White armor

Chapter 431 Anorexia nervosa and malignant arrhythmias

a few days later.

Luo Hao arrived at the hospital early in the morning and saw Shen Zizai waving at him in white clothes.

"Director, you're here so early." Luo Hao greeted.

"I was called in last night to join the rescue, just to watch the excitement and show my concern." Shen Zizai said, "Xiao Luo, thank you."

Thanks?
Luo Hao thought of Shen Zizai's son Shen Yifei, and then smiled slightly.

It seems that Shen Yifei realized the gap, gave up the "delusion" of becoming a professional player, and studied hard.

Yes, he couldn’t even beat someone of his training camp level. He really overestimated himself.

"How's Yifei?"

"It looks like he has really started to learn. The teacher praised him yesterday." Shen Zizai chuckled, "What a bastard. If I don't teach him a lesson, he won't know how high the sky is or how deep the earth is."

Luo Hao smiled.

"Come on, let's talk inside."

Luo Hao originally wanted to see a group of patients first, but he did not refuse Shen Zizai and went into the director's office.

After sitting down, Luo Hao asked, "Director, what patient?"

"A patient with advanced cancer hanged himself last night."

Hang yourself? !
This way of dying is really tragic.

"The person was already dead when he was found. Director Feng called the heads of relevant departments to participate in the consultation and rescue. You know~~~" Shen Zizai stretched out the last syllable.

"Oh, I see."

In similar situations, the hospital should take adequate measures.

As for rescue, we should rescue if necessary, and rescue even if it is not necessary. We can talk about the rest later.

"It's really hard to say what's going on right now." Shen Zizai sighed, "Xiao Luo, have you ever encountered something similar?"

"It happened to me. When I was doing my doctorate at the hospital next door, Director Gu, the director of the cardiothoracic surgery department of that hospital and I went to see a specialist. As soon as we got on the escalator, a dark shadow fell from above."

"Are there any psychological traumas?" Shen Zizai asked.

"It was okay. I didn't dare to look closely. Later, I heard from the director of that hospital that the patient was diagnosed with advanced cancer and had only about three months to live, similar to Chen Jiao at the time, so he jumped directly from the top floor of the outpatient clinic."

“How much did the hospital pay?”

"It seems that they paid tens of thousands of dollars out of humanitarianism. I heard people talking about it later when we were having dinner."

Shen Zizai smiled slightly, "Now, it's not this price anymore."

Luo Hao raised his eyebrows.

"This patient will have to pay at least several hundred thousand dollars, Director Feng said."

"why?"

"How would I know? I'm just reminding you that Chen Jiao is a student and has a lot of student spirit. She won't cause you any trouble. But if you meet someone with a lot of bandit spirit, you may not be able to escape unscathed."

Shen Zizai gave Luo Hao instructions in a fatherly manner.

"Yes, yes, yes." Luo Hao responded repeatedly.

Shen Zizai was very dissatisfied with Luo Hao's attitude.

"Xiao Luo, you are good at surgery, let me ask you a question."

"Director, please tell me."

"For example, today we went to the CCU for a consultation, and a patient was packing his things and shaking hands with the doctor to be discharged. When he was halfway out of the CCU ward, he suddenly collapsed and stopped breathing. How would you feel about this?"

Luo Hao pondered for a moment and answered seriously, "I won't do anything if it comes to diseases like heart rupture. In the acute stage, especially for patients in the CCU, once this happens, it's impossible to sew them up even if you go on stage. Many seniors with broad minds have confirmed this."

Shen Zizai was a little surprised and looked at Luo Hao deeply.

"Director, don't worry. I never think that I am good enough. No, I think my level is high objectively speaking, but I am definitely not an omnipotent god. I will not let the words "healing and saving lives" get me so high that I can't step down from the stage."

Luo Hao had said everything Shen Zizai wanted to say, and he nodded slightly.

As the saying goes, when you are in high spirits, the horse gallops fast. Ronaldinho is at the age when he is in high spirits and arrogant, but he does not belittle himself, nor does he overestimate himself. He has a very normal evaluation of himself.

"I have seen many such patients, especially those in the 912 hospital. Once, I saw Director Gu talking to the patient's family and said that his skills were not good enough and suggested that they go to the Union Hospital for treatment. The patient's family readily agreed."

“?!” Shen Zizai was stunned.

"I was very confused at the time, so I asked Director Gu. Director Gu said that the patient needed a valve replacement, but the preoperative evaluation showed that the patient's basic conditions were not good enough and there was still hope, so he did not accept the case. He implicitly refused twice, and the patient's family did not understand."

"Just push it to Union Medical College?" Shen Zizai asked in surprise.

"Who made Union Hospital known as the last stop for domestic patients?" Luo Hao sighed, "It's not Director Gu's fault. He said that the patient's heart condition is like a piece of rag, no matter how you sew it, it will leak. Even if he has the physical condition of a 20-year-old and Boss Zhou's experience, he can't perform this kind of surgery.

Moreover, if you tell patients about Anzhen and Fuwai, they may not accept it. After all, our Union Hospital is known as the last stop for domestic patients.

Empty reputation, empty reputation is tiring. "

He really knows what's going on, Shen Zizai thought.

"Director, don't worry. But have medical disputes reached this level now?" Luo Hao was surprised.

"We had a meeting yesterday afternoon. I'm going to say, do you know what the medical insurance is going to check?"

Luo Hao shook his head.

"For patients without diabetes who undergo the glycosylated hemoglobin test, it will be considered a violation. If we trace back five years, whoever wrote the order will pay for it, and the money paid will go directly into the medical insurance."

"!!!"

Shen Zizai's words were even more terrifying than a ghost story, and made Luo Hao shudder.

"And they say that - conventional blood glucose measurements usually reflect instantaneous blood glucose levels, while A2C reflects a patient's average blood glucose level over the two to three months before the blood test.

Because the average life cycle of red blood cells is 120 days. Therefore, glycated hemoglobin can be more stable and more accurately reflect the patient's blood sugar control over a period of time."

"It is meaningless to repeat the test in a short period of time. Everything is done according to the most stringent conditions. Even if the doctor suspects a laboratory error, another glycosylated hemoglobin calibration is not allowed."

"Is medical insurance already so scarce?" Luo Hao asked in a hoarse voice.

"Well, so you should be more careful in what you do in the future." Shen Zizai warned, "This little money is nothing to you, but it's not good to say it, especially in the eyes of people with ulterior motives."

Shen Zizai almost said Wen Youren's name.

"I understand, Director." Luo Hao smiled and nodded, indicating that he understood and accepted Shen Zizai's kindness.

"Go to the Medical Department to report your work when you have time. Director Feng seems to be in a bad mood recently."

If an ordinary person saw Feng Zixuan in a bad mood, he would definitely stay as far away as possible and would never get close to him.

But Luo Hao is different, his main focus is on sharing weal and woe.

After handing over the shift, Shen Zizai repeated what had happened in yesterday's meeting.

There are very few patients in the interventional department who need to have their glycated hemoglobin checked, so this aspect is not involved, but Shen Zizai still spoke in a heavy tone for several minutes and gave one vaccination after another.

After the operation, Luo Hao changed his clothes and took Meng Liangren and Zhuang Yan to see the patient, then went to the medical department to report to Feng Zixuan.

Knock on the door.

"Come in." Feng Zixuan's voice came out.

Luo Hao pushed open the door and saw Feng Zixuan wearing reading glasses and flipping through his phone with a cup of tea at his side.

Huh? It's different from what I imagined.

"Director Feng."

"Xiao Luo, sit down, sit down, what do you want to talk to me about?"

"Nothing, it's been a while since I last came to report to you on my work, and I've been missing you."

"Hahaha." Feng Zixuan took off his glasses, and with a turn of his eyes, he already knew Luo Hao's purpose.

"That old ghost Shen Zi said something to you, right?"

Feng Zixuan made it clear directly.

"A patient with advanced cancer hanged himself yesterday. This is what Director Shen was talking about."

"Well, indeed, Shen Zizai can't see clearly this kind of shit." Feng Zixuan said disdainfully, "He thought I would be worried and terribly anxious, but in fact, there is no need to panic about this kind of thing."

"Oh?" Luo Hao became interested.

"What are we? Public ownership! Xiao Luo, I'm going to test you on Ma Yuan. Can you explain public ownership to me?" Feng Zixuan looked at Luo Hao with a smile.

“It refers to a form of public ownership in which all working people in socialist society jointly own the means of production.”

"Right? The means of production of our public hospital are owned by all the working people. The terminally ill cancer patient who hanged himself is also part of the working people. Why should I be so anxious?"

"!!!" Although Luo Hao understood what Feng Zixuan meant, he was still a little surprised.

"For this kind of thing, we have to do whatever the higher authorities say. The medical department is only responsible for calming the emotions of the patient's family. And similar things are not uncommon, it's just that the compensation has increased in recent years."

"What can I do? I have to pay. Isn't it popular to distribute according to the noise now?"

"I'll just watch and see when the boomerang hits the spectators' backs."

Luo Hao was silent. Feng Zixuan said one thing, but his tone expressed another.

Feng Zixuan's phone flashed. He picked up the phone and his expression suddenly became serious.

Luo Hao sat upright and looked at Feng Zixuan seriously.

"It's okay, Xiao Luo, just go and do your work, no need to comfort me." Feng Zixuan grinned.

Luo Hao had an idea and wanted to tell Feng Zixuan the truth. But it was not a good idea to do so. Luo Hao was just thinking about it.

"Then I'll go first. Director Feng, are you free to play with cats on the weekend?" Luo Hao made the invitation.

Feng Zixuan was a little excited, but then he shook his head, "I'm busy on the weekend, I don't have time, let's do it another day."

"Okay, Director Feng, please call me whenever you are free."

Luo Hao greeted Feng Zixuan politely and then left.

There were classes in the afternoon, and when Luo Hao came back from the class, it was almost time to get off work. He asked Meng Liangren and Zhuang Yan to go around the ward, and Luo Hao had no complaints about Meng Liangren's level of patient care.

To express it in a long and difficult sentence from Northeast China, Meng Liangren takes care of all his patients in a strict and orderly manner.

Luo Hao was quite satisfied with Meng Liangren as it saved him a lot of worry.

But Luo Hao was always thinking about Feng Zixuan in his heart. He had recently seen some strange scenes of Feng Zixuan. Although he had no way to investigate, Luo Hao still remained curious.

"Luo Hao, promotional video..."

Before Chen Yong finished asking, Luo Hao's cell phone rang.

"Luo Hao, emergency department!" Feng Zixuan's voice came directly after Luo Hao answered the phone.

"it is good!"

Luo Hao stood up and strode out of the office.

As expected, the little tail Zhuang Yan followed behind him with a curious look on her face, and Chen Yong followed too. "When will the promotional video be finished?" Chen Yong asked.

"Why are you so anxious?"

"I want to see what they cut the bamboo into," Chen Yong said eagerly. "If it's done well, I think it can have the effect of Terminator. I'm happy when I think of bamboo becoming the big boss in Terminator."

"Stop kidding. How can we make a Terminator?" Luo Hao replied as he walked quickly towards the fire escape. "The people's view of history is not the heroic view of history. Your three perspectives are wrong."

As he spoke, he strode forward, and his voice echoed in the fire escape like an echo in a valley.

Zhuang Yan took small steps and tried to keep up with Luo Hao's pace, but Chen Yong did not run over to watch the fun.

He just watched Luo Hao and Zhuang Yan running away quietly. Seeing Zhuang Yan stagger, Chen Yong's fingers moved involuntarily.

"Huh?" Chen Yong was a little surprised. He seemed dissatisfied with the result of his calculation and calculated again.

……

Luo Hao ran downstairs and strode down the corridor.

He was tall and had long legs, so Zhuang Yan had to jog to catch up with him.

"Senior brother, senior brother!"

Luo Hao ignored Zhuang Yan and quickly walked to the emergency department and went straight to the rescue room.

Feng Zixuan rarely called himself for emergency treatment, and this should be one of those rare times.

When we arrived at the emergency room, we saw a skinny girl lying on the bed. The emergency doctor was applying coupling agent and preparing for defibrillation.

When Feng Zixuan saw Luo Hao come in, he didn't say anything. He just grabbed the electrocardiogram from the professor of cardiovascular medicine who was looking at it next to him and handed it to Luo Hao.

Supraventricular tachycardia with aberrant conduction!
Luo Hao turned on the AI-assisted diagnosis, and the situation was similar to what was shown on the electrocardiogram, with no difference.

Luo Hao could recite this electrocardiogram by heart.

Luo Hao made a gesture to stop the emergency doctor from performing defibrillation.

He came to the patient and gave him vagus nerve stimulation.

Luo Hao performed the carotid sinus massage and Valsalva maneuver quite standardly. "6mg adenosine," Luo Hao said.

The emergency department nurse immediately pumped adenosine into the patient's vein.

With vagus nerve stimulation, the patient's heart rate showed some changes.

But Luo Hao did not relax. Vagus nerve stimulation was only symptomatic treatment, and he did not know the cause of the patient's malignant arrhythmia yet.

About half an hour later, the patient's heart rate returned to an acceptable level, and Luo Hao turned and left.

"Director Feng?" Luo Hao asked in a low voice.

"This is not the first time. It happens every 1-2 months." Feng Zixuan said seriously, "Do you see what's wrong?"

Luo Hao shook his head.

Feng Zixuan sighed. Luo Hao was a "secret weapon". Generally speaking, Luo Hao could find corresponding cases of some rare diseases and difficult and complicated diseases in the medical records of Peking Union Medical College.

But this time even Luo Hao shook his head.

"No underlying disease? That shouldn't be the case. Let me see the test results."

The patient's blood routine, biochemistry, myocardial enzyme tests, as well as cardiac ultrasound and other examinations showed no obvious abnormalities.

This is strange. Luo Hao is a little confused.

Almost all tests were normal, so how did the malignant arrhythmia come about?

"Where are the patient's family?" Luo Hao asked.

"Here, my classmate." Feng Zixuan took Luo Hao out of the emergency room and brought him to a tall and thin man, "Liu Peien, Luo Hao."

After a brief introduction, Feng Zixuan frowned and said nothing.

Luo Hao didn't feel like teasing and asked about the relevant medical history.

Liu Peien is the father of the female patient. The patient began to suffer from intermittent arrhythmia at the age of 16, and the condition became increasingly serious.

At first, the condition could be maintained with medication, but later on, the medication was no longer effective and I needed to go to the hospital for defibrillation.

The patient's family also took the girl to the capital and the Magic City, but they were unlucky. When they arrived, her heart rate was normal and no problems were found after many examinations.

I can't live in the capital forever. Besides, I have tried almost all the specialists in Fuwai and Anzhen. My family has no choice but to bring the girl back.

The same thing happened after I got home. I had intermittent arrhythmias, and serious cases had to be sent to the hospital immediately for defibrillation, just like what we just saw.

Faced with the normal test report and the fact that AI-assisted diagnosis could not give a diagnosis of rare disease, Luo Hao felt it was quite difficult.

"If it doesn't work, implant an ICD." Luo Hao could only say nonsense.

Feng Zixuan nodded. Just as Luo Hao said, the only option was to implant an ICD.

ICD is an implantable arrhythmia treatment device that integrates the functions of pacing and cardioversion. It has the characteristics of small size and safe and reliable cardioversion.

It's not a good thing to have such irregular heart rhythm all the time.

Luo Hao always felt that something was wrong, but the thought was flying in front of his eyes, but he could not catch it no matter what.

What was the problem? Luo Hao frowned and stood outside the emergency room, thinking intently.

"Brother, what are you thinking about? I saw that your vagus nerve stimulation technique was really proficient!"

"Oh, there's nothing perfect about it. You'll become proficient if you practice more." Luo Hao said calmly, but his eyes were a little empty.

Zhuang Yan raised her hand and waved it in front of Luo Hao's eyes, "Senior Brother? Senior Brother?"

"Don't make a fuss. The patient's examination results are all normal, but he has a malignant arrhythmia. Why do you think so?" Luo Hao wanted to see if Zhuang Yan could provide some ideas.

After all, Luo Hao never thought of himself as a god, nor did he believe that AI-assisted diagnosis could solve all problems.

After all, the system gives AI the name of "auxiliary diagnosis", which already indicates assistance.

"Malignant arrhythmia refers to arrhythmia that causes hemodynamic disorders in a short period of time, leading to fainting or even sudden death in patients." Zhuang Yan began to recite.

Luo Hao sighed. There was no point in chatting about this with Zhuang Yan at this time.

The patient went to Anzhen Hospital, Fuwai Hospital, Peking University, 912 Hospital, and Union Hospital. It can be said that all the experts in the capital have visited all of them, but they couldn't find any problem.

Weird.

Luo Hao used the system's capabilities to go through the medical record database of Peking Union Medical College and found several similar medical records, but those patients all had rare diseases with clear diagnoses.

What about the person in front of me?
I have absolutely no idea what caused it.

"Xiao Luo." Feng Zixuan came over and patted Luo Hao on the shoulder. "Thank you for your hard work. If there is no diagnosis, forget it."

"No, Director Feng, I think it's more than that." Luo Hao said firmly, "Where are your classmates?"

"Liu Peien!"

"Hey." The patient's father walked over with a gloomy face, his face full of fatigue.

The short distance seemed to be covered with thorns, and every step was difficult.

"Hello, I'm Luo Hao." Luo Hao stretched out his hand and shook hands with the other party.

"Hello..." the patient's family member greeted dejectedly.

"Can you give me your entire medical history? The more detailed the better."

The patient's family looked at Feng Zixuan helplessly.

"Just say what you are told. Xiao Luo's diagnostic skills are second to none in our First Hospital of Medical University. You have met the previous Director Shen. He called him Uncle Xiao Luo."

After hearing what Feng Zixuan said, the patient's family members tried to cheer up.

He ran a hand through his hair.

Luo Hao was startled. This action of the patient's family seemed to be connected with the patient himself.

That vague thought suddenly became real and clear.

"Wait a minute!" Luo Hao suddenly interrupted the patient's family loudly.

"???"

"???"

"Have you always been this thin?"

"???"

"!!!"

Feng Zixuan looked at Luo Hao in surprise, while the patient's family members looked a little confused, with a hint of anger in their confusion.

Zhuang Yan didn't say anything and stood behind Luo Hao.

"I mean, the patient looks very thin. Does he have anorexia?"

"Anorexia will not cause malignant arrhythmia, Xiao Luo." Feng Zixuan reminded, and then remembered something.

But ionic disorder seems impossible.

It’s not that ion disorders won’t lead to malignant arrhythmias, but that the vast majority of patients’ test results are normal. If anorexia caused ion disorders, all the symptoms would have already appeared.

"We both have anorexia nervosa, but it doesn't seem to be hereditary," the patient's family member said with difficulty.

"Then how did you treat it?" Luo Hao asked directly before he finished speaking.

"Ah? No treatment." The patient's family member was stunned, then raised his hand, "I have a similar problem, and the medicines the hospital asked me to take all have various side effects. I feel it's better not to take them. Besides, I had treatment when I was young, but it didn't work, so I didn't let my children take it."

"No treatment? No treatment~~" Luo Hao held his chin with his hand, lost in thought.

Just as the patient's family member was about to speak, Feng Zixuan stepped on his foot, telling him not to interrupt Luo Hao's thinking.

A few seconds later, Luo Hao frowned and said, "Since you are Director Feng's classmate, let me ask you a question directly."

"Professor Luo, please speak." The patient's family's attitude became much better.

"Where's your lover?"

"I'm at work. I brought the child here. She... should be here soon."

Luo Hao's brows furrowed more and more, but Feng Zixuan felt that the window paper in front of him was about to be broken.

This time, Professor Xiao Luo did not give a diagnosis after just one look, but was in a dilemma.

But because of this, Feng Zixuan's confidence in Luo Hao increased a little more.

It's obvious that Professor Xiao Luo has thought of something!
Seeing Luo Hao taking out his phone and looking for something, Feng Zixuan curiously moved over. Feng Zixuan had no idea what the relationship between malignant arrhythmia and anorexia nervosa was.

"The patient's diet... is not right." Luo Hao took out his cell phone, "Take a look, have you seen this in your home?"

Before Luo Hao handed over the phone, the monitor in the emergency room issued a sharp alarm.

The sound was shrill, like a wail.

(End of this chapter)