novelraw Chapter 361 - 187: All Four Causes Ruled Out, The Final Breakthrough_2
Chapter 361 - 187: All Four Causes Ruled Out, The Final Breakthrough_2
The outside hospital started with the patient’s nasal discharge, discovered the presence of bilateral nasal polyps, and then became stuck in this dead-end cycle.
To achieve a significant breakthrough with this case, it is very necessary to change the perspective.
"I have tried addressing this issue, but there hasn’t been much progress."
How could Lian Tao not think of this problem?
"What I mean is, stop the prednisone first, and then make a diagnostic breakthrough focusing on granuloma."
Hearing Li Jingsheng’s suggestion, Lian Tao’s eyes brightened slightly.
"This proposal is a bit bold, but the thinking is very unique, somewhat unorthodox, with the intent of cutting through the fog to find the truth. It’s worth trying."
"Alright, let’s give it a shot first."
Li Jingsheng could only wait until after stopping the medication to conduct further examinations on the patient for diagnosis.
...
The next day, Li Jingsheng opened the clinic for normal operations.
There were quite a lot of patients.
Once the doors opened, they rushed to the reception desk, wanting to be the first to see the doctor.
Li Jingsheng asked everyone to queue civilly and distributed number tags to prevent queue jumping.
"Dr. Li, please take a look at my father, his right hand seems to be broken, can it be treated?"
The first person in line was a young, robust man, about twenty-five or twenty-six years old.
He took the spot, and family members helped the patient in.
The old man appeared to have a severely hunched back, and was quite frail. However, there were four family members accompanying him, plus the young man holding the spot, totaling five family members.
Needless to say, it was definitely a large family with many children.
Having many children makes upbringing strenuous, but as long as the children are filial, in old age, they have plenty of caregivers for any ailment.
"Help him to sit down, I’ll take a look first."
Li Jingsheng said to the family.
As the family helped the patient sit, he noticed a painful expression on the patient’s face as he sat down. Furthermore, he moved slowly while walking earlier.
Old people typically have porous bones, making fractures from falls easy.
If his right hand is broken, the fall was definitely severe.
Could there also be a fracture or injury in the hip joint?
"Where do you feel pain now?"
Li Jingsheng asked the old man.
"The hand, and here!"
Sure enough, the old man pointed to his right hand and his hip.
Li Jingsheng palpated his bones, the right elbow joint was dislocated, but surprisingly not fractured.
Moreover, this old man’s bones were much sturdier than those of a typical elder.
Raising so many children must have been particularly taxing, doing a lot of work, and his body got quite a bit of exercise, so even in old age, his bones are much sturdier than a typical elder.
That was the summary Li Jingsheng made in his mind.
"Let me check your hip."
He palpated the hip again but found no fracture or joint capsule tear, only a soft tissue contusion.
"Go inside and get an X-ray, if there’s no severe fracture, I can treat it here. The X-ray is 100 yuan."
"Alright!"
The family consented cheerfully.
The spending habits of the younger generation are nothing like the older one, treating money as if it were paper.
Of course, Li Jingsheng appreciated having such family members.
They helped the old man into the medical examination room for an X-ray, which showed no fracture. The hip joint examination results matched his palpation; no bone cracks were found.
The old man’s luck was quite good.
They helped him back outside, letting him sit down.
"Siying, bring over the plaster and get ready to assist."
"Okay!"
She had just arrived not long ago. She was initially planning to help Dr. Gao sell health medicine, but now she was needed for treatment here, she was naturally happy.
She could learn a lot from the experience.
Moreover, she was very curious about the bone setting technique and took the opportunity to gain more insight.
Li Jingsheng discussed the treatment costs with the family, and one well-situated daughter paid promptly by scanning the code without hesitating.
Treatment could begin then.
He instructed the family to hold the old man steady to prevent falls.
He dared not use anesthesia.
The brachial plexus block posed certain risks, especially for such an elderly patient with a fall injury, any incident could spell disaster.
Fortunately, Li Jingsheng’s bone setting techniques were quite adept.
He calmly manipulated the old man’s arm with gentle movements, and then with a gentle pull.
Accompanied by the old man’s cries of pain, the dislocated elbow was successfully set back in place.
He carefully applied the plaster for stabilization, instructing the children to help him sit by the side, observing for half an hour to ensure no blood supply disruption due to the plaster wrap being too tight before allowing the patient to leave.
If the plaster is too tight, compressing the blood vessels, it could lead to ischemia at the distal end of the hand.
Once over half an hour, necrosis could easily occur.
That would be a serious incident.
Seeing how effortlessly Li Jingsheng treated the old man with the broken right hand, everyone naturally held his medical skills in higher regard, and the trust level soared to a new height.
After dealing with the old man with the broken hand, he continued to treat other patients.
Han Siying observed and learned from the sidelines, acting as an assistant.
As new patients joined the line, she would go over to distribute number tags.
Altogether, twenty-one patients were diagnosed the entire morning.
No complex cases were encountered.
It was nearing noon, around twelve o’clock.
After handling all the patients, Li Jingsheng could finally get up to use the bathroom.
Tang Ping was busy administering infusions to the patients.
Xiagao was diligently selling medicine.
"Siying, I’ve reviewed your case notes from yesterday and made some annotations, feel free to take a look when you have time. Also, your female classmate should ideally go to a large hospital for a check-up, in case it’s something serious."
Li Jingsheng said to Han Siying.
"She refuses to go! Besides, she’s planning to visit you today, can you take a look at her then?"