Those years when I hung up and upgraded in the hospital

Chapter 18: Seeking Change (please read)

When you meet a layman, you can deceive, and when you meet a half-hearted person, you can deal with it by saying that you are not good enough. But when you meet an expert, when there is a disagreement, you have to reason with him, otherwise it will be difficult to convince others.

Chen Shengwu tapped the table with his fingertips four times and then asked: "Doctor Fang, what do you think about this patient's treatment plan?"

Chen Shengwu is not a person who likes to keep his word. He must adhere to the principle of observing and controlling the surgical indications.

However, there are two difficulties at present. The first is that the patient will be stabbed sooner or later. At least if the current medical level cannot completely reverse the avascular necrosis of the femoral head caused by corticosteroids, the consequences of surgery will definitely be unavoidable.

The second is that the patient has already developed symptoms that have affected his or her life, but the worst outcome has not yet occurred, which is the absolute limitation of joint function.

The third is that the patient is young, and if she undergoes direct joint replacement, her prognosis will be poor.In the future, you will have to undergo multiple joint replacements or revisions, which will increase the financial burden and physical harm.

Chen Shengwu analyzed from an objective perspective that the sooner this patient undergoes surgery, the sooner he can relieve his pain and be able to undertake a certain amount of housework or work to supplement the family income.

Of course, this patient Chen Shengwu has only been in contact with him in the outpatient clinic, and his understanding of him is not particularly in-depth.

Fang Yun knows the current difficulties in the department, and also knows that Chen Shengwu hopes to revitalize the department. This may be related to Chen Shengwu's future. His suggestions will affect Chen Shengwu's overall plan.

But Fang Yun still said: "Director Chen, my idea is to seek the opportunity for conservative treatment before deciding to have surgery, using medication and functional exercises to delay the patient's surgery time and alleviate the corresponding symptoms."

"Before the patient decided to have surgery, the treatment she received was all symptomatic and supportive treatment, that is, using non-steroidal anti-inflammatory drugs to analgesia and reduce the inflammatory reaction. However, this actually reduces the symptoms and treats the symptoms rather than the root cause."

"I think she can still look forward to using a combination of medications, such as anticoagulant drugs, and drugs that promote microcirculation, to alleviate ischemic symptoms to a certain extent."

"Second, the patient must have osteoporosis, which will eventually develop into collapse. We can use drugs to adjust lipid metabolism and bone metabolism, and increase the patient's stress activities to reconstruct the bone tissue to a certain extent and delay the collapse time. ."

"Third, the reason why the patient did not choose joint replacement surgery first, but chose hip-preserving surgery. It proves that there is a certain degree of difficulty in the family situation, and the patient has a strong desire to preserve the hip on his own. This lies in the choice of treatment, which is very important."

Fang Yun is naturally not that kind of person. I suggest not having surgery. If you ask me what to do, I will just say I don’t know.

To refuse first and then use ignorance to excuse and avoid responsibility is to act like a hooligan.

Fang Yun's theory is very practical. Solid theory cannot achieve success in surgical operation technology in one step. However, by flexibly applying these things, we can play around with treatment plans and choose more, more appropriate and more appropriate treatment plans.

This is what theory brings to Fang Yun.

Naturally, Fang Yun added: "If the patient independently chooses to undergo hip-preserving treatment, coupled with the principle of patient voluntariness, the surgical indications have been met."

Indications for surgery vary, and patients have treatment options.

When a patient has a strong will, the patient's choice needs to be respected unless it violates the basic principles of medical care.

Even if it means seeking death, the patient's choice must be respected.It’s just that patients cannot be allowed to take themselves into the ditch, such as fetal gender identification, non-therapeutic height-increasing surgery, etc.

"If you think you can expect it, then we will slowly study this case, check the information, literature, and refer to the treatment plans of other colleagues, and then comprehensively consider the treatment method of this patient..."

"The idea is to solve the problem through surgery, but for this idea, the effort required is actually greater than that of surgery." Chen Shengwu retreated slightly, but did not say anything. die.Fang Yun looked at Chen Shengwu with bright eyes.

The same is true for Dong Yunshan.

"No matter how embarrassing the situation is, no matter what kind of dilemma the surgeon is in, the surgeon cannot perform surgery just for the sake of performing surgery."

"You don't have to look at me like this. I'm not that noble. I really want to improve myself and have something to do. But seeking common ground while reserving differences has always been a model I support."

"So whether it's Dr. Fang or Dr. Dong, you can all express your opinions. If it's reasonable and well-founded, then we can each argue based on our reasons." After Chen Shengwu said this, he did not continue. Go down.

……

During ward rounds, there were still just a few patients.

The postoperative recovery of the patient in bed 1 was relatively good. At present, intravenous medication has been stopped and oral analgesic treatment is sufficient. No special treatment is required.

The patient with skin infection in bed 3 is scheduled to be discharged from the hospital tomorrow.The patients and their families were also smiling.

The 6-bed patients who were transferred from Jishi People's Hospital continued the treatment suggestions and plans given by Fang Yun after the ward check. It was impossible for them to undergo earth-shaking changes in one day. The faces of the patients and their families were full. The helplessness.

No one can give them a definite reply or answer. After all, this is something that Jishi People's Hospital has not been able to solve in the ward. It may have to be transferred to a higher-level hospital for further treatment. The development and concealment of some diseases are beyond the scope of the method. Yun and Chen Shengwu’s cognitive level.

In front of bed 7, Chen Shengwu, on behalf of the entire surgical team, said that surgery could not be performed yet and that he would wait for conservative treatment.

The patient and his family members were shocked for a moment. The patient asked: "Director Chen, is it really okay for me not to do surgery for the time being?"

"I won't be paralyzed like this, right?"

Chen Shengwu couldn't give a positive and direct answer, and replied: "Paralysis is still not possible. Even if all your femoral heads are necrotic, there is still a solution."

"But you don't have to expect too much. You will definitely have symptoms that get worse in the future, and you will have to undergo joint replacement surgery. But for now, we are using other methods to give you a short-term opportunity to improve your life without surgery. Quality opportunity.”

"It's like, before we have lunch, I'll give you a steamed bun to cushion the meal."

"But if you don't eat at noon, you have to eat at night, or you always have to eat tomorrow. That's pretty much the idea."

Hearing this, the man glanced at his wife, and then looked at Chen Shengwu: "Director Chen, it's not that we don't want to do joint replacement surgery, but recently, my eldest son is getting married, and I have a daughter who is studying outside. University does have a relatively large financial burden.”

"Otherwise, when it comes to joint replacement surgery here, it costs more than 1 yuan after reimbursement, no matter how hard you grit your teeth, you can get through it..."

"My daughter-in-law is pretty good too. The wedding date has been set, so I can't just buy everything for their new home. My daughter is only a freshman and she just finished the college entrance examination this year. We also sent her to school before she came back. Originally, she wanted to Study as a normal college student for free..."

Hearing this, Dong Yunshan and Chen Shengwu couldn't help but glance in the direction of Fang Yun, with thoughtful expressions in their eyes.

(End of this chapter)