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The arrival of Duyal and Renaud made Qin Chuan feel a lot better. The ability to see the patients he treats is well www.biquge.info which makes Qin Chuan feel very good. It is impossible for a doctor to heal all the patients he takes over. There will always be limitations to medical skills, or to technology. There's no way around it, science will always lag behind the discovery of new diseases.

But any success is like applause in the doctor's career. This kind of applause is inspiring and motivates people to move forward.

Dujar and Renault brought the turkey again. Last time, Qin Chuan accepted their turkey and expressed his gratitude. They thought Qin Chuan loved turkeys. In fact, Qin Chuan is not used to the flavor of turkey. Chinese, accustomed to oil, salt, sauce and vinegar, will bring the taste somewhere whenever they go. Chinese may be more receptive to the culture of a place, but it is always difficult to accept the flavor of that place.

Although Qin Chuan didn't like to eat, he happily accepted the gift from Dujar and Renault.

Qin Chuan was also embarrassed to ask, and Duyal seemed to be still working in that supermarket.

However, Duyal quickly gave Qin Chuan an answer: "I have already left that supermarket." My husband thinks it should be male outside and female inside. I feel like I'm leaving the burden of life to my husband. ”

After Renault retired, he continued to write, and after recovering from his illness, ← submitted his manuscript to a magazine, which was accepted. It will be published soon. As a result, Renault received a large amount of money for the manuscript. It also strengthened Renault's determination to continue writing.

When Renault left, he turned around and shouted to Qin Chuan: "Qin, when my book is published, I will send it to you." ”

"Then I'll thank you in advance." Qin Chuan saw that Renault and his family could leave happily, and he was in a very good mood.

Qin Chuan, who was in a good mood, met the sullen Linus in the corridor.

"Dr. Linus, it seems that you are not in a good mood. Did something happen? Qin Chuan asked.

"Indeed." Linus nodded.

Linus spoke out about his troubles from beginning to end. It turned out that he had just taken over a very tricky patient.

The patient's name is Vary. Valay is 50 years old today. He was rushed to the emergency room because of asthma. Varley has gained a sudden amount of weight in recent times, and his physical strength has decreased significantly. Do a little physical activity. will be out of breath.

Emergency physicians believe that Vare is fluid retention due to heart failure. Obese patients like Vallée, who weigh several times the normal person, often overload their hearts, which is almost equivalent to strenuous exercise all the time. And the average obese patient will have snoring. In fact, it is caused by the obstruction of the airways. As a result, there is a lack of oxygen due to suffocation, which further damages the heart. As a result, heart failure edema is often a common condition in obese patients.

Based on this, the emergency patient judges. Vareh may be heart failure edema. The emergency physician prescribed a dose of diuretic, and it was estimated that after the injection, he would be able to go home.

However, although Vare diuretic, his symptoms did not lessen, but became more severe. Blood pressure plummeted, and he was almost in shock. So it was sent to the ICU.

"As soon as the patient came, I took vasopressors. But I don't understand why he has low blood pressure. Linus grimaced.

Without finding the cause, it is impossible to fundamentally reach the danger of the patient's matter.

"What's your preliminary judgment?" Qin Chuan asked.

"I suspect it's a lack of blood supply to the heart muscle. Dr. Qin, can you go and have a look. Maybe you'll have some good suggestions. Linus said.

Unconsciously. Qin Chuan's status in the ICU ward has slowly improved. It's a place to tell the truth. If you are very capable, you will naturally be respected by others.

Qin Chuan nodded: "It just so happens that I don't have anything at hand, let's go over and have a look together." ”

Seeing Vare himself, Qin Chuan knew why Linus had difficulty with the diagnosed patient's illness.

Valay was so fat that he weighed more than five hundred pounds. There is thick fat everywhere. Conventional means simply could not be performed, and the CT scan table could not support his weight at all.

"Doctor Qin, what do you think?" Seeing that Qin Chuan was a little dazed, Linus asked.

Qin Chuan was also a little embarrassed. Not enough, but it feels like Vare's condition doesn't seem to be like heart failure. Patients with heart failure generally have edema of the lower extremities. But Qin Chuan was able to feel it during the inspection just now. Vare's two pillar-like thighs, though fat and bloated, did not resemble edema, but thick fat. However, his belly is somewhat disproportionate to his obesity. Qin Chuan could feel that there seemed to be a large amount of fluid in Valé's stomach.

"You stop the diuretics first." Qin Chuan hurriedly said.

Linus didn't understand why Qin Chuan did this. But at this time, he really had no choice, since Qin Chuan said so, he had no choice but to do it.

Really. In this way, the situation of Vare has indeed been alleviated. Blood pressure is slowly rising.

"Doctor Qin, it's really working! Have you found the cause of Vare's cause? Linus asked excitedly.

Qin Chuan shook his head: "I just roughly feel that the cause of his illness is not heart failure. His illness should be in his abdomen. ”

"How so?" Linus asked, puzzled.

After Qin Chuan examined Valé, he quietly took Valé's pulse. The examination was carried out using the techniques of traditional Chinese medicine. Vare is so fat that it will not be easy to take his pulse. However, Qin Chuan still overcame difficulties. Give Vare a diagnosis to Vary. Varley's illness is indeed in the abdomen. Tumor is suspected. But Qin Chuan couldn't say that to Linus.

Qin Chuan could only say some of the anomalies he had just seen. As for the situation of the pulse, it was concealed by Qin Chuan.

"By the way, Doctor Qin, did you have any special meaning for Valey just now? Is it your own original inspection method? "Linus looked really closely. However, although he saw the process of Qin Chuan taking the pulse, he didn't understand what was going on.

"It's not. I'm just feeling Vallé's heartbeat. I think all I can do now is do a paracentesis for Valley and a test for ascites. Qin Chuan said.

Linus was in trouble again when he tried to find a way to pierce Valley. Varley was too obese and the needle was too short to pierce the abdominal wall. There's a thick layer of grease there.

"What to do? I can't wear it at all. Linus asked, embarrassed.

"A long needle with a spinal tap should do the trick." Alyssa on the side suggested.

Qin Chuan nodded: "This is feasible." ”

Alyssa took the puncture needle, and Qin Chuan asked Alyssa and Linus to help and personally insert the long needle into the abdominal wall. But after a large stab in it, I got a tube of liquid. The liquid was dark red, but under the microscope, Qin Chuan did not see any abnormal cells, all of them were red blood cells. It is also unknown whether it is ascites or blood that is taken out.

"Let the surgeon consult." Qin Chuan said.

It wasn't long before surgeon Morriman arrived.

"I want to do a laparoscopy on the patient to see if he has a lesion in his abdominal cavity." Qin Chuan said.

Morriman hurriedly shook his head, he didn't know Qin Chuan, and a resident doctor who had just arrived in the hospital not long ago had no influence on Morriman, a surgeon.

"I'm sorry, laparoscopy has to be done in the operating room. Because laparoscopy is done under general anesthesia. How can laparoscopy give you fluid ascites? Morriman shook his head.

"But without that, we have no way of knowing what kind of lesions are happening in the patient's abdomen. Only after confirming the patient's condition can we take action. You must help with this. For this patient whose life is on the verge of death. Qin Chuan said.

Morriman hesitated: "However, this is really not in accordance with the procedure. And, are you really sure that he has a lesion in his abdominal cavity? ”

Qin Chuan told Morriman his reasoning again.

Linus was somewhat familiar with Morriman: "Morriman, in fact, I am in charge of this patient. Dr. Qin is helping me. His diagnosis was very accurate, and it was he who corrected my previous mistakes. Morriman, we're friends, you need to help me. ”

Linus's words made Morriman a little embarrassed, "Okay. Linus, you'd better not lie to me. Otherwise, you won't even have to be friends in the future. If there is a vacancy in the operating room, I will make arrangements for Vallé. ”

It was only in the evening that Morriman found a gap for Vare. Finally gave Valley a laparoscopy.

The results of the laparoscopy were terrifying, and the walls of Vare's abdominal cavity were densely covered with tumors. And this one couldn't be pumped, and more than a dozen liters of ascites were pumped out at once.

Moriman sighed very much at Qin Chuan: "Doctor Qin, I'm really sorry before. Your judgment is really accurate. This kind of disease, if it doesn't happen to you, most of them will be misjudged. But your judgment is very accurate. ”

"Moriman, you're doing a good job too. All of this is also thanks to you. Qin Chuan said with a smile.

Linus also admired Qin Chuan very much: "Doctor Qin, you are really a god. After just a few glances, he roughly judged Vare's condition. ”

"Dr. Linus, I think you'd better tell Vare the news as soon as possible." Qin Chuan said.

Telling a patient about a bad condition will not be an easy thing for a doctor. Especially when you tell a patient about a condition that could kill him, his despair is too much for you to face.

Linus has been in the ICU for several years and is more experienced in doing such things. But it's still not easy.

"Monsieur Valley, there is something I have to tell you. You know, we checked you out tonight. In order to win you the opportunity for this examination, Dr. Qin tried his best. Finally checked out the results. Linus didn't get straight to the point.

"Is my condition serious?" Vareh seemed very calm, as if he was not talking about his own condition. (To be continued.) )

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