The Godfather of Surgery

For this gout patient, whether to have surgery or not, and if so, what kind of surgery to choose?

Corey's doctor is very contradictory. Gout has come to this point, and everyone can't come up with any good solutions.

The patient went to many hospitals for treatment. The huge gout nodules at the bilateral ankle joints were ruptured. The lime-like substances were continuously discharged. The distal tibia and fibula, talus, and calcaneus on the lateral side have been exposed and partially necrotic, resulting in chronic osteomyelitis.

Such wounds have little chance of healing.

In fact, this is also the case. These wounds have undergone the efforts of many hospitals, debridement, negative pressure suction, etc., various operations, but 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 the better hospital? The patient's family does not know.

Because the patient's bilateral lower extremities are already filled with uric acid crystals, after amputation, the stump faces a very high risk of non-healing. Once non-healing, a new chronic wound will be formed.

Money is spent, the disease is not cured, and the legs are gone. If the family does not understand and tangle, the doctor will fall into the quagmire, devastated and unable to extricate himself.

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

Don't touch, go around!

There is nothing like this. Over the years, the doctor's courage has become smaller. Apart 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 ruptured wound, at the level of the calf, amputate the lower limbs on both sides.

Although it is possible that the stump will not heal, it is only possible, and now, the chronic wounds of the bilateral ankle joints have no chance of healing at all.

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

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

Amputation - sometimes a hopeful, bright, constructive surgery.

Some serious lower extremity injuries require long-term treatment and repeated operations, which consume a lot of time, energy and money. The final limb function is very poor and cannot be compared with prosthetic limbs.

Such limb salvage is a kind of devastation to the patient and an ineffective treatment plan. At this time, amputation is a reconstructive operation, in which useless limbs are amputated, prosthetic limbs are installed, normal walking function is restored, and the patient can quickly run to the normal sunshine life.

I agree! Chronic osteomyelitis has developed in the bilateral ankle joints. Continuing treatment will only waste time and money. Both lower limbs are amputated from the lower third of the calf. If the stump does not heal, continue to raise the amputation level, and once again Amputation, until it heals, other gout nodules can be carefully removed. For the patient, the goal is to restore a normal life. If the prosthesis can end the current bad life and make him a normal person again, why is amputation considered so much? Terrible. Song Zimo agreed with Yang Ping very much.

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

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

The treatment plan was thus decided, and when the patient's daughter heard the news in the consultation room, she was disappointed.

She thought that when she came 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 a prosthetic he could walk normally as before.

Yang Ping said with confidence.

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

Yang Ping actually 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 details of the doctor's treatment, 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, doctors are of course unwilling to take risks and do not perform this operation. No matter in terms of law or morality, doctors do not have to bear any responsibility. On the contrary, if they do, once they fail, doctors may face endless trouble.

Is the surgery successful?

The patient's daughter's greatest concern.

It's hard to say the specific success rate. His condition is special, and there is no similar statistics. If you have to say the success rate, it is 50% to 50%. If it fails, the stump of the amputation will not heal, forming a new wound that is difficult to heal. Let's come again. An amputation will raise the plane. Yang Ping explained the rescue plan for the failed operation.

The patient's daughter is 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?

No one is sure, no one is sure! His current condition and state have been decided, this is an operation that is uncertain, not because the doctor is technically uncertain, or his body has reached the point where it is not certain to heal, this outcome 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 truthfully.

Although these words are ugly, they are true and candid.

The patient's daughter's face was full of anxiety and hesitant. After thinking for a moment, she said, If the operation fails, will the failed operation still be charged? 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.

It's unreasonable to charge for a failed operation. I go to the store to buy something, and if it's broken and can't be used, I can return it for a refund, or get a new one. Likewise, I paid for the medical bills, but no To achieve the expected purpose, why do you still need to pay for it, that is, the money is still collected even if the work is not done? The patient's daughter mustered the courage to speak out.

Yang Ping is not angry: Treatment and saving people cannot be compared with commodity trading. You use the wrong metaphor. If you follow this logic, you think this is a commodity trading, and I refuse to provide you with medical services now, that is, I refuse to sell. This product, for you, I want to take this product off the shelves, is that okay?

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

The human body is very complex, and all the therapeutic effects are statistical effects, which cannot be guaranteed 100%. 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 surgery, otherwise it is easy to fall into the quagmire after surgery.

To be honest, Dr. Yang, although my father has medical insurance, the treatment for such a long time has also brought a heavy financial burden on us. Several elderly people in the family are overwhelmed. The patient's daughter told the truth.

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

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

The choice rests with the patient, and the doctor can only help him make that choice.

I'll 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 choices, either maintaining the status quo, or amputating the limbs, challenging the risks, and pursuing a normal life.

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

Money is not everything, but nothing is impossible without money.

If the patient's daughter didn't think about money, she wouldn't have so much to worry about, and wouldn't ask questions that the doctor couldn't understand.

Her biggest worry was the failure of the operation. After repeated operations, the money was spent in the end, the disease was not cured, and the leg was gone.

Every family had a hard-to-read scripture, 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, with a sleepy tone, and briefly replied: Zhibai, what else can I do——

The tone seemed helpless and helpless.

After calling her husband, the patient's daughter thought for a while and swiped on her phone, as if she was looking up the address book. It seemed that there was no one else to discuss.

Both husband and wife are only children, who to consult? There is no negotiation, everything is borne by oneself.

The woman's phone rang again, and it was her husband's: Wife, don't worry, follow the doctor's plan, do you want me to come over now? There are risks in doing anything, and there is a risk of choking when eating. Cut it once, if it doesn’t work, cut it again, anyway, it’s not a problem now, the big deal is still bad, how bad can it go.”

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

The man on the other end of the phone understood and smiled: I'll go to the company to pay for next month's salary in advance, and the surgery will be arranged first.

Not long ago, an old man in the family had a stroke. He spent a lot of money in hospital. He was just discharged from the hospital, and now he is hospitalized again.

Isn't it already paid in advance for next month?

Women have good memory.

She found that she was still in the meeting room, and greeted Yang Ping with a smile, intending to go out and call: Doctor Yang, I'm sorry, we'll discuss and decide.

Yang Ping nodded.

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

The husband on the other end of the phone faltered.