(Thanks to Northern Night Wolf, Reader 161216101042457, and Evening Breeze for their encouragent with monthly tickets)
There are thousands of illnesses, and the pathways of infection are also diverse. Take today's sinusitis fungal infection patient, he never dread it would be related to his athlete's foot.
Many patients feel their conditions are bizarre. But for those working in hospitals, it's nothing unusual.
"Teacher Liu, the last patient's issue is quite complicated. I suggest a colonoscopy review; found three lumps in the rectum." Liu Banxia was reading when Xu Yino returned with the film.
Taking the film and inserting it into the viewing lamp, Liu Banxia frowned.
Indeed, one of them has a relatively low position, about six centiters.
"Alright, have her co over, I'll ask her so more." After looking for a while, Liu Banxia said.
Xu Yino hurriedly went out and brought the patient in.
"Still feel a dragging pain in the lower abdon?" Liu Banxia asked.
The patient nodded, "Doctor, is it cancer?"
"Don't jump to conclusions so quickly. I, the doctor, haven't figured it out yet and you're already diagnosing." Liu Banxia said with a smile.
"Any usual sensations? When defecating, the shape or color of your stool, have you paid attention to these? Is your pain suddenly magnified today or is it there every day?"
"I haven't paid attention. These days have been very painful, but today is worse." The patient said.
"So you an it didn't hurt much before?" Liu Banxia continued asking.
The patient nodded, "Hmm... it's not like there was no pain at all, just not very strong. Doctor, am I too late?"
"Don't worry yet, given your situation, we need to do a colonoscopy." Liu Banxia said.
"Because a colonoscopy provides a more direct view and is the gold standard for diagnosing intestinal diseases. Though, there needs to be so bowel preparation, co tomorrow morning to do it directly."
"Don't scare yourself, I just said, I don't know what's going on. But based on your description, I think there shouldn't be much of a problem."
"Otherwise your symptoms would be far more serious than they are now. Hmm... Any occurrence of bloody stool? Can you recall any of that?"
The patient nodded, "There have been instances, but I have hemorrhoids."
"Then don't overthink it. Go ho and prepare your bowels, get a colonoscopy tomorrow, and it'll be clear." Liu Banxia said.
The patient glanced at him and nodded. Given the current situation, who wouldn't be worried?
Growths where they shouldn't be are definitely problematic. She regrets not paying more attention when going to the toilet in the past.
Ding! Consultation complete
Experience Points earned: 30
"Teacher Liu, why didn't we do a digital rectal exam?" After the patient left, Xu Yino asked.
"Silly girl, if a colonoscopy can solve the problem, why put more burden on her?" Liu Banxia responded.
"A digital rectal exam is also considered invasive, and not everyone is comfortable with it. She's already worried, even with a digital exam, we couldn't make a better judgnt."
"So let's minimize the tests, see what's going on with the colonoscopy tomorrow. For such situations, a comprehensive consideration is necessary."
Xu Yino nodded, indeed, she was thinking too hastily.
For this patient, her ntal state is already tense. She needs a buffer; anyone would have a hard ti calmly facing potential bad news.
"Teacher Liu, your friend is here."
At this mont, Miao Rui ca in.
Liu Banxia nodded and went outside.
"I ca to see Old Zhou, and also to check on you." Liu Haibing said with a smile.
"Old Zhou is recovering well, but given his age, he can't compare to younger folks and needs to stay a few more days here." Liu Banxia said.
"No need to worry too much now. The key is the future. He shouldn't be overly emotional; it'd be best to have others share so of his work."
"Recovering in our hospital is just the first step, there's a long road ahead. Don't think that everything's fine once the ergency surgery is done."
"Don't worry, even if you don't ntion it, Old Zhou will be more ticulous than others." Liu Haibing said.
"There's another reason I ca to you; Old Zhou wants to thank you. I reminded him that we don't really do such things here. But he insisted, so I had to co and ask you."
"If he really wants to express sothing, just buy so waterlon or fruit. Don't buy anything too expensive or too much; just enough is fine, since there are no outsiders here." Liu Banxia said.
"Alright, with your approval, I can go ahead and buy." Liu Haibing nodded with a smile.
This is a very interesting situation. Even if you want to give a gift, you have to see if the other person wants to accept it.
The hospital has rules against accepting such things. But if a patient is intent on giving, and Liu Banxia gets along well with them, accepting a bit of fruit is usually fine.
However, Liu Haibing cannot just buy and bring them over directly; he needs to consider Liu Banxia.
If it were a personal matter of his own, it wouldn't be an issue. But since this is about Old Zhou, who has had so minor complaints about Liu Banxia in the past.
Liu Haibing departed eagerly, while Liu Banxia pulled up the CT images of the recent patient on the computer.
He has the feeling that the likelihood of this patient having rectal cancer is very low, partly because the patient is still quite young and partly due to her symptoms.
Ding! Task issued: Is it rectal cancer?
Open task: CT examination results show three abnormal growths in the rectum. The host doubts whether it is rectal cancer, requiring further examination. Rewards will be granted based on the diagnosis outco.
"Xu Yino, in your opinion, what are the differentiating factors that make this patient's condition atypical or peculiar compared to rectal cancer?" Liu Banxia asked.
"Teacher Liu, how could I possibly say that?" Xu Yino said with a bitter smile.
"From the scans, the growth is not small. But the base doesn't seem to have shown any infiltration. I'm currently just hoping it's benign."
"You've said so much already, isn't there anything else you wish for?" Liu Banxia glanced at her.
"Actually, you haven't paid careful attention to the patient's self-report, which was puzzling to . The patient hasn't exhibited severe symptoms generally, only significant pain during her nstrual cycle, which is magnified today."
"That's precisely why we conducted the pelvic CT, identifying these three growths. Logically speaking, nstrual pain is just nstrual pain; growths, cysts, or tumors shouldn't be associated with it."
"But for so unknown reason, after hearing the patient's explanation, I feel there's sohow a connection. While nstrual pain includes heavy, stabbing pain, my judgnt is that the patient is capable of distinguishing between them based on her own experience."
"Otherwise, if everything were normal, she wouldn't have co to us today. I actually wanted to ask about it earlier, but since a colonoscopy needs to be done anyway, I decided to wait for the results first."
"Teacher Liu, did you think about all this just now?" Xu Yino asked in surprise.
"Long illness makes a good doctor. nstrual pain is not easy to handle. For this patient, she must have deep understanding of her symptoms." Liu Banxia said.
"So, we have the task ahead. The patient will arrive early tomorrow. You'll assist outside and inform imdiately once the colonoscopy results are available."
"Okay, no problem." Xu Yino nodded.
"Teacher Liu, have you discovered anything else? Teach a few tricks so I can beco more proficient. I hadn't considered all this before, just felt pity for the patient."
"You're learning from Liu Yiqing, aren't you? We see many patients daily; if you invest comprehensively in each one, we might need to find a psychologist for you." Liu Banxia said helplessly.
"It's fine to care for patients, but don't invest too much emotionally. Be mindful in this regard. How many leave here in perfect condition?"
"The best help we can provide patients is diagnosing illnesses and offering appropriate treatnt. Speaking of this, especially for late-stage cancer patients, when we have a chance to save them and the family refuses, what can we do?"
"Sigh... Previously, I would have tried to convince the family as much as possible. But after handling so many cases, I've opted to respect the patient's and family's choices." Xu Yino said.
"Aha, not falling into my trap!" Liu Banxia nodded in approval.
"We have to center our actions around the patient." Xu Yino said.
"However, it's not always clear-cut, like with so trauma patients. How would you handle it, Teacher Liu?"
"We adhere to protocols. When patients cannot make decisions themselves, their imdiate relatives authorize our actions." Liu Banxia said.
"Whether they agree to rescues or abandon treatnts, it's an authorization we must respect. Isn't it a bit cruel?"
"Take the scenario of a patient who's lost heartbeat and pulse, where despite lengthy revival attempts, brain death occurs due to prolonged oxygen deprivation. Wouldn't this be another layer of trauma for both patient and family?"
"Indeed, there are too many variables in such situations, and our judgnts must rely on experience, often driven by intuition."
"As for assessing patients, we just need to be more conscientious. Patient remarks, often considered irrelevant, could significantly aid our diagnoses."
Xu Yino nodded, recognizing today's patient as a real-life example, and realizing she hadn't analyzed it herself, just participated in a re commotion.
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