"It's an old problem." The old lady said to Zheng Ren with a smile, "It's okay."
How could this be okay? Zheng Ren quickly supported the old lady and helped her sit on a small stool aside.
"Auntie, what's wrong with you?" Zheng Ren asked with a smile.
Zhao Wenhua and Gao Shaojie didn't think there was anything weird. This was a very common way of putting distance between themselves and patients' families. However, most bedside doctors are meticulous, but not many leaders of the medical team or department directors do this.
"I have bone spurs. In addition, I had a few blisters on my feet before I came here. It hurts a little when walking, but nothing else." The old lady said with a smile.
"Are the blisters caused by grinding?"
"I soaked my feet at night. I was just thinking that the old man was going to have an operation. I didn't notice that the water was too hot, so I got two blisters."
Diabetic patients have peripheral sensory problems, which can appear in the early stages of diabetes. It is characterized by symmetrical sensory disturbances in the limbs, more in the lower limbs than in the upper limbs, and abnormal sensation appears earlier than pain.
Paresthesias included many points and were cross-referenced with the system panel. Zheng Ren vaguely understood that the patient's family members were probably insensitive to pain.
When soaking your feet, if the water temperature is too high, most people will lift their feet. This is an instinctive reaction.
The patient's family members have peripheral nerve sensory disorders, which makes the body's self-protective reflex less acute.
Moreover, they all had symptoms of toe necrosis, and the patient’s family members were still able to walk with a limp, which proved this point from another perspective.
"Auntie, let me take a look." Zheng Ren said with a smile, "It's okay to lather it. I just wanted to see if it needs disinfection."
Although the patient's family members were a little confused, they saw that Professor Zhao, who performed the surgery on them, was respectful to the young doctor in front of them and did not refute. Instead, he sat down honestly and took off his socks.
As the socks were taken off, Zheng Ren's eyebrows tightened.
The patient's family members had gauze wrapped around their left foot, and there was leakage from the toes, and there was a vague strange smell wafting out.
Gao Shaojie was stunned for a moment. He didn't expect that Boss Zheng "randomly" found a patient's family member, and the situation was so serious.
The same goes for Zhao Wenhua, who had previously criticized Boss Zheng for not doing what the bedside doctor did. At this time, seeing the bandages on the feet of the patient's family members, they couldn't help but be startled.
"Change the medicine pack." Zheng Ren took another stool and said in a deep voice.
The young doctor next to Zhao Wenhua quickly went to get the dressing kit and ran back to the ward.
"Auntie, let me change your medicine." Zheng Ren said gently.
"Doctor, it's no trouble, I can do it myself."
"Your blisters look very serious." Zheng Ren did not follow the patient's words and worry about whether numbness is troublesome, but went straight to the topic with a little awkwardness.
Su Yun was not here, so Zheng Ren was too lazy to consider more details. Gao Shaojie has just arrived. As for Zhao Wenhua... Even if he has doubts, what can he say.
Unconsciously, Zhao Wenhua has been ignored by Boss Zheng. The person who used to say that eating more and occupying more has been dumped by Zheng Ren and disappeared.
After opening the bandage, Zheng Ren saw that the patient's family member had multiple scabs on the toes of his two feet. Among them, the fourth toe on the left foot was red, swollen, and ulcerated, with a small amount of blood oozing out. The front end of the toe was black and purple, and some of the toes were necrotic.
"Prepare to be hospitalized." Zheng Ren checked Big Pig Hoof's system diagnosis and found it to be accurate, and sighed.
The patient's son was stunned. He didn't expect his mother's illness to be so serious.
Not to mention anything else, just the dark, charcoal-like color at the front of his toes made him feel horrified. Coupled with the peculiar smell, even someone who is not a doctor can tell that it is necrosis.
"There are already preliminary signs of gangrene." Zheng Ren said later.
"What?" The patient's son was stunned and didn't hear what Zheng Ren said clearly.
"This toe already has necrosis. Wet gangrene is because the necrotic tissue contains a lot of water, so the putrefactive bacteria are seriously infected, and the local area is obviously swollen and appears dark green or dirty black." Zheng Renxu tapped the old lady's left foot The fourth toe.
"Spoilage bacteria decompose proteins and produce indole, skatole, etc., causing foul odor. Because the lesions develop quickly and inflammation is diffuse, there is no obvious dividing line between necrotic tissue and healthy tissue."
"..." The patient's son was really stunned this time.
When he got closer, he smelled a foul smell. It's not very strong, but you can definitely smell it if you get close.
"Doctor..."
"I'm going to the trauma surgery department for hospitalization, and I'll probably have to amputate the toe." Zheng Ren said, "Auntie, what other illnesses do you have?"
The old lady knew the condition of her foot, but it wasn't too painful, and she kept thinking that it could be cured. Hearing what Zheng Ren said, she felt a little confused.
"I also have diabetes."
"Is your blood sugar under control well?" Zheng Ren asked.
"I'm taking insulin, and my fasting blood sugar is 8.2."
"Your condition is fine, but the treatment was not timely." Zheng Ren said, "Don't worry about your lover's condition. The operation has been completed and he will be discharged from the hospital soon."
After this incident, the patient can be discharged and go home, but the family members of the patient who come to accompany him will probably have to be hospitalized. Moreover, her hospitalization time was much longer than that of her husband.
In the case like this, after the toe is amputated, negative pressure suction is required to suck away the inflammatory exudation and other substances. Zheng Ren did all these things during earthquake relief.
The conditions of necrosis are similar, but the triggers are different.
"Professor Zhao." Zheng Ren said in a deep voice.
"Boss Zheng." Zhao Wenhua bent slightly and stood beside Zheng Ren, respectfully.
"Send aunt to the trauma department for hospitalization. If the family is too busy, please help contact a nurse."
As Zheng Ren spoke, he simply disinfected, cleaned and then bandaged the old lady's toes.
"Don't wear shoes, use a wheelchair to push you."
Zheng Ren stood up, patted the old lady on the shoulder, and said gently: "Auntie, don't worry, you will get better soon after being hospitalized for surgery."
"..." The old lady didn't expect that things had changed so drastically. After suddenly hearing about the toe amputation, she couldn't accept it for a while.
After Zheng Ren comforted him, he turned and left.
As a senior doctor, Zheng Ren no longer interacts with patients' families. It is relatively worry-free to have someone like Chang Yue in charge.
At least despite the heavy workload and ultra-high turnover, Chang Yue still did things in a orderly manner without any flaws.
The situation has been explained and the solution has been stated. All that remains is Zhao Wenhua’s communication and the patient’s family’s own choice.
Gao Shaojie followed Zheng Ren to the treatment room. Watching Boss Zheng wash his hands, Gao Shaojie said, "Boss Zheng, you are really busy today."