Chapter 790 - 368: Conservative Treatment Is Compassion, Dangerous Complications (Part 2)

Chapter 790: Chapter 368: Conservative Treatment Is Compassion, Dangerous Complications (Part 2)

She moved into a rented old two-bedroom apartment with two children and two elderly people.

In the end, she couldn’t bear the multiple blows and chose to leave her two young children and jumped off a building.

The two elderly people had already been grieving after losing their son.

Now seeing their daughter-in-law commit suicide, they felt it was themselves who had become a burden to her, leading her to desperation. Not to mention, they were unable to repay the huge debts they owed.

They felt too ashamed to face relatives and friends.

The elderly couple ultimately chose to end their lives, one hanged in the bathroom, the other overdosed on sleeping pills.

An originally happy family was left with two children with no one to care for them.

The department head, a fifty-two-year-old man, was choking up several times during the department meeting.

He wanted this bloody lesson to be remembered by everyone.

If at that time we had directly told the family that the patient was unlikely to survive, it would have been better to offer some humanistic care, to reduce the patient’s suffering. Utilizing some more conservative treatment options.

In that case, even if the patient died, the household would still have three adults, plus two children, and could completely live on properly.

With time, they could overcome the grief of losing loved ones and live a new life.

That incident left a very deep impression on Li Jingsheng.

Back then, he was just a junior resident newly transferred, with very little clinical experience.

But since then, whenever he encountered patients with extremely severe conditions, like late-stage cancer or hard-to-treat severe illnesses that may drag down the entire family financially and emotionally, resulting in nothing left at the end.

He would decisively persuade patients and their families to accept more affordable treatment options.

"Jingsheng, I understand your point, and I really admire your kind heart for considering long-term interests of patients and their families. But this patient’s situation is very special.

Firstly, the patient’s family is in a good condition, and there is public medical insurance coverage.

As per the treatment cost, we essentially don’t need to worry.

Secondly, this patient was very inspirational when he was young. His hypertension is due to over-stress from preparing for college entrance exams back in those days.

He spent his whole life dedicated to benefiting humanity.

The monograph he is completing is unfinished, and he particularly wishes to live a few more days to finish it before leaving this world.

I’m willing to take on this challenging patient not because I’m foolish, let alone sacrificing my career advancement and scores. I just wish to use my modest abilities to help this admirable old man."

After hearing Lian Tao’s explanation, Li Jingsheng nodded and said nothing more.

Doctors often encounter some admirable patients when receiving them.

For instance, the scavenger elderly man Li Jingsheng encountered, despite having a retirement pension to live a decent and comfortable late life, he chose to collect garbage just to gather a bit more money to donate to children in impoverished areas, helping them get a chance to sit in a classroom and learn.

Such patients have a shining soul and naturally earn admiration.

Doctors also try all means to help them.

Li Jingsheng began carefully reviewing the patient’s profile.

The patient is currently in poor physical condition, lethargic, and has no jaundice in skin sclera.

Glandular resistance shows abnormality.

No abnormalities were found in heart and lungs, so that’s a good point, at least there is a decent basis for treatment.

Abdomen is soft, no tenderness upon pressing.

Bowel sounds occurring 6 times per minute.

That counts as normal and somewhat active.

Because in a normal person, bowel sounds generally occur three to five times per minute.

For the patient’s complete blood count, the WBC count is 25.6 times ten to the ninth power per liter. This alone startled Li Jingsheng, exceeding the normal value by more than double.

In fact, many adults have a normal white blood cell count value of about 4.

In medical textbooks, anything between 3.5 to 9.5 is considered normal.

There are various reasons for elevated white blood cell count, the most common being infectious diseases.

Besides this, hemolytic streptococcus, influenza bacillus, leukemia, early myelofibrosis, and adult Still’s disease among others, can also lead to elevated white cell counts.

The patient’s second figure, the GR ratio reached 93%.

Neutrophil percentage, normal adult value should be between 50% and 70%.

The patient’s neutrophil percentage also far exceeds the normal value.

Further examining other auxiliary test results of the elderly, platelet count is normal, 267 times ten to the ninth power per liter.

Stool routine test did not find abnormalities.

Liver function, heart rhythm is a very standard sinus rhythm.

Just widespread T-wave flattening.

Usually, there are many reasons for T-wave flattening, the most common being hypertensive patients.

This patient has had nearly sixty years of hypertension, so the appearance of T-wave flattening is not out of the ordinary.

Li Jingsheng continued checking other data of the patient, hypokalemia, hyponatremia, hypochloremia.

Blood pressure is high, with systolic at 160mmHg and diastolic at 100mmHg.

However, his blood oxygen saturation is still okay at 99%.

For a very weak elderly person, having this blood oxygen saturation is quite decent.

It indirectly shows that the patient’s pulmonary function and oxygen exchange are rather good.

Li Jingsheng picked up the patient’s electrocardiogram for examination.

Sinus rhythm but with widespread T-wave inversion, and multiple atrial premature beats, precordial lead R-wave is somewhat low.

Upon seeing this electrocardiogram, he realized the patient had acute myocardial infarction.

Of course, since the patient has been admitted to the hospital for a period of time, they must have received timely treatment.

"Brother Lian Tao, the patient’s left heart function seems to be a bit insufficient as well!"

"Hey, not bad, you spotted it just at a glance. Looks like your diagnostic skill in cardiology has greatly improved!"

Lian Tao smiled and praised him.

It’s not surprising to notice this, many experienced cardiology doctors can diagnose it just by looking.

Li Jingsheng has been frequently performing surgeries in cardiothoracic surgery recently, learning quite a lot.

Significant progress made in medical clinical knowledge and experience in cardiovascular medicine and cardiothoracic surgery.

"After admission, diuretics and vasodilators have been given to enhance volume treatment. Symptoms in this aspect have already been significantly improved."

The People’s Hospital truly deserves its reputation as a strong hospital with impressive capabilities.

Diagnostic procedures in all aspects are highly standardized.

As long as patients can be admitted, it’s approximately equivalent to holding a get-out-of-jail-free card.

Medical staff will conduct professional treatment for them.

Qiaobang feels somewhat lax in comparison.

But to become a top-tier hospital, they can’t be too bad.

At most, they’re not as friendly to patients not admitted.

"Have you used aspirin, fosinopril, bisoprolol, simvastatin, etc. for preventive treatment?"

Li Jingsheng thought just diuretics and expansion were indeed not enough.

Using secondary preventive medications for coronary heart disease is very necessary.

"Hey, it’s really impressive even after just a few days, you’re surprising everyone! Your medication knowledge for cardiovascular disease treatment has clearly improved significantly compared to before! Where have you been training recently?"

Hearing this, Lian Tao couldn’t help but look at Li Jingsheng in a new light.

"Just hanging out at our Second Hospital, where else can I go! As for training, I actually did. Recently, I’ve been at your People’s Hospital, learning a lot with Professor Wang Weiwei and Professor Luo Binggang."

Unconsciously, Li Jingsheng has come to know many famous experts and professors.

Moreover, he gained their recognition and teachings.

"No wonder, no wonder, I was wondering! This patient is left to you today, no dropping the ball, otherwise you’ll be letting down your impressive skills."

Lian Tao suddenly realized.

Being able to learn from an eminent cardiovascular expert like Wang Weiwei, how could his skills not progress rapidly?

It’s truly enviable.

"Brother Tao, is the patient’s diarrhea and vomiting still being treated under acute gastroenteritis?"

"Yes! Because indeed no other cause could be identified. You might not believe it, but the first day the patient was admitted, their cardiovascular status was still fine. But by yesterday, the patient had already developed acute myocardial infarction. Luckily we discovered it promptly, otherwise the consequences would be unimaginable. Now with treatment, myocardial infarction shouldn’t pose much of an issue."

Complications are the most dangerous condition for this patient.