When doctors have a simulated operating room
Chapter 522
The child's father lifted the child's clothes and said: "Doctor Zhang, please take a look at my son's belly. Why... why is there a lump?" Almost at the same time as he lifted the clothes, Zhang Yi's eyes fell on the child's belly. Lump? A lump protruded from the right lower abdomen? The diameter was about five centimeters. Zhang Yi immediately felt that the lump was not simple! Looking inside, it turned out to be a lymph node sarcoma! No! It's not just a sarcoma. Below the lump... there seems to be something wrong with the kidneys. Both kidneys are swollen! Zhang Yi frowned. The edema of both kidneys should be related to the tumor.
And the lymph nodes around the tumor, including the lymph nodes around the kidneys, seem to be very different from normal lymph nodes.
This mass is not simple!
Seeing that Zhang Yi looked a little strange, the child's father also became nervous:
"Doctor Zhang, you are a miracle doctor. Is my son's condition... good or bad?"
Zhang Yi looked up at him and asked:
"Does this mass hurt? When did it grow?"
"No~"
Before the child's father could reply, the little boy took the initiative to reach out and poke the mass on his stomach.
The boy looked very well-behaved, with round eyes and a baby voice when he spoke.
Although he knew that he seemed to be sick, he always gave Zhang Yi a feeling of a little adult.
Zhang Yi couldn't help but touch his head and asked:
"Child, does this lump really not hurt?"
The boy shook his head: "It really doesn't hurt, try poking it."
"Oh, no, no, no! Stop poking." Zhang Yi saw the boy poking his stomach hard, and was frightened and quickly took his hand away.
At this time, the child's father replied:
"The lump has been growing for more than three months. Before, I just felt that my stomach seemed hard when I was bathing the child. At that time... I also suspected that I was sick.
But... but I didn't have money in my bag at that time, so I delayed it.
I saved some money after running takeout for a few months, so I registered your number to come to the hospital for a check-up."
"Besides the lump? Are there any other symptoms? Do you have a stomachache? Fever?"
"Yes! It's just that my stomach hurts occasionally! The color of urine is also abnormal!"
Zhang Yi got angry immediately after hearing this, and his voice was raised:
"The color of urine is abnormal? Then you should have come to the hospital earlier! The urine of such a young child is abnormal, which is very dangerous! What color is the urine??!"
The child's father was also shocked by what Zhang Yi said.
He replied with some guilt:
"The urine...seems a little...a little bloody."
"Blood?!"
Zhang Yi couldn't help rolling his eyes!
A five-year-old child has blood in his urine!!
He was only sent to the hospital now? !
I have to say that this father is really careless!
Although he was angry, Zhang Yi didn't say anything when he thought of him saying that he had no money before and came to the hospital now that he had some money.
Being poor is actually a disease.
"Apart from blood in the urine, are there any other symptoms?"
"I can't eat much. It seems that my appetite has decreased since the lump appeared."
Zhang Yi lowered his eyes and looked at the little boy again.
A five-year-old boy can actually have a normal conversation with an adult.
Zhang Yi lowered his head and asked:
"Child, besides the stomachache, what else do you feel uncomfortable about? Tell me everything, okay?
I'm a doctor, if you tell me, I can help you."
The boy blinked and smiled shyly:
"Uncle doctor, if you can help me, how should Fanfan thank you?"
"It's okay, you don't have to thank me, I'm a doctor, it's my duty to help you, you know?"
"Um... Fanfan has a stomachache and often wants to vomit..."
After waiting for a while, the little boy stammered.
"No wonder I can't eat, I guess my stomach is uncomfortable."
Zhang Yi said while typing on the computer keyboard to write a check list.
The child's father also looked worried:
"Doctor, my child...what's going on? Is it serious?"
"It's hard to say at the moment. We need to do an examination first, abdominal color Doppler ultrasound, enhanced CT, and even tissue biopsy. All these examinations must be done."
"Biopsy?"
"The tenderness of this child is on both sides of the lower abdomen, close to the lower back. For the location of male organs, this is the kidney.
Plus there is a mass, so biopsy is necessary.
It must be done, and as soon as possible! "
——
The child's father has a low level of education, and he doesn't know some medical terms.
But the word biopsy doesn't sound like a good thing to him.
After looking at the ignorant child in his arms, the father asked again:
"Doctor Zhang, could it be that my son... has... a terminal illness?"
He pronounced the last two words "terminal illness" very lightly, as if he was afraid that his son would hear it.
The child is still too young, so it's better not to let him know some things.
Zhang Yi didn't give a very definite answer, just said:
"Don't worry too much for now, everything will be decided after the test results come out, okay?"
"...Okay then, thank you, Doctor Zhang."
"Uncle, what disease do I have? Is it serious?"
The boy lay on the table and stared at the expression on Zhang Yi's face curiously.
"This..." Zhang Yi smiled and reached out to touch his forehead: "Don't worry, child, uncle wants to check you, so you have to wait for the test results to know. ”
“Oh…”
The boy seemed to understand and answered obediently with his head tilted.
After the prescription was issued, the child’s father took the child out of the clinic.
First pay the fee, then do the examination and take the biopsy tissue.
Generally, taking a biopsy tissue is also considered a minor operation, which requires anesthesia.
Especially since this is a child, you have to be more careful when taking the biopsy.
Result…
An hour later.
But the family member hurriedly returned to the clinic with the child in his arms.
“Doctor Zhang, please help me take a look. The doctor who did the CT scan said that my son might have…maybe a tumor? !
He asked me to show you the test results and then decide whether to do a biopsy! "
The family members were a little excited.
If such a young child really has a tumor, it would be very uncomfortable.
Zhang Yi quickly took the list and looked at it.
A mixed-density mass appeared in the bilateral kidney area, and the lymph nodes around the bilateral kidneys were significantly enhanced.
A high-density hemorrhage focus appeared in the right lower abdomen, and small calcifications around the mass were visible.
Damn!
Zhang Yi really guessed it right!
When the child just came in, he actually took a look, just a glance, and he began to suspect that the child might have a tumor.
But he didn't say it clearly in front of the family members and the child.
The test results came out, and the answer to the guess in his heart also fell to the ground.
Seeing that Zhang Yi looked at it for a long time without saying anything, the family members asked:
"Doctor Zhang? Is... is it true? Is it really a tumor? ! "
"Well... now it is highly suspected, because you see here, mixed-density masses appear in both kidneys. If this density is just simple edema, then the surrounding lymph nodes will not show abnormalities.
Based on my experience, 80% of it is a tumor.
Also, if a child aged 4-6 has a painless mass in both kidneys, it can be diagnosed as a tumor.
This tumor is called a nephroblastoma. Of course, no biopsy has been done yet.
Only after a biopsy can we know whether it is a nephroblastoma. Even if it is confirmed to be a nephroblastoma, we still have to see if it is malignant. "
Nephroblastoma, in layman's terms, means that during the growth and development of a child, the kidney cells mutate, and they do not develop or develop deformed.
It will eventually develop into a tumor called a nephroblastoma.
Nephroblastoma is also classified into low-risk, medium-risk and high-risk types.
A biopsy must be taken to the pathology department for examination to distinguish what the mutated cell nuclei in the kidneys have become.
——
"Is it really... a tumor? ! "
The little boy's father was not calm, and he became nervous unconsciously, and his body was shaking a little.
Such a young child actually got a tumor?!
What should he do as a single father?
Zhang Yi looked at the expressions of the family members and comforted them:
"Don't worry, we haven't done the biopsy yet. Many tumors need a biopsy to know what kind of tumor it is. It may be benign. Generally, benign tumors can be removed by surgery."
"What if it is malignant? What should I do if it is malignant? !"
"Malignant tumors can also be operated on, but the prognosis is definitely not as good as that of benign tumors.
You can even choose chemotherapy and radiotherapy first, and then surgery."
The child's father lowered his head, and a complex and tangled look flashed across his face.
Then he raised his head and asked:
"Doctor Zhang, then... then how much will my son's disease cost? The total cost of hospitalization, surgery, and examinations. "
Zhang Yi looked at the father, then looked down at the boy lying on the table playing with paper.
"If it is benign, you can go straight to surgery, the cost is about 50,000.
If it is disgusting, you have to first radiotherapy, chemotherapy and then
Then surgery, as for the duration of radiotherapy and chemotherapy, it depends on the degree of tumor deterioration.
In general, if it is a malignant tumor, it should be a minimum of 100,000 yuan. "
"10...100,000 yuan as a minimum?!"
The boy's father swallowed in shock.
100,000 yuan is fine.
They even added a minimum...
It means at least 100,000 yuan, and if the condition changes, it may be more than 100,000 yuan?
150,000 yuan? 200,000 yuan is possible?!
Ah!
Generally, when family members ask about money, and then they show this helpless and tangled expression after asking about money.
Zhang Yi knows what the family members mean.
After thinking about it, Zhang Yi asked:
"Does your child have any insurance? Our hospital can reimburse you, and some can reimburse up to 90%."
"Insurance?" The family members shook their heads: "No, I don't have money, I don't even have money to see a doctor, so where can I buy insurance! ”
“That’s it…”
The atmosphere in the office suddenly became awkward.
Suddenly, the little boy who had been sitting on the table playing with paper tugged at his father’s sleeve and said:
“Dad, I’m actually just a little bit in pain. Fanfan is a man and he’ll be fine if he endures it. Dad, let’s go home? I don’t need to spend money.”
As he said that, the child patted his stomach hard.
It seemed that he wanted to prove that his stomach really didn’t hurt.
But, does it really not hurt?
A tumor grew in his stomach, cysts appeared in both kidneys, and there was blood in his urine?
Does it really not hurt??!
For a moment, Zhang Yi couldn’t help but look at the little boy more.
He’s only five years old.
How can he be so sensible?
He’s so sensible that it makes people feel distressed!
On the side, the child’s father also looked guilty.
“Son, Dad… Dad has money. Dad made a mistake just now. We have money. Since we are in the hospital, we can rest assured to treat it.
Doctor Zhang, I… Should we do a biopsy first or apply for hospitalization first?
No matter what, you must get treatment if you are sick!"
Hearing this, Zhang Yi felt relieved.
I am afraid that the family members have no money to treat the child. Such a young child... If he really doesn't get treatment, he may die.
"Okay, I will arrange hospitalization for you first. It has been confirmed that it is a tumor, but the specific tumor and whether it is nephroblastoma still need to wait for the results of the biopsy.
Arrange hospitalization first, I will ask the doctor in the hospitalization department to arrange a tissue biopsy for you."
"Okay, Dr. Zhang, thank you!"
"By the way, you need to pay two or three thousand yuan in advance for hospitalization. How much do you plan to pay now?
What is the subsequent treatment cost? ? ? "
The family member's eyes flickered a few times before smiling and saying:
"Haha, Dr. Zhang, don't worry, I have saved tens of thousands of yuan in the past few months. If it is not enough, I will borrow some from relatives. I have to cure the child anyway."
"Okay, then you go, go to the nephrology department to arrange hospitalization. ”
“Oh, OK, thank you, Doctor Zhang.”
“It’s OK, bye, Xiao Fanfan.”
“Well, goodbye, Uncle Doctor~”
The little boy waved to Zhang Yi.
Hey, this kid should know everything even though he is young.
When he heard his father said he had no money, he took the initiative to say that he didn’t feel any pain and didn’t need to be hospitalized.
He wanted to relieve his father’s pressure.
But when he heard his father say he could be cured with money, the child smiled shyly again.
Such a sensible child, I don’t know whether it’s good or bad.
With a bang.
The door of the clinic was closed again.
“But fortunately, he still has tens of thousands of yuan in his bag, so he can still be cured for a while. "
As he said this, Zhang Yi used the office landline to call the Nephrology Department.
Because of the patient Jiang Yimin who was poisoned before, Zhang Yi had some friendship with the Nephrology Department.
I just called over to take care of it and help as much as I can.
After hanging up the phone, Zhang Yi started to call the next number.
It was an old man who came alone.
He looked to be nearly 80 years old, and he walked in hobbled with a cane.
"Uncle, your name is Liu Aihua, right? What's wrong with you? Are you coming to the hospital without a family member?"
"Ah? What? "
Although the old man had a full mouth of dentures, he still spoke a little unsteadily.
Zhang Yi took a look up and down and found that the old man's forebrain was a little atrophied.
It should be senile degeneration.
But this kind of problem should be accompanied by family members, right?
Why do you come alone at such an old age?
Zhang Yi was about to ask more when the door of the clinic suddenly opened again.
A middle-aged man in his forties came in.
"I am number seven, Liu Aihua, Doctor Zhang, why are you cutting in line?"
The patient walked in with the number in his hand and looked at the old man who had already sat down and said with a little dissatisfaction.
Zhang Yi then realized that the old man must have walked into the wrong clinic
it’s done!
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