After leaving Teacher Yan’s ward, I went to see the young man with osteomyelitis.
Yang Ping asked the bed doctor to bring the dressing kit, changed the dressing himself, and measured the area of the skin defect.
"After the operation, everything went fine. Three months later, there was a bulge here, and then it burst and turned into a small opening. From then on, pus has been flowing here." The young man said.
"How many surgeries have you had?" Yang Ping finished changing the dressings and chatting with him while bandaging.
"Yes, I did several debridements, cut off the skin, cut off the flesh, and removed a piece of the bone. The nail was exposed. The doctor did not dare to move the bone anymore. He said that it was all infected and there was no use in cutting it. Originally
I wanted to be a soldier, but it turned out like this, ugh——.” The young man was very depressed, feeling sad that his dream had been shattered.
If you become a soldier, even if your osteomyelitis is cured, your hyperthyroidism cannot go away. This path of becoming a soldier will not work.
After bandaging, Yang Ping said: "We are trying to find a way to cure it, but the process will be very troublesome. Today we took the bones for examination, and we will have to draw blood tomorrow morning. When the results come out, we will study your condition."
"Can I still serve as a soldier after being cured? They said that my legs will be like this for the rest of my life, unless they are amputated?" The young man looked sad.
"Have a good rest these days and don't be anxious. There are more solutions than problems." Yang Ping comforted him.
"Well, I must be a soldier." The young man is very persistent in his ideal of being a soldier.
"There are many careers to choose from, you don't have to be a soldier." Yang Ping comforted him.
"Doctor, as long as you are cured and can serve as a soldier, no matter how many operations you perform, you will definitely have a solution." The young man's eyes were filled with hope.
"Try your best!" Yang Ping said.
At this time, an old man and an old lady came in and delivered meals in insulated lunch boxes. The old couple looked like they were eighty years old, but they were still in good health and could walk without crutches.
After changing the medicine, he discovered that Director Zeng had been waiting at the door. Yang Ping thought something happened to him.
It turned out that I wanted to treat Yang Ping and others to dinner, so I called all the doctors in the department, except those on duty.
I originally planned to invite him a day later, but I heard that Yang Ping and others were going to the countryside in the next two days, so I was afraid that the meal would be delayed and my sincerity would be weakened.
So I decided to invite you now to a restaurant near the hospital.
The bed doctor helped clean up the trash.
Let’s go out to eat together. It’s not far, just walk there.
The atmosphere was very good during the banquet, and Director Zeng was always talking about the difficulties and sufferings faced by grassroots hospitals.
Speaking of the young man with osteomyelitis, Director Zeng looked embarrassed.
The young man’s surname is Xu. He is actually quite pitiful. His parents died when he was young and he was raised by his grandparents. Now his grandparents are eighty years old.
Because the treatment of chronic osteomyelitis takes a long time and costs a lot, even if you have medical insurance, it is difficult to bear the out-of-pocket cost. In order to treat him, the old man’s only house was sold and he now lives in an old bungalow owned by a relative.
That's not what Director Zeng said during the ward rounds that morning. His words were contradictory.
Zhang Lin seemed to be about to say something, but Yang Ping immediately said: "Zhang Lin, pour me a drink."
Zhang Lin also understood the meaning, so don’t deliberately embarrass others.
In fact, Yang Ping knew that what Director Zeng said on the first day was just to stop himself from acting rashly. Director Zeng had gone astray.
"If this is the case, cost is a problem, and we have to find a way." Yang Ping said that this problem is very realistic.
Let the hospital pay? If the hospital had to pay for this situation, the hospital would have closed down long ago.
Sanbo's medical assistance this time is a charity event, but it only refers to the voluntary labor of Sanbo's doctors.
Yang Ping and Director Zeng began to calculate the cost. If the test results are in line with expectations, surgery can be performed.
The intramedullary nail needs to be removed and replaced with an external fixator. The bone defect needs to be filled with calcium sulfate containing antibiotics. This stuff is more expensive than gold. Calculated in grams, this consumable is estimated to cost 30,000 to 40,000.<
/p>
Even if medical insurance reimburses part of it, the cost he will bear will be at least a little over 10,000 yuan.
It is possible to find equipment manufacturers to sponsor consumables, but this grassroots county hospital uses very little, so they may not be willing to do so, especially for calcium sulfate. Director Zeng will definitely not use more than a few grams throughout the year.
The essence of doing business is to make money and seek sponsorship from others. The wool comes from the sheep. I rarely use this thing, so how can others be willing to sponsor it?
Director Zeng is worried about this matter. Moving this mountain is much more difficult than Teacher Yan's.
Yang Ping took a sip of his drink and said: "The biggest cost of this surgery is the external fixator and calcium sulfate. Let me find a way!"
Yang Ping said this, Director Zeng felt relieved, and the cost issue was settled.
No one drank, fearing that there would be an emergency. In a small hospital, there are few staff, and even fewer people can perform surgeries.
Unlike Sanbo Hospital, all the directors who lead the team are not on stage, and the operation is still not delayed, because the old attending doctors below, such as Dr. Jin, can cope with it without any problem.
After dinner, I returned to the dormitory. Director Tian returned early today and did not have any social activities.
He gave Zhang Lin a list: "The weather is getting better these days. There is an activity going to the countryside. You and Xiaowu will allocate the personnel together. Those who have been circled will not need to go. I will inform everyone to have a meeting in the hospital conference room at noon tomorrow.
, departure the day after tomorrow, a whole day of activities, starting early in the morning and coming back in the evening."
Zhang Lin took over and said: "Aren't we going to the countryside now? Are we still going to the countryside? Where are we going?"
"Go to the mountains, go to the villages, send doctors and medicines, get physical examinations and see doctors." Director Tian said.
"How long?"
"In one day, there will be a total of ten villages, all of which are inhabited by ethnic minorities. There will be village doctors and village cadres to lead the way," Director Tian said.
"This is good, we should do it for a few more days or a week." Zhang Lin was very happy.
Director Tian rolled his eyes at him and said, "Are you here to support the border or on vacation?"
"Both poetry and modesty are required, Dean Tian! This is called the spirit of revolutionary optimism."
Zhang Lin took a pen and started sketching on the paper.
Fatty Liang asked: "Should I go too? Shall I deliver the anesthetic?"
"You don't need to do anything about losing your head. You can just go and check your blood pressure. Aren't you losing weight? You can lose five kilograms of meat by walking back and forth on the mountain road. All luggage is included. Ten kilograms is not impossible." Director Tian said leisurely.
Say.
When Director Tian was free, Yang Ping went to Director Tian and said, "Director Tian, I have something to report to you."
For patients with chronic osteomyelitis, Yang Ping had briefly reported before, but now he needed to report in detail. When it came to calcium sulfate and external fixators, Yang Ping said that Director Zeng wanted to find a supplier to solve the problem, but there must be difficulties.
Director Tian thought for a while and said: "They use less, why would anyone sponsor him? The loss is to make more money in the future. I will solve this problem. How much does calcium sulfate cost?"
"At least thirty grams." Yang Ping estimated.
Director Tian immediately picked up the phone: "Xiao Lin, this is Tian Yuan. I have a charity surgery at Nanqiao County People's Hospital. I need 30 grams of calcium sulfate. I will send you the address and send it over. It needs to be used urgently as soon as possible. In the evening
Just express delivery? That’s the best.”
After hanging up the phone, he made another call to fix the external fixation bracket.
"They will deliver the goods tonight and they will arrive tomorrow or the day after tomorrow. It won't affect the operation. If not, I will ask them to send a special car to deliver it." Director Tian was very enthusiastic.
"That's no need. The operation will definitely be done in a few days," Yang Ping said.
Originally, he just reported it first, as the matter did not need to be so urgent, and he was not yet sure whether the operation would be performed. However, it took Director Tian a few minutes and two phone calls to resolve the matter.
After the matter of consumables is resolved, the only thing left is to confirm the diagnosis. No one can be absolutely sure whether the patient's condition is as expected until the results come out.
After solving this problem, Yang Ping had a good sleep at night.
Another day has passed, the third day of work.
Just after he finished his shift and before doing rounds, Director Zeng received a call from the director of the laboratory department.
"Thyroid hormones, T3, T4, FT3, and FT4 have all increased, especially T3 and FT3 have increased significantly! The thyroid function is really hyperthyroid!"
Director Zeng put down the phone and sounded excited, as if he was expecting the patient to have hyperthyroidism.
If imaging examination is the first evidence.
Then, the second piece of evidence already supports my judgment.
Now let’s wait for the third piece of evidence—bacterial culture! This is the most important piece of evidence. If bacteria are cultured in all the specimens taken, the first two pieces of evidence will automatically stand aside.
It usually takes three to five days for bacterial culture results to be available, so you have to be patient.
Unlike Mr. Yan, this patient can be diagnosed quickly and get immediate results with just one operation. The diagnosis alone is a troublesome matter.
Teacher Yan is doing well now. Except for the slight pain at the surgical incision, the previous numbness in the right lower limb has completely disappeared, and there is no worrying rebound.
During the ward rounds, he was on the phone: "It's too small, a little bigger, a little bigger --"
His son went to buy breakfast. There was a pair of crutches next to the bed. There was a wound on his buttocks, which made it difficult for him to sit on it, but it made it easier for him to walk.
Seeing Yang Ping come in, he immediately smiled and said: "I had a good sleep last night. It was so relaxing. It was so relaxing. In the past, a few Valium tablets were like eating beans, but they didn't work. I deliberately didn't take Valium last night. Hey, before I knew it,
When I fall asleep, it’s almost eight o’clock when I wake up. This is how people live.”
After lunch, we went to the conference room of the hospital. Director Tian and Director Pan convened everyone for a small meeting, which was an activity to deliver health to the countryside tomorrow.
Ten villages were selected, all of which are relatively remote and where ethnic minorities live. Two or three people were assigned to each village, carrying a medical kit, to provide physical examinations and medical treatment to the villagers. The doctors assigned by Sanbo to the traditional Chinese medicine hospital and maternal and child health hospital were not used.
Participate.
The Health Bureau will send a vehicle to take people to the entrance of the village, and each group will be accompanied by village cadres or township cadres throughout the process.
Don't go to work in the afternoon, go back to the dormitory to prepare.
Yang Ping packed his backpack and looked at the weather forecast on his phone. It has been sunny these days, which is indeed more suitable for going to the countryside.
The countryside here is a real village. The cement road only leads to the village entrance. The so-called village entrance is just a conceptual village entrance, not a geographical one.
Because their households are very scattered, some of the roads into the mountains are completely on cliffs, and there is no way to build roads to get in.
"It's such a sunny day, why are you bringing a raincoat?" Zhang Lin looked at Yang Ping packing his raincoat.
Yang Ping feels that the weather forecast is not 100% reliable, so it is better to bring one to rest assured.