Chapter 148 Dr. Pascal's Diagnostic Recommendations
Wei Jinshui was discharged from the hospital, which is a good thing. As long as the brain aneurysm does not rupture, many people can achieve "almost no sequelae" after GDC (guglielmi detachable coil, electrolytic detachable coil) treatment.
the point.
After saying goodbye to everyone, Wei Jinshui and his parents left the ward. Dr. Pascal looked at the ward with some emotion. "China's inpatient wards are really tense."
"Is our hospital okay?" Sun Lien didn't quite understand why Dr. Pascal made such a statement. He looked at the three-person ward and felt a little confused. The ward had not been used for too long, and the patients' families and cleaning staff were worried about the room.
It is also very tidy. Although it is a specialized ward of the emergency center, the conditions are better than those of the inpatient departments of many old tertiary hospitals. At least the hospital provides free wifi and bedside power supply for patients.
"To be honest, the last time I saw a double ward in the United States was fifteen years ago." Dr. Pascal spread his hands, "The Massachusetts State Hospital where I work abolished all double wards fifteen years ago.
There are only single rooms..." He pointed to the LED light tubes on the ceiling of the inpatient department, "Direct light is not good for patients to rest. The state hospital changed all light sources to reflector lights about five years ago."
Sun Lien explained helplessly, "We lack enough manpower, there are too many patients and the beds are too tight..." He suddenly remembered something, "How many beds and doctors are there in the inpatient department of your department?"
"A Nightingale unit has 28 beds. We have twenty-one attending doctors and five resident doctors." Dr. Pascal counted on his fingers. "There are twenty-six doctors in total."
"I don't know the specific situation of our rheumatology and immunology department, but for neurosurgery, we have two chief physicians, three deputy chief physicians, five attending physicians, three resident physicians, and one regular trainee this year." Sun Lien
He crossed his arms and replied, "In addition to daily outpatient clinics, these fourteen doctors also need to take care of 36 wards, with three patients in each ward, a total of one hundred and eight patients. This does not include the number of patients who sometimes appear.
Extra bed situation." When Sun Lien said this, he suddenly began to feel that the emergency room was also very tiring. Although it was not as good as the emergency, it was still a real hardship. "Every Thursday is the operation day of the neurosurgery. On this day, there will be seven operating rooms.
For use in neurosurgery. It means that half of the doctors in the entire department have to perform operations on this day, and in order to free up as many hospital beds as possible to accept new patients, each of these neurosurgeons needs to perform at least three operations in order to
Ensure the circulation of hospital beds.”
Dr. Pascal was stunned when he heard this. He came to China before, mainly to the western region to provide medical assistance to local patients with autoimmune diseases and to train local grassroots physicians on autoimmune diseases. What he did not expect was that higher-level hospitals
There will be so many patients, and the doctors at higher-level hospitals will work so hard.
"Make it a single room?" Sun Lien continued with a wry smile, "The doctors' work may be much easier, but that means that more than two-thirds of the patients cannot receive treatment in time. There are only a few hospitals in Ningyuan that can do four
For high-level neurosurgery operations, beds are tight almost every day.”
After leaving the ward, Dr. Pascal followed Sun Lien with a serious expression. He looked thoughtfully at the building of the Fourth Central Hospital. It seemed that for the first time he discovered that this large hospital was also facing such a severe situation.
challenges.
Passing by Qin Ya's ward, Sun Lien stood at the door and took a look inside. Qin Ya's bed was neatly folded with quilts, and she didn't seem to be in the room.
Sun Lien took out his phone and called Feng Ming, "Second brother, why isn't your wife in the ward?"
"Xiaoya and I are waiting in line." Feng Ming smiled heartlessly on the other end of the phone, "We are getting our certificates today."
"Huh?" Sun Lien raised his eyebrows, "In such a hurry?"
"It's okay to get the certificate early. We've been talking about it for several years anyway." Feng Ming chuckled, and the groom's joy almost spilled from one end of the phone to the other. "Why did you suddenly remember to call me?
"
Sun Lien also laughed, "Marriage is a big event in life, congratulations." After saying congratulations first, he said, "I was doing rounds here and found that my sister-in-law was not in the room, so I thought of calling you.
Say."
"Please take care of the follow-up surgery." Feng Ming asked again before hanging up the phone, "Have it done as soon as possible, and I will get rid of this mental burden earlier."
The next stop for ward rounds is the endocrinology department on the eighth floor. Xiaolin Xun is also preparing to be discharged from the hospital today. Roger came here specially to help and send off this international friend who used to be his "neighbor".
Sun Lien caught him and became a translator.
"Mr. Xiaolin." Sun Lien came over and shook hands with Xiaolin Xun. "You seem to be in good condition."
The hematoma on Kaoru Kobayashi's face has begun to subside. From this point of view, the bulging eyes caused by hyperthyroidism still exist. However, after receiving medical treatment, his thyroid hormone levels have subsided a lot.
"Mr. Sun!" Xiao Linxun held Sun Lien's hand tightly, "Thank you for saving me and my wife."
Sun Lien wanted to comfort him, but he was a little worried about what if he was too modest and Xiao Linfeng suddenly decided not to donate. He could only glance at the "amnesia" state that still existed on his head with some embarrassment, and asked in a low voice
, "You still don't remember your father?"
"It sounds like a lie...but I really have no impression." Xiaolin Xun shook his head bitterly, "I saw the family photos and family photos he brought, as well as some things I used when I was a child.
.But...I don't remember anything."
"Amnesia may be just a temporary phenomenon. After all, the working principle of the human brain is still very complicated. Maybe you can slowly remember it after you go home." Sun Lien patted his shoulder, "You plan to leave the hospital after
Are you going back to Japan right away?”
"No." Xiao Linxun shook his head, "I want to wait until Lin Ya's second operation is over and take her to Japan with me."
"The second time..." Sun Lien opened his eyes wide. Lin Ya must have told Xiao Linxun everything about him, otherwise he would never know the plan for the second operation.
Kaoru Kobayashi smiled and patted the guardrail beside the bed, "It's indeed amazing to say that. My wife is a male in terms of chromosomal structure, but she is indeed different. She has no response to male hormones at all." He asked with a smile.
Said, "Generally, women also have male hormones in their bodies to some extent, and they will become... somewhat aggressive due to the increase in the level of this hormone. And the purest women who do not respond to male hormones are actually men, right?
Sound ironic?"
Strangely enough, "women" like Lin Ya all have very fair and delicate skin, as well as beautiful faces. Although a large number of patients will be diagnosed with external genital malformation at birth because of
Androgen insensitivity syndrome, but Lin Ya obviously should belong to the category with a complete female external genital structure.
"She used to be bothered by her irregular menstrual cycle, but now it seems that we don't have to worry about it in the future." Kaoru Kobayashi seems to really not care about the fact that his wife is actually a man. "I already
I have consulted many doctors and they said that as long as the surgery is completed, there will be no risk."
"Irregular menstruation?" Sun Lien frowned, feeling that there might be something wrong with this matter.
Xu Yourong also frowned, "Androgen insensitivity syndrome... shouldn't it be manifested as primary amenorrhea?"
Dr. Pascal suddenly asked, "Have you done any genetic testing based on her reproductive abnormalities?"
Sun Lien shook his head, "She was admitted to the hospital due to severe trauma. Her condition has been unstable before, and follow-up tests haven't been done yet."
"Maybe... it's not AIS (androgen insensitivity syndrome)." Dr. Pascal pondered, "Irregular menstruation, female external genitalia, this sounds more like PMDS (Müllerian Syndrome) to me."
Mullerian syndrome is a rarer reproductive malformation than AIS. The patient will have two sets of reproductive systems, one male and one female. Depending on the type of reproductive malformation, the patient will show male sexual characteristics.
Or female sexuality.
"But...Lin Lan's appearance is indeed that of a woman." Sun Lien had never heard of PMDS at all. He used his mobile phone to look up the disease on a professional website. He looked at the diagnostic guide above and said hesitantly.
, "If it is a female deformity caused by pmds, Lin Lan should show some male characteristics."
"AIS will not cause menstruation." Dr. Pascal insisted. "I have diagnosed two patients with lupus erythematosus before. Their social gender is male, but their estrogen levels are very high. Later I found out that they were
pmds male malformation patients.”
"Dr. Sun... I don't quite understand..." Xiao Linxun said confused, "Are you discussing my wife's problem?"
Sun Lien nodded, "Her gender problem...may not be consistent with our initial diagnosis. I will add a few more tests as soon as possible."
"Is she... going to be okay?" Xiaolin Xun's expression turned serious, "This shouldn't be a very serious condition, right?"
"Of course." Sun Lien patted Xiao Linxun's shoulder, "You don't need to be so nervous. Maybe we can find out some good news in the end."