Chapter 735: Chapter 300: Twists and Turns, Pathological Diagnosis Promoted to Level 5
These days, healthcare fraudsters have evolved, no longer the naive types loitering like pimps in the lobbies and entrances of clinics, pulling people aside. The news about fraudsters tricking patients into small hospitals or private clinics for treatments and swindling money has already sunk deep into people’s minds.
People are no fools.
When encountering those who strike up a conversation out of nowhere, enthusiastically introducing ’Divine Doctor,’ or cheap hospitals, they immediately become vigilant.
To increase their success rate, fraudsters have long learned to disguise themselves.
They could both avoid the strikes of hospital security and better deceive patients and their families’ trust.
Whether this family member requested the transfer to another hospital on their own or was persuaded by someone else, nobody knows. Zhou Can certainly wouldn’t inquire about these privacy details of the patients.
What he needs to do now is to sort out the entire process of the patient’s disease progression from the onset to the present and the treatments they’ve undergone. What are the current symptoms?
"I’ve noticed that he looks quite thin now, was he heavier before he fell ill?"
"Quite. My son was definitely heavier before the illness, almost seventy kilograms, now only fifty-nine."
The family member responded.
The weight loss of eleven kilograms in just over two months is another very bad signal.
Persistent low-grade fever also suggests a significant issue with the patient’s health.
For instance, the most common symptoms for diseases like leukemia and most cancers appear as a persistent low-grade fever.
Zhou Can reviewed all the patient’s medical records again from top to bottom, forming a complete pathological mechanism in his mind.
"Little friend, Uncle will do a physical examination on you now, be good!"
Zhou Can stood up, together with Ji You, to perform a physical examination on the patient. He wanted to challenge himself with a case that seemed troubling to others.
Du Leng had only glanced at the examination data before pushing the patient away.
But Zhou Can couldn’t do such a thing.
He first conscientiously followed the reception process, performed a physical examination on the patient, and then perfected the reception medical record information.
Blood pressure and heart rate were not significantly problematic.
The body was too thin, low fever of 37.9°C, legs involuntarily trembling when standing. It probably wasn’t caused by knee joint pain, but likely due to the patient’s physical weakness, or even an issue with the nervous system.
The nervous system doesn’t only narrowly refer to the brain’s neurons but involves various nerves throughout the body, including motor neurons, pain-sensing nerves, sympathetic nerves, etc.
"Does it hurt or feel swollen in these areas on your neck?"
Zhou Can asked the patient while palpating.
Palpation is a fundamental physical examination skill.
"No!"
The patient shook his head.
Zhou Can indeed didn’t feel any lumps on his neck. With a meticulous attitude of not overlooking any detail, he felt the patient’s one armpit.
"Hmm?"
His eyes brightened slightly.
The patient, however, became too itchy and giggled, avoiding his hands.
"Don’t move, bear with it a bit, I think I felt a lump."
Zhou Can said seriously.
After palpation, he found nodular lumps in both armpits to varying degrees. Many people know that the neck has abundant lymph nodes but are not aware that the armpit does too.
If he wasn’t wrong, the lymph nodes in the patient’s both armpits had enlarged.
This was a new significant finding.
Proteinuria 3 plus, enlarged lymph nodes in the armpits, rapid weight loss of several kilograms, persistent low-grade fever... These symptoms together were definitely not indicative of any ordinary illness.
Zhou Can never diagnosed diseases based on conventional thinking, but preferred to find answers from some special perspectives.
Even though there were no test results indicating the patient had a malignant disease, he had already labeled the patient as having a malignant disease in his mind.
Certainly a serious illness like leukemia or cancer.
Of course, he couldn’t disclose this thought to the family yet. Otherwise, if the family thought he was cursing their son, they would surely lash out.
"Let’s get a CT scan of the thorax, abdomen, and pelvic region! Given his current symptoms, the situation looks grim."
Zhou Can looked toward the family member.
"Sure!"
The family members just wanted to find out the cause of their son’s illness as soon as possible and did not object to doing more tests.
Not long after, the patient returned from the CT scan.
Zhou Can reviewed the results, and indeed there were new significant findings.
Enlarged lymph nodes in both armpits, fluid accumulation in both sides of the thoracic cavity.
Enlarged spleen.
Actually, the patient had always had an enlarged spleen. It was the same result when first checked at the county women and children’s hospital.
Thick bladder wall, bilateral renal pelvis, bilateral ureteral dilatation with fluid accumulation.
There was also fluid accumulation in the pelvic cavity and thickening of the left half of the colon wall.
Seeing so many affected areas in the patient and the serious changes, Zhou Can worried that the patient’s heart might also be affected. For the safety of the patient, he asked the family to take the patient for an echocardiogram.
This test uses the special physical properties of ultrasonic waves to examine the anatomical structure and functional state of the heart and great blood vessels.
It is a non-invasive examination.
It is an advanced testing technique.
Xinxiang Women and Children’s Hospital being able to conduct these tests sufficiently indicates its solid foundation.
The strength of a hospital is never solely determined by having extensive facilities. In any hospital, what’s most important are the talents; frankly, the treatment level of a hospital is directly determined by the level of its doctors.
The echocardiogram showed an LVEF of 48%, pulmonary artery pressure of 34mmHg.
This pulmonary artery pressure is significantly higher than the normal range of 12-20mmHg.