Chapter 926 - 467: Doctor-Patient Cooperation Is Key, Tumor Recurrence

Chapter 926: Chapter 467: Doctor-Patient Cooperation Is Key, Tumor Recurrence

"This is exactly what I was going to explain to you. Nosebleeds can be divided into anterior nasal bleeding, anterior septal bleeding, posterior nasal bleeding, intracranial bleeding, etc. When the dura mater at the skull base ruptures or is injured, it can cause bleeding in the brain tissue, which then flows into the nasal cavity through the ruptured opening."

"Unfortunately, your uncle’s situation should fall under intracranial bleeding, not just a simple wound inside the nasal cavity as you thought."

"Also, I noticed that his nasal bleeding is mixed with a yellowish fluid."

"That’s probably not nasal mucus, but cerebrospinal fluid. Under such circumstances, if you block the nostrils, it’s very easy to cause retrograde infection."

"By then, meningitis and intracranial infection may occur."

"Not only is the treatment very expensive—at least tens of thousands, or even hundreds of thousands—but it may also lead to lifelong disability, or even death."

Li Jingsheng talked on and on, but the family members didn’t seem to understand.

What did get through to them was the part about treatment costing tens of thousands, hundreds of thousands.

It scared him so much he shuddered on the spot.

"Th-this consequence is too serious. Doctor, maybe I should just take my uncle to the hospital instead."

Never mind hundreds of thousands, even just tens of thousands was beyond what he could afford.

He’d originally thought bringing his uncle to the clinic would save some money.

Now, hearing that a small slip during treatment could easily lead to something major—

"Hospitalization in a hospital is indeed safer and more reliable. You should hurry to the hospital, and remember, do not block the nostrils. Let the blood and cerebrospinal fluid drain out."

Dr. Li happened to not want to take on this kind of high?risk patient.

He had just gone through a medical dispute not long ago, so he was doubly cautious in his practice now.

"The doctor said nosebleeds shouldn’t be blocked; as long as you listen to the doctor, nothing will happen. Going to the hospital—do you know how much that costs! We just took over this storefront, we’re still short on money even for stocking up goods. We might as well just close this fruit shop down."

The woman in the family wouldn’t have it.

Her husband hadn’t understood what Dr. Li said, but she had.

They had just taken over a shop, and who would have thought something like this would happen.

They’d asked the uncle to help with the renovation, originally to save some money, but it turned into trouble instead.

"You two have it hard enough as it is. Just get treated here at the clinic!"

The uncle spoke up.

Although he’d injured his head and was in a lot of pain, this uncle was clearly a kind and considerate person.

Hearing the young couple quarrel, he took the initiative to request treatment at the clinic.

"Uncle, thank you for understanding us. Then let’s first get some medicine here at the clinic and treat for a couple of days, see how things go. I’ve heard people say this clinic has the best medical skills around here."

This time the male family member no longer insisted on taking his uncle to the hospital, and directly agreed.

"Doctor, can my uncle’s injury be treated here?"

"We can give it a try. The main thing is that you need to be careful during rest at home. With cerebrospinal fluid leakage, the recovery period is relatively long. As for medication, I’ll use some antibiotics to prevent intracranial infection, to bring the infection risk down to the minimum..."

Dr. Li was aware how hard life was for this family.

He took on the case.

In his view, although treating this patient carried some risk, the main risk was not in the treatment itself.

It lay in whether the patient could rest and recuperate properly.

In fact, most diseases require cooperation between doctors and patients.

If patients don’t follow the doctor’s instructions, no matter how skilled the doctor is, there’s nothing he can do.

In the hospital, situations like this are very common.

Back when Dr. Li worked in the Department of Respiratory Medicine at the First Hospital, some patients had bronchitis to begin with. After prescribing medication, he warned them not to smoke for the time being.

Yet the patients would sneak into the fire escape in the stairwell to smoke when the doctors and nurses weren’t looking.

Their condition kept relapsing; they ended up hospitalized for more than two weeks before finally being discharged.

There was an even more frightening case: Dr. Li and the responsible nurse both warned a patient never to drink alcohol. The patient still secretly drank about 100 grams, and was dragged into emergency rescue in the middle of the night.

Cephalosporins with alcohol—straight to the grave.

Fortunately, after resuscitation, the patient pulled through. For this incident, Dr. Li was severely scolded twice by his superior and the Medical Affairs Office leadership, and he had no one he could vent his grievances to.

The responsible nurse was an intern nurse, and she was scolded to the point of tears.

She didn’t show up the next day.

He didn’t know whether she had changed careers or been reassigned to another department for her internship.

Dr. Li carried out a series of treatments for this patient, prescribed medication, and instructed him on lying position, telling him to seek medical attention immediately if he felt any discomfort.

...

Five days went by in a row; this skull?base fracture patient had not developed intracranial infection, and the bleeding had long since stopped.

There was just a bit of cerebrospinal fluid leakage left.

There was no helping that; the recovery time would be quite long.

Skull healing takes at least one to two months.

Generally, if nothing has happened by day five, the situation can basically be considered stable. As long as rest continues, he can slowly recover.

Dr. Li was still as busy as ever every day.

The high?end colonoscopy business had initially opened up; at peak times, he could get four cases a day.

This also gave him the opportunity to get acquainted with the elite class of Jiangli City and its counties, and even towns and villages.

These people either had children who were doing very well and were very wealthy,

or they themselves had achieved something in their careers.

Their reasons for colonoscopy were all over the place; out of ten colonoscopies, only one or two would turn up larger polyps or other lesions. The vast majority showed nothing after the exam.

Besides colonoscopy, Dr. Li had also gradually performed some very difficult interventional cardiovascular procedures along with Wang Weiwei.

Under his resuscitation, no fewer than thirty patients had been successfully saved.

There were also some patients whose condition was too severe, where interventional therapy was ineffective or too technically difficult to place a stent. In the end, they died despite rescue efforts.

The two most dangerous types included acute myocardial infarction leading to sudden cardiac and respiratory arrest.

Although some people could be brought back by cardiopulmonary resuscitation, the myocardial infarction was too severe, and in the end they couldn’t be stabilized; the patient still died.

The second one is aortic dissection.

Li Jingsheng had only known before that this disease was very dangerous, but he had never seen its power firsthand.

Until one day, he and Wang Weiwei and the others were resuscitating a patient with chest pain.

As soon as the patient was pushed into the interventional room, the blood pressure instantly disappeared.

The reason was rupture of an aortic dissection.

The speed of death was such that the doctors simply had no time to rescue.

One second, the person was still fine.

The next second, the blood pressure plunged off a cliff, practically gone in an instant.

Previously, whenever he saw his colleagues in the emergency department diagnose a patient with an aortic dissection, no matter how good the patient’s condition looked, they would immediately issue a critical illness notice to the family.

He felt they were making a fuss over nothing.

It wasn’t until not long ago, when he personally witnessed that patient die in an instant, that he realized how valuable the seniors’ experience was.

That day, Li Jingsheng was eating lunch in the hospital cafeteria.

He wasn’t eating with Ou Qinglan because she had more patients recently, and Professor Wu had given her extra responsibilities.

She herself was also very driven.

Coupled with the support and help of Li Jingsheng behind the scenes, Ou Qinglan’s skills had improved at an astonishing pace.

Her status in the second team and even in the entire orthopedics department had also risen very quickly.

Among the many residents, her level was even catching up with those who had already worked three years.

While eating, Li Jingsheng was summarizing the day’s treatment experience with several of his subordinate doctors.

At the moment, he had already passed on the Bone Touching Skill to three people: Ye Hui, Liu Xian, and Jin Yanyu.

Jin Yanyu was the last one to be granted the Bone Touching Skill.

But in terms of bone touching, this kid displayed an astonishing talent, even surpassing Ye Hui and Liu Xian.

It really did make Li Jingsheng feel a bit surprised and delighted.

As the scope of his medical techniques grew broader and broader, on the manual Bone Setting side he badly needed a few capable disciples to share the diagnostic and treatment workload.

Jin Yanyu had extremely high talent for the Bone Touching Skill; after just one day of learning, he was already able to feel the basic bone positions.

In only one week, he was able to feel the condition of the blood vessels around the bones.

This even made Li Jingsheng suspect that he had "turned on cheats" too.

Yang Luqing and Dr. Chen had not yet been granted the Bone Touching Skill for the time being.

Dr. Chen was still diligently practicing the basics.

He belonged to the type with especially poor talent, so all Li Jingsheng could do was have him solidly practice each basic skill one by one. After he had truly built a firm foundation, then he would pass on the other, more advanced Bone Setting techniques one by one.

As for Yang Luqing, if he wanted to obtain a core medical technique like the Bone Touching Skill, he still had to work harder.

For now he had not yet moved Li Jingsheng’s heart.

"Teacher, can I ask for half an hour off from you today?"

Jin Yanyu asked.

"Why are you asking for leave?"

Li Jingsheng would not easily approve leave.

There had to be a legitimate reason.

Jin Yanyu’s eyes flickered a bit.

"Can I tell you later?"

He clearly didn’t want the other colleagues to know.

"Then send a message to my phone. If the reason is proper, I’ll naturally approve your leave."

Li Jingsheng had no idea what this kid wanted to do by getting off work half an hour early.

If he started floating just after learning the Bone Touching Skill, he would definitely need to be knocked down a peg.

Not long after, he received the message from Jin Yanyu.

"Today is Ye Hui’s birthday. I want to get off half an hour early to decorate the private room and give her a little surprise. I plan to invite you and all the colleagues from clinic to have a meal together to celebrate Ye Hui’s birthday, and I’d like to ask you to honor us with your presence."

Jin Yanyu had been pursuing Ye Hui all along.

This, at least, was something Li Jingsheng knew.

Yang Luqing hadn’t given up either, but ever since the assassination attempt on Li Jingsheng, he had fallen behind.

"Approved!"

Once he learned the reason for the leave, Li Jingsheng agreed to it.

Just as Li Jingsheng was about to finish eating, Director Zhang from cardiothoracic surgery walked over with two of his subordinate doctors.

"Dr. Li, can you come help me with a surgery after work today?"

"Since Director Zhang has spoken, I’m happy to oblige. What time should I be there?"

"Around 19:00. I know you have a lot of clinic patients and are often busy until six or seven. The patient is a lung cancer case. When it was first found, it was early-stage and we resected it. But now, after only eight months, the tumor has recurred. Whether it recurred because we didn’t cut it cleanly enough or for some other reason, I’d like you to help and give your opinion when the time comes."

The surgeries Director Zhang invited him to do were all relatively difficult or problematic cases.

As long as lung cancer is found early, once it’s resected it’s generally fine.

You can achieve a curative effect.

But tumors have a characteristic: they love to recur and metastasize. These two points alone have claimed countless patients’ lives.

There are many reasons for tumor recurrence.

Not cutting it cleanly is one of the most common causes.

There is also a view that during tumor resection, if tumor cells get onto the scalpel,

and then that same scalpel cuts into normal tissue, there is still a possibility that cancer cells will adhere to the normal tissue, thus planting the seeds for recurrence in the future.