Doctor: I picked up attributes in the hospital

Chapter 120 Special Patients with Advanced Cancer

The next day.

Twenty eight.

In the anesthesiology office.

As soon as Zhao Heng entered the office, he picked up the schedule on the table and looked at it.

Today is the general shift, which means that the firefighters will go to support wherever there is a problem.

Under normal circumstances, only senior and experienced doctors are competent.

Speaking of which, during this period of time, most of Zhao Heng's shifts were regular shifts. Every day, there were only a few surgical anesthesias scheduled for a fixed time, and the rest of the time was used for consultations in various departments.

At this moment, nurse Tian Zhen came in and said to Zhao Heng: "Dr. Zhao, there is a consultation in the oncology department, I want you to go there."

"Oncology? Well, I see."

Zhao Heng was a little puzzled, he received relatively few consultations from the oncology department, but he still nodded.

This nurse Tian Zhen is said to be a nurse in the anesthesiology department who is responsible for coordinating consultations. This kind of work is actually envied by many nurses. To put it bluntly, coordinating this work is to be a mouthpiece.

After a while, Zhao Heng came to the oncology department.

As soon as he entered the doctor's office, Zhao Heng clearly found that the atmosphere of the oncology department was completely different from other departments.

how to say?

There is a very solemn feeling, probably because many patients in the oncology department are cancer patients who are dying.

As soon as he entered, Li Haiyang, the chief physician of the oncology department, stood up, greeted Zhao Heng and said, "Dr. Zhao, you are here."

"Ah."

Zhao Heng nodded.

However, Zhao Heng has often heard Li Haiyang say this sentence recently.

"Today, I invite Dr. Zhao for a consultation. We have a patient with advanced liver cancer who needs neuraxial analgesia."

The attending doctor Li Haiyang said straight to the point.

"Do you need neuraxial analgesia?"

Hearing what Li Haiyang said, Zhao Heng was a little surprised.

Here, I have to talk about the treatment of pain in the late stage of cancer. As we all know, in the late stage of cancer, the pain of patients will increase day by day.

At the beginning, oral analgesics can suppress the pain, and then nerve plexus damage must be performed. In the end, pain that cannot be suppressed even by nerve plexus damage requires an anesthesiologist to implant an intraspinal analgesic device.

It can be said that the implantation of an analgesic device in the spinal canal is the last resort.

In fact, the scope of application of anesthesia is far beyond the cognition of ordinary people, and it can not only be applied in surgery.

Among them, the reason why pain treatment is less well known is that once pain treatment by an anesthesiologist is needed, it is usually pain in the late stage of cancer.

"Yes, this patient has undergone celiac plexus damage twice before, but the relief of pain symptoms is still not obvious. No, I'm afraid the only option is spinal analgesia now."

Li Haiyang sighed and said.

As a doctor in the oncology department, Li Haiyang feels that the daily work is very depressing.

If you think about it, you will know that most of the patients we face every day are terminal cancer, and their lives are not long.

For many patients with advanced cancer, the main treatment is actually analgesia.

"The patient's situation is complicated?"

Zhao Heng thought for a while and asked.

If the situation is not complicated, it is estimated that he will not be invited.

Intraspinal analgesia is actually giving analgesics directly into the spinal canal. This operation is similar to clinical puncture anesthesia, and ordinary anesthesiologists can do it.

"The patient's spinal tumor mass invaded most of the lumbar vertebrae, and the puncture was very difficult."

Li Haiyang said slowly.

"It has spread to the spine?"

Hearing Li Haiyang's words, Zhao Heng was a little surprised. As we all know, in advanced cancer, cancer cells will spread throughout the body. The wider the spread, the shorter the remaining life span of the patient.

This has spread to the spine, which means that the patient has not had it for several months.

"Yes."

Li Haiyang nodded heavily. This feeling of heaviness is experienced by every doctor in the oncology department every day.

"What did the patient's family say?"

Zhao Heng asked again.

This neuraxial analgesic treatment does not mean that it will be effective for a long time if it is completed once.

For the patient mentioned by Li Haiyang, the pain could not be suppressed even by opioids, and he had already undergone nerve damage surgery. Now, spinal analgesia is the last resort.

Neuraxial analgesia is rarely used as a last resort for pain relief in cancer patients, not because the treatment is ineffective but because it is expensive.

An analgesic device in the spinal canal, one end of which is a silicone catheter, is punctured and implanted in the subarachnoid space, and then goes out of the spinal canal and is fixed under the skin.

The catheter is connected to a programmable computer pump subcutaneously in the abdomen, and the drug infusion mode is set according to the pain characteristics of the patient, so that the morphine is directly delivered to the cerebrospinal fluid to achieve the purpose of efficient use of morphine.

Among other things, the programmable computer pump implanted under the skin of the patient's abdomen is very expensive and can only be imported.

"The family members agreed, but the patient himself was unwilling to undergo the treatment."

Li Haiyang sighed and said.

In the treatment of advanced cancer, there are often dilemmas.

Most importantly, it is a moral dilemma.

As we all know, many patients with advanced cancer cannot be cured, and the remaining time of their lives is limited.

And within a limited time, what degree of treatment should be carried out has gradually evolved from a medical problem to a moral problem.

For many families of patients with advanced cancer, there will be a situation of "both human and financial resources".

"The patient wants to leave some money for his family."

As soon as Zhao Heng heard it, he knew that this must be the case, because such things had happened countless times in the hospital.

"Yes, many patients in our department have this idea. In order to reduce the burden on their families, they are unwilling to continue treatment."

Li Haiyang nodded and said.

"Dr. Zhao, the family members have already approached me about this matter. What the family members want is for us to describe this treatment as a very normal and ordinary treatment. In this way, patients can also receive this treatment."

After a pause, Li Haiyang said with some embarrassment.

"White lie?"

Zhao Heng thought for a while and said.

"Yes, the family really can't bear the patient to endure the pain of the advanced stage of liver cancer, but the patient is stubborn, so this is the only way to go."

Li Haiyang said helplessly.

The reason why liver cancer is called the king of cancers is that the pain tormented by patients in the advanced stage of liver cancer is the most severe among all cancers.

How should I put it, it was a kind of pain and torture that ordinary people could not imagine.

According to statistics, 60% of patients with advanced liver cancer will have the idea of ​​committing suicide within one month after diagnosis.

The reason for this is because I don't want to face the terrible pain of the advanced stage of liver cancer every day.

(End of this chapter)