After being separated from my family, I became a darling of the military region thanks to my medical
Chapter 419 The plan needs to be revised.
At 6:30 a.m., the ICU lights in the Beicheng Military Region General Hospital were still on. Night shift nurse Liu Xiaolan put the last blood gas results into the medical record folder, turned around and saw Ye Zhen already standing at the door. Underneath her white coat, she was still wearing the dark sweater she had worn when she went home last night. Her scarf was not tied and was draped over her arm. Her eyes and brows showed the weariness of not having slept enough all night.
"Dr. Ye, Tian Xiaobao's blood gas came out at three o'clock in the morning. The acidosis has been corrected well, the lactic acid has also gone down, the urine output is more than yesterday, and the body temperature has been kept below 37.2 degrees Celsius."
Ye Zhen took the medical record folder, turned to the latest test report, and traced the values with her fingertips. Hemoglobin had rebounded, potassium, sodium, and chloride levels were basically stable, and albumin was still low, but it was enough to barely withstand a major surgery.
"Did you experience another episode of oxygen deficiency last night?"
"No, he calmed down after receiving oxygen and woke up twice, asking if his parents were still outside."
Liu Xiaolan lowered her voice and glanced back at the hospital bed. Tian Xiaobao was curled up in the blanket, his face still bluish-purple, but his brows were no longer furrowed, and his chest was rising and falling much more gently than the day before yesterday.
"His mother didn't sleep a wink all night. The head nurse advised her to go to the family area to lie down for a while, but she held onto that red card tightly and wouldn't let go, saying that she was afraid that if she left, her child wouldn't be able to find her."
Ye Zhen closed the lab report, walked to the bedside to listen to the heartbeat, and then checked the temperature of her extremities and the color of her fingertips.
"Xiao Bao, are you awake?"
Tian Xiaobao opened his eyes, his eyelids were heavy, and he blinked twice when he saw Ye Zhen.
"Aunt Ye, is my father still alive?"
"I'm outside, watching over you, I haven't left."
Where is my mother?
"Also there."
Tian Xiaobao's fingers peeked out from under the blanket and touched the oxygen tube; his voice was a little hoarse.
"Could I take this tube home? I need to use it when I can't breathe at night."
Liu Xiaolan's eyes welled up with tears, and she quickly turned her face away to tidy up the IV stand.
Ye Zhen tucked his hand back under the covers, her tone lacking the softness one would use to coax a child.
"You won't need it after the surgery."
"Can I run away as soon as I finish?"
"Walk first, then run, and make sure you eat properly."
Tian Xiaobao stared at her for a while, then asked in a low voice.
"Can I go to school?"
Ye Zhen tucked the blanket around him.
"Yes, I can. I need to recover first before I can carry my schoolbag."
When Gao Haiping pushed the door open, he happened to hear this. The old man hadn't slept much all night, his eyes were red, and he was holding a stack of preoperative data that he had compiled the night before.
"Dr. Ye, I looked at the blood gas analysis from this morning. Could you arrange a follow-up ultrasound for my child today?"
"Do it now."
"That's what I meant too. The acidity and alkali levels have returned, and the blood pressure is more stable. Let's have one more check on the outflow tract before the surgery, just to be on the safe side."
Ye Zhen nodded and turned to instruct Liu Xiaolan.
"Notify the ultrasound room to move the machine to the ICU, don't move the child."
Liu Xiaolan agreed, but stopped again just as she reached the door.
"Dr. Ye, Mr. and Mrs. Tian are outside. Should we let them see you first?"
"Wait until the ultrasound is finished."
As the ultrasound machine was wheeled in, its wheels rolled over the rubber mat at the ICU entrance, making a very soft rolling sound.
Xiao Zhang from the ultrasound department received the notification last night and arrived early today. The probe had been preheated and the coupling agent had been soaked in warm water. When he saw Ye Zhen standing next to him, he spoke with some caution.
"Dr. Ye, I'll scan the sections as usual. Just tell me where you need to see."
"Paris long axis, short axis, right ventricular outflow tract, below the pulmonary valve, slower speed."
Tian Xiaobao felt a chill and hunched his shoulders.
Liu Xiaolan quickly grasped his hand.
"Don't be afraid, Xiao Bao. Let me show you a picture of your chest. It won't hurt."
Tian Xiaobao glanced at Ye Zhen.
"Does Aunt Ye watch it too?"
I think so.
The gray images on the screen gradually unfolded, showing thickening of the right ventricular wall, narrowing of the outflow tract, and a more congested blood flow path than in the previous data.
Xiao Zhang's probe stopped at a certain angle, and his throat moved.
"Dr. Ye, the echo here is not quite right."
Ye Zhen took half a step forward, her gaze falling on the overlapping muscle bundles in the lower right corner of the screen.
"Change to a shorter shaft, then move up."
Xiao Zhang did as instructed, and the probe was gently turned at an angle. He saw the blood flow struggling to squeeze through the extremely narrow opening, and the Doppler blood flow frequency shift signal was compressed into an extremely narrow beam of light.
Gao Haiping stood at the foot of the bed, his face slowly darkening.
"This pressure difference is incorrect."
Ye Zhen reached out and pressed her hand against the bed railing, her eyelashes drooped for a moment, then lifted again.
"Measure the maximum flow velocity."
Xiao Zhang operates the machine keys with his fingers.
"Dr. Ye, the estimated stenosis rate is probably over 90%."
Liu Xiaolan crumpled the gauze in her hand, then quickly loosened it, afraid that the child would see it.
Gao Haiping stared at the screen for a long time before speaking.
"If it's really over 90%, the pulmonary artery approach doesn't provide enough field of vision, and the muscle bundle roots can't be seen clearly. If it's not cut cleanly, it's all for nothing."
Ye Zhen shifted her gaze from the screen back to the child's face.
Tian Xiaobao didn't know what the string of numbers meant; he only noticed that the adults had stopped talking, and a look of panic appeared in their eyes.
"Aunt Ye, am I not good at treating patients?"
Ye Zhen leaned down to look at him and pressed her hand against his shoulder through the blanket.
"It can be cured, but we need to use a different method."
Will it hurt if I change the method?
"You're asleep, you don't feel the pain."
"Will you be there?"
"I am here."
Gao Haiping closed the documents in his hand and asked in a low voice.
"Dr. Ye, should the preoperative discussion be conducted in advance?"
Ye Zhen handed him the ultrasound report.
"Half an hour later, in the teaching conference room, notify the expert group, the anesthesiology department, and the extracorporeal circulation team to all be present."
"The surgery time will remain as scheduled."
"As originally planned."
Gao Haiping looked at her, his wrinkles deepening.
"Dr. Ye, you need to change your approach."
Ye Zhen put the medical record folder back on the bedside table. Her tone was very soft, but it made Liu Xiaolan feel a tightness in her back.
"The plan needs to be revised."
Tian Xiaobao couldn't understand the "entrance" (入路), but he understood the "change" (改) character. He reached his hand out from under the covers and grabbed Ye Zhen's white coat sleeve.
"Aunt Ye, have I caused you any trouble?"
Ye Zhen lowered her head and warmed his fingers one by one in her palm.
"The trouble caused by the illness is not your fault."
"My dad says kids from the mountains are tough."
"Being resilient isn't enough; the doctor also needs to be skilled."
Liu Xiaolan couldn't help but laugh, but her eyes were even redder.
"Your Aunt Ye has the toughest hands; she's really good with a knife."
Tian Xiaobao nodded seriously, his eyelids slowly drooping again.
"I'm going to sleep now, wake me up when you wake me."
Ye Zhen tucked the blanket around him and then turned and left the ICU.
Outside in the corridor, Tian Gensheng and Cuihong sat at the far end of the bench. Cuihong was holding an enamel mug in her arms. The hot water in the mug had already cooled down. Tian Gensheng's two chapped hands were resting on his knees. When he saw Ye Zhen come out, he immediately stood up.
"Dr. Ye, how is the baby?"
"The patient is more stable than when they were admitted. The acidosis has been corrected, and their blood has recovered somewhat."
Her rosy lips moved slightly.
"Then the surgery can be performed today."
"It can be done."
Tian Gensheng breathed a sigh of relief, but then noticed something was wrong on Ye Zhen's face.
"Dr. Ye, is there anything else?"
Ye Zhen did not take a detour.
"Preoperative follow-up examinations revealed that the child's cardiac outlet was narrower than previously indicated, requiring adjustments to the surgical plan and making the procedure more challenging."
Cuihong's hand trembled, and the water in the enamel mug spilled onto her cotton trousers, but she didn't bother to wipe it off.
How difficult is it?
Gao Haiping stood to the side, wanting to say a few words on Ye Zhen's behalf, but Ye Zhen raised her hand to stop him.
Prepare for the worst, but act in the best possible way.
Tian Gensheng's throat was dry.
"Dr. Ye, tell me the truth, what are the chances of the child surviving?"
Ye Zhen looked at the man who had come all the way from the mountains in a military truck, and at the pair of cloth shoes at his feet that were still covered in mud.
"If I'm the surgeon, I'll fight for everything I can."
Tian Gensheng's eyes reddened, and he wiped his hand on his clothes, unsure of where to put it.
"Then I'll sign it, I'll sign anything."
Cuihong took out the crumpled red card from her bosom and handed it to Ye Zhen.
"Dr. Ye, is this still working?"
Liu Xiaolan stood to the side, her nose tingling with emotion.
Ye Zhen pushed the red card back into Cui Hong's hand.
"It worked. Keep it safe. It led you through this door. I'll lead the children through the rest of the way."
Tian Gensheng lowered his head and placed his palm on the seam of his trousers, his voice hoarse.
"Dr. Ye, I'm not good at sweet talk, but you saved the child, and he'll remember you for the rest of his life."
Ye Zhen glanced at him.
"It's enough that he remembers how he survived."
Gao Haiping coughed to remind everyone of the time.
"Dr. Ye, we should be at the conference room by now."
Ye Zhen nodded and was about to leave when Gu Zheng came up the stairs, carrying hot soy milk and two brown paper bags. His military jacket was unbuttoned at the top, indicating that he had rushed back from outside.
"Have you had breakfast?"
"No time."
"Then let's drink as we walk."
Gu Zheng handed her the soy milk and then glanced at Tian Gensheng and his wife.
"You all have some too, the buns are in the bag, eat first."
Tian Gensheng quickly waved his hand.
"Commander, we're not hungry."
Gu Zheng stuffed the bag into his arms.
"If you can't stand up while your son is on the operating table, you'll only cause trouble."
Tian Gensheng, holding the hot bun, dared not push it away again.
Ye Zhen took a sip of soy milk, and the warmth went down her throat, easing the tension in her shoulders and back by a little.
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