godfather of surgery

Chapter 461 Difficult couple

For this gout patient, whether to have surgery or not to have surgery, and if surgery is to be done, what kind of surgery to choose.

The doctors in the department are very contradictory. The gout has reached the end of its rope, and no one can come up with any good solutions.

The patient went to many hospitals for treatment. Huge gouty nodules with ulcers on the bilateral ankle joints, "lime" like substances were continuously discharged, and the wound surface was getting bigger and deeper, mixed with various drug-resistant bacteria. The distal tibia and fibula, talus, and calcaneus on the side have all been exposed, and some of them are necrotic, forming chronic osteomyelitis.

This kind of wound has almost no possibility of healing.

In fact, this is also the case. These wounds have been debridement, negative pressure suction, etc. through the efforts of many hospitals, and various operations have no effect.

The doctors in each hospital just shook their heads: only amputation!And it is recommended to go to a better hospital for surgery.

Where is a better hospital?The patient's family does not know.

Because the patient's bilateral lower limbs were already covered with uric acid crystals, after the amputation, the stump faced a very high risk of non-healing. Once it did not heal, new chronic wounds would form.

The money is spent, the disease is not cured, and the legs are gone. If the family members don't understand and get entangled, the doctor will fall into the quagmire, burnt out and unable to extricate himself.

So, the best way is --- don't touch!

Don't touch, walk around!
There is nothing like this. Over the years, doctors have become less courageous. "Aside from amputation, is there any other way?" Song Zimo broke the silence.

Yang Ping shook his head: "Amputation is the best way for him."

From above the ulcerated wound, at the level of the calf, the bilateral lower limbs were amputated.

Although the stump may not heal, that's just a possibility, and now, the chronic wounds on both ankles have no chance to heal at all.

"Don't be so depressed, everyone. For many patients, amputation is a constructive operation, not a destructive operation. Amputation can bring patients from darkness to light!"

Because, after the amputation, if the stump heals well, a prosthesis can be installed to restore normal walking function, so that the patient can return to society.

Because the artificial limbs of the lower limbs are very developed, modern medicine has innovated the concept of amputation of the lower limbs.

Amputation - sometimes hope, light, constructive surgery.

For some serious lower limb injuries, long-term treatment and repeated operations cost a lot of time, energy and money, and the function of the limbs saved in the end is very poor, which cannot be compared with artificial limbs at all.

This kind of limb salvage is a kind of devastation to the patient, and it is a treatment plan with no benefit; at this time, amputation is a reconstructive operation, which cuts off useless limbs, installs prosthetic limbs, restores normal walking function, and helps the patient quickly go to the hospital. Normal sunny life.

"I agree! The bilateral ankle joints have already formed chronic osteomyelitis. Continued treatment will only waste time and money. Both lower limbs will be amputated from the lower third of the lower leg. If the stump does not heal, continue to raise the amputation plane, and then again Amputation, until it heals, other gout nodules can be carefully removed, for the patient, the goal is to return to a normal life, if the prosthesis can end the current bad life and make him a normal person again, why amputation so important Terrible." Song Zimo agreed with Yang Ping's opinion very much.

Especially what Yang Ping said: Sometimes, amputation is a constructive operation, not a destructive operation. Amputation can bring a patient from darkness to light!

Others don't seem to have a better way, and the condition is at the end of the road, and there are not many ways to choose.

The treatment plan was decided in this way. When the patient's daughter heard the news in the consultation room, she was very disappointed.

She thought that coming here, there could be a better way, a different way.

"The method that is most beneficial to him is the best method. This method is not necessarily the latest or the most expensive. Most of the treatment methods are ordinary methods!" Yang Ping saw her disappointment and told her Explain patiently.

"The amputation, if successful, could end his current dark life and with the prosthesis, he can walk as normal as before."

Yang Ping said confidently.

The patient's daughter was tempted, and other hospitals have also mentioned it, but the doctors are not willing to undertake this operation.

In fact, Yang Ping also saw the problem. Because the patient's daughter took care of her father for too long, she also knew some knowledge about her father's condition, so she repeatedly questioned the doctor's treatment details, and even questioned each medication one by one.

It's easy to give the doctor the impression that she doesn't trust the doctor.

Since there is no trust, the doctor is of course unwilling to take risks. If he does not perform this operation, the doctor does not have to bear any responsibility in terms of law or morality. On the contrary, if he fails, the doctor may face endless troubles.

"Is the surgery successful?"

The patient's daughter's biggest concern.

"It's hard to say the specific success rate. His condition is special, and there are no similar statistics. If you have to say the success rate, [-]% vs. [-]%. If it fails, the stump of the amputation will not heal and form a new difficult-to-heal wound. We will come again." An amputation raises the plane." Yang Ping explained the remedy for the failed operation.

The patient's daughter was very embarrassed: "How many times do you have to do this? Don't you have any confidence?"

The implication is that doctors are not sure about what they do?
"I'm not sure, no one is sure! His current illness and state have already determined that this is an unsure operation. It's not because the doctor is technically unsure, or his body has reached the point where he is not sure of healing. This kind of ending is His body determines whether he succeeds or not, the initiative is not with me, but with him, I can only do my best." Yang Ping said realistically.

Although these words are not pleasant, they are true and frank.

The patient's daughter was full of anxiety and hesitated. After thinking for a while, she said, "If the operation fails, will there be a charge for the failed operation? Is it free?"

I didn't expect the patient to ask such a question.

Yang Ping said seriously: "Every operation, regardless of success or failure, will be charged."

"How can I still charge for a failed operation? It's unreasonable. I go to the store to buy something. If it's broken and doesn't work, I can return it for a refund, or get a new one. Similarly, I paid for medical expenses, but no If the expected goal is achieved, why is there a fee, that is, if the matter is not completed, the money will still be collected?" The patient's daughter summoned up the courage to speak out.

Yang Ping was not angry either: "Healing and saving lives cannot be compared with commodity trading. You have used the wrong analogy. If you think this is a commodity transaction according to this logic, I refuse to provide you with medical services now, that is, I refuse to sell This product, for you, I want to remove this product, is that okay?"

The patient's daughter's face turned red and turned pale, and she was speechless for a while.

"The human body is very complicated, and all treatment effects are statistical effects, which cannot be guaranteed to be [-]%. This is the characteristic of medicine. If you follow your logic, I will tell you very frankly-no doctor is willing to operate on your father. Including me!" Yang Ping had to tell him this truth.

Some things must be sorted out before the operation, otherwise it is easy to fall into the quagmire after the operation.

"To tell you the truth, Dr. Yang, although my father has medical insurance, we are financially burdened by the treatment for such a long time. There are several elderly people in the family who are overwhelmed." The patient's daughter told the truth.

Yang Ping was also very helpless: "I sympathize with you, but I am just a doctor. We really can't help you financially. We can only try to help you save hospital expenses. If you are really a poor household, we will help you fight for it." Some charitable relief. You are willing to take the risk of surgery with me, and I will go all out; if you are not willing to take the risk, or think that all the risks must be borne by the doctor, then it is only a pity that I cannot bear all of them.”

In the face of risks, doctors can only be reasonable. If patients and their families are determined not to take risks, no one can force others to make a choice.

The right to choose lies with the patient, and the doctor can only help him make a choice.

"Let me think about it. Is there any other way? More conservative?" The patient's daughter was still hesitant.

Yang Ping shook his head: "At present, there are only two options, either to maintain the status quo, or to amputate, to challenge risks and pursue a normal life."

In many cases, it is money that affects the decision!

Money is not everything, but without money absolutely nothing.

If the patient's daughter hadn't thought about money, she wouldn't have worried so much, and she wouldn't have asked questions that the doctor couldn't understand.

Her biggest worry was that the operation failed, and she had to undergo repeated operations many times. In the end, the money was spent, the disease was not cured, and her legs disappeared again.

Every family has scriptures that are difficult to recite, and the patient's daughter began to call her husband in front of Yang Ping to ask for his opinion.

The other party was silent for a moment, and in a sleepy tone, he replied shortly: "Zhi, what can I do——"

The tone seemed helpless and helpless.

After calling her husband, the patient's daughter thought about it, and swipe on the phone, as if looking up the address book, but there seemed to be no one to discuss with.

The two couples are both only children, who can they consult with?No one discusses, everything can only be borne by oneself.

The woman's phone rang again, and it was her husband's: "Honey, don't worry, follow the doctor's plan. Do you want me to come here now? There are risks in everything, and there is a risk of choking when eating. It's really not possible. Cut it once, if it doesn’t work, cut it again, anyway, it’s not a problem now, it’s not a big deal, it’s not good, how bad can it be.”

"That, that—" The woman was worried about money, but couldn't say it.

The man on the other end of the phone understood very well, and said with a smile: "I'll go to the company to advance next month's salary, and the operation will be arranged first."

Not long ago, an old man in the family had a stroke and spent a lot of money in the hospital. He just got out of the hospital, and now another one is in the hospital.

"Isn't the payment for next month already paid in advance?"

Women have good memories.

She found that she was still in the conference room, and greeted Yang Ping with a smile, intending to go out and make a phone call by herself: "Doctor Yang, I'm sorry, let's discuss it and make a decision."

Yang Ping nodded.

"Oh, I haven't finished paying in advance, but I can still pay in advance!"

The husband on the other end of the phone faltered.

(End of this chapter)