(Thanks to my friends Pirate Qi Xinuo, Elephant, Valley Pavilion Master, Book Eater, and Chen Wenlong for their encouragement)

"Don't be discouraged, this has little impact, and you will be able to think of it when you see such a similar patient in the future. Liu Banxia encouraged again.

"Teacher Liu, have you ever encountered such a patient before?" Miao Rui asked curiously.

Liu Banxia shook his head, "It's also the first time I've encountered it. ”

"Then how did you come up with that?" Miao Rui asked.

"Stupid, I forgot that I can do osteopathy? I'm not very sure when I straighten the bones of obese patients. Her neck is so thick, I may not be able to tell the position without touching it carefully. Liu Banxia said.

The three of them were stunned, thinking about it carefully, it was really like this. But it's such a simple truth, Mr. Liu can think of it, why didn't he think of it?

"So I'm a teacher, and you're interns. In the future, when you graduate and become a resident, you can educate new interns in this way. Liu Banxia said with a smile.

Don't look at it as just an out-of-tune joke, the three of them all laughed along.

Teaching work should not be blindly criticized, the work here is very stressful, if you blindly criticize, I am afraid that no one will be able to persevere.

When I walked out of the emergency room, I just saw Wang Huan walking out of the internal medicine clinic and waving to him.

"Brother Wang, what's the situation?" asked Liu Banxia.

"I have a patient here who comes with my boyfriend. Mood is somewhat unstable, with blunt abdominal pain, not severe. Wang Huan said.

"At the initial diagnosis, appendicitis and cholecystitis were ruled out, and CT was done directly. The results have just come out, everything is normal, and the blood test is also normal. ”

"The patient had had enteritis a week ago and had taken cotrimethoxazole tablets. An allergic reaction to sulfonamides has been ruled out, so I ask you for help. ”

Liu Banxia also had a headache, and followed Wang Huan into the consultation room. I was stunned for a moment, and it turned out that the guy I had just seen was the patient's boyfriend.

"By the way, why didn't you do an ultrasound examination?" asked Liu Banxia after reading the blood test report.

Wang Huan shook his head, "The patient was very resistant, so he did the CT directly." ”

"Young man, does your girlfriend have any other symptoms?" asked Liu Banxia after calling the guy aside.

The guy shook his head, "There are no other symptoms, but I started to lose my temper after that enteritis." I don't like to talk at home, and I'm so worried these days. ”

"What was her previous personality?" Liu Banxia asked again.

"It used to be fine, although I was a little bit introverted, but it wasn't like now. Doctor, why don't you do an MRI? Doesn't it mean that an MRI can see more accurately and more advanced?" said the guy.

"It's not like that, basically CT and MRI are about the same. But I suggest you talk to her and do a colonoscopy. Liu Banxia said.

"Now it may be that there are some conditions in the intestines, and we can't give an accurate judgment without a detailed examination. If the colonoscopy doesn't find any problems, all we can do is add a urine test and stool test. ”

"If none of the above is found, and the patient's pain symptoms have not been reduced, we can only do laparoscopic exploration to see if there are any subtle lesions that we did not find. ”

The guy nodded, but he was actually a little worried.

If it's a former girlfriend, these tests can be done smoothly. Not now, I was persuaded to come to the hospital today.

Leaving time for this young couple, many times the persuasion of the family is more effective than the doctor.

But even so, the guy persuaded him for more than 20 minutes before the patient reluctantly agreed.

"I have some headaches, the symptoms are not diagnosed, and the patients are not easy to communicate. I asked ten sentences, and it would be nice to be able to answer three sentences, and many cases were relayed by his boyfriend. Wang Huan said.

"I was also very resistant to doing the physical examination, so I mentioned an ultrasound and shook my head directly. Later, I heard from the guy that they had a child before, but they lost it. ”

At that time, the girl was a little mentally wrong, and the boy was also worried that it would become the same as before. Judging from my observation and judgment, it is really a little uncertain, and it seems that there are really some signs of depression. ”

"The miscarriage was last year, and if it was caused by the miscarriage, it would not have been possible to delay it until now. Now I'm really having a headache and I'm counting on you. ”

"I don't have a problem, I just told the guy, the last trick is laparoscopic exploration. Let's take a look at the results of colonoscopy first, there is nothing else. Liu Banxia said.

When he came outside, Huang Bo came over, "Mr. Liu, the CT examination of the car accident patient just now was normal. The unsuccessful laryngeal intubation was also due to edema squeezing the airway, and our cricothyrotomy was also considered to have saved the patient's life. ”

Liu Banxia smiled and nodded, "It's not bad, after all, it's an invasive test, so it's better to use it or not." ”

"Teacher Liu, what kind of case did Teacher Wang call you to diagnose just now?" Huang Bo asked curiously.

"Abdominal pain, normal CT, normal blood test, now I have a colonoscopy. If you have a tendency to depression and resist the examination, you say that you are not worried, but if you come to receive the consultation, what will you do?" asked Liu Banxia.

Huang Bo was dumbfounded, a person with a tendency to depression and resistance to the examination made him not know how to deal with it, not to mention that the cause of abdominal pain could not be diagnosed.

"If it weren't for the patient's emotional problems, I would have sent you to Dr. Wang's place for an apprenticeship. This is also a good opportunity to accumulate experience, and you will also encounter it in the future when you really receive patients independently. Liu Banxia said.

"Anyway, our job as a doctor is to live and learn until we are old, and no one can expect to be able to learn it when we are alive, and we will not have the opportunity to learn it after we die. ”

Huang Bo grinned, this sound a little crazy, but it is also a fact.

"Come on, boy, we're just going to have to get through a little bit. Liu Banxia patted him on the shoulder.

Huang Bo nodded, the days of this line really have to be measured by "boiling".

"Sister Li, what's the situation?" At this time, Liu Banxia saw Zhou Li with a resentful expression, which made Liu Banxia very surprised.

"It's not the old lady's daughter, but really, I've never met anyone like this. Zhou Li said with a wry smile.

"What are you doing today? Isn't the old lady recovering well?" asked Liu Banxia.

"It's a good recovery, but her daughter doesn't want to be in bed here tonight and has to go home. Zhou Li said.

"That's okay, right? Liu Banxia said casually.

"Anyone else? I don't see anyone else. Zhou Li said disdainfully.

"Yesterday there was such a chaotic group of people, still studying eating this and drinking that, and today I saw the old lady's three daughters. The other two also came to take a photo and left, and I heard from the nurse that it had not been more than 20 minutes before and after. ”

"The son didn't show up, and the grandson, grandson, and granddaughter are probably all stewed black chicken soup at home. Yesterday, I was muttering, I guess I have to stew the chicken bones, otherwise I can't stew it for so long. ”

Liu Banxia was stunned when she heard this, but she didn't expect that the old lady's house was still like this.

"Sister Li, every family has a scripture that is difficult to read, maybe their family has a special situation. We can't interfere either, so let's have more snacks at night. Liu Banxia said.

There is no need to ask, Zhou Li is so angry because other people will not come over to accompany the bed. Maybe it's inconvenient for my son to come over to stay with me at night, but I still have two daughters.

Zhou Li nodded, "Don't worry, although I don't think her daughter is happy, the old lady's care still has to be done." However, there are many things that need to be paid attention to during night rounds, and too often will cause dissatisfaction among other patients. ”

"Anyway, I am very relieved to have Sister Li, Sister Wang has taken leave for the past two days because of things, and she has also called me, and she will be able to come back to work tomorrow. Liu Banxia said.

"Don't worry, I'm fine, I still have to have professionalism, but I'm not very comfortable in my heart. When I'm done, I'm done, and I'm done. Zhou Li dropped a sentence and walked directly to the side.

Liu Banxia had a headache, and after the number of patients increased, the work of the nurses became more and more difficult. Fortunately, the old lady's recovery is okay, and she can be discharged from the hospital after a few days.

But I was also very emotional in my heart, after all, it was full of "illusions" everywhere. How about such a lively family, so caring for the old mother?

If you are busy during the day and don't have time to come over to stay in bed, this is understandable. It's impossible to work overtime at night, and judging by the age of those two daughters, they should be about to retire.

Although they are a little unaccustomed to it, this matter is not under their control, it is the patient's family matter.

In his heart, he pondered Wang Huan's patient again, whether laparoscopic exploration can be done or not. This is an invasive exploration and is also intrusive to the patient.

After waiting for a while, Wang Huan beckoned to him.

"The results of the colonoscopy are out?" asked Liu Banxia.

"I didn't see any polyps or lesions, so the phone call from that side told us to be prepared. Wang Huan said.

Liu Banxia grinned, the patient had already resisted the examination, and the current instrument examination had not detected anything. The next "confrontation" with this patient should be a very serious challenge.

The scare set doesn't work.

If you are frightened by the patient's current state of mind, you may just leave.

Ding! Patients with complex abdominal pain

Open-ended task: the patient has abdominal pain, the cause cannot be identified at this time, and further diagnosis by the host is required. Task rewards will be awarded based on the diagnosis results

This made Liu Banxia even more headache, and even the task came out.

But whenever it hurts, there will be a reason. The current patient has abdominal pain, which is most likely due to intra-abdominal causes. The results of CT and colonoscopy are normal, what can I do next?

If it really doesn't work, you have to persuade the patient to do an ultrasound and scan the pelvis.