Chapter 805 - 376: There Must Be a Reason for Vascular Changes, Direct Thorough Examination_2

Chapter 805: Chapter 376: There Must Be a Reason for Vascular Changes, Direct Thorough Examination_2

This evaluation is quite high.

Li Jingsheng doesn’t really feel his achievements are remarkable.

At least for now, they aren’t at a particularly high level, barely reaching the director-level.

He feels a bit embarrassed to call himself an expert.

He exchanged a few modest words with Teacher Yu before ending the call.

After adding each other as WeChat friends, Teacher Yu soon sent over more than a dozen sectional images of human head blood vessels.

When creating specimens, the blood vessels are typically dyed.

Veins are dyed blue, arteries red, nerves yellow. Ligaments are usually left undyed.

Medical students, when first learning anatomy, have to strongly endure their inner fear and discomfort, carefully observing the distribution of blood vessels and the structure of muscles and nerves.

More complex blood vessels and nerves are often arranged in a tree-like distribution.

Even if one commits their distribution to memory, when it actually comes to performing surgery and dissecting the patient, it’s basically a mess in their brain.

After multiple exercises like Li Jingsheng, one can remain calm and have clarity in mind.

He examined the physical images sent by Teacher Yu, carefully analyzing the direction and distribution of the blood vessels.

Teacher Yu was very thoughtful, even specially sending over a vascular specimen image.

The patient’s other tissues were dissolved away, leaving only the blood vessels. Even the capillaries were clearly visible.

They spread out like roots, densely across the whole body.

The head’s blood vessels are also extremely abundant.

Li Jingsheng quickly picked up the head imaging report of the female patient.

Even though it’s MRI and CT, it can only distinguish the main tissues and blood vessels.

After all, what is observed now isn’t dynamic.

If you really want to check, doing an MRA or CTA is a good choice.

In comparison, he found the female patient indeed has more abundant head blood vessels than normal.

Could overly abundant blood vessels cause head lesions?

Never heard of that.

But the vascular network formed in the patient’s head is clearly different from ordinary people, how do you explain this?

He decided to consult Director Luo from the Neurology Department at the Second Hospital.

Although he doesn’t quite like Director Luo’s personality, within the Second Hospital, only Director Luo has a higher level in this area.

As for the Neurosurgery Department, that’s a cold and arrogant division, feeling even more arrogant than General Surgery.

Li Jingsheng has had no contact with the doctors from Neurosurgery so far.

Cardiac Surgery and Neurosurgery, both are known as high-tech and cutting-edge surgical divisions.

The doctors in these two departments generally have a bit of arrogance.

And indeed they’re quite capable.

The call was quickly connected.

"Hello, Director Luo. It’s Li Jingsheng from Orthopedic Surgery!"

"I have your number saved, Dr. Li, even if you don’t introduce yourself, I know. Is there something you need?"

Director Luo appeared very affable.

"I have a case I want to discuss with you..."

Li Jingsheng explained the situation of the patient.

"Uh... this issue—I’m not very familiar with it either. But I think that if the blood vessels are more abundant than normal, unless they’re like that throughout the body, it means there may be some changes in the head blood vessels. Blood vessels have a strong ability to self-modify. For instance, when a major artery gets blocked, as long as the blockage doesn’t happen suddenly, the surrounding blood vessels will definitely respond.

They will slowly replace the blocked vessel.

For such intracranial bilateral vascular networks becoming more abundant, I think you should consider doing an angiography. If possible, checking an MRA at their People’s Hospital or Qiaobang, or further doing a DSA would be good."

Director Luo never hesitates to prescribe tests for patients.

If he deems it necessary, he will prescribe them all for the patient.

"Okay, thanks for your advice! I’ll have the patient go for an MRA check."

"If you’re going to do it, it’s best to also check a DSA. Even if it doesn’t reveal a problem, it should at least uncover something."

Director Luo emphasized.

"Sure, I’ll communicate with the family."

Li Jingsheng felt that applying for both tests might not be agreeable to the family.

Moreover, his small clinic cannot perform them, so he can only let the patient go to the People’s Hospital or Qiaobang Hospital.

Usually, doing these two tests would require an appointment and might possibly need hospitalization.

Taking advantage of some time he had left, he talked with the family.

To his surprise, the family trusted him greatly, readily agreeing to take the daughter for the tests.

Considering the patient’s family came from another province, unfamiliar with the area, living and sleeping in their vehicle while caring for their immobile daughter, Li Jingsheng decided to pull some strings.

He had no acquaintances at Qiaobang.

At the People’s Hospital, however, he had numerous acquaintances.

This time, instead of calling Lian Tao, he reached out to Professor Wang Weiwei.

The title of Old Wang isn’t given lightly; when something arises, it’s certain to turn to him for help.

In terms of status, connections, and familiarity with hospital personnel and various regulations, Professor Wang Weiwei is evidently stronger than Lian Tao. Having Professor Wang handle this makes it easier.

Li Jingsheng called to chat with Professor Wang Weiwei about the issue.

"Jingsheng, although the patient’s case isn’t in my area of expertise, after hearing your thoughts, I suggest directly doing a DSA. The family trusts you highly and is willing to cooperate, which is a very good foundation.

MRA and DSA tests overlap; in terms of accuracy, MRA is far inferior to DSA.

The gold standard for diagnosing cerebral vascular abnormalities, everyone currently only recognizes DSA results.

MRA head exam costs, while not particularly high, are over eight hundred. Plus, it requires an appointment and queuing. It’s better to go directly to DSA. Yet, you need to communicate and explain it to the family.

This test is invasive and quite costly.

At least, it requires nearly nine thousand yuan."

DSA usually requires femoral artery puncture and the injection of contrast agent.

Its accuracy is very high.

It’s just that many patients are unwilling to inject contrast agent, fearing invasive examination.

In such cases, only MRA can be chosen.

"Alright, I’ll first talk to the family, I believe they’ll understand our kindness. Once it’s discussed, I’ll call you."

Li Jingsheng thought what Professor Wang said was very reasonable.

The patient has already had an MRI at another facility, doing an MRA again might not yield satisfying results.

It’s better to directly go the DSA route.

Doctors sometimes prescribe routine imaging tests for patients, then if further examination is needed, would prescribe more advanced tests. This is just procedural.

In cases of high doctor-patient trust, and already suspecting a problem with the patient’s head blood vessels, requiring more precise examination, there’s no need to take detours.

He found the family to communicate, and once again, they exhibited extreme trust in Li Jingsheng.

This elderly couple had been taking their daughter around for treatment; they presumably knew how to interact with doctors.

If not cooperating with doctors, many needless troubles could easily arise.

...

On the following day, under Professor Wang’s arrangement, the patient underwent a DSA examination at the People’s Hospital.

Li Jingsheng specifically requested two hours off from the hospital to finalize the purchase of the clinic’s property.

Signing contracts, various procedures, paying the deposit, and so on.

It took him more than an hour to get it all done. Only when everything was completed smoothly did he finally breathe a sigh of relief.

Despite the fact the extortion attempt failed, it still caused significant psychological pressure on Li Jingsheng. He was worried about things going wrong at the crucial moment.

Luckily, everything went smoothly.

After completing the deposit step, the next thing is to quickly make money to pay the full amount on the next payment date.

With a total amount of nearly 8.4 million yuan, it’s still quite a challenge for him.

Fortunately, the clinic’s online pharmacy business, offline pharmacy business, and clinical service have all been developing well.

Especially the online pharmacy, which has given him many surprises.

The local convenient pharmacy service, however, did not perform as well as expected.

Though the number of people buying medicine has been steadily increasing, the revenue brought in remains far below expectations.

Additionally, a person is required for dispensing medicine overnight on duty.

This increased the operation costs.

However, everything has two sides, and it cannot be viewed solely in terms of profit.

The local pharmacy service greatly facilitates those patients who find it inconvenient to go out and buy medicine. It even opens a green self-rescue channel for some emergency patients.

At night, if a child suddenly develops a high fever, it’s difficult to buy medicine after 10 p.m.

At that time, one can only take the child to the hospital.

Sometimes, it’s just minor illnesses like colds or fevers.

If only the mother is at home with the child, it is very inconvenient to take the child to the hospital for treatment late at night.

If there are two children at home, it’s even more troublesome.

Leaving the other child at home, the parents certainly won’t feel at ease.

Therefore, the local pharmacy service is a truly people-friendly initiative. It can earn Sunshine Clinic a reputation and support.