After dinner, Director Cai called Dr. Wan to send the patient to the operating room and start preoperative preparations.
Yang Ping prefers to watch the patient complete preparations in the operating room. He doesn't like to see the patient who has already been draped when entering the operating room. In this way, only the surgical area is exposed, which makes him feel uneasy. p>
Boss Cheng and Dean Cai both knew Yang Ping's habits, so they did not start anesthesia, disinfection and drape prematurely.
The patient has been moved to the operating bed, and the nurse has connected the intravenous channel and hung a bottle of 500ml 0.9% sodium chloride injection to maintain the intravenous channel.
This is a special patient. The doctors and nurses are very careful when crossing the bed and positioning themselves, for fear of breaking a bone.
The anesthesiologist checks the teeth in the patient's mouth one by one to determine whether they are loose. Once loose teeth fall out, they may fall into the trachea, causing suffocation and endangering life.
Patients with brittle bone disease will lose their teeth prematurely, and this patient is no exception. Many of his teeth have become loose and fallen out and have been replaced with dental implants.
After confirming that there were no loose teeth, the anesthesiologist checked his hearing aid again. Because of his hearing impairment, he relied on hearing aids to complete normal auditory functions.
"Don't take it off! I can't hear it, I'm scared." The patient was very panicked.
The anesthesiologist explained: "How about I let you sleep during the operation? Once you wake up, the operation will be done."
Even if the choice is not general anesthesia but combined spinal-epidural anesthesia, in order to reduce the patient's adverse experience, most anesthesiologists will use drugs to put the patient into sleep.
Otherwise, the patient will hear the sound of all metal instruments being operated during the operation, leaving him with an indelible bad memory.
The patient shook his head: "No! Please don't. Keep me awake throughout the entire operation."
Yang Ping sat aside and waited for them to prepare: "There is no need to take off the hearing aid, let him wear it, wake up or sleep, as he wants."
If the patient remains awake and suddenly cannot hear the surrounding sounds, he will fall into a state of isolation and helplessness, and the entire operation process will be very depressing and frightening.
It won't have much impact if you don't take off the hearing aid. Just pay attention to it regularly and don't fall out.
The anesthesiologist, nurse, and several other doctors carefully placed the patient in a side-lying position.
"Doctor, take it easy. I heard that lumbar anesthesia will leave back pain in the future. Is this true?"
Patients talk a lot and always want to chat with the doctor.
"Don't move around, lower your head, bend your waist, bend your knees, like a shrimp, bend your waist out so that I can anesthetize you." The anesthesiologist is beginning to disinfect the drapes and perform lumbar puncture.
"I'm so panicked. You haven't answered my question yet?" The patient was very persistent.
"In the past, the needles used for spinal anesthesia were very thick, so it was possible. Now they are all thin needles, so the possibility is very small." The anesthesiologist had no choice but to answer him.
"Be careful. How old is your child? If you want to learn painting in the future, come to me. Don't look at my thighs and arms. He is an expert in teaching painting." The patient kept talking.
Patients with brittle bone syndrome have a disorder in the intraperiosteal osteogenesis of the long limbs, resulting in dysplasia of the long bones, which are very slender, especially the thighs. Some patients' thorax and waist also become thinner, and the internal organs inside are squeezed into long strips.
The anesthetist positioned himself again and said, "My baby is still in my arms. It's early."
"Ah ---, doctor, do you have enough experience? You are not an intern apprentice, are you?"
"Don't move! The second child, the eldest is in high school!"
"Oh!"
"When I was undergoing surgery and anesthesia at Yunjian Hospital, there was a nurse who chatted with me to ease my nervousness. In this regard, you did not do a good job." The patient complained a little.
Boss Cheng stood up, walked to the patient, and chatted with him: "I also want a nurse who is dedicated to chatting with me. No problem. We have a package that is better than Yunjian's service. Ronaldo's enhanced anterior cruciate ligament reconstruction, the cost
The starting price is 600,000, do you want it? If possible, I will immediately call two nurses to chat with you."
"Six hundred thousand, so expensive? No, no, no," the patient shouted.
"Play some music, something more soothing." Boss Cheng asked the nurse to play some music.
Why have we forgotten the most important thing? Now, patients undergoing surgery can listen to music, and they can choose the music themselves.
"What kind of music do you like to listen to?" the nurse asked as she announced a few pieces of music.
The patient said: "Rock! Metal rock!"
Boss Cheng smiled and said: "We are all soothing songs to relieve your nervousness. There is no metal rock. What kind of rock do you listen to during surgery? Aren't you afraid that the doctor will be excited and the scalpel will rock twice?"
"You're right. I once sang rock music and I moved too hard and broke my bones." The patient actually had such an experience.
Boss Cheng spent a lot of money on the speakers for this multifunctional operating room. German Palace Audio spent hundreds of thousands.
The excellent sound quality is not comparable to that of popular products. When the music starts, the patient immediately closes his mouth and feels relaxed.
"Shall we give it a shot? I'm not afraid now. You can give me anesthesia as you please." The patient's nervousness was completely relaxed.
The anesthetist opened the disposable drape: "It's done!"
Everyone worked together to turn the patient to the supine position.
When changing positions, everyone is extremely careful for fear of accidentally breaking a bone.
For this kind of patient, fractures are like a curse that cannot be shaken off.
This patient has a fracture almost every year, and the causes of fractures are varied.
I was so happy that I laughed so hard that I broke my ribs.
I had to go to the bathroom urgently in the morning and walked too fast, spraining my ankle and causing an ankle fracture.
When they were together, they lost control of their movements and fractured the femoral shaft.
When sitting on the sofa, I moved too fast and sat down, causing my lumbar spine to fracture.
In his own words, he fractured his bones once a year and was invulnerable. One year, he still had no fractures by New Year's Eve. He was so happy that he finally had no fractures. He was so happy, but he smiled and felt a sharp pain in his chest - his ribs.
Broken bones.
When he saw the speed bump in front of him while riding in the car, he was sweating all over, and the car shook for fear of breaking his bones.
Fractures have become a part of his life, and he has become accustomed to them. He treats fractures just like ordinary people treat colds.
Doctor Wan finished the disinfection and spread the sheets, and Yang Ping took Su Nanchen to the stage.
Music regulates emotions very well, the patient is no longer nervous and the operation begins.
Yang Ping's movements were extremely gentle, and the target of his current operation was fragile and pathological bone tissue, which was like a dry biscuit.
During the internal examination of the knee joint, the probe wandered through the gaps without any collision.
The rear side of the medial knee joint space is the most difficult to expose. Now even if the medial knee joint gap is opened, it is the same without any stress.
To deal with the medial joint space of the knee joint, you need to flex the knee joint 20-40 degrees, apply a certain amount of stress, and allow the knee joint to abduct and externally rotate. This can increase the medial gap and provide sufficient space for instrument operation.
Now if you use force to open the medial gap, it will easily lead to fractures. Otherwise, why would such a patient be called a "porcelain doll"?
When digging a tunnel, be careful. The drill bit advances a little, pauses, and then continues. This way, it advances steadily and alternately to avoid excessive vibration of the rotating drill bit on the bone, which may also cause fractures.
Surgery is a process of walking on thin ice, and awe allows the doctor to be as careful as possible.
If a doctor does not have a sense of awe, it will be a very scary thing for the patient.
Don’t do to others what you don’t want others to do to you! This sentence is most suitable for doctors.
Should this patient undergo surgery or not?
Is the surgical plan good or bad?
Just ask, if the patient were yourself, would you be willing to use it?
This kind of reflexive question is a question that goes straight to the heart.
If the doctor is lying on the operating table by himself, he hopes that the surgeon will be careful and strive for perfection in the process and results, or he will do it hastily and not seek precision.
Yang Ping often asks himself this, and every time he asks, all dilemmas will become clear and clear.
This patient, no matter how he was deceived by others, his idea has never changed, he just wants to cure his own disease.
Treatment is the most fundamental need of patients.
All other needs are derived from the fundamental needs and cannot be caused in the first place.
The drill bit advanced, paused, and with rhythmic efforts, the tibial tunnel was opened without any sign of fracture.
In this operation, Yang Ping does not pursue the speed of the operation. In fact, he never pursues the speed of the operation. Whether it is fast or slow is not a problem in itself, but the needs of the patient and the condition.
After the tibial tunnel was opened, he started to open the femoral tunnel. Because the operating space was narrow, he tried to prevent the instruments from causing any compression to the surrounding bone tissue.
The patient's lower limbs during surgery should hang down by the edge of the operating bed, and the posture should be as natural as possible, so as not to produce shear stress with the edge of the operating bed.
The sterile liquid collection bag, a little water that leaked out, was sucked away by the suction device, and there was not a drop of water on the operating room floor, which was very clean.
The femoral tunnel was also gently opened, and the prepared allograft tendon was implanted into the bone tunnel, and both ends were fixed with button steel plates.
This is almost the only fixation method for this patient, because extrusion fixation will collapse the fragile bone tissue due to the extrusion of the screw and the expansion stress.
Although the movements are relatively slow, there are no repetitive or ineffective movements because the entire surgical process is connected.
In less than half an hour, the operation was completed.
When the sterile drape was lifted, the patient's face turned pale and he looked resigned, sighing: "Did you do it again?"
"How do you know you made a mistake?" Yang Ping asked him.
The patient said frustratedly: "The operation has just begun and the order is over. It must have been a mistake."
Yang Ping smiled and comforted him: "The operation was successful. I will wear a brace for protection for a while and try to avoid fractures."
"Successful?" the patient asked.
Yang Ping asked Dr. Wan to play back the surgery video for him. Dr. Wan explained the patient's face from white to red.
"You are still awesome. Even with your reputation, there are no empty ones." The patient praised.
Boss Cheng said to him: "How about writing us a service experience report when the time comes? You write it according to your own ideas, and don't worry about our face."
"Well, this is easy to handle. How about I write one for you every year?" The patient did not hesitate.
He fractures his bones almost once a year.
"Your speaker is better than Yunjian's. It's not just a little better. It sounds so comfortable. I don't dare to sleep. Without this speaker, I would feel like a cat scratching my head when I hear the sound of the drill bit spinning."
The patient looks around, observes the operating room, and guesses:
"Is it from the German Palace?"
"Expert!" Boss Cheng praised.
The patient clicked his tongue: "Are you willing to buy it?"
"You dare to get circumcised for 40,000 yuan, so why don't I dare to buy a stereo?" Boss Cheng joked with him.
