"Okay, let's go for ward rounds!" Yang Ping said, and the questions were almost finished.
Regarding Director Zeng's subtle attitude, Yang Ping could feel it keenly and would not care about it for the time being.
Accompanied by Director Zeng, Yang Ping led everyone in ward rounds.
Twenty-one patients, in addition to the young man just now, there are twenty more.
Six patients with neck, shoulder, waist and leg pain were treated conservatively; fourteen surgical patients, two had clavicle fractures, one humerus fracture, two radius and ulna fractures, one femur fracture, three tibia and fibula fractures, and three tendon ruptures.
One had a broken finger and the other had a broken pelvis, and an external fixator was used.
Although he is a temporary director, he is not here for a vacation. He is here to treat illnesses and save lives. Yang Ping is very serious about his ward rounds.
After checking the last patient, there was another ward with the door closed. It should be empty and unoccupied. Yang Ping took a look.
Director Zeng said: "No more."
Suddenly, the door opened, and an old man about seventy years old with black-rimmed round glasses came out: "Zeng Xiaobao, I'm not a patient. You have two brushes. You asked people to drive me to the surgery, but I didn't. I
It's back again."
Isn't this ward called locked? Why did he move back again?
Director Zeng was embarrassed now, and his face felt as if he had been smeared with chili oil and was burning.
"Um, what's going on?" Yang Ping asked in a low voice. He was already standing at the door, so he couldn't help but ask.
"This patient has undergone surgery for more than a year and is now here for recuperation. Let's take a look at it too." Director Zeng said bravely.
Immediately he went to the door with a smile on his face and said: "There, Teacher Yan, there is a private room in the surgery department, so I have arranged for you to go there. Patients will be admitted here soon."
"Huh!" The patient snorted coldly.
Yang Ping took everyone in.
"Who is in charge of this patient? Report the medical history!" Director Zeng shouted.
Before the doctor could speak, the patient spoke himself: "The main symptom of lumbar disc herniation is numbness and pain in the right lower limb. The numbness and pain are so severe that it is difficult to walk. Even after surgery, the pain is still there. I spent a lot of money, but the pain has not been reduced at all."
”
"Can we take a look?" Yang Ping had already noticed that this patient was a troubled patient.
Director Zeng introduced: "This is Director Yang from the provincial capital. He is here to help you. Maybe there is a good way."
"Director Yang? From the provincial capital? It just so happens that I have to go to the provincial capital to petition and complain. The surgery was done by a professor from the provincial capital? Excluding the reimbursement from medical insurance, I paid more than 20,000 myself. Now the leg pain problem has not been solved, and my waist is injured."
It doesn’t work.” The patient’s attitude was very bad and full of resentment.
"Zeng Xiaobao, let me tell you, when my legs get better, I will definitely go to petition and file a lawsuit against you. What are you doing? You are taking human lives at a loss. You think I don't know that you are related to Professor Zeng from the provincial capital. You are colluding with each other.
There must be something ulterior in it, and I have already written the complaint letter." The patient sputtered, talking in the same tone.
Yang Ping held his hand and said: "What do you call me? Let's calm down first. What's the problem? I can help you look at it?"
"Teacher Yan!" Director Zeng said, very embarrassed.
Yang Ping said: "Teacher Yan, what is your problem? Tell me."
The patient took out a notebook: "On June 17 last year, a CT scan was performed here in this hospital to diagnose lumbar disc herniation, L4/L5, L5/S1, spinal stenosis, and right nerve root compression.
One month of conservative treatment was ineffective. Zeng Xiaobao recommended Professor Zeng to do the surgery. I looked at the date of the surgery. On July 28 last year, I asked Professor Zeng to do the surgery here. At that time, I gave him a red envelope of 5,000 yuan, which is recorded in
Here. The pain in my right lower limb did not get any relief after the operation. After the sutures were removed and I was discharged, I came to the hospital again on September 20. From that time on, I was hospitalized and discharged, and discharged and hospitalized. This has been repeated for more than a year, and now it is almost the end of the year.
If there is no relief, how do you solve it?"
The thick notebook, fingers sticky with saliva, flipped through page after page, and then took the pen and started writing again: "Today, what is today's date, I'll write it down, what is the name of Zeng Xiaobao's provincial capital?"
The old man looked at Yang Ping's work badge: "Yang Ping, Director Yang, did rounds on the ward. I took note of it."
After finishing writing, the old man closed the notebook and put it under the pillow.
This medical history does not need to be introduced, it is clearer than what is written in the medical record. He has it in the medical record; he has also written down what is not in the medical record.
"Teacher Yan, what are you teaching before you retire? Can I check it for you?" Yang Ping said.
He lay down and said: "High school politics, check-ups are done, and I will cooperate with them. Don't say that I didn't cooperate with the doctor, so the results were not good."
When the patient was describing his medical history, Yang Ping also looked through the medical records. He had previously undergone L4/L5 and L5/S1 lumbar disc removal, posterior decompression, intervertebral fusion, and pedicle screw internal fixation.
Yang Ping didn’t know Professor Zeng from the First Affiliated Hospital, but he knew that his surgical skills were definitely no problem and were top-notch in the province. So what was the problem?
He performed a straight leg raising test on the patient's right lower limb, and it was obviously positive. He could not lift it at 30 degrees. He checked the muscle strength and sensation. The muscle strength and sensation of the muscle innervated by the sciatic nerve were slightly weaker, and the right calf muscle was atrophied. The resisted abduction and external rotation test and the 4-figure test were both positive.
"No, no, it's numb and painful, I can't bear it." The patient shouted.
Yang Ping asked the patient to lie down, and he pressed the piriformis muscle. The muscle was harder than normal. As soon as he pressed it, the patient cried out again and felt severe numbness and pain in his right lower limb.
Is this possible piriformis syndrome?
Professor Zeng came down for surgery. He might have been busy. He only looked at the X-ray and found that the lumbar disc herniation was pressing on the nerve on the right side. The image was highly consistent with the symptoms, so he did not check it carefully and went directly to the operation. This situation is not uncommon.
"How about it, do you understand? You have nothing to do with this incident. I won't sue you, but Zeng Xiaobao, I will definitely sue you." The patient sat up.
After checking the room, Yang Ping sorted it out in his mind. Apart from the chronic osteomyelitis on the left side of the diaphysis, the patients in the department also had problems with their diagnosis and treatment.
Through a lot of reading in the system space during this period, Yang Ping, coupled with the original solid theoretical foundation, has made rapid progress in terms of both knowledge breadth and depth.
These two patients have to come one by one. If they tell him directly, it will naturally make Director Zeng lose face. Although Yang Ping only has two weeks here, there is no need to lose face.
There are two things you cannot do as a human being: ruin your wealth and ruin your face.
Yang Ping decided that it would be better to take a roundabout way and first talk about the patient who had just been involved in the dispute. This patient was probably very worried, so Director Zeng would be very happy if he could give him some advice.
"You've made a fool of yourself, you've made a fool of yourself!" Director Zeng wiped his sweat.
Yang Ping said easily: "Every hospital has difficult patients, it doesn't matter."
Director Zeng said: "Director Yang! Look, what guidance do these patients have?"
"Not to mention guidance, Director Zeng has rich experience and has studied in the First Affiliated Hospital. These cases are handled very well. It seems that Director Pan has the confidence to separate the Department of Orthopedics." Yang Ping said in front of everyone. Although Director Zeng made a fool of himself just now, Yang Ping said this and saved a little face.
"Director Zeng, shall we sit in the office?" Yang Ping said.
Director Zeng knew he had something to say and nodded immediately.
Go to the director's office and Director Zeng pours tea.
Yang Ping said: "Director Zeng, I suspect that this person with lumbar disc herniation has piriformis syndrome. If he can be mobilized to do MRI and electromyography of the piriformis muscle outlet, we can identify it. It is really the piriformis muscle outlet."
Syndrome, another operation can be performed to release the sciatic nerve, and the problem can be solved."
If the problem could really be solved, he would be willing to kowtow a few times. This patient is his heartache and is too difficult to deal with. Half of the white hair on his head is his fault.
The patient has made trouble several times. He went to the office to cause trouble and was blocked on the way to get off work. Now he simply lives here and cannot leave. All the letters of complaint have been sent to the county magistrate's mailbox.
"The hospital does not have an MRI. You have to go to Shipo People's Hospital to get an MRI. The outpatient service cannot be reimbursed, so he will definitely not do it. Now he doesn't even get a penny for hospitalization." Director Zeng was bitter.
"It's okay to do a CT and an electromyogram. You can also see it. Both CT and electromyography are available, right?" Yang Ping said.
"Yes, they are all!" Director Zeng said.
"Then let's go see the patient together and talk to him?" Director Zeng said.
Yang Ping said: "No problem, I'll talk to him. It's best to call him here."
"I'll call!" Director Zeng wanted to go out.
Yang Ping stopped Director Zeng and asked him to find out more about the patient's family situation, and then asked him to call for help.
Not long after, the patient came over with a cane and a limp.
