Practicing Medical Skills in a Small Clinic
Chapter 509 - 236: Eight Episodes of Diarrhea a Day, Steatorrhea (Part 3)
The emergency department’s monthly visit volume was initially one million, suddenly dropping to five hundred thousand, effectively halving. The hospital surely cannot sustain this!
"Meng Luo, come here for a moment!"
Li Jingsheng turned his head to look at Meng Luo, who was with Tang Ping.
Upon hearing her boss calling, she quickly stepped forward, with a trace of nervousness still on her face.
"Please measure this lady’s blood pressure and heart rate, along with basic vital signs like temperature."
"Alright!"
Like most new employees, she felt a bit nervous when measuring a patient’s vital signs for the first time. 𝒇𝙧𝙚𝓮𝙬𝙚𝓫𝒏𝓸𝓿𝓮𝒍.𝓬𝙤𝓶
Almost dropped the thermometer gun when picking it up, barely keeping hold of it.
Luckily, Li Jingsheng was quick to react and caught it.
Breaking it would certainly be painful for him, the boss.
It’s not cheap.
"Don’t rush; take your time!"
Li Jingsheng didn’t scold her but instead reassured her gently.
If he scolded her or glared at her now, it would only make her more nervous.
"To speed up the process, she’ll measure your temperature, while I inquire about your condition."
Li Jingsheng explained to the patient.
"Alright, go ahead!"
"How long have you had diarrhea?"
"Almost half a month now, maybe even longer. It started with occasional diarrhea, but now I have it seven or eight times a day. My boss thought I was intentionally hiding in the restroom to slack off; feels so wrongly accused."
She said with a bitter expression.
Diarrhea comes in various forms, slight diarrhea once or twice a day, as long as there’s no serious issue like bloody stool, it’s usually nothing serious.
Normalcy returns after two or three days, or five or six days.
Her diarrhea lasts more than half a month, and she experiences it seven or eight times a day, definitely indicating illness.
It doesn’t seem like just bad food or abdominal chill.
"Have you noticed the color and shape of the stool?"
"It’s... a bit disgusting, so I haven’t paid much attention."
The patient was obviously a bit embarrassed.
Judging by her expression, she obviously has seen it.
Normal people would take a look.
Especially after prolonged diarrhea, what if there’s blood in it?
"Don’t let discomfort hold you back from discussing illness openly. It’s not about being disgusting. We, as doctors, aim to uncover the cause, treating your illness swiftly. You surely wish to regain normalcy soon."
Li Jingsheng said.
"Exactly! You’re absolutely right. I specifically came here hearing about your profound medical ethics and skills. My fellow workers suggested visiting a large hospital, but I headed straight to you."
Her flattering words brought comfort to Li Jingsheng.
"Let me ask question by question! Was there any blood in the stool or was it black?"
Li Jingsheng maintained a pleasant demeanor with such loyal fans.
"Seems to be yellow, sort of translucent."
She claimed earlier not having looked, yet now described it as yellow. This reflects some patients’ genuine mindset.
This requires doctors to patiently communicate, easing their awkwardness.
"Any foam in it?"
"Yes!"
"Is the stool volume large? Does the amount passed out seem excessive?"
"Yes, it’s a lot!"
"Is there an unpleasant smell?"
"Of course, it’s stinky!"
"Compared to before, would you say it’s smellier? Some patients with diarrhea describe it smelling like rotten eggs, while others mention a putrid stench. Therefore, you need to share the most accurate details with me."
"Uh... it’s really smelly, far worse than before, simply unbearable."
"Do you experience bloating or weakness in your body?"
"Oh, Dr. Li, no wonder everyone praises your remarkable skills; you nailed all my symptoms!"
"You’re too kind. Any difference in appetite compared to before?"
"Not much difference, seems I eat even more now, but still don’t gain weight. Those two coworkers lament about gaining weight while I don’t."
She said with some pride.
With diarrhea seven or eight times a day, even eating fatty meat won’t cause weight gain!
Having asked all essential questions, Li Jingsheng looked at Meng Luo.
She was now less nervous, and the vitals were mostly measured.
Her actions and focus in handling these situations were skillful and professional.
"How about the temperature? No fever?"
Li Jingsheng asked her.
"Forehead temperature is 36.7 degrees, normal. Blood pressure slightly high, but everything else is normal."
Meng Luo handed the recorded data to Li Jingsheng.
The handwriting was beautiful and neat.
Written in semi-cursive script.
Hospitals now require doctors and nurses to write in regular script. Especially in prescribing medications, where previously only insiders could understand.
Current operation like this is against regulations.
Most formal hospitals have corrected this, with written regulations forbidding doctors from prescribing in cursive.
"Please lie on the examination bed over there. I will examine your abdomen."
Li Jingsheng felt certain but cautiously did the final check.
A small room dedicated to examinations is available nearby, ensuring patient privacy.
Occasionally, bone setting treatments also take place there.
For some bone-setting adjustments, patients need to cooperate by lying down.
Such as hip joint realignment, where the doctor might use body weight to press down for restoring the joint.
After the clinic moved, all services improved.
Many diagnostic operations have indeed become more convenient.
Post-examination, no apparent lumps were found in the abdomen. However, the lower abdomen showed some tenderness.
It seemed unrelated to diarrhea.
"Your condition falls under severe diarrhea, potentially steatorrhea. We’ll start infusion treatment, tentatively scheduled for three times, once a day, preferably visiting daily at a fixed time."
Li Jingsheng contemplated the medication plan.
The clinic now supports both insurance card purchases and direct prescription drugs, significantly boosting its capabilities and patient willingness for treatment.
Based on the patient’s narrative, steatorrhea seemed certain. Her slender build suggested malabsorption syndrome.
Vitamin C, prescribed 40 tablets, orally.
Complex Vitamin B, similarly 40 tablets, orally.
Calcium tablets, prescribed one bottle.
Folic acid, also one bottle.
Additionally, prescribed compound Azithromycin enteric-coated tablets, orally. Mainly for treating steatorrhea.
Despite being prescribed numerous medications, none were costly.
All affordable options.
For underprivileged patients, Li Jingsheng ensures prescriptions balance cost-effectiveness and efficacy.
If patients insist on expensive medications, there’s little choice.
If willing to spend, what more could he say?
Otherwise, he’ll opt for cheaper alternatives where possible. Some expensive drugs might be swapped for substitutes.
Only when no alternative exists, or upon identifying a patient’s need for quality medication, will he prescribe expensive ones.