Doctor of Healing

When he came to the outpatient clinic, Ji Xiang helped Deng Chaohong write the medical records familiarly.He typed extremely fast, and his medical record writing was quite standard.

After all, Lu Gang was "assigned" to Ji Xiang's medical team by Director Bai recently, and Ji Xiang learned a lot from him.

Deng Chaohong did not expect that taking Jixiang out to the clinic would reduce his workload drastically. He only needs to ask about medical history, check up, diagnose, and prescribe medicine. Jixiang will do other trivial tasks.

When he was about to leave work at noon, Deng Chaohong called the last number.

"Doctor Xiaoji, do you eat in the cafeteria at noon or go out?" Deng Chaohong asked casually.

"It's all right, see you, Mr. Deng."

"Then go out to eat, simply eat casserole meat." Deng Chaohong said, "Director Liu and Senior Colonel Wang of the Department of Urology often go to Kuangyang to eat barbecue. I used to go there too, but it is barbecue after all, so eating less is not harmful. "

"I think back when I came to the hospital, the salary was still paid in cash, and I had to eat two skewers of chicken heads every time I was paid. I really miss it."

Just as he was talking, a middle-aged man limped in.

"Doctor." The patient sat on the stool opposite Deng Chaohong, "My legs hurt when I walked in the past two months, and I feel like I'm limping."

"Not before?"

"No."

"Aside from lameness, is there any other discomfort?"

"I felt fine when I woke up after a short rest, but after walking a few steps, I felt my waist getting heavier and heavier, and then that's it."

Deng Chaohong smiled slightly, "This is called intermittent claudication, which is generally caused by stenosis of the lumbar spinal canal."

Seeing Deng Chaohong's determined face, the patient asked, "Professor, is this disease curable?"

"Lie down first, I'll check your body and then do a checkup."

The patient sat on the examination bed and began to slip on his shoes. Deng Chaohong smiled and said, "Just lie on it, it doesn't have to be so troublesome."

But the patient moved quickly, took off his shoes before Deng Chaohong finished speaking, and went to bed obediently.

In an instant, Ji Xiang vaguely saw that the color of the patient's skin exposed between the socks and trousers was a bit wrong.

This is also because Ji Xiang's eyesight has improved after using the skill of discerning the details more times, and Ji Xiang can discover this in an instant.

The dark color was so different from the exposed skin of the patient that Ji Xiang felt that he had misread it. What was black was not the skin, but something like line pants or discreet underwear.

"What are you wearing?" Ji Xiang blurted out.

Deng Chaohong was startled, and gave Ji Xiang a slightly reproachful look.

What kind of underwear the patient wears has nothing to do with the disease.Although the medical records have to write about the skin color and so on, the orthopedics department can't ask the patient to take off his clothes after seeing a joint.

There are similar doctors, but most of them are called scum, ahem... Deng Chaohong no longer thinks about it.

However, to Deng Chaohong's surprise, the patient smiled embarrassingly, "I didn't wear anything. I don't know what happened recently. It may be that the color of the socks has faded, and the feet and ankles are black."

"Oh?" Deng Chaohong didn't want to raise his eyebrows at Ji Xiang on the first day, he still valued Ji Xiang more in his heart, otherwise he wouldn't follow Director Liu and others into Director Sui's office.

"Want to take a look?" the patient asked.

Before Deng Chaohong could say anything, Ji Xiang stood up and walked to Deng Chaohong, "Let me see."

"..."

Deng Chaohong was a little helpless.

They cooperated tacitly throughout the morning, but Jixiang was interested in this limp patient, but what he was interested in had nothing to do with orthopedics.

"No need." Deng Chaohong denied Ji Xiang's approach.

"Xiaoji, I'll tell you later." Deng Chaohong didn't sternly reprimand Ji Peisheng like he did to other ignorant Ji Peisheng, but explained to Ji Xiang gently.

Ji Xiang didn't speak, and quietly watched Deng Chaohong examine the patient.

The physical examination process went smoothly, and Deng Chaohong knew it well. According to the physical signs, it was indeed spinal stenosis, but it was not particularly serious.

"Have you been checked?" Deng Chaohong asked after the checkup.

"It was done in our local hospital." The patient replied.

Deng Chaohong glanced at it, seeing that the patient didn't take the film, he felt helpless, "Where's the examination report and film?"

"..." The patient was taken aback for a moment, but then he was a little happy.

"We said that when we come to the provincial capital to see a doctor, we have to have a re-examination, so I didn't bring it with me, and it was in the car."

"Look at it first, if you can, don't do it, and spend the money for nothing." Deng Chaohong said, "It's nothing to spend a little money, the key is that it takes about 2 weeks to queue up for the MRI at the Second Affiliated Hospital."

"so long!"

"Go get the movie." Deng Chaohong waved his hand, "Hurry up, I'm going to eat after watching your movie."

"Thank you professor, thank you professor."

The patient quickly put on his shoes and limped out of the consulting room.

"Xiao Ji, why did you ask the patient what he was wearing in his socks just now?" Professor Deng waited for the patient to leave, and asked in a calm tone as much as possible.

"I think the color of the skin on his feet is a bit strange."

"See it?" Deng Chaohong tried his best to recall that when the patient took off his shoes during the physical examination, he didn't see anything.

"It may be that the socks are fading." Deng Chaohong said with a smile, "The patient has typical symptoms of spinal stenosis. Let's see the film first, and then choose the treatment method."

"You may still be stuck with what the clinical teacher taught you, or what was written in the book."

"When you go out to see a doctor, you can see where you feel uncomfortable. It's a male patient. If you meet a female patient, you ask to see it. It's easy to be complained."

"..." Ji Xiang scratched his head.

"This is something that must be paid attention to clinically. Do you remember?" Deng Chaohong looked into Ji Xiang's eyes and asked earnestly.

"Remember." Ji Xiang didn't insist, and nodded.

Chapter 313 Doctor Xiaoji and I Think

"Spinal canal stenosis is very common in our orthopedics department. Most patients do not need treatment, because vertebral body surgery is relatively difficult, and no one wants to do it without absolute certainty." Deng Chaohong saw that Ji Xiang communicated well and was not stubborn, so he went Turn on the teaching mode.

His teaching mode is different from that of the system NPC, and it is not verbose. It may have something to do with his age and Deng Chaohong's personality.

Ji Xiang listened carefully, and Deng Chaohong took advantage of the patient's time to pick up the film to tell Ji Xiang more.

His basic skills are solid, and the operation is also good, otherwise Director Zhao Jixiang would not have sent his son to Deng Chaohong.

Ji Xiang listened with gusto.

About 10 minutes later, the patient limped back with the film in hand.

"Professor, I'm back. Here's a film for you to see." The patient came back with a film bag and handed it to Deng Chaohong.

"You will know what spinal canal stenosis is after watching the film." Deng Chaohong smiled, full of the teacher's demeanor, full again.

"click~"

The film is inserted into the film reader.

Deng Chaohong glanced at it, and was startled.

I actually "guessed" wrong, the patient is not a problem with the spinal canal!

There are cord-shaped and tortuous abnormal space-occupying shadows in front of the spinal canal. Both T1 and T2 weighted images showed low signal, distributed behind the L4-S1 vertebral bodies, and the L4/5 gap was obvious. The two longitudinal arches of the venous plexus are dilated, located on the ventral side of the dura mater, forming a specific imaging manifestation of "spectacles sign".

The very typical "glasses" sign appeared. Professor Deng stared at the "glasses" on the film in a daze. After a few seconds, he tried to recall what he saw during the physical examination.

The physical examination process was not difficult. There was joint pain and no other neurological symptoms in the limbs, which were consistent with the clinical signs of spinal stenosis.

but!

Deng Chaohong thought of the question that Ji Xiang had just been "trained" by himself.

"It's not spinal stenosis, it's a problem with blood vessels." Although Deng Chaohong didn't want to admit it, it was meaningless to hold on to death.

Deng Chaohong didn't think about how to choose between his face problem and a true diagnosis and corresponding treatment.

How to choose, isn't it very clear?

"Our local doctors didn't understand it." The patient said hopefully, "They asked me to come to the provincial capital to have a look."

"You sit on it."

Deng Chaohong heard what Jixiang said to the patient more than ten minutes ago.

He felt that his old face was a little red.

But what else can I do if I make a mistake in diagnosis?

It should be because of a rare disease. It is also a good choice to continue the physical examination following Ji Xiang's train of thought. Deng Chaohong comforted himself.

The patient takes off the socks.

Just as he was taking off his socks, Deng Chaohong's eyes widened in surprise.

The patient wore a pair of black socks, but there was almost no difference between taking them off and not taking them off.

Even taking off the socks gave Deng Chaohong the illusion that the patient was wearing another pair of socks inside the socks!

wrong!

As a doctor, Deng Chaohong immediately felt that something was wrong.

But what was wrong, he couldn't tell.As for the discoloration of underwear and socks, it is even rarer than a rare disease. Few of the patients we see usually have a brain missing to this extent.

"I wash my feet every day, and I don't know why the socks are fading, really." The patient said indifferently, "Professor, do you need me to lie down?"

"En." Deng Chaohong nodded absent-mindedly.

Seeing that Ji Xiang didn't speak, he began to check his body.

A few minutes later, Deng Chaohong went to wash his hands, "Is your blood sugar normal?"

"Normal, I don't have diabetes."

According to the description in the book, the patient's condition is called pigmentation on the boots, which is extremely rare, and Deng Chaohong himself has only seen it once or twice.

What is the diagnosis?Deng Chaohong tried his best to find the remaining fragments of memory in his mind.

"Don't you have a stomachache?" Ji Xiang asked suddenly.

Belly, belly...

Ji Xiang's question was like a flash of lightning, and Deng Chaohong immediately thought of a patient he met when he went to the consultation several years ago.

Finally, the patient should have received the Department of Vascular.

"It doesn't hurt." The patient grinned.

Although Jixiang is a young doctor, he still gives enough courtesy and respect.

"Xiao Ji, what are you thinking about?" Deng Chaohong, like the patient, also gave Ji Xiang full respect.

He never thought that Ji Xiang was just a training student, and which training doctor could break so many records in knotting.So this time, Deng Chaohong was as good as he was, and knelt down immediately, ready to hear what Ji Xiang had to say.

"Why do I feel like Budd-Chiari syndrome." Ji Xiang said the diagnosis given by the NPC when he went to the operating room of the system for advice.

"Uh..." Deng Chaohong was taken aback, and then said, "You, lie down and expose your belly."

The patient was a little surprised, but he still lay down according to Deng Chaohong's words.

When the clothes were lifted, several thick veins on the patient's stomach were winding like worms, and they seemed to be still moving with the blood flow.

Enlarged veins, pigmentation on the boots, these key words and the MRI images all reminded Deng Chaohong that the patient was definitely not a simple spinal stenosis!

"I'll make a phone call." Deng Chaohong patted the patient and signaled him to get up.

"Professor, what's the call?" the patient asked.

"Ask someone else for consultation. Your current condition should not be a disease of our orthopedics department." Deng Chaohong tried his best to contain his inner emotions, and gently explained to the patient, "Don't worry, there is a high probability that you will have a definite diagnosis when you come to the Second Affiliated Hospital. "

Patients are very pleased.

Toss hundreds of miles, dozens of days, for a correct diagnosis.

Deng Chaohong turned and left, and looked back at Ji Xiang when he was about to leave.

A few minutes later, Deng Chaohong came in with Director Wang of the Vascular Department and Director Zhao Xiangming of the Interventional Department.

"I...and Dr. Xiaoji suspected Budd-Chiari syndrome." Deng Chaohong said.

"Don't have a stomachache? Do you have to come to your orthopedics department? Does the patient have spider-man signs?" Zhao Xiangming asked.