Check-in at the Hospital: The First Surgery Shocked the Nation!

Chapter 389 - 271: Subclavian Steal Syndrome, Drunken Construction Site

"Recently, it felt a bit uncomfortable, like there’s something weighing down my arm, and I can’t lift it."

The man raised his left arm and patted it,

"Sometimes there is a dull pain, but it quickly fades."

What the patient said caught Qin Feng’s attention.

This situation is very similar to the symptoms of a relatively rare vascular disease, and it’s usually not examined in this area.

"Okay, understood. You can put it down now."

He proceeded with a series of physical examinations and inquiries, confirmed the situation, and stood up.

"Doctor, is there anything wrong with me?"

The man asked somewhat nervously.

"Haha, don’t worry. It’s not a big issue. We might need to perform some tests to confirm."

Qin Feng shook his head and reassured him with a smile. As he stepped out of the ward, he looked at Director Han.

"Director Han, I’d like to do a few more tests to confirm the diagnosis."

"Have you found the cause?"

Han Yun asked curiously.

"Not sure yet, we need to wait for the results."

He pondered for a moment and nodded at Lin Ran,

"Dr. Lin, please ask the nurse to measure the skin temperature and blood pressure of the patient’s left upper limb."

"Okay, I’ll go right now."

After speaking, Lin Ran turned and walked to the nurse station.

The temperature of various parts of the human body differs, sometimes significantly.

It’s higher at the head, and lower at the feet, determined by the thermal balance between the core and the skin surface influenced by the environment.

Under normal, comfortable conditions, the average body temperature is around 33 degrees Celsius, with minimal variance.

Skin temperature measurement is usually a habitual record, making the process simple.

In the duty room, Qin Feng and Han Yun were discussing.

Symptoms include dizziness, fainting, deteriorating vision, and double vision.

Weakness in the left upper limb, slight pain, and a sense of weight.

These conditions are crucial for diagnosis and exclusion.

"Here it is, the left upper limb skin temperature is 33 degrees, and the systolic blood pressure on both sides is 33 mmHG."

At that moment, Lin Ran came in, handing over the report sheet.

"Is the systolic pressure difference over 20mm?"

Hearing this, Han Yun was also a bit surprised, "Are you sure there was no error in the measurement?"

"No, both the head nurse and I measured it personally."

Lin Ran shook his head.

"During this morning’s examination, it wasn’t that high. Suddenly, the difference is so large."

Han Yun frowned, deep in thought.

"In such a case, excessive systolic pressure difference in both upper limbs is already quite rare."

Qin Feng nodded, aligning with his speculation,

"Dr. Lin, could you please schedule an appointment with the imaging department to perform a vascular angiography and arterial ultrasound from the left upper limb to the clavicle position?"

"Oh, sure."

Lin Ran was stunned for a moment after hearing this and nodded.

Left upper limb angiography is quite rare, especially in emergencies.

"Xiaoxin, are you suspecting blood steal syndrome in the patient?"

Director Han Yun reacted and immediately asked.

Subclavian steal syndrome!

It’s mainly caused by significant narrowing or occlusion of the subclavian artery, causing the vertebral artery to supply blood in reverse to the subclavian artery due to the siphon effect.

This results in diminished brain blood supply, transient dizziness, blurring, and fainting, which improve after brief rest.

The patient also shows symptoms of upper limb arterial ischemia, with increased bilateral blood pressure differences and weakened radial artery pulse on the affected side.

"Yes, Director Han, it seems like blood steal syndrome."

Qin Feng nodded, confirming that all the symptoms matched the condition.

Especially upon seeing the pressure difference between both upper limbs, reinforcing his judgment.

Soon,

The test results came out.

Han Yun was a bit surprised as she read the report and handed it over.

"Xiaoxin, you were right. It indeed is blood steal syndrome."

She couldn’t help but be a bit amazed and envious,

"Old Meng’s eyes are truly sharp. With you in critical care medicine, perhaps he can consider some personal decisions too.

I’ve heard a bit about you. Apparently, you’ve spent three years in the emergency department, with nearly two years as a director in a tertiary setting?"

"Haha~ That’s all in the past, incomparable to Beijing."

Qin Feng slightly bowed his head, smiling humbly.

"Clinical medicine relies not on luck but on skill."

Han Yun shook her head, her eyes gleaming with an unusual light, her tone somewhat complex,

"You, from a mere undergraduate background, have already surpassed all your peers, standing alongside us veterans. Across Jiuzhou Country, I dare say you’re the only one.

Feel free to visit our emergency department more often. Young doctors like Lin Ran need exposure to someone like you, haha~"

"Sure, thank you, Director Han. I’ll visit often in the future."

Qin Feng nodded with a smile.

He felt an innate closeness to the emergency department, perhaps due to familiarity and nostalgia akin to Jiangcheng City First Hospital.

Though the days in emergency were tough and exhausting, they’re fulfilling, facing the myriad facets of life at all times.

Aren’t doctors supposed to confront life and death directly?

...

In the ward,

Qin Feng entered with the report, accompanied by Lin Ran.

"Doctor, you’ve come. How is my health?"

The man asked promptly upon seeing them.

"Don’t worry; the diagnosis is subclavian steal syndrome."

Qin Feng nodded, addressing the patient and family.

"Subclavian steal syndrome? We don’t understand, doctor. Is this serious?"

The man exchanged a glance with his wife, asking nervously.

"Rest assured, it’s not a major illness, and temporarily poses no harm to the body."

Qin Feng smiled and began explaining to the family, while Lin Ran observed his skilled and casual communication.

"Let me describe subclavian steal syndrome this way: there’s a partial blockage in one of the arteries beneath your clavicle."

The pressure in the arteries is already quite high. You should know this, so when it narrows, a phenomenon called siphoning occurs.

The blood is drawn away by some tiny blood vessels surrounding the arteries, which is what we call blood stealing.

This leads to insufficient blood supply, making you faint and have discomfort in your arm and so forth...

Watching Qin Feng explain with extremely simple and understandable narration and gestures, the patient’s family listens carefully, without any difficulty comprehending.

Such rich and harmonious doctor-patient communication makes Lin Ran envious~~~~

"That’s good, that’s good, thank you, doctor."

The man and his wife finally breathe a sigh of relief after listening to him, smilingly thanking him.

"No problem. Yours is the rather common subclavian steal syndrome. It affects the major blood vessels of the brain, upper limbs, chest, and back, so you still need to pay attention in the future. Don’t sit for long periods, binge eat or drink, and disrupt your body’s balance like before."

Qin Feng cautioned,

"Currently, we are giving you conservative treatment, mainly relying on medication and exercise.

I’ll prescribe you some drugs to promote blood flow and supply, you must stick to taking them, and exercise more regularly as you gradually recover over time."

"But I’ll put the ugly truth upfront, if this continues without change and your blood vessels become severely blocked, it may cause other problems, and you’ll have to undergo surgery."

"I know, I know."

The man scratched his head awkwardly, nodding repeatedly,

"Rest assured, doctor, I will take the medicine and exercise when I get back home!"

"Well, alright, later Dr. Lin will write you a discharge form, tidy up and you can leave the hospital."

Qin Feng nodded, handing over the report he held to her.

After leaving the ward, Lin Ran followed behind with an admiring look.

"Alright, my task is complete, the rest is up to you."

Qin Feng stopped, hands in the pockets of his white coat, smiling.

"Senior Qin, how did you become so skilled?"

Lin Ran blinked her eyes, asking curiously.

"No special talent, just practice makes perfect, hahaha~"

He looked at her charming face, unable to hold back his laughter,

"Follow Director Han closely, and you’ll be able to do it in the future. I’m off now."

After finishing,

Qin Feng left the emergency room without turning back.

"Hmph! Fine, if you won’t tell me. Anyway, my goal is intensive care, just wait and see!"

Lin Ran puffed her adorable nose in slight annoyance, watching the handsome back stride away.

Ring ring ring~

Just after stepping out of the emergency room,

His phone rang.

"Hello, this is Qin Feng."

"Qin Feng, are you still in emergency?"

Lin Hai’s familiar voice came through the line.

"I just reached the door; what’s up?"

"A critical patient was just brought in, it’s urgent. I can’t leave here, and Director Meng asked you to check on it!"

"Alright!"

Hearing this, Qin Feng jolted with determination, didn’t hesitate to respond.

He hung up the phone, turned, and dashed toward the emergency room!

...

hours ago,

Late at night, a construction site in Beijing.

A group of migrant workers was transporting all the window glass up to the floors through the night. Exhausted, they were breathing heavily, sweat streaming down.

Their bodies were covered in layers of black and white dust, but nobody cared.

"Finally finished, I’m exhausted."

"Damn, working like this, without catching the chance to go home for New Year’s, I’ll die here from fatigue."

"Old Zhang, isn’t this all about earning more money? It’s worth the exhaustion!"

"Hahaha! If you really die from exhaustion, it’s a relief. Your wife and kids will receive a big sum of money. How convenient!"

"Old Lu! You and your foul mouth! You’re the one dying of exhaustion. I still want to go back and cuddle with my wife; it’s been over half a year since I went back."

"Old Lu, you moved the most and made the most today, it’s your turn to treat us!"

"Alright, alright, let’s go. Tonight’s my treat, unlimited drinks under 30 bucks!"

...

After saying it, the few men wiped their sweat, dusted off the dirt from their clothes, laughing and joking as they took the elevator downstairs.

They headed straight to the nearby small restaurant, having befriended the owner over the past six months.

"Boss, stir-fry some dishes, three bottles of baijiu, a dozen beers, we’ll help ourselves!"

"Got it, you guys get started drinking, the dishes will be ready soon!"

While the kitchen was busy, the men skillfully fetched and poured the drinks, gulping down glass after glass.

After some unknown time, they finally returned to the construction site dormitory late at night.

The next morning,

"Why hasn’t Old Lu gotten up yet? It’s time to start work."

"Hey, he’s off today. He drank a lot last night and moved more than us, let him sleep more."

After saying that, seeing that they couldn’t wake him, they washed up and left the dormitory.

During the lunch break,

After finishing lunch and returning to the dormitory, they found the man still soundly sleeping, but the snoring had stopped.

"How much did Old Lu drink last night?"

"A bottle of baijiu, five or six beers, drank quite a lot."

"He’s been sleeping for over ten hours, could something be wrong?"

One of the men furrowed his brow slightly, somewhat concerned.

"No idea, maybe we should try waking him."

"Old Lu, Old Lu! Get up!"

A young man went to the bedside, patted his face, and called loudly.

No response~~~

Seeing this, the few exchanged worried glances, and a tense atmosphere pervaded the dorm room.

"Old Lu! Old Lu!"

An older man stepped forward, called out twice, and checked for breath, his expression darkening considerably,

"Can’t wake him, hope nothing’s wrong. Xiaozhu, go find the foreman!"

"Alright, I’ll go right away!"

After saying that, the young man rushed out of the dormitory.

...