etc. Under the pressure of performance, doctors can only focus on the few patients who come to see them in order to survive.
Zhou Can followed Director Xueyan to the corridor.
A temporary bed has been added for this patient, which is a great privilege.
You should know that it is hard to find a bed in the cardiothoracic surgery department. Many patients who come for treatment are forced to sleep on the floor of the waiting room and corridor. These patients who do not have a bed are still in the waiting stage and cannot enjoy medication, surgical plan formulation and promotion.
Only after being admitted to the hospital and completing the hospitalization procedures can you enjoy the care and attention of nurses, medication, surgical planning, various monitoring, etc.
"Mr. Lan, this is Dr. Zhou Can, who has taken the time to come here for a consultation with you."
Director Xueyan introduced Zhou Can's identity to the patient.
The patient was a young man of about 17 or 18 years old, very young. His face was extremely pale and his breathing was rapid, which were typical symptoms of heart failure.
Usually, mild heart failure has no typical symptoms.
Because heart function is impaired in the early stages, the heart's reserve capacity will help compensate for the damage.
It can be understood in this way: the heart normally works 24 hours a day, but it is actually slacking off, leaving at least 40% of its energy unused.
It must be sneaky and cunning to retain its strength.
Because if the owner of the body ignores its feelings and eats very salty food or other food that will seriously increase the burden on the heart, the heart will not be exhausted at this time because it has retained its spare strength.
Also, when the owner of the body does some strenuous exercise and wants to explode, the heart is willing to sacrifice its life to keep him company.
This patient now has typical symptoms of heart failure, indicating that he has severe heart failure.
"Hello, Dr. Zhou. I came all the way from the capital to see you. I've been to several hospitals for my illness but they couldn't find the specific cause."
The patient was very young, but his speech was very imposing, his eyes were open and generous, frank, but with an indescribable indifference. His tone was neither fast nor slow, very stable, and faintly revealed an extraordinary demeanor.
Children from ordinary families, let alone at the age of seventeen, may not be able to have such extraordinary bearing even at the age of twenty-seven.
It’s just like the saying that only after three generations of prosperity can a wealthy family learn how to dress and eat.
Cultivating a child's bearing is a very complex and long process, which considers the overall strength of a family. It is definitely not possible to cultivate a child with "general bearing" by giving him tens of thousands of yuan in pocket money a month.
If a family without such financial resources gives a teenager 50,000 yuan a month in pocket money , it will most likely only make the child feel that money comes too easily, and he or she will make friends with a bunch of bad people and spend money on drinking and partying and do whatever they want.
Some children aged fifteen or sixteen, whose bodies are not fully developed yet, are even more playful than the experienced clients.
He is good at everything, including whoring and gambling.
Aren't it because parents spoil their children in all kinds of ways, give them lots of pocket money when their children are mentally immature, and thus raise them to be like this?
A family with real background will definitely pay great attention to their children's education.
From an early age, we will consciously cultivate his correct three views, broaden his horizons, and instill in him various philosophies and wisdom of dealing with people and things.
Such children have seen the world at a young age and are mentally mature, far beyond their peers.
They often have many shining points, such as being very self-disciplined, calm in the face of things, able to distinguish right from wrong, and having their own rules in dealing with people, etc.
The young patient in front of us is one of these particularly outstanding teenagers.
Although Zhou Can is already very outstanding among his peers, if he compares his state when he was 17 or 18 years old with this young man, he is far inferior to the other.
"Thank you for your trust. Let me check your body first!"
Zhou Can said to him.
"Thank you for your help."
The young man was very cooperative.
The middle-aged man standing next to the bed was about 30 years old, with cold eyes and did not speak. This man must be a family member, but it was hard to say who he was.
Zhou Can was secretly thinking in his heart that it seemed that it was easy for patients coming from the imperial capital to become noble people!
"How long have you been feeling unwell?"
"I seem to have felt something wrong with my body since I was twelve years old. At that time, I wanted to get into a key class, so I read books day and night, did exercises, and memorized some hard knowledge points. I often sat in the youth library for a whole day. At first, I didn't think it was a big deal, but then about a month before the transition from primary school to junior high school, I felt a little uncomfortable."
He thought for a moment and answered seriously.
"Why do you feel uncomfortable?"
Zhou Can asked.
The patient is currently 17 years old, almost 18. If the disease started at the age of 12, it has been five or six years now.
The disease has been progressing for a very long time.
"I can't really explain it, but I just feel a tightness in my chest, as if a big stone is pressing on my heart, making me feel heavy. Then if I exercise a little more, I will feel short of breath and my face will turn red. In serious cases, my hands and feet will even tremble slightly uncontrollably."
The patient's answers were clear, well-organized and accurately expressed.
This also provided a good reference for Zhou Can's further diagnosis.
"I really admire you. You were able to work so hard for a goal at the age of twelve. When you felt unwell, did you go to see a doctor?"
He really admired this young man.
"I didn't go to the doctor. One reason was that I was in a critical period of transition from primary school to junior high school. I wanted to get into a key class through my own efforts and didn't want my family to help me get in through the back door. Also, at that time, I thought that as long as I could get through the exams and relax a little, I would recover slowly. After the exams were over, I was admitted to the key class I wanted as I wished. After a period of rest, my health improved a little. Later, as the workload gradually increased, those symptoms became obvious again."
I really feel sorry for this hard-working child.
He is so ambitious at such a young age.
Zhou Can felt ashamed. When he was twelve or thirteen years old, he was the most naughty and rebellious.
I still remember when I was in junior high school, I wanted to flirt with and chat with pretty female classmates when I saw them.
For a while, he was like a troublemaker on campus.
The head teacher has talked to parents many times.
Some children are born to be generals. They know how to strive for what they want and plan their lives rationally.
"You know what? At that time, I actually wanted to improve my physical condition through exercise, but as long as I exercised for a little longer, my body would feel very uncomfortable. Once, the school asked us to run a 1,000-meter long-distance race, and I fainted just after running 400 meters. It was also from that time that the teacher did not dare to let me participate in too many sports in physical education classes at school."
Almost every child in physical education class will experience a 1,000-meter long-distance run, and girls run 800 meters.
Children who have physical problems or lack of exercise are indeed more prone to fainting.
However, most people faint after running 1,000 meters or 800 meters.
The young man fainted after running only 400 meters, which shows that his physical condition was very poor.
"Did you go to the hospital for a checkup?"
"Yes! When my parents heard that I fainted during physical education class at school, they immediately took me to the hospital for a check-up. At first, the doctor thought I had a congenital heart disease, but after a careful examination, no problems were found. The doctor told me to exercise more and do it step by step. For a period of time, I did feel much better by exercising for more than two hours every day. My parents and elders also often buy supplements for me, but they don't seem to have much effect after I take them."
"Later, when I was in the second year of junior high school, my study load was already very heavy. I represented my class in many competitions such as the Mathematical Olympiad and painting. In order to bring honor to my class and school, I had to gradually reduce my exercise time. When I was in the third year of junior high school, I wanted to apply to a key high school, so I was even busier. I could spare less than half an hour of exercise every day. Later, my health gradually started to have problems again. After being admitted to a key high school, my study load was still very heavy. I should have been in the second year of high school this year, but I had serious health problems and had to take a leave of absence to treat my illness."
After listening to the young man's story, Zhou Can was really impressed by him.
If this young man's illness can be cured, I believe that N years later, he is likely to become a pillar of the country.
"I have been examined in several major hospitals. Have you ruled out the possibility of congenital heart disease?"
Zhou Can asked.
"Yes, they all said that I didn't have any congenital heart disease, but they did find heart failure. At first it was left heart failure, then right heart failure, and then total heart failure. After a joint consultation by experts from Renhe Hospital in the imperial capital, they suggested that I consider a heart transplant or an artificial heart. My parents thought the risk was too great and never agreed to this plan. A top cardiac surgery expert at Renhe Hospital is a good friend of my father, and he told my father that I could try Tuya Hospital. He also specifically mentioned your name."
These words immediately made Zhou Can feel somewhat proud.
I didn’t expect that even the top cardiac surgeons at the Imperial Capital Renhe Hospital knew about my fame.
It was just a live broadcast of an operation. Although the operation was indeed very difficult, in the eyes of the top cardiac surgeons at the Imperial Capital Renhe Hospital, it should be nothing, right?
No matter what, Zhou Can was still very happy to get the recognition from such a big shot.
"I am actually just an ordinary surgeon at Tuya Hospital."
No matter how humble you are, you still need to continue to check your illness.
After checking the patient's heart rate and pulse, he also listened to the patient's pericardial area. A good cardiologist or surgeon can diagnose many diseases by listening to the heart and chest sounds.
For example, if the aortic valve is insufficiency, it is easy to hear a murmur.
Also, although pulse and heart rate seem to be the same thing, they actually have different meanings in clinical diagnosis.
Auscultation can reveal some clues when the heart beats irregularly or abnormally.
The pulse helps us understand the working condition of the heart, especially the strength of its blood pumping ability, which can be reflected more intuitively in the pulse.
For example, the pulse of the patient in front of us is very thin and fast.
When heart failure occurs, it actually means that heart function declines, and it has a compensatory mechanism.
The main manifestation is that the ability to eject blood decreases with each contraction. At this time, it is necessary to increase the heart rate, and the heart rate within a unit of time is accelerated, even if the amount of blood released during each contraction is reduced.
However, when the heart rate increases, sufficient blood output can still be maintained within a unit of time, which is a compensatory process.
This is why patients with heart failure may experience tachycardia.
The heart's work has a certain degree of flexibility.
The amount of blood it ejects at one time has decreased, and it can only make up for it by increasing the frequency.
"You're not skinny, but you lack muscle. Academics are important, but health is also important. You will definitely need to make a comprehensive trade-off in the future and maintain a balance between the two. Otherwise, no matter how good your academic performance is, if your health is broken, you'll have nothing."
After the examination, Zhou Can said to the patient.
"Sometimes I just have no choice! I have to work hard because everyone is working hard. Maybe it's because I didn't like sports since I was a child, and my mom had a difficult birth, which caused me to be weaker than other people of my age."
The patient gave a bitter smile.
Adults don’t understand the hardships of teenagers. If they don’t work hard, how can they get into key classes? How can they get into key high schools?
"Have you brought all the test records from other hospitals?"
“It’s all here!”
The middle-aged man who was accompanying the bedside finally spoke and handed Zhou Can several large information bags.
When taking the bag, Zhou Can subconsciously glanced at the middle-aged man's hand.
You can see that the fists on the back of the hands are covered with calluses, and the palms are also covered with calluses.
What a master!
This person is definitely a martial artist.
The middle-aged man was quite cold towards Zhou Can. Perhaps because he saw that Zhou Can was very young, he thought that Zhou Can could not have any great ability, so he did not think highly of him.
After looking at the other person's hand, Zhou Can stared at the other person's face for a few seconds.
The middle-aged man's face darkened and he glared at Zhou Can.
"I suggest you get a liver check."
Zhou Can said lightly.
The middle-aged man's expression froze for a moment, and he hummed without commenting.
Judging from his attitude, it was obvious that he didn't take Zhou Can's words seriously.
Zhou Can did not try to persuade him any further, but took out the patient's information and began to carefully examine and study it one by one.
Director Xueyan was always by his side.
