Chapter 791 - 369: Both Fronts Are Hard to Hold, When Weakness Cannot Be Supplemented

Chapter 791: Chapter 369: Both Fronts Are Hard to Hold, When Weakness Cannot Be Supplemented

Many critically ill patients actually do not die from the original disease, but from complications.

Take AIDS for example, the virus itself cannot kill humans. However, it can damage our immune system, resulting in immune deficiency.

Without the barrier of the immune system, the human body is extremely susceptible to various infections and the occurrence of multiple malignant tumors.

An unfortunate AIDS patient, by the time of death, was found to have 11 types of cancer.

For an ordinary person, suffering from one cancer is already terrifying and fatal enough.

A patient with 11 types of cancer simultaneously, even among survivors in nuclear radiation zones, no one has had so many types of cancer at once.

Li Jingsheng initially advised Lian Tao to abandon treatment for this case, considering it from multiple perspectives.

Acute myocardial infarction was only the first complication and definitely not the last.

Although the patient has some decent foundational treatment conditions, based on his height and weight, the assessment during physical examination, and current indicators, it’s clear his health is already very poor.

There’s an old saying that when the wall is about to collapse, everyone pushes.

A strong person may not be invulnerable, but can recover quickly even if a disease occurs.

However, a weak person can be toppled by even a very minor illness.

"Since the patient developed acute myocardial infarction after being admitted, I suspect it’s very likely due to his blood volume deficiency, causing slow blood flow which then triggered the heart attack. Although the condition has been controlled through timely treatment, the root of the problem hasn’t been solved, and the issue still remains."

Li Jingsheng analyzed the patient’s current situation.

He speculated that the patient’s diarrhea, fever, vomiting, combined with discomfort and poor food intake, all led to blood volume deficiency.

For ordinary patients, poor food intake might only cause the body to become weaker and prolong the recovery time.

But for elderly patients like this, with inherently poor blood circulation, blood volume deficiency leading to slow blood flow is akin to adding insult to injury.

Heart attacks, strokes, naturally all came along.

"The issue you mentioned, Professor Wang Weiwei also raised. Communication with the family was done yesterday, providing nutritional injection therapy for the poor food intake problem. The effect is temporarily good. The key is to find the cause of the patient’s vomiting and diarrhea, otherwise, nutritional injections cannot be administered indefinitely. The longer it drags on, the more disadvantageous it is for the patient.

To be honest, I’m really anxious here.

I just hope to help the patient find the cause of illness as soon as possible, allowing the condition to improve.

Those complications that can pop up at any moment are like little devils. They’re now merely preparing to attack the patient or lurking in the shadows waiting for the right opportunity. Once the issues of the patient’s vomiting and diarrhea are resolved, and the patient resumes food intake, all the impending complications will disappear without a trace."

Lian Tao had his treatment strategy.

Moreover, this strategic thinking is at a high point.

Chief physicians usually possess such comprehensive, far-sighted diagnostic capabilities in dealing with diseases.

The patient seems to have a myriad of problems, but as long as the core problem is firmly grasped and resolved, everything else can be swiftly sorted out.

"I really agree with your treatment strategy. Just, it’s very difficult to pinpoint the cause when trying to investigate it. If quickly, it can be discovered tonight, slow, it might still be a guessing game with the real cause for ten days or half a month. If the cause can’t be found within a day or two, I’m very worried about the patient’s lung getting infected."

Since Li Jingsheng decided to help Lian Tao treat this patient, he must first think of ways to prevent potentially lethal complications.

The heart and lungs are extremely critical areas.

There’s no room for mistakes.

In fact, regarding the heart, acute myocardial infarction has already occurred.

Equivalent to one vital area nearly being overrun.

Luckily, through efforts, the heart area has been successfully defended.

If the lungs get infected, given the patient’s current situation, it would be disastrous.

Because the patient is already using many antibiotics.

If the lungs get infected under these circumstances, normal antibiotics would be like a drop in the bucket, having no effect at all.

The best approach is to prevent it in advance.

"Jingsheng, is this concern of yours based on the patient’s CXR results?"

"Yes! The patient’s chest X-ray shows patchy infiltrates in the upper right lung, indicating a potential infection."

"Don’t worry, pulmonology is my strong suit. The patient has already been given antibiotics like cefuroxime, ceftazidime, and ciprofloxacin. I’m confident that within half a month the patient’s infection can be controlled."

Lian Tao spoke with full confidence in his tone and demeanor.

"Brother Tao, we have a strong relationship, you’ve never considered me an outsider, so I’ll speak candidly."

"Go ahead, I’m not someone petty. Any criticism is welcome. Those who criticise me are actually my benefactors."

Lian Tao said earnestly.

Indeed, as he said, those at his level generally hear praise and flattery most of the time.

Rarely does someone criticize him.

Just imagine, would any employee dare to criticize their leader?

Unless the employee’s emotional and intelligence quotients are struggling, they certainly wouldn’t do such a foolish thing.

Directly criticizing a leader, many leaders might accept criticism gracefully and even commend the critic. But in reality, that foolish person who criticized the leader may already be sidelined.

Even if a broad-minded leader doesn’t put them in a cold spot, they would certainly not consider promoting or utilizing that individual.

Li Jingsheng and Lian Tao are friends, so there’s no such concern.

But among friends, opposing views sometimes still need to be tactful.

"Does the patient cough now?"

Li Jingsheng didn’t immediately offer opposing views but asked first.

"Yes, coughing, why?"

"Can he cough up sputum?"

Li Jingsheng asked again.

"I haven’t really inquired carefully about this, but it seems that he’s not coughing up phlegm very smoothly."

Lian Tao’s face flushed slightly.

Being busy and the patient’s short admission time are not excuses.

The ability to cough up phlegm smoothly is very important for bedridden patients like this.

"In my experience, when a patient shows patchy exudative shadows in the upper lungs, it usually means the patient has trouble coughing up phlegm. Otherwise, as long as the phlegm can be expelled, upper lung infections generally don’t occur."

The lungs, like the female urinary tract, have a certain self-cleaning capability.

When there are foreign bodies, inflammation, or infections in the lungs, it tries to form mucus and expels the germs and mucus through coughing.

Many people start coughing around the third day after catching a cold.

Experienced patients know this indicates the cold is about to heal.

Why does runny nose and coughing indicate the cold is nearly over?

Because coughing is itself a self-protection mechanism.

The pus-laden sputum contains a large number of mucosal tissues damaged by germs, along with many bacteria and viruses.

They’re all stuck together in the purulent sputum, expelled from the patient’s mouth or nasal cavity.

Once the bacteria and viruses are expelled, the body naturally recovers.

"This patient is elderly, bedridden, and unable to cough up phlegm, which can easily exacerbate lung infections. Right now, the use of drugs like cefuroxime is effective, but as time goes on, the efficacy will diminish. Eventually, it will be difficult to control the patient’s lung infection. When that time comes, the patient’s death will truly arrive."

Li Jingsheng didn’t directly say that Lian Tao couldn’t control the infection.

Actually, this analysis is equivalent to telling Lian Tao that the patient’s lung infection is difficult to control.

Without special means, the patient’s lung infection will become increasingly severe.

At that point, organs like the heart, liver, and kidneys will be affected.

"We can’t just watch the patient die, can we? At least after trying our best, we can know the outcome."

Lian Tao’s face felt hot.

Only now did he realize that the bold words he expressed with confidence might backfire.

However, he possessed a bit of scholarly pride and was unwilling to easily give up.

He still wanted Li Jingsheng to help with the treatment.

"There’s certainly no problem in trying. As long as the family members and the patient are willing to cooperate, I’m willing to do my best to treat this patient with you. But I still want to discuss with you the potential progression of the illness. After the crucial area of the lungs falls, the liver and kidneys will be the first to suffer. It’s necessary to protect the liver beforehand. I suggest real-time monitoring of kidney function, providing symptomatic treatment, and adjusting timely when problems occur.

If the patient can survive for a month, there is hope for survival.

But if not, even if we discover the cause of vomiting and diarrhea, it’s still hard to overcome the infection."

Li Jingsheng is not trying to discourage Lian Tao.

These issues he mentioned are likely to turn into facts.

The patient’s condition will progress step by step.

Li Jingsheng now has a strong ability to predict, foreseeing the future direction of the patient’s condition.

From the beginning, he suggested that Lian Tao stop ’tossing’ the patient, and he has his reasons.

Because the chance of this patient being cured does not exceed 5%.

According to his clinical experience, this patient will develop many complications within a month and ultimately die despite rescue efforts.

"Can we go to the ward to see the patient now? I’ve reviewed all the information and haven’t found any direct indications of other gastrointestinal diseases. Based on the existing examination data, it should be acute gastroenteritis. The only regret is that the patient should not have delayed coming to the hospital for so many days."

After reviewing, Li Jingsheng gave his diagnostic conclusion.

"If it’s acute gastroenteritis, why is it that even when we’ve been treating according to gastroenteritis protocols, it has almost no effect?"

Lian Tao, an expert in digestive medicine, indeed feels a bit at a loss while treating this patient.

"I estimate that the most likely reason is that the patient’s diarrhea and vomiting have lasted too long, depleting the body, hence the lack of treatment effect. In traditional Chinese medicine, there is a principle called ’insufficiency does not accept supplements’. This principle is applicable to the treatment of digestive diseases in patients as well."

Hearing Li Jingsheng’s novel explanation, Lian Tao asked puzzledly, "Do you mean that the patient’s gastrointestinal issues have lasted too long, preventing them from absorbing the oral medication components?"

"That’s just one aspect."

Li Jingsheng’s medical theory is more profound.

"But we also used intravenous drips and injections when giving medication, which bypass the digestive tract and enter the bloodstream directly. Isn’t it unlikely that digestive tract issues would affect the drug absorption?"

Lian Tao clearly does not readily accept Li Jingsheng’s view.

"What I mean by ’insufficiency does not accept supplements’ is that the patient’s body is too weak, so whether taking oral medications or intravenous drips, the drug effectiveness is poor due to weak absorption capacity, slow blood circulation, and metabolic obstacles."

"Oh, I see! So what good methods do you have to resolve this?"

Lian Tao showed a flash of understanding.

The idiom "Among three people walking, there must be my teacher" fits the situation.

Li Jingsheng has obviously gained more profound and thorough insight into clinical pharmacology and medical theory than he has.

He applies it more flexibly.

Capable of drawing inferences and integrating information seamlessly.

"They can’t be called good methods, but there are some ordinary ways. We can strengthen the patient’s parenteral and enteral nutrition. At the very least, complications like low potassium and low sodium currently appearing can be quickly corrected."

At this moment, although Li Jingsheng is talking eloquently, his herbal medicine skills have not yet improved.

There is still a bit of a lag.