In clinical time, always encounter patients to ask all kinds of questions. Some can rely on medical professional knowledge to solve quickly, but some problems, a word or two is really not clear. For example: doctor, I am a headache brain fever minor illness, why do you give me so many examinations? In the answer to this question, Let’s not talk about the big truth, Let’s share with you three things I met. Illness will lie to a patient in our department. The patient’s family is very poor. Is the village’s five guarantees, Recurrent mental abnormalities have occurred since they were in their 20s, Shout, beat and kill all day long, He hallucinated. The old father sent him to the local psychiatric hospital. The local psychiatric hospital also did not do electroencephalogram examination, according to the typical medical history diagnosis for schizophrenia, began to take medicine for treatment. The effect has not been too good. Later, I came to the city psychiatric hospital for medical treatment and asked our director to consult. The director brought him back to do an electroencephalogram. Incredibly found that his electroencephalogram is different from the electroencephalogram of mental patients! Diagnosis of epilepsy? ! Start adding antiepileptic drugs, Later, the symptoms were gradually brought under control. Perhaps the epilepsy commonly known as epilepsy should be sudden eyes turning up, falling to the ground, limbs twitching and foaming at the mouth. But in fact, epilepsy has various manifestations. Sometimes it is staring blankly and stupidly, sometimes it is hallucinating, sometimes it is vomiting, sometimes it is one limb pain… so, Diseases lie. These examinations and tests are tools to help us identify these lies. Patients will lie. This is a story told to me by the anatomy teacher. He had fun in class, Huang Duan Zishou, hand work is also very good. On the day of class, he told us a story: Many years ago, he was a young doctor in the emergency department of the affiliated hospital next door to the school. One night, a mother brought her 16-year-old daughter to the emergency department. According to the little girl’s description, she had some pain in her lower abdomen. After physical examination, he asked: “Has the little girl menstruated recently?” Have you ever had sex? (to the effect) The little girl’s white face suddenly turned red: [I came last month, I am a little girl, how could I do those things! The mother’s face turned white and she stared at the little girl maliciously. The little girl was anxious and tears poured down: “I swear, I never did that!” If you don’t believe me, I will be struck by lightning. Not to die…] Well, in that case, Treat the symptoms first, Stay and watch. Later, the little girl suffered from ectopic pregnancy, ruptured and bled, The only thing to be thankful for is that I stayed in the emergency department. It was handled in a timely manner, The teacher said regretfully that he had saved his life. At that time, if I checked the hCG and did a B-ultrasound, That’s good. Because of this, He was punished, I was transferred from the affiliated hospital to the anatomy teaching and research section. [I’ll tell you this story. Be on guard, Clinical treatment is no better than laboratory anatomy, One omission, When you make a mistake, beyond redemption, Harm others and harm oneself.] Sometimes, Not only do diseases lie, Patients also lie. Without tests, tests, It is difficult to capture the real culprit of the disease. Different doctors know different things. Although inside and outside, women and children, every doctor has learned, but there are specialties in the technical field. Treating each disease, the understanding is not as clear as that of the specialized disease. I am in charge of a small patient with vomiting, repeated vomiting and stomachache. Pressure the stomach, left lower abdomen is a little painful. How about eating? I ate very little before, but I vomited as soon as I ate today and felt very bloated. Have you defecated these two days? No, I haven’t defecated in days. What about farting? Not these days. Huh? This is not the typical symptom of intestinal obstruction originally learned: Pain (abdominal pain), distension (abdominal distension), closure (anus without exhaust and defecation), vomiting. Although I have learned it, the time spent in general surgery is relatively short, and I have not actually met it. Immediately let him take abdominal plain films, draw blood, and call general surgery for urgent consultation. After drawing blood, after filming, the general surgery hospital always arrived. He stretched out his hand and touched his stomach: [belly is not hard, how can it be intestinal obstruction! [But he has vomiting, pain, and poor bowels? [Have some lactulose, The plain film of the abdomen is not serious, Don’t be too nervous] and then leave in a hurry, He left [his belly was not hard, what’s bowel obstruction] echoed in the aisle. I am very sad, It was later confirmed that, The general method of hospitalization is still effective. Vomiting is a manifestation of epilepsy. Insular epilepsy is like to vomit… So, Doctors with different departments and qualifications have different degrees of understanding of diseases. Examination, examination is a means to increase doctors’ understanding of the disease. If the patient is first admitted by the general resident, Then he will definitely not let him take a plain film of his abdomen. He’s met hundreds of them because of intestinal obstruction, He has met all kinds of typical, atypical and mutant, So he can know if it’s intestinal obstruction at a glance. I’m an epileptic surgeon, Since becoming a doctor, Unfortunately, there was not a single case of intestinal obstruction, Knowledge of the disease comes only from books, The book tells us that the diagnosis of intestinal obstruction is not only medical history and physical examination, but also abdominal plain film and blood amylase examination. The diagnosis of the disease is never a simple matter. Although the patient may only show some symptoms of [minor illness], It seems that diagnosis is easy, but it is hard to realize that if the causes of these symptoms are not found through examination and treatment, these annoying symptoms will continue to exist and even lead to [serious illness]. Therefore, from the perspective of being responsible for yourself, if you get sick, please follow the doctor’s advice.
