I Can See Health

After listening to Min Ling's story, Lu Chen understood.

In clinical practice, many things are not black and white.

Many times, the patient's family factors and economic conditions will seriously affect the patient's treatment effect.

It’s not just about drugs or the doctor’s medical standards.

Lu Chen began to write the patient's first course of illness record.

The current main diagnosis is hypoglycemic coma, excluding cerebral infarction.

In this case, it is necessary to complete the brain DWI examination in time to rule out acute cerebral infarction.

As for hemiplegia, hypoglycemia can also cause hemiplegia, but the current treatment mechanism is not yet clear.

…

Half an hour later.

"Doctor Min, bed 18, the blood sugar just checked is L."

The nurse walked into the doctor's office and called out.

"Okay, I understand, keep going." Min Ling nodded, "Is the patient's son here?"

The nurse replied uncertainly: "It seems that a man has arrived, and several family members are discussing something in the corridor."

"Yes." Min Ling stood up, "We can't delay it any longer. I'm going to communicate with the family."

Min Ling walked out of the doctor's office, and Lu Chen followed her.

In the corridor of the ward.

Four family members of the patient gathered in a group and were having a heated discussion.

Seeing Min Ling coming, the middle-aged woman from before came out.

"Doctor, my brother is here. He wants to know more about my dad's condition."

A thin man with a scar on his right eye took a step forward and said, "Doctor, what's going on with my dad now?"

Seeing that the patient's family members were all present, Min Ling explained patiently: "Currently, it is considered to be coma caused by hypoglycemia, but the presence of acute cerebral infarction cannot be ruled out, so now we need to go out and do an MRI of the head to rule out cerebral infarction! Because once Once a cerebral infarction is diagnosed, the treatment will be very different!”

The middle-aged man touched his chin and asked doubtfully: "Doctor, do you have to do this examination? Can't you do it?"

"No, cerebral infarction must be ruled out." Min Ling said.

The middle-aged man frowned, "I just told a classmate who is a doctor about my dad's condition. He said it was just hypoglycemia and there was no need for an MRI."

Min Ling replied expressionlessly.

"It's okay if you don't do it. Just sign to express your refusal to inspect and bear all risks."

Upon hearing this, the middle-aged man hesitated again.

"If the examination shows that it is cerebral infarction, can it be cured?"

Min Ling shook her head, "Not necessarily. It depends on the size of the patient's cerebral infarction and the individual's condition. Some people have no sequelae, some may suffer from hemiplegia, and a small number of people may even be in a coma forever and become a vegetative state."

"This..." The middle-aged man was stunned and looked back at several other family members.

"Actually, this examination is not expensive. It only costs a few hundred yuan, and it can be reimbursed." Min Ling looked at the middle-aged man's clothes. He didn't look like someone who couldn't even get a few hundred yuan out of his family.

"This..." the middle-aged man paused, "Actually, it's a problem with my dad's medical insurance. His medical insurance will stop paying this year, so he may have to pay for it out of pocket."

Min Ling raised her eyebrows.

"At your own expense?"

"Yes. I asked. If you pay for your medical insurance now, it will take three months before you can use it."

"I know you have your own reasons, but the disease waits for no one. You have five minutes to make a decision." Min Ling gave an ultimatum, "If you do, go now. If you don't, just sign."

"Okay, okay." The middle-aged man nodded quickly.

…

Back to the doctor's office again.

"Xiao Lu, if the family members are willing to go out later, you can accompany them." Min Ling smiled.

"Okay, Teacher Min." Lu Chen nodded. , "Do you think his family will agree to go for an examination?"

Min Ling paused, then smiled and said: "Yes, after all, it is their father, lying on the bed like this. If it is an acute cerebral infarction, other family members of their family may gossip if we don't talk about the treatment."

"Sometimes, people's words can be scary."

Lu Chen nodded.

"Hey, by the way, do you remember the last time you sent a patient to the ICU?" Min Ling said suddenly.

"Yes." Lu Chen nodded, "What happened to the patient afterwards?"

Min Ling shook her head: "Hey, the patient stayed in the ICU for a few days. The cost was too expensive, so he was transferred back to the general ward. Within two days, he was almost dying. He was just dragged home yesterday."

"This is the case in his family. People must not be dragged home until they take their last breath, otherwise the neighbors and some relatives nearby will gossip."

Chinese people love face, and this is clearly shown in many things.

…

Five minutes later, the middle-aged man walked into the doctor's office.

"Dr. Min, we agree to do the examination. You can arrange it now."

"Okay." Min Ling then looked at Lu Chen and said, "Dr. Xiao Lu, you will take the patient's family out for a brain DWI now."

"Yeah. Lu Chen nodded, and then followed the middle-aged man out of the doctor's office.

The nurse has placed the ECG monitor at the bedside.

"Doctor Lu, you are ready. You can go out for examination at any time."

"Okay, then let's go."

The patient's four family members, two in front and two behind, pushed the bed out of the inpatient building of the endocrinology department. UU Reading www.uｕkanshu.ｎ

Generally speaking, MRI is not an emergency examination.

The exception is head DWI.

DWI of the head refers to MRI, which is diffusion-weighted imaging.

This is a generalized functional nuclear magnetic resonance technology. Clinical application is mainly used to determine acute cerebral infarction, which can clearly display the lesions early and provide important help for treatment.

Come to the magnetic resonance room.

Four family members lifted the patient onto the examination table.

Lu Chen also came to the operation room and stood beside the operation technician.

"What's the condition of the patient?" the technician asked while adjusting the examination interface.

"The patient was admitted to the hospital in a coma, with low blood sugar and left hemiplegia. We considered the possibility of hypoglycemic coma, but cerebral infarction was not excluded."

"Oh." The technician nodded.

In the inspection room, the machine is already running.

On the computer, brain MRI images began to appear.

Lu Chen concentrated on watching the video data on the computer.

Picture after picture, slowly developed.

Until, on a black brain tissue map, a white mass appeared.

At this time, the technician turned back and glanced at Lu Chen.

"You asked the patient to come out and do a DWI. The magnetic resonance diffusion DWI showed a high-intensity image, and the possibility of acute cerebral infarction was considered."

Lu Chen felt a little lucky. Fortunately, Teacher Min Ling insisted on pulling him out for DWI.

If you continue to treat hypoglycemia and the patient doesn't wake up, the problem will be serious.

Even if the patient's family has signed the informed consent form, the hospital will still bear some responsibility.

Lu Chen immediately sent a WeChat message to Min Ling.

"Teacher Min, the result is out, acute cerebral infarction!"