White armor

Chapter 619: Encounter with Liu Ruyan

Zhuang Yan's expression suddenly changed, and her originally bright eyes dimmed in an instant.

Her fingers unconsciously twisted the corner of her white coat, her knuckles turning slightly white from the force.

The memory came flooding back like a tide - the roar of the helicopter propellers seemed to ring in my ears again, and I seemed to smell that pungent smell of pesticides in my nose again. The patient's painful and distorted face and my own panic and confusion, and finally the same miserable appearance as the patient, appeared before my eyes.

Her breathing unconsciously quickened, and her chest felt as if it was being tightly grasped by an invisible hand.

Every detail of that day was so clear, and the scenes flashed through my mind like a kaleidoscope.

It’s too painful to recall. Every time she thinks about it, Zhuang Yan feels like she’s dying suddenly.

Zhuang Yan's lips trembled slightly, and she wanted to say something but no sound came out.

She subconsciously took a half step back, as if this would allow her to escape from the unbearable memory. The fine beads of sweat oozing from her forehead shone faintly under the light, revealing her inner panic.

Although it had already passed, Zhuang Yan didn't want to see anything again. Although she felt a little regretful, she still turned around and left.

"Xiao Luo, I have always forgotten to ask, what happened to the patients poisoned by paraquat later?" Chen Yan asked.

"The lung tissue lost about 30% of its function, but the patient survived. If you pay more attention to it in the future, your survival period will not be greatly affected."

"Amazing!" Chen Yan exclaimed. "In my mind, drinking paraquat would definitely lead to death. I didn't expect that even this terminal illness can be cured now."

"The Qilu Plan is still useful, and the patient's family is obedient. They directly pushed the patient to the side of the dry toilet and fed him feces soup..."

Having said that, Luo Hao hesitated.

"What do you want to say? Just say it. I was born a dung collector. I'm a senior dung collector. Why should I be afraid of these things?" Chen Yan said self-deprecatingly.

"I now highly suspect that the patient had aspiration when he was fed the fecal soup, because his condition recurred on the third day and there were signs of widespread lung infection.

But we did a bacterial culture and used high-grade antibiotics, and it went away without causing any problems.”

"It's good that he can be rescued. He induced vomiting at the time... Xiao Chen is in good health." Chen Yan thought of Chen Yong's "heroic appearance" on the helicopter that day.

"It's okay. After all, you are young." Luo Hao smiled.

"Where's Chen Yong? Why didn't I see him just now?"

Luo Hao continued to poke the feces, moistening the dry feces bit by bit, and then peeling it off with a grinder.

The operation is not difficult, but it is completely different from the interventional methods used by the circulatory department to grind away blood clots in the coronary arteries.

If they changed the body position and used a dilator to dilate the anus, Luo Hao even felt that he could complete the operation.

"I haven't started work yet today. I won't start work until tomorrow. Chen Yong should still be at home."

Chen Yan recalled that a year ago, Luo Hao and Chen Yong came to the First Hospital of Medical University where they were unfamiliar with the place, and in just one year, such a big storm had occurred. He felt quite emotional.

"Director Chen, please be careful."

After a long time, Luo Hao said in a deep voice.

Chen Yan had already moved away from the spraying position long ago, and he could still see the difference in his eyebrows and eyes.

Luo Hao's reminder was most likely to let others get out of the way and avoid being sprayed all over their bodies and faces by the contents of the high-pressure intestine.

Although the physical attack is not high, it adds magic damage, the damage is still very high, and it ignores defense.

Otherwise, why would Zhuang Yan just leave after saying that without even looking back?

Luo Hao also moved to the side of the patient's head, chatted with the little patient for a few words, and then "knocked" open the obstruction site.

"Pfft~~~"

A lot of gas came out.

But there was only one sound, and Luo Hao immediately blocked the anus.

Once the high pressure causes the intestinal contents to flow out quickly and the intra-abdominal pressure changes greatly, many reactions may occur, including but not limited to cardiac arrest and other more complex physiological and biochemical changes.

He did this at least a dozen times and lasted for nearly 20 minutes. With the whole room filled with the smell of stale fart, Luo Hao finally finished all the operations.

The extreme situation of jetting did not occur, everything was smooth.

Luo Hao did not say what to do after the operation. He just collected the feces and put them in a curved tray.

"Director Chen?"

"Let's go together." Chen Yan invited Luo Hao.

Today was a leisurely day, so Luo Hao nodded, picked up the tray, and followed behind Chen Yan, pretending to be a junior doctor.

It is very important to give postoperative instructions to the patient's family, and this operation was a perfect success, and Chen Yan was happy.

This is a good start.

"Look, this is a piece of dung. Look at the melon seeds inside it. Tell me, it's New Year's Day and you didn't watch your children closely enough, so such a big thing happened." Chen Yan scolded while fiddling with the dung while wearing gloves.

"!!!"

"!!!"

The patient's family members did not expect to see this scene. Although the smell of feces was irritating to the eyes, they still understood that doctors had to work harder.

After watching quietly and listening to Chen Yan's explanation, the patient's family members continued to express their gratitude.

Luo Hao stood behind Chen Yan without saying anything, just watching.

He noticed that behind the patient's family member who was speaking, there was a man with a complicated expression, as if he was relieved, but also worried.

All these expressions combined made it seem as if he was also constipated.

When Chen Yan finished his last sentence and solemnly told the patient's family, "Observe overnight, and if everything is fine, you can be discharged tomorrow," the atmosphere in the entire ward instantly relaxed.

The patient's mother's tense shoulders finally relaxed, and she wiped the tears from the corners of her eyes with the back of her hand; the father let out a long sigh, and a relieved smile appeared on his face.

Chen Yan couldn't help but smile with relief as he looked at the joyful face of the family.

He patted the patient's mother on the shoulder and gave her some instructions on what to pay attention to after the operation.

The patient's family members nodded repeatedly and kept expressing their gratitude. The patient's mother was even so excited that she wanted to bow to Chen Yan, but he quickly stopped her.

The ward was suddenly filled with a long-lost cheerful atmosphere; even the sunlight coming in from the window seemed to become brighter.

Luo Hao and Chen Yan turned around and went back to the endoscopy room to change clothes. The man with a complicated expression came over and said, "Hello, teacher."

"Oh?" Chen Yan stopped.

"The patient is fine after the operation, right?" the man asked.

"Didn't I just tell you that you can be discharged from the hospital tomorrow after 24 hours of observation?" Chen Yan said.

"thanks, thanks."

"Who are you?" Chen Yan asked.

"Dr. Liu from our county hospital," a patient's family member scolded, "half of the children's illnesses were caused by him."

Has the intestinal obstruction been cured?

Luo Hao frowned slightly, looked around, combined with his previous impression of everyone, pondered for a few seconds, but still couldn't figure it out.

"What's going on?" Chen Yan was in a good mood and wanted to help the doctor from the county hospital, so he asked.

"My child caught a severe cold during the Chinese New Year. He took erythromycin and had diarrhea. Doctor Liu insisted on giving him montmorillonite powder. I said it was okay, but he kept saying a lot of things."

Chen Yan smiled. It was such a small matter that he didn’t need to solve it himself.

For diarrhea, give montmorillonite powder, this is the standard treatment plan. Who lets the child eat handfuls of melon seeds and not even spit out the skins?

"As for this matter, I think Doctor Liu is right."

Before Chen Yan could speak, Luo Hao's voice came.

Chen Yan immediately said, "This is Professor Luo who performed the colonoscopy on the child. All physical examinations in the province are done by Professor Luo, and his level is quite high."

The patient's family didn't think anything of it and just expressed their gratitude, but Dr. Liu was stunned.

“Macrolide antibiotics, represented by erythromycin, are widely used in pregnant women and children because of their high safety and lack of adverse reactions such as teratogenicity and mutagenicity.

However, its gastrointestinal motility-promoting effect causes some users to experience significant digestive discomfort, which was counteracted by scopolamine drugs such as 654-2 in the past, but the side effects were significant and difficult for children to tolerate. "

Luo Hao explained.

"Is it because the diarrhea has not been relieved after taking erythromycin?" Luo Hao asked the patient's family.

"Yes, the doctor gave me other medicines, but they didn't work well either."

"That's because the child has a strong reaction to erythromycin. An experienced doctor will definitely use montmorillonite powder at this time."

"!!!" Doctor Liu stared at Luo Hao without saying a word.

"Besides treating diarrhea, does it have any other uses?" Chen Yan has changed his role and become the supporting actor.

“近年发现在输注红霉素10分钟内口服思密达，1岁以内每次1/4包，1-2岁每次1/2包，大于2岁每次服1包，用药后93.4％的患儿不出现不良反应或仅有轻微恶心，可完全耐受应用红霉素治疗。

It is significantly better than adding vitamin B or scopolamine drugs during infusion. "

"Although it has not yet been written into the pharmacopoeia and treatment guidelines, this is a summary of clinical experience. There is nothing wrong with Dr. Liu's treatment. The main reason is that the child ate a lot of crude fiber melon seeds without peeling them. Did you play mahjong during the New Year?"

"..."

"..."

Luo Hao's words were full of contempt, and he did not hide it. The patient's family members felt a little embarrassed and completely forgot what they had just said about Doctor Liu.

They were relatively simple and honest, just complaining, but now that Luo Hao pointed out the problem, they all fell silent.

"The baby will be out soon. We are lucky this time and can solve it with minimally invasive methods. Go home and be more careful. You may not be so lucky next time."

"Yes, yes, yes." The patient's family members kept responding.

Luo Hao and Chen Yan turned around to change their clothes without communicating with the doctor from the county hospital.

"Xiao Luo, does montmorillonite powder have this use?"

"Well, there are other uses, which are all summed up from clinical experience. Because the abdominal discomfort caused by erythromycin will be mixed with the previous symptoms, neither the doctors nor the patients' families paid attention to it."

"Oh? What other uses does it have?" Chen Yan asked curiously.

"I think the biggest use is in treating bedsores and in the end-of-life care of patients in the ICU or in advanced cancer."

“???” Chen Yan was stunned.

One is for internal use, and the other is for external use. Although the principles should be similar, they can't be mixed together.

"Xiao Luo, tell me. Bedsores? Is that what I understand?"

“As the condition of oncology patients worsens and their systemic failure persists, they remain in the same position, and the incidence of pressure sores is high.

According to literature reports, Smecta can be used to treat patients with pressure sores. According to document records, for stage II-III pressure sores, Smecta powder was directly applied to the pressure sore wound surface, which achieved better results than ulcer patches. "

"I'll try it if I have a chance." Chen Yan said happily while twisting the heart-protecting hair. Bedsores are a headache in the clinic. Since there are treatments for bedsores in stages II-III, we must give it a try!
The two changed their clothes and went out, and saw Dr. Liu from the county hospital waiting at the door with his head down.

"Director Chen..." Doctor Liu rubbed his hands awkwardly, with a complicated expression on his face. He looked at Luo Hao, not knowing how to address him.

But he didn't ask and just stood there awkwardly.

The man looked a little dull. Luo Hao smiled and said, "My last name is Luo, Luo Hao from Xiehe University."

When Dr. Liu saw Luo Hao stretch out his hand, he was stunned.

It was the first time he heard someone connect Concord with his name... The last time was Zhao Zilong of Changshan and Zhang Yide of Yan.

Luo Hao from Concord?

What the hell is this.

"Hello, Professor Luo." Although Doctor Liu was clumsy, he still extended his hand and shook hands with Luo Hao gratefully.

"I'm a doctor at Linyuan County Hospital, Liu...Liu..."

Luo Hao was puzzled. Was this person a stutterer? Or was he like Teacher Pan, thinking too fast that his mouth couldn't keep up with his brain?
"Liu what?" Chen Yan was a little dissatisfied and reprimanded with the authority of a senior doctor.

"I'm sorry, my name is Liu Ruyan."

"???"

"???"

Luo Hao almost stopped laughing.

Chen Yong said that his master Jiang Wenming mentioned that AI writing marked all female protagonists as Liu Ruyan.

This name seems good at first glance, but it seems a bit strange that hundreds, even thousands of heroines in novels are named Liu Ruyan.

However, the doctor in front of him was also called Liu Ruyan.

"When I was born, a fortune teller passed by and said that my fate was...harmful. Let's not talk about that. He said that it would be better for my future if I was given a lighter name."

Chen Yan twirled his beard and laughed, "Liu Ruyan, you...hahahaha, Liu Ruyan."

Doctor Liu didn't seem annoyed. It seemed that he was used to being laughed at.

"Hello, Doctor Liu." Luo Hao moved his hand seriously, as if to shake hands with Liu Ruyan, then withdrew his hand, looked at him, and waited for him to express his gratitude before leaving.

"Director Chen, Professor Luo, thank you." Liu Ruyan bowed deeply.

"It's all right." Luo Hao said with a smile, "Don't be so polite, the child is fine, don't worry. You've come all the way here during the New Year, go home and have a rest, you'll have to go back to work soon."

"Professor Luo, thank you for speaking for me." Liu Ruyan said sincerely.

"By the way." Luo Hao smiled and said, "Regarding the usage of montmorillonite powder, did you summarize it clinically?"

"Professor Luo, part of it is my clinical summary, but the main thing is that I read relevant content in journal reports."

"Oh?" Luo Hao became interested.

Doctors at the county hospital actually read journals? Chen Yan thought this doctor, who was older than himself, was interesting.

"Let's talk while we walk. If you're not in a hurry to go back, we can chat for a while." Luo Hao invited Liu Ruyan.

"Professor Luo, I'm sorry to waste your precious time."

"You're welcome. What other uses does montmorillonite powder have?" Luo Hao tested Liu Ruyan.

"For secondary gastrointestinal bleeding in newborns, while actively treating the primary disease, add 1/3 of a pack of Smecta to 2-3 ml of normal saline to make a paste, take it orally 3 times a day for 7-10 days.

Stop using other systemic or local hemostatic drugs. For patients with moderate or severe anemia, give supplementary fresh whole blood at 10-15 ml/kg body weight each time until the anemia is corrected.

The hemostasis rate is 24% within 29 hours of medication, and 3% within 100 days, which is better than the currently commonly used hemostatic drug therapy. "

Luo Hao raised the corner of his mouth. Apart from the strange name, this Doctor Liu was really interesting.

"In addition, breast milk jaundice often occurs in premature infants and low-birth-weight infants who are exclusively breastfed, and jaundice appears 1-4 weeks after birth.

For such children, 1-2 packets of Smecta can be tried, 3 times a day, orally, and it can be mixed with 10 ml of 15% glucose. After taking it for 7 days, the jaundice of the children will disappear and there will be significant improvement, without any adverse reactions. "

"Oh? It can be used this way?" Chen Yan was surprised.

"Well, I met a related patient a year ago, and the effect of using this method is indeed very good." Liu Ruyan replied.

"Anymore?"

"Treatment of infant lactose intolerance, fungal enteritis, oral ulcers and stomatitis in children."

"Why are they all children's?" Chen Yan asked.

Luo Hao glanced at Liu Ruyan out of the corner of his eye.

"There is no one in the pediatric department of our county hospital, so we will take a look at whoever we can. If we can cure the disease, we will treat it, but we usually ask them to go to the city. Some children's families are not well-off, so I made up for it by intensively studying the relevant knowledge."

Luo Hao nodded slightly.

"Thank you for your hard work, Doctor Liu." Luo Hao said seriously.

Liu Ruyan was stunned for a moment. Why was she working so hard?

"There's no one left in the pediatric department of the county hospital." Chen Yan twirled his beard, feeling a little emotional.

"Well, the schools are all closed. We used to have four elementary schools, but now they've been merged into one."

"Anything else?" Luo Hao didn't want to talk about this kind of question, so he continued to ask.

"Also, for things like pediatric dermatitis, I found that the drug Smecta has very low toxicity."

"So awesome?" Chen Yan looked at Luo Hao.

"Montmorillonite powder has a molecular structure of hexagonal montmorillonite, a multilayer structure composed of double tetrahedral silicon oxide and single octahedral aluminum oxide.

Because of its strong covering ability on the digestive tract mucosa, it has good effects in protecting the mucosa and inhibiting viruses, bacteria and their toxins. It has been used for various diarrhea, esophagitis, gastritis and peptic ulcers.

It comes from pure natural minerals, is highly safe, and has no toxic reactions. It has been widely used in the treatment of common diseases in recent years, and its clinical uses are constantly expanding.”

"But I just read it in books and medical records. I have never used it on infants and young children myself."

Luo Hao emphasized.

Chen Yan seemed to be thinking about something.

"Professor Luo, I have used some..." When Liu Ruyan talked about similar professional things, he suddenly became interested and began to talk about some of his clinical records of using montmorillonite powder.

This guy is quite interesting, Luo Hao listened carefully.

Looking at the time, it was already late. Chen Yan returned to the ward, and Luo Hao called Liu Ruyan to go eat hand-rolled noodles across the hospital.

After all, we just met, so it’s not appropriate to treat him to the medical team’s boxed lunches.

After sitting down, Luo Hao asked, "Doctor Liu, is your work in the county hospital hard?"

"It's OK. I was a technical secondary school student in the 1990s."

“After graduating from technical secondary school, I returned to the health center. The conditions were tough and my monthly salary was 200 yuan.

At that time, I felt that life could not be like this. My colleagues spent all their time at work playing mahjong, and I didn’t know how to play mahjong, so I took time to read.

In 2000, he obtained a diploma in clinical medicine from the provincial medical university. In 2001, the state implemented the medical license examination. He passed the examination with a score 120 points higher than the national passing score, almost without any preparation.

"Awesome." Luo Hao praised sincerely.

He did not think Liu Ruyan was talkative or long-winded, but instead thought carefully about Liu Ruyan's life.

In that era, there were indeed not many people who could do this.

“The hospital is poorly equipped with only one DR, electrocardiogram and black-and-white ultrasound.

If you need to go to a county hospital for more than 10 stitches of debridement and suture, let alone tendon anastomosis for hand injuries. Local patients don’t come to the hospital to see a doctor. When you ask them what’s wrong with them, they just say you can prescribe some isatis root and painkillers.”

“Isatis root?”

"Yes, at that time, Isatis root was a miracle drug. No matter what disease it was, the patient would feel much better as long as he took Isatis root."

"..."

"Later, I was transferred to the county hospital, where I was responsible for clinical anesthesia, gastroscopy, and drug storage. I had three jobs and a monthly salary of 400 yuan."

Liu Ruyan talked for a long time. He regarded Luo Hao as his confidant and told him everything.

Luo Hao guessed that Doctor Liu was the type who didn't fit in at the county hospital and was different from everyone else.

While others spend their days playing mahjong, he reads books every day, so others will definitely exclude him.

It is even hard to say whether there is any other power behind this little patient.

Luo Hao never hesitates to assume the worst of others. This is what his bosses taught him, and Luo Hao agrees with it.

"This year... no, it was last July. The hospital finally equipped me with a Shanghai AQ-7 gastroenteroscope. Professor Luo, you don't know that when I touched the mirror for the first time, I was so happy that I almost flew away."

"How is it used?"

"So far, we have performed four band ligation hemostasis surgeries."

"!!!" Luo Hao was surprised.

The ligation treatment of gastric varicose vein bleeding is quite difficult, and there are not many people in Donglian Mine who can perform similar operations.

The person in front of me is truly a talent.

It’s a pity that I’m old. I guess my eyesight and hands will be shaky after working for a few more years. I can only work in grassroots hospitals and contribute my remaining energy.

This was also due to the limitation of the times. There was no other way, so Luo Hao handed Liu Ruyan a clove of garlic.

Liu Ruyan looks like an old man from the countryside, honest and simple. He has worked at the grassroots level all his life, but at this age he is still reading literature and even taking on some of the work in the pediatric department of the county hospital.

Luo Hao admired this very much.

After eating a bowl of noodles, Liu Ruyan said goodbye.

"Doctor Liu, add your contact information. If you have any difficult cases that need consultation, please contact me. If I can't solve it, I will contact the higher-level hospital."

Liu Ruyan was stunned. He originally thought that they were just going to have a casual chat, and he didn't even have the courage to ask Luo Hao for his WeChat ID.

But unexpectedly, Professor Luo Haoluo suggested exchanging contact information.

Liu Ruyan immediately took out her Redmi and opened WeChat. "Professor Luo, should I scan you or..."

"I'll scan you."

Luo Hao didn't bother to be polite with Liu Ruyan. After adding her as a friend, he immediately sent her his cell phone number.

Waving goodbye, Liu Ruyan looked at Luo Hao's departing back. After thinking for a while, she picked up her phone and wrote in the notes - Union Medical College Luo Hao.

(End of this chapter)