This doctor has a system

Chapter 11 11. It's all the pepper's fault

The patient in the afternoon was a 52-year-old middle-aged man named Xie Yupeng, who was a salesperson.Gao Feng asked about the medical history in detail. The patient started to have a chronic cough more than 4 months ago, and occasionally coughed up some white sputum.Since it doesn't affect life, I don't care too much.A week ago, bloodshot sputum began to appear. The family was worried and asked him to go to the hospital to have a look.

The chest CT report of the community hospital indicated: obstructive pneumonia in the left lower lung, accompanied by stenosis of the lumen.After more than 10 days of infusion of antibiotics in the community hospital, the symptoms of bloody sputum disappeared, but re-examination of CT showed no change in the left lower lung.

"You may be something bad." The doctor at the community hospital had a serious expression on his face. "Why don't you go to a big hospital."

Xie Yupeng emo, my uncle died of lung cancer, it's over, I was inherited!
The wife was also very frightened, and after discussing it, they decided to come to the provincial hospital for hospitalization.The nurse in the outpatient triage was very professional and told him that he could call the respiratory department or the thoracic surgery department.Like the vast majority of people, Xie Yupeng had a natural fear of surgery and decided to take respiratory medicine.

Director Li at the outpatient clinic looked at the film and told him that he needed a bronchoscopy. If it was inflammation, it would be easy to talk about. If it was malignant, he could evaluate it first to see if surgery was possible.

Gao Feng prescribed a blood test for Xie Yupeng. Before doing a bronchoscopy, at least four items of blood routine, coagulation function, electrolytes, and infectious diseases should be checked. Some anesthesiologists also need to check liver and kidney function, and myocardial enzymes.An electrocardiogram is also essential.

Many people don't understand, why are you asked to do an electrocardiogram as soon as you enter the hospital?If you have a headache, ask for an ECG, if you have chest pain, ask for an ECG, if you have abdominal pain, ask for an ECG, and even if you have a toe headache, ask for an ECG!
Gao Feng didn't understand it before, until later when he was in graduate school, a big brother who had a stomachache had an electrocardiogram and was found to be acute myocardial infarction.Gao Feng had never seen his mentor run so fast before, and his eldest brother was directly pushed to the CCU.

The final result is: the eldest brother spent 6 and took two brackets home.

So if you go to the hospital in the future, the doctor tells you not to make noise during the electrocardiogram, just do it, and if you find out that you have a heart attack, you will make a lot of money!

By the way, I asked Xie Yupeng to do another chest enhanced CT. The CT in the community hospital has 16 rows, and the resolution is not very good.

Chest-enhanced CT is different from ordinary CT in that it requires intravenous injection of contrast agent and completes the scan within a specified time.

In this way, the density of lesions, blood vessels and surrounding tissues can be different, which is helpful for the diagnosis and treatment of diseases, and is of great significance for the identification of inflammation and tumor.

The patient had just settled down when another middle-aged male patient came in.

This patient is more interesting. The patient likes to eat chili, and he likes every meal without spicy food. I choked when I ate red pepper one day ago, and it felt like it went into my lungs.A CT was taken in the outpatient clinic, and it was indeed stuck at the orifice of the right main bronchus.

Then this also needs to be bronchoscopy, and then it can be directly clipped out with biopsy forceps or foreign body forceps.In fact, in this case, local anesthesia can also be done, but the patient feels that he can't stand it and strongly demands anesthesia.

"I have strong financial strength, so I can be as comfortable as possible." The patient said to Hu Jiaran who treated him.Hu Jiaran checked the patient's payment records, "This person paid 10 yuan!"

"It won't cost 1 yuan to die, but if you do local anesthesia, you can solve it with more than 1000 yuan." Cheng Song said.

"By the way, here you are. Arrange a full set of physical examination for me. Isn't there a Parker CT? Make me one." The rich elder brother and son brought 2 large boxes of fruit to Hu Jiaran.

"I'm afraid it won't work. The medical insurance doesn't allow this. You have to pay for the physical examination." Hu Jiaran was a little embarrassed.

"If you pay for yourself, pay for yourself, it's not bad for money!" The elder brother's son was very arrogant. "That's fine, I'll prescribe it for you after the bronchoscopy is done tomorrow." Hu Jiaran followed suit.

After the eldest brother and his son left, Hu Jiaran patted his head: "What is Parker CT? Why didn't I mention it."

"The patient should be talking about PET-CT. The Chinese name is positron emission computed tomography."

"PET-CT integrates PET and CT. PET provides detailed molecular information such as function and metabolism of lesions, while CT provides precise anatomical positioning of lesions. One imaging can obtain tomographic images of all directions of the whole body, which is sensitive and accurate. It can understand the overall condition of the whole body at a glance, and achieve the purpose of early detection of lesions and diagnosis of diseases."

"That's what the book says, and the cost is about 1 yuan." Gao Feng said: "It's a bit outrageous to do this for a physical examination."

"Then what should I do? I promised him just now." Hu Jiaran was a little embarrassed.

"Just tell him that the radiation in this inspection is a bit high," Gao Feng gave him advice.

Sure enough, when the eldest brother heard that the radiation was high, his face changed, "Forget it, let's not do it, let's do other things." At the end, he emphasized: "If it is not harmful to the human body, don't think about money. I will come back later." Go make a deal."

Hu Jiaran stopped him, "Enough is enough, I can't spend it all!"

In the office, everyone sat together to eat fruit. The fruit bought by the elder brother should be very expensive, and there are knives and spoons in the box.

Gao Feng likes to eat this dragon fruit. Dragon fruit is divided into white and red. The white taste is average, while the red is sweeter.Dragon fruit is rich in nutrients and has the functions of preventing constipation, promoting eye health, lowering blood sugar, blood fat, and blood pressure.

The pulp contains anthocyanins, which can promote gastrointestinal digestion, prevent anemia, whiten the skin and prevent dark spots.

"Nan Nan, you can take these two dragon fruits back to the dormitory and eat them. You are black and whiten it." Hu Jiaran was very concerned about Qi Nannan.

"Get lost! My skin isn't dark, okay, I'm the only one in our dormitory!" Qi Nannan was furious.

But she looked at it herself, and found that Hu Jiaran, Cheng Song, and Gao Feng seemed to have fairer skin than her.

Family members, who knows, there are 3 sissies in the department, their skin is whiter than that of women, what a shame!Qi Nannan's mentality collapsed.

When he was about to get off work in the afternoon, Xie Yupeng came back from the enhanced chest CT. Gao Feng told him to drink plenty of water to metabolize the contrast agent.

Turned on the chest CT from the computer, Gao Feng took a closer look, and found something abnormal. What is this long strip of high-density shadow?
It seems that we need to ask about the medical history, "Have you ever choked on anything before?" Gao Feng asked, "Did you choke while eating or drinking?" "Think about it."

"No." Xie Yupeng tried hard to recall.

The wife next to him suddenly stood up at this moment, "Didn't you choke while eating chili?" "You forgot the long chili?"

"Oh, I remembered, I choked. It's been almost half a year, and I didn't feel uncomfortable at the time. I thought it might have been swallowed." Xie Yupeng finally remembered.

"It probably choked into the lungs!" Gao Feng told him, "The enhanced CT of your chest just now shows a long foreign object inside, which may be the chili pepper."

"However, the pepper looks quite long. Do you usually eat it so long?" Gao Feng became interested.

"No, I ate it in my hand. At that time, my wife asked me to serve the meal, so I put it in my mouth." "The rice was too hot, so I took a breath and sucked the pepper in. "

Going back to the office, Gao Feng told everyone about the situation. Pepper is the protagonist of today.

(End of this chapter)