I run a clinic in the United States

Chapter 199 Internal recommendation rewards and two-stage surgery in one
"Hello, you two, I'm Zhou Qiao!" As soon as Zhou Qiao came over, he greeted each other with a smile.

In any case, in a foreign country, seeing compatriots is still very friendly.Maybe some people will deliberately cheat their own people.But if you don’t look friendly, can you be fooled?
Zhou Qiao has always felt that most people are ordinary people, and it is necessary to have the necessary vigilance and guard against others. But when you meet your compatriots, rejecting them from thousands of miles away is the same as guarding against thieves. It is really unnecessary.Except for northern Myanmar.

In addition, he runs a clinic. If he really wants to cheat, he will cheat others.

Fortunately, Iris Clinic has always had a good reputation and is basically not a scam.For example, he has never sent anyone a sky-high bill.If there are expensive expenses, make it clear to the other party before incurring the expenses.

If the other party is not willing, then there will be no next step.

The secret medicine is so profitable, but it has never been used by poor people. All the people who come to make appointments for medical beauty treatments are rich people.

Rachel explained Sister Ying's condition, including some of the main symptoms. Sister Ying's husband thought for a while and added that Sister Ying still had frequent urination and urgency during this period.

Sister Ying immediately glared at him angrily and asked, "Are you so careless? Why do you say everything? Isn't it embarrassing?" !
Zhou Qiao smiled slightly and said with approval: "This is also quite important information."

Only then did Sister Ying give up. Since she was in a clinic outside, she didn't get angry.If I were at home, Hedong Lion Roar would come right away!
Even so, her husband shuddered and regretted that he shouldn't have said anything.However, he always felt that not fully explaining the symptoms would be a hidden danger and not conducive to doctors' diagnosis.

In fact, this is indeed the case. Symptoms that many patients think are irrelevant are of great reference value in the eyes of doctors!

Zhou Qiao pondered for a moment, glanced at Sister Ying's neck, and said, "Sit over here and I'll check it for you."

Liu Ying sat over. After all, she used to be a teacher and her posture was very upright.

Zhou Qiao stood behind her, gently pinched her neck with both hands, placed the thumbs of both hands on the back of the neck, and placed the index and middle fingers of both hands on both sides of the trachea under the cricoid cartilage, palpating the thyroid isthmus and left and right lobes respectively.

"Don't be nervous, relax, head slightly forward." Zhou Qiao said.

"Swallow...well, do it again!"

When the patient makes this swallowing action, his thyroid gland moves up and down with the swallowing, and Zhou Qiao can feel its condition more clearly.

Zhou Qiao continued: "Turn your head slightly to the left... Very good, turn your head to the right..."

When the head is slightly turned to the left, the left lobe of the thyroid is being examined. Zhou Qiao places his left thumb on the posterior edge of the left sternocleidomastoid muscle and pushes it forward slightly. His index finger and middle finger touch the left lobe, and his right index finger and middle finger push the thyroid gland to the opposite side. .

Turn the head to the right to examine the right lobe. At this time, Zhou Qiao places his right thumb on the posterior edge of the patient's right sternocleidomastoid muscle and pushes it forward gently. His index finger and middle finger touch the right lobe, and his left index finger and middle finger point to the opposite side. Move the thyroid gland.

"Does it hurt?" Zhou Qiao asked while squeezing.

"It hurts a little, and it's very uncomfortable. Cough~, cough~"

Although Zhou Qiao tried to be as gentle as possible during the examination, Sister Ying still couldn't stop coughing.

Zhou Qiao let go.

"Doctor, how are you? Is there something wrong with your neck?" Sister Ying's husband asked very worriedly.

Zhou Qiao nodded and said: "Yes,..."

Before she finished speaking, she was interrupted by Sister Ying!

Sister Ying frowned and shouted anxiously: "Isn't it because you have a stomachache, diarrhea and fever after eating too much? Why is it hurting your neck?"

I thought to myself that Dr. Zhou seems to be quite famous, so why is he less reliable than that white aunt?Also, I’m so young, I don’t know if it’s okay?Isn't fame just something you blow off?

Zhou Qiao smiled slightly, spread his hands, and said: "Look, you are so grumpy, it's hyperthyroidism! Your face will turn red and your neck will be thick at the slightest thing. You must be less angry and cheerful in the future. A smile will save you ten years!"

"Ah? Hyperthyroidism?" Sister Ying was immediately confused!

I thought to myself, I’ve really had a bad temper lately, ever since I came to the United States.But I really didn’t expect it to be hyperthyroidism, I just thought it was because there were too many unpleasant things going on.In addition, forehead wrinkles have indeed increased!

Zhou Qiao warned: "In addition to being less angry, you should eat less seafood in the future, don't eat iodized salt, and buy iodized salt. In addition, eat less spicy food, and don't drink irritating drinks such as strong tea and coffee, as well as Coke and Sprite. Wait for gas-producing drinks. Don’t stay up late and get enough sleep!”

"Eat less seafood? Is it caused by eating seafood?" Sister Ying asked suspiciously.After she came to the United States, she did eat a lot of seafood because San Francisco is close to the sea.

Zhou Qiao shook his head and said: "Eating seafood is just an inducement and will aggravate the condition. In rare cases, it will be the real cause."

There are many causes of hyperthyroidism. Clinically, diffuse toxic goiter with hyperthyroidism (Graves' disease, GD) is the most common, accounting for about 85% of all hyperthyroidism patients, followed by nodular goiter with hyperthyroidism and subacute thyroiditis. With hyperthyroidism.Other rare causes include iodine hyperthyroidism, pituitary hyperthyroidism (TSH tumor), etc.

The specific cause needs further investigation.

Zhou Qiao continued: "I just palpated, but I have already felt the enlargement of the thyroid gland, and there are also several small nodules. If you want to confirm further, you need to do a thyroid B-ultrasound, serum thyroid hormone, thyroid stimulating hormone, Testing for thyroid autoantibodies, etc., if you agree, I will arrange it right away.”

Sister Ying: "..." Just as I was about to get anxious, I remembered Zhou Qiao's words and couldn't help but take a deep breath and silently chant, don't be angry, don't be angry, don't be anxious!
"You can arrange it!"

She was really frightened.Okay, why are you hyperthyroid?
Her husband also frowned.

However, the facts are before our eyes and we have to believe them.I thought to myself, this Dr. Zhou is still very capable, much better than that white aunt!

In fact, this is not because Rachel is not good at it. Rachel is just a physician and is not very good at surgery.And checking the thyroid gland is a surgical method.

Maybe some experienced doctors, who have done both medicine and surgery, can quickly think that there is a thyroid problem, but Rachel was still not interested.

Rachel was originally positioned as a relatively grassroots doctor, used to deal with the daily needs of ordinary patients.Compared to medical seeds like Murphy and Stephanie, Zhou Qiao didn't have high requirements for her.

For difficult and complicated diseases, if Zhou Qiao is here, Zhou Qiao will come. If Zhou Qiao is not here and Murphy cannot solve it, he will be referred directly.Anyway, in primary care clinics in the United States, referral is the most common thing.

Not ashamed.

On the contrary, a grassroots clinic like Iris Clinic has repeatedly performed difficult surgeries, which is an anomaly!There are not many in the United States.

Rachel's job is simple but high volume.

Rachel receives many more patients than medical beauty patients, and it is also one of the main businesses of the clinic.

Next, Zhou Qiao arranged a series of related examinations for Sister Ying. The test results came out. Sure enough, Sister Ying's thyroid hormone was too high to be detected, and her procalcitonin index was also much higher than the normal value.

This indicator showed that the infection had spread into the blood. Combined with symptoms such as high fever, diarrhea, vomiting, frequent urination, urgency, etc., Zhou Qiao was finally diagnosed with hyperthyroid crisis combined with sepsis.

"Hyperthyroidism is just hyperthyroidism, why is she suffering from sepsis?" Sister Ying was shocked and extremely anxious.

Zhou Qiao told her to relax. As long as the cause of the disease is found and it is not an incurable disease, it can be controlled quickly with medication, so she should be calm and calm.Of course, this disease is actually quite serious. If it is not discovered early, delayed for a while, or treated improperly, there is a certain chance of death, about 20%-50%.

The risk of death is quite high, and it has reached the standard for issuing a serious illness notice!

Zhou Qiao analyzed the risks and causes of the disease for the couple.

"If we compare the human thyroid gland to a machine that synthesizes thyroid hormones, other people's machines produce the thyroid hormones needed by the human body on demand, but Sister Ying, your machine is like a model worker. It is in a state of excitement for a long time and synthesizes and releases Too much thyroid hormone.”

“Excessive thyroid hormone will cause hypermetabolism and sympathetic nervous system excitement, causing palpitations, sweating, increased eating and defecation times, and weight loss.”

Sister Ying said: "Yes, yes, I have indeed lost a lot of weight. At first I thought it was a successful weight loss!"

I ate so much seafood and made so many leftovers every day without getting fat!I was lucky before that I could eat without getting fat, but now I realize that it was just ignorance!
“Generally speaking, hyperthyroidism crisis mostly occurs in patients with hyperthyroidism who have not controlled their thyroid hormone levels for a long time or whose hyperthyroidism has not been treated at all. Their metabolism is extremely hyperactive due to infection, surgery, trauma, mental stimulation, stress and other inducements. Signs, often accompanied by decompensation of one or more organ functions.”

"As for the cause of your illness, Sister Ying, when I asked about your symptoms before, your husband mentioned that you have frequent and urgent urination. I speculate that your hyperthyroid crisis is most likely caused by a urinary tract infection."

As soon as these words came out, Sister Ying's husband immediately raised his eyebrows, thinking that I was right. How could he hide his symptoms just because he was embarrassed?Doesn't this work?

Sister Ying was sweating.

Zhou Qiao: "After the human body is infected with a certain kind of bacteria, the immune system will automatically start the protection work. For severe hyperthyroidism patients with high thyroid hormone levels, their hormone levels will become chaotic or even riot as the immune system is turned on."

"In this case, after high concentrations of thyroid hormone enter the blood, the body 'collapses'. If it is not diagnosed and symptomatic treatment is obtained in time, multiple organ failure will lead to life-threatening situations."

Sister Ying: "..."

Sister Ying’s husband: “…”

They felt very lucky to have come to Zhou Qiao. If they had gone elsewhere, they might have been misdiagnosed and delayed.Then karma!
Zhou Qiao admitted Sister Ying to the hospital and arranged her in a ward on the second floor. Then, she chose antibiotics for anti-infection treatment and a large dose of drugs to control hyperthyroidism. Soon, Sister Ying's symptoms were relieved, and her thyroid hormone levels also tends to be stable.

It can be said that the medicine cures the disease!

The reason why it didn't work before was because the medication wasn't right.

Of course, a situation like Sister Ying's would require further treatment and regular follow-up. They decided to come to Zhou Qiao in the future.One of the old customers of Iris Clinic has gained a new one.

Although Sister Ying and her husband work very hard, their income is still good. If they save a few more years and return to China to retire after their children graduate from college, their life will be very comfortable.

After all, saving US dollars to spend back home is indeed an advantage.

However, people who come out rarely go back.

Zhou Qiao is still young and has not yet thought about his future arrangements. However, there is a high probability that he will choose to return to China.For no other reason than wealth and honor, don’t return to your hometown, just like walking in fine clothes at night!As for the little red heart, that is a basic quality.

A family like Sister Ying's does not have real wealth.

Of course, Zhou Qiao is not really rich now. He only has tens of millions of dollars. He is still a small kid in the United States and has a long road ahead!
It was time for Veronica's fifth period of surgery, which coincidentally was May 5th.

However, several of his women are foreign girls, so they can't do this.

520, although it is a very romantic holiday in China, there is no such atmosphere here in the United States.

Mainly, 520 and 521 are Chinese homophones, and foreigners don’t speak Chinese!
Because the clinic was too busy, Zhou Qiao didn't take anyone with him this time and went there alone.

Last time, Veronica was transferred to San Francisco in order to have surgery as soon as possible. However, after the surgery, after playing for about half a month, she got tired of staying and went back.

So this time, Zhou Qiao is still going to Los Angeles.

Originally, Zhou Qiao divided the operation into six phases, leaving the fifth and sixth phases. The reason for dividing it this way was mainly because there were not enough points to exchange for so many secret medicines at one time.

But now that the "secret medicine" has been mass-produced at the East African base, this problem no longer exists.

Zhou Qiao called Governor Hulk and told him that the remaining two surgeries would be done at once this time.

After Governor Hulk heard about it, he quickly shared the good news with Veronica. Veronica was so happy!She can't wait to call her friends and get ready to go to the sea and enjoy the beach, sunshine and bikini on the island!

Before getting on the plane, Zhou Qiao was still feeling that it was too "miserable" to be alone. It was time for the clinic to recruit people again, so he called Elena and asked her to continue contacting the headhunting company, or let her Rachel, Park Soo-joo, Stephanie and others recommended familiar and reliable friends.

Don't let them recommend in vain. For every senior doctor they recommend, if they are hired and have been employed for 6 months, they will be rewarded with US$4000. For every senior nurse they recommend, if they are hired and have been employed for 6 months, they will be rewarded with US$2000.

After all, it is really difficult to recruit the right people.

With rewards, they will be more motivated to contact some of their former colleagues.

The current recruitment plan is for one doctor each from internal medicine and surgery, and two nurses.

No, as soon as the news came out, Rachel and Park Xiuzhu immediately started looking through their address books to see who else they could poach.

Even Stephanie began to wonder if there were any friends from the former Johns Hopkins Hospital who could be poached.

Their efforts were effective. Park Soo-joo contacted a nurse named Kim Hee-jin, a Korean girl, gentle and careful, 26 years old. She was previously in another clinic in the Bay Area. She was not married anyway and had no fixed residence. I happened to be dissatisfied with my original working environment, so I came here.

Elena, Ava and Murphy conducted an interview with Jin Jizhen and were quite satisfied. After asking Zhou Qiao, they went through the entry procedures for her.

Jin Ji is not pretty, she seems to be honest, virtuous and hard-working, so the three girls are not worried that she will pose a threat.

Rachel also contacted a doctor, who was also a white aunt like her. She had worked in grassroots clinics for many years. She had rich experience and could handle most daily cases skillfully. However, the doctor's interview required Zhou Qiao to conduct it in person, so she made an appointment at After a week.

As for Stephanie, the environment where she worked before was so good that none of her colleagues at Johns Hopkins Hospital wanted to come here.When Stephanie called to inquire, they laughed at her, saying that they would leave a hospital as big as Johns Hopkins Hospital and go to a small clinic.Do you think I'm as stupid as you?
Of course, that's not how it was said, but that's what it meant.

Moreover, a colleague also mentioned the surgery competition with great regret, saying that Stephanie had missed a good opportunity and lost the chance to become famous. She expressed great sympathy for this.

Stephanie curled her lips and hung up the phone angrily, feeling that she was really asking for trouble.

"Is Johns Hopkins Hospital really that good? Why do I feel so happy at Iris Clinic now? Tsk~, if you don't come, you will regret it later!" Stephanie snorted.

　Thanks to "Book Friend 160601130111263" for the reward.

　　
　
(End of this chapter)