Unfortunately, this motivation only lasted for 3 days, and Sun Yuenan started to have a fever. At first, she endured it, thinking that she was young and in good health, and that she would be over it after a while.
But soon she was so feverish that she couldn't get out of bed. She had no choice but to take antibiotics at a nearby clinic.
She estimated that the area of her tattoo was too large. The tattoo artist also said at the time that such a large area of tattoo might cause fever after surgery.
No matter what bad luck happened to him, Sun Yuenan had no choice but to deal with it honestly.
Her condition went up and down. She was almost fine for one day, she felt a little more energetic, and her temperature started to rise again when she was getting ready to go to work.
Lying on the bed, Sun Yuenan could hear her heartbeat. Since her last aortic valve replacement, the clicking sound of the mechanical valve as her heart beats was like an alarm clock, which made her tired again.
Half asleep and half awake, the clicking sounds echoed in my ears. In the haze, Sun Yuenan felt very cold, and she began to shiver. My body didn't seem to be my own, I couldn't control it at all, and I couldn't stop shivering.
The static therapy for the past few days has had no effect at all, and the condition shows no signs of improvement.
The person at the small clinic took her temperature, which was 40.5 degrees Celsius. After seeing this temperature, they were frightened.
With such a high body temperature, it can burn people to a point of confusion
I wanted to ask for the phone number of Sun Yuenan's relatives, but she was already semi-conscious and had no idea what happened. Only the trembling body and the sound of the aortic valve clicking with the beating of the heart circled in my ears.
The 120 ambulance sent Sun Yuenan to the 912 emergency department.
Zhou Litao is flipping through "New England" magazine. This issue of the magazine contains the case report he wrote under the guidance of Brother Yun.
A case like eating 5 pounds of iron nails can be published in the New England magazine. My case is more bizarre and rare, so it should be published.
It's great to have Brother Yun here, Zhou Litao thought happily. I don’t know what Boss Zheng’s Nobel Prize is like, he thought while smelling the smell of ink wafting from the magazine.
The results might be available in the next few days, but Zhou Litao didn't dare to ask. Yesterday, when Boss Zheng went to Mr. Cui's office to look at the medical records, he asked about it, but he met Su Yun's disgusted look.
It's nothing to be scolded by Brother Yun. He's a sharp-tongued person. But Zhou Litao could clearly sense that Brother Yun was very concerned about the Nobel Prize. But then again, who doesn’t care
There is no need to be annoying, Brother Yun is too nervous, Zhou Litao excused Su Yun in his heart. And with Boss Zheng here, is it possible that he won’t get the Nobel Prize? He already has a blind trust in Boss Zheng and the medical team.
"Mr. Zhou, there is a patient with a high fever. Mr. Tang is busy and wants you to take a look." The emergency physician knocked on the door and said outside.
"Oh, okay." Zhou Litao stood up, the freckles on his face were dancing.
Ever since Su Yun pointed out a clear path, Zhou Litao felt that his life was full of ambition. As for the girlfriend I have been thinking about before, it is completely meaningless.
Everything will fall into place as time goes by, there is no need to rush.
Arriving at the emergency room, the physician began to report the condition. If nothing else, just a body temperature of 40.5 degrees Celsius is enough for people to take it seriously.
Zhou Litao began a physical examination and took out his stethoscope to listen to the breath sounds of the patient's lungs.
Symptoms of pneumonia are present, but not severe. When he listened to the breath sounds of the patient's left lung, he heard a clicking sound.
This is the standard heart sound after valve replacement. Zhou Litao was startled. Does the patient have a history of valve replacement? How could this happen to someone so young? Perhaps it was congenital heart disease, Zhou Litao made an instant prediction.
After taking off Sun Chaonan's coat, Zhou Litao saw a bright plum tree.
Today's young people are really good at playing. Zhou Litao just glanced at them and didn't care about it. Instead, he noticed the surgical scars hidden under the plum tree. He probably had heart surgery. He made a preliminary judgment and then began to examine the patient.
There were no bulges or depressions in the precordium, the heart boundary was generally normal, the heart rate was 54 beats/min, and the heart rhythm was regular. A grade 3/6 diastolic wind-like murmur could be heard in the mitral valve auscultation area.
Whistling murmur, after aortic valve replacement... Zhou Litao's heart suddenly tightened, could it be the valve problem again
First, let’s do the examination. Zhou Litao gave the patient a routine blood collection as well as a cardiac ultrasound, lung CT and other examination items.
The inspection was carried out step by step, and soon Zhou Litao got the information.
Nothing else to say, the problem was on the echocardiogram.
After mechanical aortic valve replacement, mechanical valve paravalvular leakage, aortic root dissection aneurysm formation, left ventricular outflow tract-anterior mitral valve root fistula formation, vegetations at the root of the anterior mitral valve leaflet, aortic artificial machinery Valvular vegetations, moderate mitral regurgitation.
Go for surgery, valve vegetations are most likely caused by infection. This kind of growth can induce infection and fever, and the most terrible thing is that once it falls off and becomes tied to important blood vessels, it may cause a series of complications such as cerebral infarction.
Zhou Litao made a judgment on the patient's condition, called Xintong, and Zhao Yunlong came down for consultation. After taking one look at the patient, Zhao Yunlong took another look at the echocardiogram and other information before picking up the patient.
912 emergency first aid is strict and precise.
But the problem stuck with Zhao Yunlong.
If the entire hospital is a machine, Zhao Yunlong thinks that he is just a part. Important, yet insignificant.
He inquired about the medical history and learned that the patient had undergone aortic valve replacement surgery a few months ago, and this time, vegetations appeared on the aortic valve again.
What a deal!
Zhao Yunlong knows how difficult secondary valve surgery is.
Since following Boss Zheng to perform heart separation surgery on conjoined twins, Zhao Yunlong's surgical progress has been amazing.
Not only others, but even he himself found it incredible when he looked back.
But that didn't matter. Zhao Yunlong re-judged the patient's condition after taking him in. He felt that if he opened his chest rashly, he might not be able to get it.
This is different from the previous coronary artery bypass grafting patients who did not dare to remove the stent and had extremely poor basic conditions. The local anatomical structure of the patients undergoing secondary valve surgery has changed greatly. No one can be sure of the success of the surgery...
No one can do it? Zhao Yunlong suddenly thought of Boss Zheng.
He should be able to, should... probably... almost.
However, Zhao Yunlong did not go to Boss Zheng directly, but reported it layer by layer. This patient is not considered an emergency, and he does not have the right to undergo surgery directly. Unlike the patient who was in the ICU last time, it was a pure emergency and there was no time to wait.
Zhao Yunlong clearly distinguishes the difference.
Moreover, the last two days are the days when the results of the Nobel Prize will be announced. If there is even a chance, Zhao Yunlong does not want to disturb Boss Zheng.
The patient was admitted to the hospital and relevant examinations were completed, but the problem immediately arose. There are only a few young girls in their 20s among colleagues in the work unit. They pooled their money together, but they only had a pitiful three to five thousand yuan.
No matter how much, they don't have it. And this little money is not enough to fill the gap between teeth. The ICU fee is 10,000 yuan a day. Even if the operation is successfully completed, this girl may not be able to survive without money.
But this is not a problem. If something like this happens, just ask the medical office to take the blame.
The patients are here and we want to treat them. Whether the medical office gives virtual money or not is a matter for the medical office. Although part of this money will eventually end up within the department, the majority of it will be borne by the hospital after all.
Small hospitals may be concerned about hundreds of thousands, millions or even millions of expenses per year, but hospitals of the size of 912 are not very concerned.
Treat it first and talk about the rest later. In fact, in clinical practice, we are most afraid of encountering this kind of problem. If the medical office takes a dark look and directly throws the blame back, the surgeon will be the most troubled.
Report to the medical office and the professor on duty. Today’s professor’s surname is Chen, and his level is pretty good. It's just that Zhao Yunlong thought that his level could not compare with his, but according to the diagnosis and treatment process, he still called Professor Chen to see the patient.
Professor Chen took a look at the patient, and then looked at the echocardiographic image data, and he was also very worried.
"Xiao Zhao, what do you think?" Professor Chen asked.
"I can't do the surgery." Zhao Yunlong's finger as thick as a small carrot pointed at a point on the echocardiogram, "The growth on the biological valve is not a big problem, but I think it is an abscess, and the erosion is very deep. After surgery, the probability of not getting off stage is at least 70%."
"Even if you can come down, postoperative bleeding will be troublesome." Zhao Yunlong added.
This is also what Professor Chen is worried about. He knew Zhao Yunlong's level, so he didn't just regard him as the chief resident, but subconsciously discussed it.
"The left atrium is involved, and it is estimated that part of it will need to be removed." Professor Chen said, "If the surgery is performed under extracorporeal circulation, the recovery is likely to fail."
The two people said the same thing, the operation was unlikely to be successful.
With no money, no immediate relatives, and extremely serious illness, no one is willing to go to the operating table for surgery as long as there is a slight possibility.
Once done, the entire department will lose money together. Fortunately, I can say that the salary of a nurse is not high. Not to mention the hard work of working the night shift and so on. If I don’t make any money, my money will be deducted. This is unbearable.
But if it is not done well, now there will be no family members. Then all kinds of family members will come in droves and make noise every day. Just thinking about it will make the doctor who takes over the job feel like he is on the verge of death.
If the patient's fever had not been so high, he would not have been admitted to the hospital without even thinking about it. For such a difficult operation, how can anyone perform an operation with a 50-50 success rate and a 50-50 failure rate if the brain is not covered
But the patient is now suffering from fever and confusion, so this cannot be dismissed. Doctors are tightly surrounded by countless rules and regulations regarding emergency first aid and first-diagnosis responsibility system.
But even a man like Zhao Yunlong would face a lawsuit when facing such a difficult patient.
The two stared at the movie. The director was not at home, and the second-tier Professor Chen had to make a decision.
"Professor Chen, anti-inflammation and symptomatic treatment, we will seek consultation from the whole hospital tomorrow. If it doesn't work... just go ahead and give it a try." Zhao Yunlong said while biting his back molars.
"Xiao Zhao, why don't you give Boss Zheng a try? He can perform surgeries for free on patients. Besides, Boss Zheng is also very skilled. At least he is more confident than the two of us." Professor Chen had no good solution in the end. He said softly.
"The operation is too difficult. I'm worried about Boss Zheng..." Zhao Yunlong didn't finish his words.
Professor Chen sighed, Boss Zheng also put his head in his waistband to perform live surgery. It would be unjust to directly push a patient of this difficulty over.
There is almost no answer to this question. The patient sweated all over after taking indomethacin suppositories. But the body temperature only dropped to 39 degrees Celsius, and then rose again.
The abscess in the heart has eroded the myocardium. Even if surgery is required, at least the top of the left atrium must be cut. This kind of inflammation, if the body temperature can be lowered casually, then it will be damned.
Early the next morning, after everyone went to work, Professor Chen explained the patient's condition. After seeing the film and inspection report, everyone shook their heads.
The patient's parents could not be contacted. It was said that they were working out of town and there was no signal on their mobile phones every day.
Having no money, no family, and being seriously ill makes people miserable.
After consultation with the whole hospital, as expected, the only option was surgery. But this road is too steep and no one dares to walk.
Time passed bit by bit, Zhao Yunlong and Professor Chen looked at each other, helpless. In the end, Zhao Yunlong sighed and said, "I'll send the image data to Su Yun and let him see if it works."
In desperation, Zhao Yunlong sent the message to Su Yun and asked for help again.
Soon, Su Yun replied with a surprised expression, and then a series of exclamation marks. If Zhao Yunlong hadn't known about this film, he would have thought that there was a big problem with Su Yun's cell phone.