I Can See Health

Remember [new] in one second! There were three electrophysiology surgeries in one morning, and the consultation fee totaled 6,000 yuan.

Lu Chen put the envelope away for now and planned to communicate with Li Yao later.

"Congratulations, I received a +1 thank you from Fan Zhiping!"

"Congratulations, I received a +5 thank you from Yin Chao!"

"Congratulations, I received a +1 thank you from Lin Xin!"

"..."

After completing these three surgeries, Lu Chen also received dozens of gratitude points.

System upgrade completion has also been improved accordingly.

"Director Li, I have booked a hotel for noon." Yin Chao said with a smile, "You and Dr. Lu can have lunch first and then rest for a while."

"Okay." Li Yao nodded in agreement.

Lu Chen was slightly stunned.

He thought Li Yao would go back to the hospital directly, but he didn't expect that he would have to stay all afternoon.

"Lu Chen, we are going to the cardiology ward this afternoon." Li Yao explained.

"Um."

With the envelope in his arms, Lu Chen got into the business car and arrived at the reserved hotel with Li Yao.

After eating a sumptuous lunch, after Yin Chao and others left, Lu Chen said: "Teacher, about the consultation fee..."

Li Yao smiled and waved her hand, "Take it, you did the surgery, and you deserve the consultation fee."

"Teacher, this is too much." Lu Chen paused and said.

If you work for two and a half hours in the morning, you can earn 6,000 yuan.

This is a substantial amount of income for most people.

"Formal income, you can take it after it has been approved by the Medical Department and the Health Bureau." Li Yao said sternly, "What's more, our electrophysiologists are small-headed and have more coronary intervention than us. You young people, use money There are many places to talk about love and so on, and the daily living expenses are definitely not enough. "

Seeing what Li Yao said, Lu Chen couldn't refuse his mentor's kindness, so he nodded and agreed.

"If I have a chance in the future, I will take you out for a spin." Li Yao added.

"Thank you, teacher."

Lu Chen knew that this was Li Yao creating another opportunity for him.

What he lacks now is the opportunity to experience.

In addition, you can earn some extra money by flying to acupuncture points, which is something no one else can ask for!

…

After lunch break, at two o'clock in the afternoon.

Lu Chen and Li Yao came to the cardiology ward of Fengm County People's Hospital.

Lu Chen also learned that this visit to the ward was mainly for a patient.

This patient is not only a relative of the dean, but also an acquaintance of the school leaders.

The patient is currently hospitalized in the cardiology department, but after almost a month of treatment, there is still no improvement.

Originally, he was transferred to Jinghua Hospital for treatment, but the patient was old, unstable and could not withstand the long journey, so he could only receive conservative treatment at the county hospital.

…

This time, taking advantage of Li Yao's visit to Feng M County People's Hospital, the director personally invited her to come and see someone.

"Professor Li, it's not easy to communicate with this patient's family!" Fan Zhiping said quietly to Li Yao, "The attitude is not very good. We usually let the director communicate in person."

He happens to be the patient's bedside doctor.

For this kind of "relationship" patients, they really have a headache.

Don't think that it's easy to communicate with acquaintances. There are quite a few "connected" patients who rely on this relationship to ignore various department rules and even interfere with the process of treatment and medication.

This medicine is made in China and cannot be used.

If the other medicine has any side effects, it cannot be used.

But Li Yao has seen too many patients like this.

If she hadn't been personally invited by the dean, she would definitely not have come.

Li Yao looked indifferently and said softly: "I'm here to see the doctor, not to please the patient or his family."

Fan Zhiping smiled. Only professors have such courage. Little doctors like them don't dare to do this.

"Professor Li, do you want to see the patient first or the medical records first?"

"Let's see the patient first," Li Yao said.

Afterwards, Fan Zhiping took the two of them to the ward.

…

This is a VIP single room.

The patient was half lying on the bed, and the head of the bed was shaken up.

His eyes were a little dull and his lips were blue and purple, but he was conscious and all vital signs were stable.

Next to the hospital bed, there was a middle-aged woman sitting. She had big red waves and was dressed neatly.

Walking to the bedside, Fan Zhiping began to introduce, "This is Professor Li Yao from the Department of Cardiology of Beijing Second Hospital."

The middle-aged woman stood up immediately, with a smile on her face.

"Hello Professor Li, please sit down quickly."

With that said, she actually took out a chair and placed it in front of Li Yao.

Li Yao frowned, "I don't have to sit down when I see a patient. And we doctors never sit in the ward."

"Uh." The smile on the middle-aged woman's face paused, and then she smiled coquettishly.

At this time, Fan Zhiping began to report the medical history.

"The patient is an 80-year-old man who was admitted to the hospital complaining of chest tightness, shortness of breath and edema of both lower limbs for 1 month."

“A month ago, the patient developed exertional chest tightness and shortness of breath, accompanied by edema of both lower limbs, loss of appetite, cough, and sputum production. He was diagnosed with pulmonary heart disease and chronic obstructive pulmonary disease at the local health center, and the treatment effect was poor. "

"I had hypertension and chronic bronchitis in the past."

After listening to the introduction of the medical history, Li Yao nodded and began a simple consultation.

Lu Chen followed Li Yao and conducted a physical examination on the patient.

"She is clear, the jugular veins are distended, the breath sounds in both lungs are clear, and no wet or dry rales are heard. Both lower limbs are edematous. Physical examination of the abdomen and nervous system are negative."

After the consultation and physical examination, everyone was ready to return to the doctor's office.

However, just as he was about to leave, he was stopped by a middle-aged woman.

"Professor Li, how is my father's illness?"

In front of the patient, Li Yao couldn't say much, "Don't worry, I will communicate with your bedside doctor after I read the medical records."

Li Yao was about to leave, but the middle-aged woman was still a little reluctant, "Professor Li, the dean is a relative of my family, and he was here today..."

Li Yao paused for a moment, then left the ward without stopping.

…

Walk out of the ward.

Fan Zhiping shook his head helplessly and said softly: "Professor Li, don't worry, she is quite good today, but her attitude is not much worse than usual."

Li Yao shook her head slightly: "I have seen many patients like this. Let's just go back and look at the medical records."

"good."

Returning to the doctor's office, Fan Zhiping frowned and said, "Professor Li, the main problem with this patient right now is that the treatment effect is not very good."

Li Yao replied unhurriedly: "The treatment effect is not good, do you have any ideas?"

Fan Zhiping has been in the Eighth District of Heart for half a year, and Li Yao also knows him.

Fan Zhiping paused and replied: "Professor Li, the first thing I think about is, is the drug treatment not in place? Secondly, is our diagnosis wrong?"

While talking, Fan Zhiping took out the patient's medical records.

He printed two copies of all the medical records and handed them to Lu Chen and Li Yao respectively.

…

After reading all the medical records, Li Yao asked, "What is your current diagnosis?"

Fan Zhiping organized his speech and said: "The patient was diagnosed with pulmonary heart disease at the health center. I think the possibility is relatively small. Based on cardiac ultrasound and other examinations, we considered hypertensive heart disease, heart failure, and chronic obstructive pulmonary disease." Lung disease.”

After hearing Fan Zhiping's description, Lu Chen looked at the patient's cardiac ultrasound report.

The cardiac ultrasound report showed that the end-diastolic diameter of the left ventricle was 40 mm, and the end-diastolic diameter of the right ventricle was 1.5 mm. Ultrasound changes consistent with hypertensive heart disease include enlargement of both chambers and normal left ventricular systolic function.

Lu Chen knew clearly that Fan Zhiping's diagnosis should be based on the heart ultrasound report.

"But we gave the patient anti-hypertensive and anti-heart failure treatment, but the patient's symptoms of heart failure were still obvious." Fan Zhiping said.

On the side, Lu Chen continued to look through all the patient's examinations.

pro-bnp: 8141.02pg/ml.

There were no obvious abnormalities in routine blood tests, liver and kidney function, qr-crp, coagulation function, D-dimer, blood lipids, blood sugar, thyroid function, urine protein, and routine stool tests.

Chest CT showed: bilateral lower lung lobes infection, a small amount of bilateral pleural effusion, and multiple small nodules in the upper and middle lobes of the right lung.

"Professor Li, your opinion..." Fan Zhiping said slowly.

Li Yao did not answer directly, but asked: "Where is the patient's electrocardiogram?"

"Oh, here it is." Fan Zhiping took out the electrocardiogram from the medical record folder.

Li Yao took a look at it, then handed it to Lu Chen, and said with a smile: "Lu Chen, what do you think?"

Lu Chen paused slightly when he heard this, "Based on all the patient's symptoms and examination results, UU Reading www.uukanshu.net heart failure is certain. Now we need to look at the cause of the heart failure."

Heart failure is just the end of the disease.

Many diseases can cause heart failure, such as coronary heart disease, hypertensive heart disease, valvular disease, pulmonary heart disease, obese heart disease, etc...

"I don't think this patient has pulmonary heart disease or hypertensive heart disease."

Lu Chen's words stunned everyone present.

The cardiac ultrasound report has already mentioned hypertension and heart disease.

Why isn't it right?

Fan Zhiping asked doubtfully: "Coronary heart disease?"

"No." Lu Chen shook his head.

"Fat heart disease?" a doctor said.

"no……"

"Valvular disease?" Another doctor asked.

Lu Chen was quite helpless. Do you want to guess all the diagnoses?