The road to the rise of great doctors

Chapter 123

"Hello, are you a patient in bed XX?"

"Why do you feel uncomfortable when you come to the hospital this time?"

"How is the meal? Do you feel choked?"

"How is your usual activity level? Can you go up to the third floor in one breath?"

"How's your weight lately? How many pounds have you lost?"

"Are there any medications or foods that I'm allergic to?"

Liu Dong inquired about their illnesses for the simple purpose of collecting complete medical history so that diagnosis and medical decision-making would be targeted.

Although the initial diagnosis of the outpatient doctor is roughly written on the hospitalization form, after the hospitalization, there is more time than the outpatient clinic, so the medical records must be well written, don't be sloppy, this is all necessary!
Focusing on the diagnosis name on the admission ticket, skillfully asking for medical history, physical examination, and collecting examination reports and imaging data from outside hospitals are the basic skills of a resident physician.A good resident physician will not be led astray by the words of patients or family members, but will also guide the conversation, ask clearly the answers he wants to know in the shortest time and record them well; and also intersperse answers to questions from patients or family members. , so that they understand what they should do as soon as possible?And it greatly eliminates the fragmentation of asking yourself.

All three people had stomach cancer.

Gastric cancer is a relatively common malignant tumor, ranking second in new incidence rates among digestive tract tumors in China.The early symptoms are not typical, such as upper abdominal discomfort, fullness and nausea after eating, which are similar to indigestion, so they are of limited help in diagnosing early gastric cancer.In advanced gastric cancer, there will be obvious abnormalities such as weight loss and weight loss.What's more, some related complications may occur, such as gastric bleeding, gastric perforation, pyloric obstruction, etc., all of which require timely treatment.

These three people really took advantage of all these items.

The first person had this kind of abdominal discomfort, but at the beginning, he didn't care, and his family didn't take it seriously either.Until he accidentally paid attention to the social platform of a digestive tumor guru, which is a platform for sending status or comments.

And the thing that this big boss is most passionate about, or the thing that he admires the most, is early screening of tumors.

According to her, "The cancers that can be 'prevented' at present include liver cancer and cervical cancer (vaccine). Early cancer screening can only prevent some intestinal cancers (intestinal polyps can prevent cancer if they are removed in time). Other cancers can be prevented through early cancer screening." Screening can only reduce mortality, and the cure rate for common cancers is as high as over 90%.”

This person is over 35 years old, has this kind of discomfort, and has recurring attacks. According to the expert's popular science, it is worth having a gastroscopy first.After hesitating and thinking about it, finally the thought of health (fear of death) took over, so I made an appointment for a painless gastroscopy.

Then, the gastroscope found that there was something growing in the stomach, but fortunately it was not too big or deep.At present, a biopsy was taken, and the pathology confirmed that it was poorly differentiated adenocarcinoma of the stomach.Therefore, he was referred by an endoscopist to general surgery to seek surgical treatment.

This is a lucky man. When asked about his medical history, he also said that he would go to Kyoto to thank the expert face to face after the operation. Although he was not masked, he was also a "lifesaver".

Early diagnosis of gastric cancer is the key to improving the cure rate.The most effective diagnostic method is gastroscopy, and the confirmed method is gastroscopy biopsy and pathological examination.

The treatment of gastric cancer is a comprehensive treatment based on surgery.The principle of radical surgery is to completely remove the primary tumor of gastric cancer, remove the lymph nodes around the stomach according to clinical staging standards, and reconstruct the digestive tract.Chemotherapy is an important treatment for gastric cancer. Chemotherapy is required regardless of whether there is lymph node metastasis after radical gastrectomy for advanced gastric cancer. The most common regimen is a combination of multiple chemotherapeutic drugs.Immunotherapy has now entered the list of options for gastric cancer treatment, but the prognosis depends on which stage it is in!

"Early cancer screening is imperative, and the contribution is indispensable!" For the first patient, he continued to improve some pre-operative examinations and eliminated surgical contraindications, and then the surgery could be arranged.And according to the preliminary examination, there is a high probability that it is early-stage gastric cancer, and a radical surgical plan of partial gastrectomy can be performed.

The second patient was not so lucky.

This person was somewhat similar to the first person in terms of disease diagnosis, but his examination was mainly due to the doctor's free clinic visit to the community near his unit. He was feeling a little uncomfortable at the time and consulted the doctor, who strongly recommended him to have a gastroscopy.

Although he was busy at work, his physical discomfort had already affected him, so he took the time to have an ordinary gastroscopy, which was not a painless type, just so that he could go back to work after the gastroscopy.

As expected, the gastroscopy found something unexpected, something growing on the stomach wall.

Because he was awake, the endoscopist adjusted the angle of the gastroscope monitor and asked him to look sideways. The assistant on the side pointed at the location of the lesion.

While waiting for the diagnosis, he worked even harder overtime; after the diagnosis came out, he continued to work hard.

During that time, his colleagues gave him a nickname, "Desperate Saburo"!
As a result, he became noticeably thinner and exhausted. He fainted at his workstation and was sent to the hospital for treatment.

When Liu Dong asked about the medical history, he was very surprised to see him holding the gastroscopy report and pathology sheet from three months ago, and asked him, "This is a tumor, do you know?"

Lying on the bed, he said, "I know."

"Then you know you won't die if you don't get treatment quickly?"

"Well, when I thought about being so busy at work and not being able to spare time, I thought about finishing this project quickly and then taking a vacation for treatment. But I found that there is no end to the work."

"When I get busy, I focus on my work and completely forget that I have stomach cancer."

"Doctor, don't I have much time?" He covered his face and began to cry. After a while, the sobbing stopped, and he continued, "If I came to the treatment earlier, wouldn't it be much better?"

Liu Dong was speechless. This was the first time he saw such an ignorant person in the real world, or someone who was hiding his ears and stealing the bell.

However, as a doctor, it is still the responsibility of the doctor to answer the patient's inquiries about the disease. Moreover, considering the compliance with subsequent treatment, he should not be too straightforward. For fear of scaring him, he will not cooperate with the treatment and will not accept the treatment. Cooperating with treatment will continue to trigger a vicious cycle!
"The main reason you are now is that your body is too weak. Gastric cancer is a wasting disease. As you know, the stomach is the main organ for digesting food. If there is a disease here and you can't eat, how can you still be cured?"

"We are going to the hospital this time and we need to do some tests. On the one hand, we want to see how your overall physical condition is. On the other hand, we want to do a systematic check to see if the disease has progressed."

"You are still young. Take good care of your body. After completing the examination, our chief physician will develop an individualized treatment plan for you!"

(End of this chapter)