medical simulator

"You continue to rest, I will check your situation first. You just need to rest quietly."

Zhou Cheng first observed the vital signs, and then recalled Fang Miaomiao's corresponding blood draw indicators, which he had already had an impression in his heart before he came to make rounds.

Fang Miaomiao continued to stare at Zhou Cheng.

Zhou Cheng then ordered: "Can you move your hands? Just move it casually."

Zhou Cheng wanted to make sure whether the movements of Fang Miaomiao's upper limbs were normal.

Fang Miaomiao shook her hands from side to side, and then squeezed her fists. It was just this movement that would press the quilt down, probably because she was shy and afraid that Zhou Cheng would lift the quilt.

Zhou Cheng looked at it and nodded: "Okay, do you feel your lower limbs now? Or, what kind of existence is it?"

"Phantom limb, numb, hot, or non-existent?"

Phantom limbs are amputee patients who feel that their amputated limbs have always existed, but in fact, they have already been amputated.Fang Miaomiao had experienced amputation, and although she was transplanted back, she might not feel like a phantom limb.

"I can't explain clearly. It feels heavy, but I don't seem to feel it. I want to move, but I can't. I can't even feel the existence of my feet." Fang Miaomiao tried her best to talk about her feelings in a low voice and intermittently.

Zhou Cheng nodded, and then pinched the corners of the quilt on Fang Miaomiao's hospital bed, exposing only the knees and below. His fingertips slowly slid down from the tibia, which was also part of the pathological examination.

But Fang Miaomiao didn't know, she didn't respond!

Zhou Cheng asked again: "Can you feel it, my fingers?"

Fang Miaomiao shook her head: "I don't know, I don't feel it."

"Move hard by yourself, and then recall the movement of raising your toes before." Zhou Cheng said again.

Double lower extremity transplantation is an easy operation, but postoperative recovery is a big problem. Zhou Cheng thinks that his operation process will never go wrong, but whether the operation can be restored to the pre-operation state, can he recover? How much, Zhou Cheng has no idea.

If the nerve dies or loses its function, even if it survives after surgery, it will shrink due to disuse.

Fang Miaomiao remained motionless.

Zhou Cheng didn't fluctuate in his heart, which is not surprising, then carefully covered her quilt, and turned to look at Fang Chujun: "Wait a minute, after the house inspection, you ask the child's mother or the nurse at our nurse station , starting from the toes of the lower limbs, all the way up."

"Be sure to find a position with a sense of touch and temperature, and confirm it before and after. This is very important for the control of the disease. I am a male doctor, so it may not be convenient."

Although there shouldn't be too much embarrassment between the doctor and the patient, Zhou Cheng could see that Fang Miaomiao was very concerned about it, and her operation of pressing the quilt proved that she was very disgusted.

"Okay, Doctor Zhou, isn't Miao Miao's current situation very pessimistic?" Fang Chujun hurriedly asked in a low voice.

Zhou Cheng replied: "That's not it. At present, you can see that the body temperature of both lower limbs is normal. Although there is no sensation or movement, there is no necrosis, pressure sores, etc., and the blood supply is also very good, which proves that it is still healthy. alive."

"As long as the limb is still alive, you can still think of a way."

"When you are taking care of her, you must pay attention to the problem of pressure sores. In addition, you have to assist her in some functional exercises, which can reduce the speed of her muscle atrophy and increase her sense of movement."

"It can also prevent venous thrombosis to a certain extent." After Zhou Cheng finished speaking, he turned to Miaomiao and said.

"Rest well, don't think too much, eat hard, eat more high-protein foods, and adjust your mentality. It's very important. You can't say, you can still restore your pre-operation appearance." Zhou Cheng gave Fang Miaomiao a certain heart Consolation, this is to let the patient have confidence first.

Fang Miaomiao's eyes lit up, and she nodded.

Then, Zhou Chengcheng and Fang Chujun walked out, went to the door, closed the door, and after walking for a while, said: "Father Miaomiao, it's like this. The current situation may not be particularly good, but I can't treat Fang Miaomiao like this." face to face."

"You also know that her legs were rescued."

"However, it can't be said that it's bad, that is, her activity is still there. Then, as long as the activity exists, we can still find ways to do it later, such as nerve transplantation and nerve transposition."

"Nerve repair is a very long-term process, and there may be no effect in three months, but at present, we must first ensure the activity of both lower limbs. This is equivalent to another kind of resurrection, and the effect will not be seen so quickly. "

"So, you want her to have consciousness and activities now, which violates the objective law of nerve growth. I can understand your feelings as family members, but at this point in time, all we can do is wait. .”

"Because what I told you before are all alternatives. Whether it's transplantation or transposition, they are not as suitable as the original nerve. We have to give Fang Miaomiao a chance."

When Fang Chujun heard the words, he probably understood what Zhou Cheng meant.

"Doctor Zhou, what do you mean to say, it's better to save this original nerve first, and not move it first, wait for a while, if the effect is really not visible, then find another way?" Fang Chujun's summary and Comprehension is very strong.

It is more comfortable to communicate with such a person: "It is like this."

"Illness comes like a mountain, and goes away like silk."

"We can still look forward to it, so during this waiting process, what our doctors can do is actually limited, but I will always pay attention to it."

"Before, Fang Miaomiao was always in the ICU. As you know, the ICU is a relatively closed place. The more people go there, to a certain extent, it will only make the patients in the ICU worse. Can't do anything."

"I can't, I didn't even give a chance, and I chose the second option directly. This is our doctor's irresponsibility."

Fang Chujun nodded: "I understand, Dr. Zhou, you have worked hard. I will explain all these. We will cooperate with everything you have explained."

"It's actually like this, Doctor Zhou, you see, my wife and I are busy, and my father is older. Tell me, if I hire a more professional nurse, will it work better? "

Zhou Cheng heard that it was difficult to give advice: "It depends on the individual, and a very careful and patient person is needed."

The current situation of Fang Miaomiao is not far from being paralyzed, so it definitely needs to be taken care of. It is difficult for Zhou Cheng to judge who can do better, the family members or the nurses.

If the nursing work is not done well and it is easy to get infected, it will be disastrous.

However, it is impossible for the doctors and nurses to have so many resources to go to the bedside to guide the nursing in person, which is unrealistic.

"Okay, Dr. Zhou, thank you for your hard work. You see that you still have to go to the outpatient clinic, and you still have to make a trip so early."

"But you can come, I feel a lot more at ease in my heart." Fang Chujun's tone was very tangled.

While talking, Muyin and Fang Miaomiao's grandfather also came to the ward. When they saw Zhou Cheng, their eyes flickered, and there was a hint of displeasure at first, but then they restrained themselves and hurried forward to ask.

Zhou Chengcheng said: "It's like this. I have explained Fang Miaomiao's situation clearly to her father. You can communicate with her. I still have to go to the outpatient clinic. If you have any questions, I will definitely come every working day. Ward, communicate with me anytime."

Chapter 326 Big Black Face and Xu Kairan!

Changshi Hospital of Traditional Chinese Medicine, Director's Office, after checking the room.

Lu Bin and Qin Ming got together, and after carefully discussing the operation arrangements and plans, Qin Ming sent the corresponding arrangements to the subordinate doctors.

Then he said to Lu Bin in a melancholy tone: "Director, do you think this case of Fang Miaomiao is suitable for reporting? At present, the publicity department and the hospital are all asking this question."

Changshi Hospital of Traditional Chinese Medicine, after knowing that Zhou Cheng is coming to the hospital, has always been welcoming. It is also hoped that Zhou Cheng can further expand the reputation of the orthopedics department during his stay here.

So far, Zhou Cheng has done it and routinely carried out minimally invasive fracture surgery in the department, which has greatly improved the reputation of the orthopedics department of the Traditional Chinese Medicine Hospital.As for the replantation of limbs after amputation, if it can be reported, it is basically the first case in the country and even in the world.

The reason why amputation still exists is to save life. In the case of limb necrosis and uncontrollable bleeding, amputation must be done first to save life.

However, after amputation, replantation of severed limbs, or even allogeneic limb transplantation, it is not the transplantation of the original limbs. The reason for amputation is because of extensive necrosis of the limbs.

However, Zhou Cheng reversed this result.

For now, it is already a miracle that the limbs in that situation can survive simply through manipulation, without talking about the function.

If it can be fully recovered, it will be a miracle among miracles. This is a very good publicity opportunity.Even though Changshi Hospital of Traditional Chinese Medicine cannot repeat it, with a gust of wind, more people can know the existence of Changshi Hospital of Traditional Chinese Medicine.

But there are several problems. First, Fang Miaomiao has a special status. He has not yet done a good job with Fang Chujun and Muyin. better.

This is to put pressure on Zhou Cheng, hoping that Zhou Cheng can work harder.

Second, Zhou Cheng doesn't seem to care much about the other party's situation at present. When he was in the ICU, he only went to the ward round once, and then he mostly refused. Moreover, Zhou Cheng's cooperation in the department is not very good. .

Not to mention Fang Chujun's relationship, a higher-ranking person is called Zhou Chenglai, and Zhou Cheng will not come.

The reason why he didn't dare to publicize rashly is because he was afraid that such a case would appear again, and Zhou Cheng would be unwilling to take another action. It would be ridiculous and generous at that time. An operation that cannot be repeated is not worth publicizing.

Third, no matter how Zhou Cheng chooses, they still have to be polite to Zhou Cheng and not be too harsh.

Lu Bin is the director of the ward, and Qin Ming is a doctor in the department, in charge of teaching, publicity and other work, so the publicity department is in direct contact with Qin Ming, because it must be Qin Ming who can write the wonderful ones.

Lu Bin frowned slightly: "It doesn't matter whether the publicity department of the hospital is asking or urging. Before there is no definite curative effect, let alone whether Mayor Fang can agree. Fang Miaomiao's mother will definitely not agree. .”

"In addition, if we can't get in touch with Dr. Zhou Cheng at any time and before volunteering, this propaganda must not be done."

"Otherwise something will happen, and the fame will be spread. After the real patient comes, but no one can do it, so the patient is not noisy?"

"Rather than that, it's better to treat it as a special case."

Qin Ming nodded and said, "Director, I think so too. I also expressed similar thoughts to the Propaganda Department and the dean, but the dean still wants us to do more work for Dr. Zhou."

"Enabling Dr. Zhou to devote more time to clinical cooperation. This is a very good opportunity to get out of our orthopedics department." Qin Ming relayed the words of the hospital leader.

But Lu Bin heard these words much more than Qin Ming.

"Dean Yang can talk up and down, and the people in the publicity department can give such suggestions as tasks, but how to do the work, who will do it? How to make it effective, have you not considered this issue?"

"Our orthopedics department, why haven't we achieved results? Minimally invasive fracture surgery, so many patients have received good reviews, and the number of outpatients has increased so much? Isn't this a result?"

"As soon as they move their mouths, we can do whatever we want. If we don't have to do it, don't do it either."

The corner of Lu Bin's mouth was cold for a while: "Some people can only see fame and political achievements, but not the hardships involved. So far, there have been no instructors who have come down from the top and routinely participated in emergency operations. precedent."

"Our hospital wants to be the first? If anyone wants to say that again, you can let him do the work of Dr. Zhou Cheng."

Pooh.Lu Bin spit out irritably.

People have to be reasonable. If Zhou Cheng is willing, that's fine. Of course Lu Bin cooperates.However, they come here to help you with your business, to teach, not to work. If you haven't done a good job in this position, what can you do to him?

Force others to pat their butts back?

Qin Ming didn't answer the question. In this case, he naturally didn't dare to speak to the leaders of the academy. Lu Bin might be able to speak, but he is not yet qualified.

Before Lu Bin could speak, his phone rang.

It was Dean Yang who was calling. Lu Bin's face became even colder. After hesitating for a while, he still connected, and turned on the loudspeaker, and put it on the table.

"Lu Bin, I want to tell you something. You have to put Dr. Zhou's work on the agenda. This is the best time for our hospital, and I have also heard the report from the medical department."

"You guys haven't discovered Dr. Zhou's strength and potential at all. Why did such a good publicity opportunity disappear when it came to you?"

"I know that there are difficulties, and if there are difficulties, I will find a way to solve them. When everyone is working, there are difficulties. Can you not do it?"

"I have discussed with several other vice presidents, and we will give you the greatest authority. During Dr. Zhou's work in our hospital, everything is easy to discuss about the treatment."

When Lu Bin heard this, he didn't hesitate: "Dean Yang, Doctor Zhou just refused a call the day before yesterday."

Lu Bin must remind Dean Yang not to be dazzled by interests.

"I know, I told you to be courteous but not aggressive. You must think of a way. If there is a problem and a goal, there will be a solution. Then you can add up."

"Remember, I need a response to this matter, preferably within this week." Dean Yang said in an orderly tone.

Lu Bin said directly: "Dean Yang, I can give you the answer right now, it's impossible. I can't complete this task."

"You didn't even try it, how do you know you can't finish it? Lu Bin, what's the matter with you?" Dean Yang's tone was a little irritated.

"Dean Yang, my ability is limited. It is impossible for me to tell Dr. Zhou about this matter. Or, have you removed me as the director? You can ask Director Guo of our orthopedics department, or other directors. .” Lu Bin’s tone was very calm.

He wants to be in the arena of orthopedics. There are some things he can do and some things he can't do.

"Lu Bin, you are teasing me at this critical moment, right?"

"I just told you that this is your task, and you must complete it for me. Keep the quality and speed."

"Doctor Zhou is not an unreasonable person. You see, Director Quan called Dr. Zhou yesterday, and he agreed. You don't ask or work hard. How do you know you can't do it?" Dean Yang said, But the tone also eased a little.

Hearing this, Lu Bin covered his forehead and said, "Dean Yang, I won't do it. This matter can only be discussed with Doctor Zhou by the hospital's medical department or the hospital."

"I'm just the director of the department. I don't have this authority." Lu Bin's tone was very firm.

"Lu Bin, what's the matter with you? Are you telling me these things at this time? I'm doing it for your own good. If you complete this task, you will." Dean Yang began to paint cakes for Lu Bin.

"Dean Yang, I don't want to think about promotion. I think I can do it now."

"President Yang, Dr. Zhou is a person who can perform top-level surgeries. How do you want me to tell him? What should I tell him? Just our hospital platform?"

"To put it bluntly, if Dr. Zhou's technology can keep up, can the technology of other departments keep up?" Lu Bin asked a very realistic question.

"This is a problem, so we have to figure out a way, Lu Bin, you have to keep this matter in mind. We don't want Dr. Zhou to stay, but we hope that he can participate in clinical affairs more. What an excessive request. Right?"

"Besides, it will also be of great benefit to Dr. Zhou's reputation. Maybe Dr. Zhou also has the same idea, but why didn't he say anything?" Dean Yang continued to indoctrinate Lu Bin on the phone. That set.

There is no way, this good opportunity, if you don't grasp it now, it will be impossible if you want such an opportunity in the future. Moreover, not only he wants to grasp this opportunity, but many people also want to grasp it .

"I think this matter is impossible. Dr. Zhou is the instructor in our department. I'm not qualified to talk to him. If I want to talk to him, I can only talk to Director Guo or the hospital. I can't talk to him alone."

"Dean Yang, I'll leave my words here. If you think I'm not capable enough, you can ask other people to take my place. I can't do anything else." Lu Bin's attitude was also very tough.

He felt that as long as he learned minimally invasive fracture surgery, he would be very good, and he would greatly improve the department. As for making a step forward, Lu Bin was afraid that he would tear himself off.

"President Yang, I still have surgery arrangements, so I need to make a plan, so let's do this first." Immediately afterwards, Lu Bin actively hung up the call from Yang Jun.

On the other side, the conversation is not over yet.

Immediately, Yang Jun called again, but Lu Bin didn't answer.

But then, the third call came again. Lu Bin knew that he couldn't escape, so he answered it again.

"Lu Bin, why don't you have any consciousness at all? This is such a great opportunity. You have to think of a way." Yang Jun's tone immediately became amiable, like an old friend .