My Medical Skills Give Me Experience Points Chapter 1345: 532: Another Troublesome Family Member—Control the Infection Before Surgery (Part 2)

The daughter-in-law's countenance remained etched with worry.

"I am aware of my actions, you should return home now! Ensure your mother is well-cared for."

The elderly cadre gestured for his son and daughter-in-law to depart, almost as if he was hastening their exit.

Observing this, Zhou Can mused that prominent individuals operated differently from common folk. Their achievements were a testament to their own endeavors, and their capacity to respond to situations was remarkably potent.

Based on the elderly cadre's conduct, it seemed he had likely grasped the root of the issue.

Given that this patient was personally designated as a priority by Dean Zhu, arrangements were swiftly made for him to undergo an angiography procedure overnight.

In contrast to cerebral or cardiovascular angiography, angiography of the limbs presented a comparatively lower risk and was simpler to execute.

Nevertheless, the prerequisite preparatory tasks could not be neglected.

Within the office, Zhou Can inquired, "Sister Yan, before we proceed with the angiography, should we first conduct an X-ray examination on this elderly cadre?"

This would facilitate a more precise approach.

An X-ray could reveal the calcification of plaques within the arteries.

Ultimately, angiography would undoubtedly be required.

This is because angiography is essential for determining the exact location and extent of arterial blockages.

For instance, one needs to ascertain if the artery is tortuous, if there is diffuse, irregular narrowing of the lumen, or if it's a segmental occlusion.

Only by scrutinizing the precise condition within the blood vessels could the most effective surgical strategy be formulated.

This particular case was not exceptionally complex.

The genuine challenge stemmed from the patient's daughter-in-law.

She proved to be quite difficult, invariably causing significant distress to the medical staff.

Ideally, the X-ray examination should have been performed at the Provincial People's Hospital, but it was simply omitted.

Regardless of how many additional tests were conducted, they could potentially generate more revenue for the hospital.

However, the medical professionals preferred to forgo this financial gain.

Doctors receive a fixed salary, and when dealing with patients presenting numerous complications, they generally felt indifferent to treating one more or one less.

To save an additional life might lead to facing complaints from family members and patients, or even threats of violence, legal action, and various personal dangers; it was wiser to avoid such trouble for oneself.

Xue Yan raised no objections to Zhou Can's proposed examination plan.

She readily concurred.

"The patient himself is quite reasonable; it's merely his daughter-in-law who is excessively troublesome. His wife was even more conniving, which truly nauseated me. Fortunately, his wife suffers from hypertension and heart disease, rendering her condition unsuitable for prolonged hospital stays, thus she has already departed."

Upon hearing this, Zhou Can couldn't help but feel a chill.

The patient's daughter-in-law alone was already a handful; if the patient's wife was even more formidable, treating this ailment would truly be an insurmountable task.

"When the time comes for the surgery, a signature from the family will be required, so what should we do? Perhaps we should gently suggest the patient transfer to another facility. Cardiothoracic surgery is exceptionally busy at the moment, and we cannot allow a troublesome patient to excessively deplete our medical resources,"

Zhou Can suggested.

"Let us observe the unfolding situation! If matters escalate to the worst, we will have to devise a strategy to transfer the patient."

Xue Yan eventually displayed a degree of leniency.

It was not uncommon for women to possess a tender heart.

Encountering a ruthless and malicious woman was every man's worst nightmare.

…

By the time Zhou Can concluded two surgeries in the Cardiothoracic Surgery department, it was already past midnight.

Presently, the major surgeries he undertakes are exceedingly demanding, often requiring three to four hours, or even longer durations.

Zhou Can increasingly felt a significant lack of time.

Heart and thoracic surgery encompass highly intricate procedures, many of which constitute substantial undertakings.

At times, aligning a blood vessel, excising a tumor, or repairing a mitral valve demands utmost precision. Furthermore, a multitude of supplementary tasks are necessary to ensure the surgery proceeds seamlessly.

To remove a tumor, not only is it necessary to open the chest cavity, but the pericardium might also need to be retracted, and in some instances, extracorporeal circulation might be established with the heart temporarily stopped.

Every phase of the preparatory process is indispensable.

And each step resembles traversing a razor's edge, demanding the highest level of care.

Dragging his fatigued body out of the operating room, Zhou Can's sole desire was to return home, take a shower, and sleep.

Initially, he had harbored the hope of finishing early to return home and work on his thesis.

Now, nothing of the sort could be accomplished.

Once this demanding period concluded, he would undoubtedly need to discover a method to carve out more time for his studies and the enhancement of his academic qualifications and standing.

The experiences shared by numerous seasoned predecessors had impressed upon him the paramount importance of education.

“Zhou Can, the results from the two tests on the elderly cadre are in. I know you’re swamped, but could you possibly look over his test results before you leave?” Xue Yan inquired, directing her question to Zhou Can after receiving the report from the ward physician.

If not now, Zhou Can might find himself without an opportunity until after 7 PM tomorrow.

“Certainly!”

Zhou Can offered no refusal.

He accepted the report and began to scrutinize it under the dim illumination of the corridor.

“Ah, an additional ultrasound test was performed. Excellent!”

Zhou Can noted that, in addition to the X-ray examination and angiography, an ultrasound had also been conducted.

“After reviewing the initial results, I observed that the patient exhibited narrowing in both the popliteal and iliac arteries. Therefore, I took the initiative to request an ultrasound examination.”

The ward physician was a doctor in his thirties, currently holding the rank of chief.

Physicians newly recruited into Cardiothoracic Surgery are typically at the doctoral level, with some even possessing postdoctoral qualifications.

These individuals possess a significant advantage: after completing just one year of service, they are directly promoted to the chief level.

Their career advancement is remarkably swift compared to physicians with more conventional qualifications.

“Splendid, adaptability is indeed crucial.”

Zhou Can offered a nod, expressing his approval of the physician’s proactive approach.

In the realm of clinical diagnosis and treatment, a patient’s condition is in constant flux, demanding that medical professionals adapt accordingly. Physicians who are rigid and unwilling to adjust are not truly suited for frontline clinical work.

Positions in administration or within medical technical departments would serve as more appropriate avenues for them.

Of course, many might eventually be compelled to seek alternative career paths altogether.

After meticulously reviewing all three reports pertaining to the patient, Zhou Can began to form a coherent understanding.

The results from the color Doppler ultrasound revealed substantial stenosis in the patient’s abdominal, iliac, and popliteal arteries. Zhou Can had not initially foreseen that the abdominal aorta itself would display signs of stenosis.

This observation also served as a reminder that his diagnostic acumen had not yet reached its absolute zenith.

Naturally, even the world’s most esteemed experts cannot always ascertain certain concealed pathologies in patients solely through palpation and a limited number of simple auxiliary examinations.

For Zhou Can to have diagnosed issues concerning both the popliteal and iliac arteries purely through palpation is, in itself, an exceptionally impressive feat.

Furthermore, the ultrasound results indicated an absence of blood flow signals distal to the right femoral artery.

This finding explained the lack of palpable pulsation in the right foot’s popliteal artery and dorsalis pedis artery.

The next step involved examining the angiography results for the patient.

The angiography revealed extensive, irregular narrowing within the abdominal aorta and both iliac arteries. Contrast dye was visualized in the right femoral artery, but its flow ceased before reaching the superficial femoral artery.

The findings from the angiography largely aligned with those obtained from the ultrasound examination.

“Based on the collective test results, a diagnosis of arteriosclerotic occlusion of the right superficial femoral artery can be definitively confirmed.”

Upon concluding his review of the examination reports, Zhou Can articulated his diagnostic conclusion.

The physicians present were, for the most part, capable of reaching a similar diagnosis given these test results.

Both Xue Yan and the ward physician were keenly anticipating Zhou Can’s proposed treatment plan.

“Zhou Can, would you be able to outline a surgical plan now? Alternatively, you could take the examination results home and provide me with a plan by tomorrow morning; that would also be acceptable.”

In the presence of other medical staff within the department, Xue Yan did not hesitate to express her inclination to hear Zhou Can’s strategic insights regarding surgical plans for certain critical patients.

“I will proceed now! The examination documents left within the department can also serve as valuable references and learning materials for the other physicians.”

Zhou Can assessed the patient’s condition as not being exceptionally complex.

Consequently, the surgical plan was unlikely to present undue difficulty.

“The patient’s angiography results indicate that contrast dye is present in the right deep femoral artery and in the popliteal artery proximal to the knee joint, suggesting that the arteries of the lower limb still possess viable pathways for blood circulation. However, upon auscultation of the patient’s lungs, crackling sounds were detected, which points towards a potential lung infection. If surgery is to be undertaken, it is imperative that the lung infection be managed pharmacologically prior to proceeding. Regarding the surgical approach, I propose the creation of a bypass graft connecting the right femoral artery to the popliteal artery, thereby facilitating the restoration of blood circulation to the patient’s right leg.”

The execution of surgical procedures necessitates careful consideration of a multitude of factors.

A lung infection, particularly in elderly patients, absolutely requires effective control before any surgical intervention can be safely performed.