The road to the rise of great doctors

Chapter 124 Stomach

After walking out of the patient's room, Liu Dong sighed, "It's difficult!"

Some people yelled loudly after getting sick, for fear of killing themselves!Some people don't care when they get sick, as if the disease is on someone else!There are also relatives who have suffered trauma, and some of them have been cured, but they believe the rumors and think that going to the hospital for treatment is paying IQ tax.
This person seems to be a workaholic on the surface, but he is even more "crazy" after getting sick than before. This may be because he cannot accept the blow of reality and is using his own way to numb himself.But such paralysis is really forcing yourself to death!

Gastric cancer is not like some indolent tumors, and you can choose active surveillance as a method.Gastric cancer is a malignant tumor that is highly invasive. To put it bluntly, it can easily progress rapidly, easily invade surrounding tissues and organs locally, and easily metastasize to the appendix, lungs, lymph nodes, etc.The overall survival time is very different between early stage limited to the stomach, local invasion to the surrounding area, and distant metastasis!
Moreover, I also "add drama"!If you are in good health and undergo neoadjuvant chemotherapy to shrink the tumor, you may have a chance of radical surgery.But for surgery, the body must be able to bear it!Long-term fatigue, obvious weight loss, and fainting due to low blood sugar are the first signs of depletion of the body.

Liu Dong seemed to have seen a scene, "Study." The gambler who was red-eyed after losing had put all his chips out, leaving only himself with red eyes and no other chips. How could he turn around?

"Well, let's recuperate first. Restore the nutritional status and provide symptomatic and supportive treatment first. When the physical condition is very poor, neither surgery nor chemotherapy can be used for treatment. The only thing that can be done is It is symptomatic and supportive treatment, which is to replenish the body, and the other is to fight against cancer cells!"

The third patient is a 30-year-old woman who is married and has not given birth to children.

When Liu Dong met her, he found that she was tall and thin, 1.6 meters and a half tall, and weighed less than [-] kilograms.

After carefully asking about the medical history, I found out that this weight loss occurred after getting sick.Before getting sick, she weighed about 130 catties.

At first, with a height of 1.6 meters and a weight of 130 pounds, I should be a little fat but with a plump feeling.However, frequent disputes and even quarrels with her boss in the workplace made her very frustrated.

I overheard others talking about her and said, "When she first joined the job, she dressed so fashionably, wore lipstick, and was not as fat as she is now. Her appearance and figure were both online and her boss was embarrassed to say anything when he saw her. Such a beautiful girl. However, over the past year, my weight has been steadily increasing, and I have also started to go to work without makeup. I really think that I am still the same person as before." "No wonder she is always quarreling in their group. Others, look at how they maintain their figure. It’s really good”

She was very annoyed, but she also strengthened her determination to lose weight.

No breakfast, no carbohydrates for lunch, and only salad for dinner.

When I feel hungry before going to bed, I will add a small amount of egg white.

Then, I lost weight and regained my figure, but my stomach pain did not disappear, and I would feel nauseated and vomited after eating too much.Even after she resumed eating three meals a day, which was closer to a normal diet, she still had some abdominal discomfort and her weight dropped a little bit.
So, she went to the gastroenterology department to register, made an appointment for a gastroscopy, and also ordered ultrasound and other examinations.

As a result, before she was scheduled for gastroscopy, the ultrasound report showed that the left ovary was occupying space.

When she brought the ultrasound report to the doctor, the doctor comforted her not to be anxious, and then asked her husband to stay and let her go out first, "I have something to ask your husband alone first."

After she went out, the doctor told her husband, "The left ovary is occupying space and is accompanied by abdominal discomfort. Pay attention to whether there is adnexal metastasis from gastric cancer. In addition, enhanced CT examinations of the chest, abdomen, and pelvis will also be done. See if there is any metastasis in other parts." After the doctor finished speaking, her husband collapsed, and the newlyweds encountered such a nightmare.He kept wiping his eyes with his hands, but the tears still couldn't stop flowing down. He wanted to cry, but he was afraid of disturbing her who was waiting outside. So, just like that, his shoulders twitched and he held the corners of his clothes with both hands. My knuckles turned pale before I could control my tears.

He took the two tissues handed over by the doctor, wiped them, and then rubbed his face to try to stay calm.

When her husband called her in, she didn't pay much attention to his strange demeanor.

"Doctor, what medicine should I take?" she asked.

"You need to be hospitalized for a comprehensive check-up. Your husband and I were talking about this just now. Are you going to be hospitalized today or tomorrow and the day after tomorrow?" After the doctor finished speaking, she turned to her husband and said, "This disease It can’t be delayed for a long time, it needs to be treated as soon as possible.”

"I'll be hospitalized today!" Her husband said loudly, his voice trembling and changing.

After saying that, he seemed to feel something different about himself, so he "cough cough", coughed a few times to clear his throat, and tried his best to perform as usual.

"I still have something to do in the evening." The girl hugged the man's arm coquettishly and shook it.

"Be good, let's treat him earlier and recover sooner. It's not too late to do it again. Be obedient." The man looked doting on his face and didn't dare to say a single harsh word.

After a few strokes of "swipe, swipe, swipe," the doctor issued the hospitalization slip.

"A comprehensive check-up in hospital will result in a high reimbursement rate. After gastroscopy and imaging examinations, if there are only lesions in the stomach and ovaries, surgery can be performed. We will check first, and then we will determine a specific treatment plan after the results are complete. "

So, the girl was hospitalized.I had an examination, a gastroscopy and a biopsy, and the result was reported to be gastric adenocarcinoma.The imaging examination also found that the lungs and liver were normal, but there were metastases in the left ovary and retroperitoneal lymph nodes.In addition, serum albumin is relatively low, electrolytes are somewhat disordered, and there is some anemia, all of which require medication adjustment.

After listening to the girl's description, Liu Dong felt a little emotional.However, clinical work is not suitable for compassion. We must remain neutral and calm. What we do is not to sympathize, but to provide services and help to help her determine the most appropriate treatment plan, prolong her survival time, ensure her quality of life, and reduce her risk of death. The pain and inconvenience caused by illness.

Because there are multiple metastatic lesions, even if surgery is possible, theoretically it cannot be completely removed.For people whose general condition is not that good, it is a good choice to skip surgery and go straight to systemic chemotherapy.After chemotherapy, if the lesions are assessed to be isolated, there may be a chance of complete surgical resection.

"Some genetic tests can be done if there are conditions; if not, for a few special recommendations, we must do it, and there may be clinical trials that meet the conditions." Liu Dong said.

(End of this chapter)