Doctor: It's reasonable to perform surgery on yourself.

First, the course of the disease.

According to the family, this is not the first time the patient has been hospitalized for ear problems.

A year ago, when the patient was two years old, she was hospitalized for pus discharge from her ears.

At that time, she was diagnosed with otitis media, and the hospital prescribed cefadroxil and conventional non-steroidal drugs.

This medication plan...

Xu Qiu was silent for a moment and asked, "Did you go to a small clinic?"

The family was a little surprised and said, "A private clinic recommended by a relative. The doctor is said to have retired from a tertiary hospital and is an old expert in his sixties."

Old expert?

Xu Qiu understood.

Generally speaking, the doctors in the clinic, if they have a position, will write that they were deputy director or chief physician before.

Only if they were attending doctors before retirement can they use the slogan "old expert".

It's not that there are no masters in the clinic.

It's just... those who still use cefadroxil these days, regardless of their previous medical skills, at least their clinical sensitivity to the current situation is poor.

For example, acute otitis media in children.

In the early years, cefadroxil was indeed the first-line drug and the most commonly used drug. However, with the continuous increase of drug-resistant bacteria in the past two years, the clinical cure rate, total effective rate and bacterial clearance rate of this drug are relatively low.

It is far less than expected.

Therefore, the third-generation cephalosporins are currently preferred in clinical practice.

And he also used fewer drugs.

The difference between children's otitis media and patients of other ages is that children's hearing structure is still developing. It is not enough to cure it, but it is also necessary to avoid the disease from affecting the development of the children.

Therefore, in order to protect hearing, experienced pediatricians will use amoxicillin or amoxicillin clavulanate potassium.

This is also a detail that only pediatricians know.

Doctors in other departments, even if they know that children are in the developmental stage and need medication protection, may not know how to prescribe the right medicine.

"What happened later?" Xu Qiu continued to ask.

Hearing this, the family member sighed and said, "My daughter has poor hearing, so she learned to speak very late. She could only speak some simple sentences at the beginning of the year.

"But she has improved a lot since she got started.

"It was this time that she began to scratch her ears frequently. I asked her and found out that she always felt it was very noisy..."

Very noisy?

Xu Qiu thought about it and immediately understood.

The "very noisy" in the child's mouth basically refers to long-term tinnitus.

Wait...

Xu Qiu suddenly caught the key words, "always very noisy?"

The family member said distressedly: "Yes, she couldn't speak before, and we always thought she was fine.

"I only found out after asking that her ears have never been quiet.

"In fact, if you think about it carefully, you can still find some clues. In the past, when we called her or talked to her, she basically had no reaction. Only when we talked to her face to face would she give some response.

"Before, we thought her ears were not good to begin with, and the hearing aid effect was not very good, but now think... In fact, she heard too many and too mixed sounds, and she couldn't recognize our voices at all. "

Speaking of this, the mother of the child burst into tears and began to sob softly.

Xu Qiu also felt a little sympathy.

The world experienced by the child is probably to put a Bluetooth headset with 100% volume next to his ear and live a normal life under this situation.

How many people can bear this torture?

"Continuous existence?"

Xu Qiu fell into thought.

But he shook his head again.

From the description of the family members, it is more likely that the tinnitus is intermittent and recurrent, otherwise she would not be able to communicate normally with her family, and it is unlikely that the hearing aids are worn until now.

Of course, diagnosis cannot be based on speculation.

Xu Qiu continued to ask in depth in this direction, and indeed found that the child was not deaf all the time.

"It is basically confirmed that it is recurrent intermittent tinnitus."

Xu Qiu wrote down this feature and asked other questions: "Have you noticed the child's words and deeds?"

"Words and deeds... Doctor, what do you mean? It seems that there is nothing particularly abnormal. "The father of the child answered on his behalf.

At this time, the young mother raised her head, wiped her tearful eyes, and said: "Yes, when I dress and undress Jiajia, she always resists, and sometimes even cries."

Hearing this description, Xu Qiu immediately paid some attention.

As we all know, pediatricians are considered profile masters in the medical industry.

In other departments, what diseases and discomforts are all based on the patient's mouth.

But pediatrics is different. Any symptoms must be seen by the doctor's eyes.

Because it is impossible for a child to describe where he is uncomfortable.

For the child, it seems that she just refuses to cooperate with dressing and undressing, but there must be some reason for her to do so.

"In addition to this?" Xu Qiu asked.

Jiajia's mother thought about it and tentatively asked: "Brushing, brushing teeth counts, she still can't brush her teeth."

Xu Qiu shook his head and said: "Children learn to brush their teeth at about three years old. It is normal not to brush. "

"Doctor, you understand it wrong. I have been trying to teach her to brush her teeth since she was two years old, but she always can’t hold the toothbrush…”

Can’t hold the toothbrush?

Then this is not a question of whether or not to brush teeth…

Xu Qiu immediately said: “Didn’t you go to the doctor?”

"It's still the same clinic... The doctor said there's no problem, she'll be able to brush her teeth in two years..."

Xu Qiu nodded, without commenting.

But he suddenly remembered another point, and then asked: "You said you can't hold the toothbrush, what about eating?"

Jia Jia's mother's expression was a little difficult to understand, and said: "It's strange to talk about this, my daughter is very smart, now she can use chopsticks, but she just won't brush her teeth..."

Talking about her daughter, she couldn't help but smile: "Speaking of which, she's very well behaved. My brother's family also has a child, that child, wants to vomit when brushing his teeth.

"But Jia Jia is different, she has never vomited, and she just waited for me to help her finish brushing her teeth.

"Didn't we do a throat swab a while ago? Jia Jia is even better than me. Our throats were poked up and down, and we always wanted to vomit.

"Especially the little one in my brother's family, he almost vomited all over the sampling nurse!

"But Jiajia is very well behaved, she doesn't move at all, the nurse said she has never seen such an obedient child!"

Speaking of this, Jiajia's mother showed a trace of pride on her face.

Although these are trivial matters, as long as it is related to her daughter, the mother is always willing to repeat it over and over again.

At the door of the emergency room.

Chen Jia stood at the door with her arms folded. She listened to the family members calling her Jiajia one by one, and she felt a little helpless.

Her mother also often called her Jiajia...

The pediatrician looked puzzled, and he lowered his voice and said: "It shouldn't be, Dr. Xu has such rich clinical experience, and the patient talked so much nonsense, but he didn't interrupt?"

Chen Jia was also stunned and realized that something was wrong.

Dr. Xu at home is very good at controlling the rhythm of the conversation. It is impossible for him to allow the family members to output information that is useless for medical diagnosis... Could it be that the clues are hidden in these messages? !