Chapter 550 The cause of the disease is found, from disbelief to belief
In the ultrasound room, Zhou Can stood next to the ultrasound doctor himself.
Echocardiography often refers to the use of pulsed ultrasound waves based on the principle of ultrasonic short-wave ranging to penetrate the chest wall and soft tissue to measure the periodic activities of the underlying heart walls, ventricles, valves and other structures. The relationship between the corresponding activities of each structure and time is displayed on the monitor, and these curves are recorded into images using a recorder.
It is an excellent tool for assessing heart size, valve function, and left ventricular ejection fraction.
What Zhou Can wants to check now is the left ventricular ejection fraction.
"LVEF, decreased to EF39%."
The doctor reported the number of births to Zhou Can.
"It's about the same as the left ventricular ejection fraction checked by other hospitals." Zhou Can nodded, and then said to the patient. "Come on, try to hook your feet, use some strength."
The patient did as he was told.
“What is the current left ventricular ejection fraction?”
“52%.”
The ultrasound doctor looked incredulous.
The ejection fraction is only 39%, which is on the low side. It's not particularly serious, but it's not light either.
A normal ejection fraction is between 50% and 70%.
The patient's left ventricular ejection fraction increased directly from 39% to 52%, which is really incredible.
If this state can be maintained, the patient will basically be able to return to normal.
"Great, relax, relax!"
Zhou Can became more confident in his judgment and instructed the patient to relax.
"Flex your calves!"
Again instruct the patient to do as he asks.
"What's the score this time?"
“46%.”
"Not bad." After testing this far, Zhou Can already basically knew the cause of the patient's illness. "I'm going to squeeze your calves, bear with it."
After instructing the patient to straighten his legs and relax again, Zhou Can tried to squeeze the patient's gastrocnemius muscles.
"How many?"
“43%, 42%.”
These are the test results obtained by squeezing the left and right legs respectively.
"Okay, thank you for your hard work! Once you've typed out the report, you can call it a day."
Zhou Can said to the ultrasound doctor.
"Doctor Zhou, is the cause of my illness really in my legs?"
"Yes, it's in the leg. I'll tell you when we get back to the ward!"
We cannot continue to occupy the ultrasound department’s resources.
It is now past the closing time and the doctors in the ultrasound department are forced to work overtime.
Unlike clinical departments, medical technology departments have very punctual working hours. They can go to work and leave work on time, and they can rest on Saturdays and Sundays. However, since the business demand of ultrasound and CT departments is very large, there will be a job transfer mechanism.
Furthermore, in a large hospital like Tuya, the ultrasound departments of the two departments of obstetrics and gynecology and cardiothoracic surgery are not managed by the general medical technology department, but are separately under the obstetrics and gynecology and cardiothoracic surgery departments.
If you want to be an ultrasound doctor, entering the ultrasound department of these two departments is generally recognized as the most promising.
Doctors in ordinary ultrasound departments have no way to break through the barriers and basically stay in the small circle of medical technology departments. Their income is above average, but there will not be any significant improvement.
Unlike doctors in clinical departments, although the work is a bit tiring, they will be called back to work overtime by the hospital after get off work or on vacation with just one phone call.
And even after get off work, I still have to worry about the patients I'm caring for and pray that nothing happens to them.
If the patient you are taking care of dies, you will definitely be held responsible.
This responsibility does not mean paying compensation to the family or even revoking the doctor's license, but there will be an evaluation mechanism that will have a great impact on the doctor.
If two patients under a doctor's care die within three days, the senior doctors will not only curse him, but also be wary of him and marginalize him. In clinical practice, he will no longer be given any weight.
To put it bluntly, words are no longer effective. Medical orders must be reviewed by senior doctors before they can be executed. Some clinical treatment measures also require the approval of senior doctors, or direct instructions from other doctors of the same level.
Not to mention the cancellation of qualifications for evaluation .
Zhou Can has a very high status in the emergency department. During clinical rescue, even the deputy chief physician has to obey his instructions.
…
Next to the makeshift bed in the corridor, Zhou Can was holding an ultrasound electrocardiogram and explaining the cause of the patient's heart failure. Director Xueyan had already rushed over after hearing the news.
"They actually found out the cause of the disease! Great!"
Director Xueyan's face was full of smiles.
She feels particularly happy every time a very difficult case is successfully diagnosed or cured and discharged from the hospital.
As the head of the department, I naturally hope that the department will get better and better.
The reputation and goodwill of a department have a certain effect on the treatment of common cases, but it is limited. The most influential thing is difficult cases.
"I still don't understand why my heart failure is related to my legs."
The patient was full of curiosity about this.
The brother Wei hired by his family stood beside the bed with an incredible look on his face.
I thought Zhou Can was talking nonsense, but after examination, I found out that the leg problem is really related to heart failure.
"The legs have several powerful muscles called gastrocnemius. Ordinary people may not know its function, but in the eyes of us doctors, it is called the second heart of the body. Ever since our human ancestors learned to walk upright, our human body has had a major defect. The heart has become far away from the ground, making it extremely difficult for blood from our lower limbs to flow back to the heart."
"At the same time, it is difficult for the blood pumped by the heart to reach the ends of the lower limbs. At this time, after countless years of evolution, the gastrocnemius muscles in the legs have evolved to function as a secondary heart. Every time it moves, it can squeeze the blood in the legs and allow them to return to the heart smoothly. Then when it relaxes, it will form a natural suction force to draw the blood over. In this cycle, it has formed a blood pumping function similar to that of the heart."
Zhou Can explained to the patient the connection between the legs and the heart.
The patient and Brother Wei learned a lot from listening to this.
As for Director Xueyan, the nurses, and other doctors, they all looked at Zhou Can with admiration. Everyone has learned the knowledge in the books, some have forgotten it after learning it, and some have not forgotten it, but they cannot use it flexibly in clinical practice.
Zhou Can, however, was able to apply what he had learned flexibly and use it with ease.
His clinical diagnostic thinking was envied by every medical staff present.
"It turns out that our legs are our second heart. It's amazing! But there's nothing wrong with my legs. How could it cause heart failure?"
The patient is currently a sophomore in high school. Because he is very studious, he must have learned a lot of knowledge.
But after listening to Zhou Can's explanation, he still felt extremely amazed and his horizons were broadened.
"This is about you. You usually sit all day long reading and studying, and you rarely exercise. Moreover, you are in the growth stage, and your lower limbs are seriously lacking in exercise and training, which has caused your lower limb muscles to become loose and severely atrophied. You need to exercise every day in the future to gradually restore them to normal levels. By then, your second heart will have basically recovered its function."
"Don't underestimate the role of the second heart. If it can work normally, it can greatly reduce the workload of the heart and promote blood circulation throughout the body. On the contrary, when it has serious problems, the heart will do the work of two people. After a long time, the heart can no longer bear it. It will be seriously strained and become weak. In this case, it can no longer do the work of two people, and the left ventricular ejection fraction will be lower than normal."
"Because the condition was not corrected in time and the real cause was never found, the heart continued to work abnormally. After a long time, it led to total heart failure."
Sometimes, Zhou Can treats his patients like his own disappointing children.
I feel both heartbroken and annoyed.
Feeling sad for their misfortune and angry at their lack of fighting spirit, this is the real mentality of most doctors at work.
Doctors feel sad when they see patients getting sick or even dying. But some patients don’t care when they are healthy. They don’t even bother to listen to you when you tell them to smoke less, drink less, or stay up late less!
Just think the doctor is exaggerating.
Then when I fell ill, I realized that what the doctor said was just advice. But it was too late and there was no chance.
"Then... can my disease be cured?"
The patient has regarded Zhou Can as a miracle doctor, and his trust in him has reached an unprecedented level. The real cause of the disease has been found, which also gives him hope of recovery.
At least we finally know the cause of this strange disease.
"It can be cured! I will develop a treatment plan for you, which mainly focuses on your exercise. If you can't stick to exercise and forget about your health when you study, I can't do anything. It's a good thing to study hard, but you must pay attention to the combination of work and rest. While studying, you must also take care of your health, understand?"
Zhou Can felt that treating this disease was not difficult.
The only difficulty is that the patient himself does not cooperate and is unwilling to persist in exercising.
"Don't worry, I will listen to you this time. After I fell ill this time, my studies were delayed, which made me realize that haste makes waste. I will learn a lesson from this and will always keep it in mind even after graduation and when I start working."
The patient expressed his opinion to Zhou Can.
This young man is a man of perseverance and determination, and he can definitely do what he says.
Zhou Can also nodded , and went back to the office with Director Xueyan to discuss the treatment plan for this young man.
The treatment plan was drawn up overnight, minimizing the use of medication and focusing on physical assistance. However, since the patient's heart failure was quite severe, the necessary medication could not be reduced.
We can only wait until the patient gradually recovers and then gradually reduce the use of drugs.
Medicines are poisonous, especially Western medicines, many of which contain hormones. They have serious side effects on the body and the impact is far-reaching.
It is easy to develop physical dependence on drugs.
In addition, if the same medicine is used for a long time, drug resistance will form, which will cause the body to absorb the medicine poorly and the efficacy of the medicine will be greatly reduced.
…
The next day, after Zhou Can finished his rounds in the emergency department early in the morning, he also rushed to the cardiothoracic surgery department to check on the young man's treatment.
A specific electric pressing tool was temporarily used on the gastrocnemius muscles of the patient's legs to assist the patient's lower limb gastrocnemius muscles to continuously contract and relax, which is equivalent to massaging the calf.
You can see that the patient's complexion has improved significantly, and his breathing is no longer so rapid and labored.
These are all good things.
Even without an examination , Zhou Can could feel that the patient's heart failure symptoms had been greatly relieved.
"You can get out of bed and walk downstairs later. Let Brother Wei accompany you. Where is he?"
Zhou Can has been here for such a long time but has not seen Brother Wei.
I haven't been with my employer for a long time. Is he constipated? Did he go to the toilet?
"Um...Brother Wei asked me for leave and went to queue up for the examination."
The patient hesitated for a few seconds, but finally decided not to lie to Zhou Can and told the truth.
"Weren't you fine yesterday? Why did you suddenly get sick?"
Zhou Can frowned slightly. It would not do to leave this patient without anyone to take care of him.
"Well, didn't you tell him the day before yesterday that it would be best for him to get a liver check-up? At the time, he probably thought you were too young and your medical skills were not very high, so he didn't take it seriously. Yesterday, when he saw that you successfully found the cause of my illness, he began to have full faith in your medical skills. Worried about my health, after buying me breakfast this morning and taking care of me washing up, he rushed to the hepatobiliary department to queue up for a doctor's appointment."
The patient may also feel that it is a bit unkind to talk about these embarrassing stories of the bodyguard.
But he couldn't lie to Zhou Can, so he seemed a little awkward when he spoke.
"I see. Then, do not leave here alone without someone to accompany you. You can walk around the bed to stretch your legs and increase the strength of your gastrocnemius muscles."
After hearing this, Zhou Can burst out laughing.
Brother Wei is really interesting. I asked him to get his liver checked the day before yesterday, but he refused to listen.
Now people have to rush to queue up for registration early in the morning.
This person is so realistic.
"Okay! Doctor Zhou, do you think Brother Wei's liver is really problematic? How did you know that there was something wrong with his liver? I'm just curious and I think medicine is amazing. Your medical skills, in particular, really opened my eyes."
the patient inquired.
"This is nothing unusual. When I first saw him, I found that his palms had some symptoms of liver palms, and then I saw red spider nevi on his neck, and there were more than one, so I concluded that there was probably a problem with his liver."
Zhou Can doesn't think he is that capable.
"There are many medical skills that seem miraculous to you ordinary people, but they are nothing more than the accumulation of medical experience. Because we come into contact with a large number of patients every day, after generations of doctors have accumulated experience, we have the ability to tell whether a person has an obvious disease with just one glance."
"I see! Thank you for your patience in answering my questions. Coming to Tuya Hospital for treatment this time should be another correct decision I have made. I have gained a lot of knowledge, and most importantly, my disease finally has hope of being cured."
The patients expressed their sincere gratitude to Zhou Can.
"If I really had a heart transplant, would my illness still be incurable?"
This question is not easy to answer, after all, we have to take care of the face of the experts in the capital. Those experts are really at their wits' end, so they consider heart transplants.
