"It's really not a big deal. I just looked at the preoperative photos of the patient, as well as the barium imaging. I reckon you performed a total gastrectomy on her. ”

Zhou Can explained with a smile.

Barium angiography examines the cardia and digestive tract, usually directly by giving the patient a barium dose, which is medically referred to as a barium swallow.

Some patients will have great concerns when they eat it, which can be completely assured and there is basically no harm.

The barium swallow used for digestive tract examination is a suspension of medicinal barium sulfate, which is insoluble in water and lipids, so it will not be absorbed by the mucosa of the gastrointestinal tract and is basically non-toxic to humans.

If you want to say that it is not toxic at all, there is no guarantee of this.

After all, it is a chemical agent.

It's just that the vegetables, fruits, and various processed foods we usually eat have many more additives in them than we think.

A barium swallow test may not be as toxic as eating a spicy strip or chewing a betel nut.

This test is not done very often, but it is checked once when necessary, so you don't have to worry too much about it.

Our human body's ability to detoxify, resist, self-clean, and heal is far beyond our imagination. Many toxic and harmful substances enter the body and are quickly broken down by our liver.

If the liver can't handle it, the kidneys will cooperate to excrete the toxic substance from the body.

At the same time, our sweat glands also have a detoxifying function.

If what you eat is very toxic, don't worry, the body will immediately activate a double protection mechanism of vomiting and diarrhea. If the poisonous contents of the stomach are vomited out and then enter the intestines, they are quickly excreted from the body in the form of diarrhea.

It can also be seen from here that our bodies love themselves more than we do.

"Yes, I did a total gastrectomy for her. My thought was that it was better to lose my stomach organs than to lose my life. Even if it only helps her to prolong her life by five years, I think this surgery has a lot of significance. Normally, if she doesn't relapse, her life can even be extended by ten or twenty years, even longer. ”

Director Le is also a veteran in cardiothoracic surgery.

In terms of surgical ability, he is quite good.

Any surgery will cause some damage to the patient's body. The attending physician has assessed that the benefits to the patient far outweigh the damage from the surgery, and that it is worth it.

Losing the stomach, a digestive organ, will definitely have a bad effect on the body.

In the future, the food can only be liquid.

It can also cause many inconveniences. Without a stomach to store food, there is definitely a need to eat small, frequent meals. There is also the reflux of food, which also makes the patients suffer a lot.

Losing the stomach not only reduces digestion and food storage capacity, but also reduces an important protective barrier for oral eating. We have stomach acid in our stomach, which can eliminate almost most germs and viruses.

If you lose it, you don't have this barrier.

Therefore, we must take good care of every organ of the body. If you find a problem, seek medical attention in time.

It's easy to miss the best time for treatment.

The body is like a house. When there is a fire in a room, extinguish it as soon as possible, and the damage to the items in the room will be slight. For the whole house, it hardly had any effect.

If you wait until the fire is big and all the items in the room are burned before extinguishing the fire, at least this room will be lost.

Each organ of the body is equivalent to a room and has its own unique role.

It's hard to replace the function of another room.

For example, if the kitchen burns out, then there is no way to cook anymore, so you can only eat takeout every day.

"After you cut off the stomach, did you pull the jejunum into the diaphragm and anastomosed the end of the esophagus?"

Almost everyone is in the same vein as Director Hu Kan, and they can guess some of the surgical methods.

"Awesome! That's exactly how it works. ”

Director Le nodded in acknowledgement.

"The feeding tube was placed in the distal jejunum, right?"

Zhou Can asked again.

"That's right." Director Le really admires Zhou Can so much, just after a few glances, he can even deduce the surgical plan accurately one by one. "Dr. Zhou must have found out the cause of the patient, so don't hang my appetite, hurry up! You know that I'm in a hurry. ”

Director Le couldn't help but urge.

With his understanding of Zhou Can, it is certain that Zhou Can has already made a diagnosis.

It's just that Zhou Can has always been low-key, and he doesn't speak easily before he is absolutely sure.

"Hehe, I won't hide it from you, I do have a preliminary diagnosis. However, if it is as I think, further testing is needed. Zhou Can smiled, and the first thing he said was not the answer, but emphasized that the patient must be examined before the treatment plan can be determined.

Medication and treatment are all rigorous things.

No matter how experienced a doctor is, as long as it is not an emergency life-saving situation, he must not rely on the doctor's subjective assumptions alone.

Even if it is an emergency life, it needs to be supplemented by some necessary examinations.

You ask, what if it is an acute and critical illness such as chest suddenness and cerebral hemorrhage?

Even in this kind of acute and critical illness, the most important thing is to do some basic rescue measures first, such as cardiopulmonary resuscitation, and then urgently do relevant examinations for the patient. Before the results of the examination are available, absolutely no doctor dares to say that the patient is given thrombolytic drugs and surgery.

If a cruel rescue condition has to be set, the patient is in a coma at the time of treatment, and the attending doctor knows from experience that the patient is suffering from cardiovascular blockage. Even the attending doctor, with his superb medical skills and rich experience, can deduce which coronary artery is blocked.

At this time, emergency intervention can save the patient's life.

If you have to wait until a CT scan or even a contrast scan is done to determine the surgical plan, the patient will die.

At this time, do you rely on the experience of the attending doctor to perform surgery first to save people, or do you insist on waiting for the results of the examination?

Unfortunately, knowing that the patient would die when the test results came out, he still had to wait.

It's not that doctors don't save them when they see death, but that no doctor dares to gamble with his future and his house. In case the patient is not saved, the family will take it to court, and the doctor will be doomed.

In order to protect themselves, doctors can only wait for the results of the examination.

In the process of waiting, I can only do some basic rescue measures, and I will never dare to open surgery or interventional surgery.

Even medication is extremely cautious.

This is the harsh reality.

It's not that the doctor is impersonal and unsympathetic, but that the relevant procedures must be strictly followed.

"This patient had jejunal-esophageal anastomosis, and based on her symptoms and surgical plan, I boldly deduced that her cause was likely to be a serious postoperative complication, with biliary sweat and pancreatic juice regurgitation."

Zhou Can gave a diagnosis.

After hearing this, Director Le fell into deep thought.

"Reflux fluid is mostly alkaline and lacks the stomach acid to neutralize and buffer, so it is more invasive to the esophageal mucosa. Therefore, whenever reflux occurs, the patient will feel unbearable pain behind the sternum, and the appetite will naturally decrease. ”

He made a further analysis based on Zhou Can's conclusions.

Zhou Can just smiled and nodded, indicating that this was exactly the case.

"So how can this problem be solved?"

Director Le humbly asked him for advice.

The cause has been found, and it is not immediately fatal, leaving plenty of time for the doctor to treat him.

What we have to do now is to find a way to treat and change the patient's status quo.

"This one has already been operated on, so I'm afraid it's a bit troublesome. If you don't have surgery before, there is a way to solve it. ”

Zhou Can's expression became serious.

He is not a god, and some postoperative complications are almost unsolvable.

It is difficult for a good woman to cook without rice.

The previous surgeon had already removed a part of the patient's tissue, and even if he knew how to treat it, he couldn't do anything about it.

"Did I mess up the surgery?"

Director Le is also a smart person, although Zhou Can didn't say it explicitly, he already understood a little.

Doctors with a level of proficiency generally do not criticize other doctors for not doing a good job in their operations.

At most, it's like Zhou Can, a little bit.

It is almost impossible to hold the previous surgeon accountable. Because before the patient's surgery, the family members all signed. I was fully informed and consented to the surgery.

Even though I knew that signing before surgery would be a huge risk, there was little solution.

It is also necessary to sign when it is time to sign.

If the family does not sign, then there is no way to operate.

You can only change hospitals.

Moreover, the professional level of the family members is definitely far inferior to that of the attending doctor, who uses the medical knowledge of Baidu, Zhihu and other online science to teach the doctor how to determine the surgical plan? Don't be funny.

As long as a family member dares to do this, after the attending doctor can't explain it, he will give up directly and let the family find another master.

Nowadays, some smart patients and family members like to ask several hospitals before surgery, and dare to make multiple comparisons of the surgical plan formulated by the doctor. This is actually a safer approach.

Of course, the premise of this must be chronic disease, and you need to have enough time, money, and energy to go to several hospitals.

If the hospital you choose is a large compound, you can basically avoid some potential risks.

Zhou Can really can't answer Director Le's question positively.

Even if the two have a good relationship, in front of Director Le, he admitted that he had done the operation badly. This is extremely stupid.

Even if people don't have any opinions in person, there will definitely be some ideas behind them.

If you meet that kind of doctor who is arrogant, it is possible to turn against him directly.

"Dr. Zhou, is there any way to solve the postoperative complications of this patient?"

Director Le asked questions in a different way.

"Show me your surgical plan and surgical records, and then you can take advantage of this time period to give the patient a 24-hour bilirubin monitoring examination, if possible, it is best to supplement gastroscopy, mainly to observe the situation of bile reflux and determine the cause."

Zhou Can did not rashly 'point out the country'.

It can be seen that as he has been practicing for longer and longer, his medical skills have become higher and higher, and he has become more cautious in doing things and speaking.

This is also a common manifestation of all doctors after evolution.

The more skilled the specialist, the more cautious he is in the diagnosis and treatment process.

It is not entirely the fear of being slapped in the face, but a more comprehensive and in-depth comprehensive assessment and judgment of the problem, which has gradually been integrated into their diagnosis and treatment habits. So I became more and more cautious when practicing medicine.

In doing so, the probability of capsizing will also decrease.

Director Le took all the surgical records and the surgical plans discussed before the operation to Zhou Can for review and study.

On the other hand, he has already started to arrange for the patient to have a second examination to observe the patient's reflux in order to determine the cause.

Half an hour later, Zhou Can had finished his research and had a surgical improvement plan.

It is estimated that the results of the examination on Director Le's side will not come out until tomorrow.

Zhou Can called Director Le and said that he would wait until the results of tomorrow's examination came out and then consult with him. Then he rushed to the pediatrics.

There's a difficult case waiting for him there!

When he came to the pediatrics, he went straight to Director Tang Fei's office.

Knocking on the office door, Director Tang Fei hadn't gotten off work yet, and might be waiting for him to come over.

Because she was very happy when she saw Zhou Can enter the door, she immediately put down the pen in her hand and got up to make tea for Zhou Can.

You know, this is the head of pediatrics.

Zhou Can is just a resident doctor, and being able to be treated so courteously by a senior director whose status is second only to the vice president is the benefit of being powerful.

Ordinary residents, if they can enter Director Tang Fei's office for a private chat, they will feel extremely honored and happy.

The whole process is estimated to be only standing.

Look at Zhou Can again, the treatment he received is completely the same level of courtesy. Even the general deputy chief physician who comes to Director Tang Fei may not be able to have this treatment.

"Doctor Zhou, please take a seat! What are you polite to me? ”

Director Tang Fei smiled and asked him to sit down, and closed the office door with his hand.

Zhou Can's expression immediately looked a little unnatural.

was misunderstood by Director Xueyan's husband, and now it has given him some psychological shadows. He became more careful when dealing with these younger, more beautiful female doctors and nurses.

Especially when you enter someone's office, if only two people are alone, try not to close the office door if you can.

Otherwise, if there is another misunderstanding, it will not benefit anyone.

"Don't be shy, Doctor Zhou, it's not the first time I've come here."

Director Tang Fei saw that Zhou Can was nervous and nervous, and immediately smiled and comforted.

"Uh...... It's not that it's inhibitive! Can you open the office door, I've been feeling a little chest tightness lately. ”

Zhou Can pulled a lame reason.

Flutter!

What kind of person is Director Tang Fei, just look at his expression and know that he is not telling the truth.

I couldn't hold back my laughter on the spot.

Zhou Can suddenly became even more embarrassed.

"Dr. Zhou, what's wrong today? Seems weird, has something happened? ”

A woman's sixth perception is too strong.

She knew very easily that something must have happened to Zhou Can.

"Hmm...... Well...... this" Zhou Can was a little hesitant.

"This is treating me as an outsider! If there is anything, you can rest assured to tell me, maybe I can give you some ideas and help you solve it! Of course, if you don't want to say it, you don't have to force it. ”

Director Tang Fei has always been kind to Zhou Can, and he attaches great importance to him as a super talent.

Zhou Can hesitated, but finally said honestly, "I didn't pay attention when I got along with a female doctor in this hospital, closed the door of the office, and discussed the patient's condition with her inside, but was misunderstood by her husband. When I was at work this morning, her husband came to me and warned me not to associate with his wife again. I'm not afraid, I'm afraid that if I hurt you lesbians, then the sin will be great. ”

When he mentioned it, he was depressed.

"Giggles!"

After Director Tang Fei heard this, he was trembling with laughter.

"What should I have done, this is what happened! In other female doctors and nurses, you are right to be careful, but in my case, you can put your heart in your stomach. The guy in my family never asked me which man I was dating with, and he was very reassuring to me. And he was bored in the lab all day long, doing research, so busy that he didn't have time to care about me. In his words, as long as I don't mess with him. ”

Director Tang Fei explained to Zhou Can.

"You're so pretty, he never worries about other men snatching you away?"

Zhou Can couldn't help but ask.

He found that there was too much difference between people.

Director Tang Fei's husband and Director Xueyan's husband are simply two extremes.

"I'd be glad if he really cared about it one day. However, for him, his scientific data is clearly more attractive to him. "Director Tang Fei is in her forties and has a sweet appearance, and her husband is not worried at all that she will be beaten by other men.

It's really funny.

(End of chapter)