Chapter 844 - 396: At Home, Obey the Boss—Heart and Lung Hurting Each Other?

Chapter 844: Chapter 396: At Home, Obey the Boss—Heart and Lung Hurting Each Other?

"Jingsheng, are you here yet? The two cases I sent you today are tougher than the last. Whether I can get a good night’s sleep tonight really depends on you."

Lian Tao never stands on ceremony with him.

He basically just gets straight to the point whenever there’s something to discuss.

It’s like the candidness with mutual friends who don’t require formalities.

A true close friendship indeed doesn’t need excessive politeness.

Excessive politeness is reserved for strangers.

Lian Tao is nearly seventeen years older than him, with academic achievements, medical status, and various other conditions far exceeding his own.

Logically speaking, such individuals are not on the same parallel track.

Yet the world’s fate is wonderfully mystifying, leading them to become friends due to a twist of events. Ironically, the main character of the baby incident, Director Yang, did not become Li Jingsheng’s confidant.

They are friends, slightly more than ordinary friends, but that’s all.

With Lian Tao, they’re truly solid bros.

Whenever Li Jingsheng has an issue, Lian Tao would go all out to help him.

"Don’t worry, I’m having dinner right now. I studied that case with the cough, cyanotic facial complexion, and whole-body edema during lunch, but the cause seems not that simple. I’ll come over to discuss it with you after dinner."

Li Jingsheng had just finished speaking when Ou Qinglan, beside him, intervened before Lian Tao could respond.

"Director Lian, hi, I’m Li Jingsheng’s girlfriend. He was stabbed in the arm during his clinic duties today and got many stitches. I want him to rest at home properly, so please find someone else for that difficult case consultation!"

Ou Qinglan usually never interferes in Li Jingsheng’s private matters.

Seeing her boyfriend nearly lose his life, and hardly eat before agreeing to help Lian Tao with the case, her pent-up anger burst forth.

"Ah... Jingsheng got stabbed?"

Lian Tao appeared quite surprised upon hearing this.

"Jingsheng, you should stay at home and rest well! I didn’t know you got injured; that’s why I thought of getting a free hand. I’ll come over later to see you."

"It’s just a small injury, no big deal! Let me talk with my boss at home, and go over to help with the case consultation; it shouldn’t be a problem."

Li Jingsheng seemed unconcerned about his hand injury.

However, being cared for by his girlfriend still made him feel quite appreciated.

"Wow, seems like your boss at home holds great authority! How did you get stabbed? You were supposed to be at the hospital today, right? Was it retribution for stealing someone’s girlfriend?"

Lian Tao was clearly concerned about him.

But it turned into gossip.

"If it was stealing someone’s girlfriend and getting stabbed, it might have been worth it. Today was really unlucky, got targeted by a psychiatric patient who pretended to be a patient, and suddenly drew a knife to kill me. The police are still investigating, with no concrete conclusion yet. All I know is the patient got injured in a car accident two months ago and was taken to the Second Hospital for an emergency rescue.

I was then invited to the ER for a consultation to see if a manual realignment was possible. I found the patient’s bone injury too severe for manual realignment, so I suggested saving life first, then treating the bone.

After the patient recovered, he had a slight limp, and that may be why he came to hate me.

There’s also a chance he developed a mental disorder and believed I caused the death of his daughter.

Because his daughter was with him during the car accident.

Ultimately, his daughter couldn’t be saved and passed away."

Li Jingsheng was quite speechless encountering such bad luck.

Some disasters are truly unimaginable.

If he hadn’t successfully treated the patient’s illness, he might have understood a bit. This patient didn’t even undergo his treatment, leaving him clueless about where the hatred comes from.

"Sigh, it’s really dangerous being doctors. We treat patients diligently, yet our lives hang by a thread. I truly hope the doctor-patient relationship gets more harmonious, and doctors’ safety gets ensured. Be thankful, at least you were lucky, and only your arm got injured."

Lian Tao comforted him.

"Is the wound deep? With your hand injured, you can’t work, won’t the Second Hospital’s manual realignment clinic be forced to stop?"

He fully understands Li Jingsheng’s special status at the Second Hospital, largely due to the manual bone setting skill.

Because this is a monopolistic technique that no one else can replace.

"I tried this afternoon, guided my assistant doctors, and as long as the cases aren’t complex, they can mostly manage them. For really difficult ones, I’m helpless and can only suggest they consider surgical treatment."

Li Jingsheng had decided to train a bunch of apprentices, anticipating eventualities.

This not only solved his academic advancement issues but also proved handy in unexpected situations like this.

"Getting back to work right after being stabbed, your mental resilience is impressive!"

Lian Tao admired him greatly.

"Alright, rest well at home! Don’t come over while injured; just check the case on your phone and share your diagnostic opinions through messages or calls whenever needed."

Initially, the plan was to have Li Jingsheng over to lend a significant hand.

Now this plan had to be scrapped.

Checking patient data on a phone and personally going for consultation are indeed two different concepts. ℯℯ𝘭.𝘤ℴ𝘮

Being onsite, doctors can not only examine and understand the patient’s real-time condition but also communicate efficiently with patients and discuss on-the-spot issues with other doctors.

After the call ended, Ou Qinglan glared at him with her bright eyes.

Looking all puffed up with anger.

"Alright, don’t get mad! I won’t head over, it’s alright?"

Li Jingsheng poked her delicate cheek.

Her skin truly looked snow-white, felt like satin. A woman’s youth is delightful, with her skin and body showing their most beautiful phase.

"Already injured, yet not properly healing? Does your body matter or not? A patient’s health is important, but yours isn’t? I don’t care, you’re extremely important to me, and I can’t let anything happen to you."

The deep tenderness in her eyes could melt any man’s heart.

Li Jingsheng followed her arrangement to rest well in the clinic.

He repeatedly checked the case details through his phone about the patient with a cough, cyanotic complexion, and edema, but was only able to determine heart problems and serious lung issues.

However, this respiratory failure may be due to heart dilation.

Once the heart’s blood supply faces issues, the lungs are among the first organs to suffer.

Clinically, respiratory failure can manifest as ventilation failure and gas exchange failure.

There are also patients experiencing failure in both aspects simultaneously.

No matter which type of respiratory failure, it is a severe pathological change. If left unchecked, it can easily threaten life.

Moreover, even if respiratory failure is not severe, over time it can lead to multi-system pathological changes.

Li Jingsheng has worked in Pulmonary Medicine for several years, deeply aware of the dangers of respiratory failure.

He is also quite familiar with the various causes of respiratory failure.

For example, airway obstruction, lung diseases, heart diseases, pulmonary vascular diseases, etc., can all lead to respiratory failure.

This patient’s hemoglobin is far above the normal value, indicating that the respiratory failure is not recent.

Moreover, the body’s hypoxia is not necessarily caused by respiratory failure.

Poor blood exchange in the heart or significant regurgitation can lead to inefficient, degraded blood oxygen exchange.

The blood supply from the heart and blood oxygen exchange in the lungs are essentially one system.

They are interrelated.

Any problem in one aspect will trigger a chain reaction.

Especially if the problems persist for a long time, it is more likely to cause multi-faceted chain pathological changes.

The pathogenesis of respiratory failure should be decreased gas exchange within the lungs, insufficient ventilation, leading to hypoxia or CO2 retention in the body without being expelled.

Li Jingsheng decided to start from both respiratory failure and mitral valve issues.

"Lian Tao, this patient named Mu Youlin, does he have mitral valve insufficiency?"

He sent an inquiry message to Lian Tao.

No response from him.

He is probably busy.

As a doctor, it’s impossible to hold a phone all day long. Any doctor who seeks progress has very little time to spend on their phone.

Li Jingsheng was preparing to review the second complicated case.

Lian Tao already replied to him.

First, he sent a thumbs-up emoji.

"Upon investigation, the patient has mitral valve stenosis and insufficiency, along with overall heart failure. Heart function is at level 4."

There are two systems for grading heart function.

NYHA and Killip heart function classification.

Killip heart function classification is often used in the clinical setting for acute myocardial infarction.

This patient obviously does not have acute myocardial infarction, so the former grading system applies.

Heart function can be divided into four levels.

Level one symptoms are milder, level four is the worst.

At level one heart function, the patient can perform daily physical activities, work, or exercise normally without experiencing heart failure symptoms such as dyspnea.

Clinically, level one heart function is often considered a better state.

If there are no organic lesions, no significant issues, it is often regarded as a normal state.

This patient has reached level four heart function, considered very severe.

Even in a calm state, the patient experiences dyspnea, panting, etc., and in severe cases, a slight stimulus or slightly intense exercise can directly lead to hypoxia and fainting.

Actually, as long as dyspnea occurs during routine activities like brushing teeth or defecating, one should be alert to serious heart function problems.

Because by then, it could already be rated level three in heart function.

Li Jingsheng frowned as he pondered deeply; the patient’s heart and lung function were so poor, along with systemic edema, certainly requires further investigation of bronchitis, respiratory tract infections, chronic obstructive pulmonary emphysema, etc.

Respiratory failure accompanied by COPD can make the patient’s symptoms more severe and prone to sudden serious issues.

Such as respiratory arrest, etc.

"Did we rule out respiratory tract infection and chronic obstructive pulmonary emphysema?"

"You’re quite good, young man; without checking further results, you can diagnose problems. Just now, it’s been confirmed the patient has chronic bronchitis and an infection. COPD is present, and pulmonary emphysema is quite severe.

A symptomatic treatment including anti-infection, diuretic, and cardiac fortification has been administered."

Lian Tao admires Li Jingsheng greatly.

These etiologies can’t just be inferred by reading a few medical books and studying some case analyses.

One must have very rich clinical experience and flexible, clear diagnostic thinking to diagnose these related issues one by one.

"I think diuretic treatment for this patient is a double-edged sword, quite dangerous!"

Li Jingsheng directly ignored his praise, while providing necessary reminders, he continued to dig deeper to find the root cause.

He sensed that it might not be as simple as heart failure causing respiratory failure.

From the first glance at this patient’s examination data and medical history, he felt the disease was chronic.

Otherwise, it couldn’t have a seven-year history.

But what exactly caused mitral valve insufficiency?

The result of mutual damage between heart and lungs?

He believes it’s still debatable.

"Edema, heart failure, without diuretics, cardiac fortification, how to treat it?"

Lian Tao questions him back.

"Solve the real cause!"

Li Jingsheng rolled his eyes; heart failure and edema treatment indeed follow these routines, but one can also deviate from conventional routines. Cut off the root cause and solve it once and for all.

"You make it sound easy, performing mitral valve repair now?"

Lian Tao is also quite indignant.

"Repairing the mitral valve now won’t solve the problem; with his heart enlarged, not addressed, your repair is ineffective. Lian Tao, do you think the patient’s problem is caused by mutual damage between heart and lungs?"

Li Jingsheng asked.