This gout patient, whether to have surgery or no surgery, and if so, what kind of surgery to choose.

Corey's doctor is very conflicted, gout has come to this point, and everyone can't come up with any good solutions.

The patient went to many hospitals for treatment, and the huge gout nodules at the bilateral ankle joints were ruptured, and the "lime"-like substances were constantly discharged, and the wound was getting bigger and deeper, mixed with various drug-resistant bacteria, which could not be cured for a long time, and the distal tibia and fibula, talus, and calcaneus on both sides were exposed, and some of them were necrotic, forming chronic osteomyelitis.

There is almost no chance of healing from this wound.

In fact, these wounds have gone through the efforts of many hospitals, debridement, negative pressure suction, etc., and various surgeries, but there is no effect.

The doctors in every hospital just shook their heads: only amputation can be processed! And it is recommended to go to a better hospital for surgery.

Where are the better hospitals? The patient's family does not know.

Because the patient's bilateral lower limbs are already filled with uric acid crystals, after amputation, the stump faces a very high risk of non-union, and once it does not heal, a new chronic wound will be formed.

The money is spent, the disease is not cured, the legs are gone, and if the family does not understand and entangle, the doctor will fall into the quagmire, anxious, and unable to extricate himself.

So, the best thing to do is --- not touch!

Don't touch, walk around!

Nothing happened like this, and over the years, the doctor's courage has become smaller. "Is there any other way than amputation?" Song Zimo broke the silence.

Yang Ping shook his head: "Amputation is the best way for him." ”

From above the rupture wound, at the plane of the lower leg, amputate both lower limbs.

Although it is possible that the stump will not heal, it is only possible, and now, chronic wounds on both ankles have no chance of healing.

"Don't be so frustrated, for many patients, amputation is constructive surgery, not destructive surgery, amputation can bring patients from darkness to light!"

Because, after amputation, if the stump heals well, a prosthesis can be fitted and normal walking function can be restored, so that the patient can reintegrate into society.

Because the prosthetics of the lower limbs are very developed, modern medicine has innovated the concept of amputation of the lower limbs.

Amputation --- sometimes a hopeful, bright, constructive surgery.

Some serious lower limb injuries, long treatment, repeated surgeries, consume a lot of time, energy and money, and finally the limb saved is very poor in function and completely incomparable to prosthetics.

This kind of limb salvage is a kind of destruction to the patient and is an ineffective treatment plan; At this time, amputation is a reconstructive operation, which amputates useless limbs, fits prostheses, restores normal walking function, and helps patients quickly run towards a normal sunny life.

"I agree! Bilateral ankle joints have formed chronic osteomyelitis, continue treatment, can only waste time and money, bilateral lower limbs amputated at the lower third of the calf, if the stump does not heal, continue to raise the amputation level, amputation again, until healing, other gout nodules can be carefully removed, for the patient, the goal is to return to the life of a normal person, if the prosthesis can end the current bad life, let him become a normal person again, why do you see amputation as so terrible. Song Zimo very much agreed with Yang Ping's opinion.

Especially Yang Ping's sentence: Sometimes, amputation is constructive surgery, not destructive surgery, and amputation can bring patients from darkness to light!

Others don't seem to have a better way, the disease is at the end of the road, and there won't be many options to choose from.

The treatment plan was thus set, and when the patient's daughter heard the news in the interview room, she was disappointed.

She thought that when she came here, there could be a better way, a different way.

"The best method is the best method, this method is not necessarily the latest, it is not necessarily the most expensive, most of the treatments are ordinary methods!" Yang Ping saw her disappointment and patiently explained to her.

"Amputation, if successful, could put an end to his current dark life, fitted with a prosthetic, and he can walk normally as before."

Yang Ping said with confidence.

The patient's daughter was tempted, and other hospitals also talked about it, but the doctors were unwilling to undertake this operation.

Yang Ping actually saw the problem, because the patient's daughter had taken care of her father for too long, and she also knew some knowledge about her father's condition, so she repeatedly interrogated the doctor's treatment details, and even questioned every medication one by one.

It's easy to give the impression that she doesn't trust --- doctor.

Since there is no trust, of course, the doctor is not willing to take the risk and do not do the operation, whether from the legal or moral point of view, the doctor does not have to bear any responsibility, but if he does, once it fails, the doctor may face endless trouble.

"Is the success rate of surgery high?"

The patient's daughter is the most concerned issue.

"It's hard to say the specific success rate, his condition is special, there is no similar data statistics, if you have to say the success rate, fifty to fifty, if it fails, the stump of the amputation does not heal, forming a new wound that is difficult to heal, we will amputate the leg again, and the plane will be raised." Yang Ping explains the remedy for failed surgery.

The patient's daughter was very embarrassed: "How many times do you do this?" Isn't there a little bit of certainty? ”

The implication is that doctors are not sure what to do?

"No one is sure, no one is sure! His current condition and state have been decided, this is an uncertain operation, not because the doctor is not technically sure, or his body has reached the point where he is not sure to heal, this outcome is determined by his body, whether it is successful or not, the initiative is not with me, but with himself, I can only do what I do as well as possible. Yang Ping said matter-of-factly.

These words are not good, but they are true and honest.

The patient's daughter's face was full of anxiety, hesitation, thought for a moment and said, "If the operation fails, will there be a charge for the failed operation?" Isn't it free? ”

I didn't expect the patient to ask such a question.

Yang Ping said very seriously: "Every operation, regardless of success or failure, has to be charged. ”

"If the operation fails, how can you still be charged, this is unreasonable. I go to the store to buy something, if it is broken and cannot be used, I can return it for a refund, or replace it with a new one, in the same way, I paid for the medical bills, but it did not achieve the intended purpose, why should I charge for it, that is, the thing was not done, and the money was still collected? The patient's daughter plucked up the courage to speak out.

Yang Ping was not angry: "Treating diseases and saving people, you can't be compared with commodity trading, you used the wrong analogy, if according to this logic, you think this is a commodity transaction, and I refuse to provide you with medical services now, that is, I refuse to sell this commodity, for you, I want to remove this commodity, is it okay?" ”

The patient's daughter's face was red and white, and she was speechless for a while.

"The human body is very complex, all the therapeutic effects are statistically effective, there is no guarantee of 100%, this is the characteristic of medicine, if you follow your logic, I tell you very frankly--- no doctor wants to operate on your father, including me!" Yang Ping had to tell him this.

There are some things that must be sorted out before surgery, otherwise it is easy to get stuck in a quagmire after surgery.

"To be honest, Dr. Yang, although my father has medical insurance, but the treatment has been for such a long time, and we have a heavy financial burden, and several elderly people in the family are overwhelmed." The patient's daughter told the truth.

Yang Ping was also helpless: "I sympathize with you, but, I'm just a doctor, financially, we really can't help you, we can only try to help you save hospitalization expenses, if it is indeed a difficult household, we will help you to fight for some charitable relief." You are willing to take the risk of surgery with me, and I will do my best; If I don't want to take the risk, or think that all the risk must be taken by the doctor, then unfortunately I can't take it all. ”

In the face of risk, doctors can only understand the reason, and if the patient and family are insistent on not taking risks, no one can force others to make a choice.

The choice is up to the patient, and the doctor can only help him make the choice.

"If I think about it, is there any other way? More conservative? The patient's daughter was still hesitant.

Yang Ping shook his head: "At present, there are only two choices, either maintain the status quo, or amputate the leg, challenge the risk, and pursue a normal life. ”

In many cases, it is the money that influences the decision!

Money is not everything, but it is impossible to do without money.

If this patient's daughter didn't think about money, she wouldn't have had so many worries and wouldn't have asked questions that would be difficult for doctors to understand.

Her biggest worry was that the operation failed, and she had many repeated surgeries, and in the end, the money was spent, the disease was not cured, and her leg was gone.

The family had a scripture that was difficult to read, and the patient's daughter began to call her husband in front of Yang Ping to ask for his opinion.

The other party was silent for a moment, a little sleepy, and replied briefly: "Zhibei, what else can I ---?"

The tone seemed helpless and helpless.

After calling her husband, the patient's daughter thought about it and swiped on her phone, as if looking for an address book, and there seemed to be no one to talk to.

Both husband and wife are only children, who to talk to? No one negotiates, everything is left to themselves.

The woman's phone rang again, it was his husband's: "Wife, don't worry, do what the doctor wants, do you want me to come over now?" There is a risk in everything, there is a risk of choking on eating, it really can't be done, intercept it again, don't do it again, intercept it again, it's not a matter now, it's a big deal or it's not good, where can it be bad. ”

"That, that---" The woman was worried about the money, but couldn't say it.

The man on the other end of the phone understood very well and said with a smile: "I will go to the company to advance the next month's salary, and the operation will be arranged first." ”

Not long ago, an elderly man in the family suffered a stroke, spent a lot of money on hospitalization, just discharged from the hospital, and now another one is hospitalized.

"Isn't it already advanced for next month?"

The woman has a good memory.

She found that she was still in the meeting room, greeted Yang Ping with a smile, and said that she would go out and call: "Doctor Yang, I'm sorry, let's discuss and decide." ”

Yang Ping nodded.

"Oh, you haven't made an advance yet, you can still make an advance!"

The husband on the other end of the phone was stumbling.