Chapter 321: 【321】Palpation Chapter 321: 【321】Palpation The patient’s pleas were heart-wrenching.
Xie Wanying thought: In such situations, doctors are put in a difficult position.
She glanced over to see how Teacher Tan would decide.
With that look towards the teacher, it appeared that she unintentionally t the sideways glance he returned to her from under his eyelids.
That look from the teacher made her suddenly feel a bit guiltily nervous inside.
“Lie on the examination bed,” Tan Kelin said, flipping back the page of the dical record and addressing the patient.
Upon receiving the command, Xie Wanying pulled back the white privacy curtain next to the examination bed.
The patient’s two sons helped the elderly woman lie down on the bed.
“You do the initial examination,” Teacher Tan ordered his student.
Following the teacher’s instruction, Xie Wanying turned towards the examination bed, took out her stethoscope from her pocket, and first listened to the patient’s heart, lungs, and abdon. After listening, she put on gloves for the palpation.
Since the patient had undergone relevant examinations at other hospitals, it was mainly about palpating the affected area to save ti.
She began with light palpation, her right hand spread flat, using her fingertips to gently touch the patient’s affected side. This was the area of the left half of the colon. Due to the narrow lun in the left side of the colon, tumor formation often leads to acute or chronic intestinal obstruction, which exactly matched the characteristics of this elderly patient’s condition.
The elderly patient, who had experienced famines in her youth with nothing to eat, found herself in better economic conditions in her old age with caring children, eating a diet much richer in fat than before. The elder didn’t restrain herself, and her children, not dically educated and ignorant of the risks, thought that feeding their mother well was an act of filial piety, not realizing that high-fat diets are one of the main risk factors for left-sided colon cancer.
It was only when they noticed the elder getting thinner despite eating more, having difficulty defecating, and even vomiting did they realize sothing was wrong and hurriedly sent her to the hospital. A checkup revealed a mid-to-late stage condition.
This is a common occurrence clinically, where well-aning family mbers inadvertently do harm. It illustrates the complete mismatch between national health education and the ever-improving economic living conditions.
Xie Wanying’s fingertips searched for masses within the patient’s abdominal cavity.
The tumor, while appearing not small on the CT scan conducted at other hospitals, was difficult to feel since tumors in the left side of the colon are inherently hard to palpate, and though the old woman was thin, her abdon was distended when lying flat, making it hard to feel the deep-seated tumor inside the patient.
If light palpation doesn’t work, proceed to deep palpation, with the second, third, and fourth fingers of the right hand pressed together, pushing deep into the patient’s abdominal area. Finally, she was able to feel a mass, which was very deep. Her fingers gently slid around the mass to get a sense of the surrounding area.
The location was too deep. Xie Wanying thought, it’s no wonder the patient, after several initial consultations at nearby small hospitals, was misdiagnosed, the doctors assuming it was just a common gastrointestinal disease and not requiring further examination. Even when the patient vomited, an ergency doctor at a second-tier hospital thought it was gastritis. It wasn’t until intestinal obstruction developed that they realized the severity of the situation and transferred her to a third-tier hospital.
Upon hearing this, the patient’s two sons expressed helplessly, “We didn’t know what those previous doctors were doing. If we’d known it was a tumor, we would have sought surgery imdiately. But now, half a year has been wasted.”
Half a year is significant; early-stage tumors and mid-to-late stage tumors are entirely different matters.
Because of such experiences and word of mouth, people now prefer to go straight to third-tier hospitals.
So diseases are easy to misdiagnose clinically, and the old lady’s case is one of them. If the doctor orders too many tests, they might be scolded by the patient. For elderly patients experiencing a bit of stomach pain and vomiting, suggesting an endoscopy might be t with reluctance, fearing the invasive nature of the procedure.
The public doesn’t understand and tends to bla the level of the doctors. In reality, the doctors have always said that it’s better to have regular health check-ups than to wait until illness strikes. Early detection leads to early treatnt, and that makes everyone happy.
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