The Enhanced Doctor

Chapter 1280: Chapter 1280: Cold Patient with Breathing Difficulties

Coming out of the anesthesiology department, Liu Banxia felt much more relaxed.

In a surgical operation, the role of the anesthetist is significant. Now with Wang Lei present, this surgery gains an additional layer of assurance.

It can be said that although the liver transplant surgery is still some time away, the emergency center is already prepared. Everything is in place except for the crucial element—the favorable condition.

This crucial element depends on when the patient’s body indicators become qualified.

Returning to the first floor, Liu Banxia decided to blend in and wait for the end of the shift.

"Teacher Liu, I have a patient and I’m a bit unsure about the diagnosis," Su Wenhao approached.

"What’s the situation?" Liu Banxia inquired.

"The patient has a history of fever and fatigue lasting about half a month. They took cold and fever-reducing medications and showed some improvement, but in the last two days, there’s been a recurrence of high fever along with chest congestion," Su Wenhao explained.

"Such a prolonged fever? It definitely isn’t just a cold, a normal cold usually resolves in about a week. How did the auscultation go? What was the fever temperature?" Liu Banxia asked.

"Auscultation revealed a few moist rales in the lungs, but the breath sounds are symmetrical, and the heart sounds are normal. The temperature is 39.3 degrees Celsius, and we did an ECG, which was negative," Su Wenhao replied.

"We’ve ordered a complete blood count for the patient and will also measure cardiac enzymes and troponin, then send him for a chest X-ray. However, the patient is very young, only 24 years old, so it shouldn’t be a heart issue, right? The ECG was also normal."

"So, what is the reason for your uncertainty?" Liu Banxia asked.

"The patient has symptoms of chest congestion," Su Wenhao said.

"My initial assessment would be that the patient’s main symptoms suggest pneumonia, but since there’s also the chest congestion, we have to consider potential heart issues. So, I suspect it might be myocarditis," Su Wenhao continued.

"But the patient doesn’t have any chest pain or other pain symptoms, just some chest congestion. I’m also worried it could be something like a pulmonary embolism," Su Wenhao added.

Liu Banxia chuckled, "You have quite a few considerations, but before clear test results, all these possibilities exist. Let’s wait for the results first, anyway, it’s not very busy today, so the results should be quick."

Su Wenhao nodded. He was considering many possibilities, which made him a bit uneasy, so he reported to Liu Banxia.

Whether it’s myocarditis or pulmonary embolism, both can be life-threatening.

"You can still feel free to ask me now, but in a few months, would you really feel comfortable coming to me with questions?" Liu Banxia asked.

"I would feel comfortable, as the patient’s situation always comes first, and if I’m unsure, I must ask," Su Wenhao replied candidly.

"That’s not quite right either, you should look at the specific situation. Currently, there’s only this possibility, but we haven’t seen the test results yet," Liu Banxia stated.

"Anyway, I’ll watch how you handle the diagnosis next; consider it a test. The patient might have other issues or it could just be simple pneumonia," Liu Banxia remarked.

Su Wenhao laughed, "Rest assured, I will definitely take this seriously."

"It’s already the third day of the Chinese New Year, have you booked your ticket yet?" Liu Banxia asked.

"Teacher Liu, I was just thinking about discussing this with you. Can I leave a few days later? I want to observe that liver transplant surgery," Su Wenhao said nervously.

"I thought it was something more serious. This shouldn’t be a problem," Liu Banxia replied with a smile.

"I just wanted to give you a break, so you can go home and give your family some confidence, letting them know that staying here was the right choice."

"Actually, they’re very supportive of me now and understand that I’m learning real skills here," Su Wenhao said.

"The more renowned you become, the better. They all know I’m learning medicine from you. The more famous you get, the more they know I’m learning something impressive," Su Wenhao added.

Liu Banxia felt a bit helpless; who would have thought Su Wenhao had such thoughts.

"Doctor, doctor, I’ve finished my X-ray. The doctor over there said we can take a preliminary look on the computer, and the problems shown are not serious," the patient came over.

Liu Banxia glanced at the patient and slightly frowned; the patient was a bit thin.

"Alright, wait a moment. I’ll take a look first," Su Wenhao nodded.

He pulled up the patient’s chest X-ray on the computer. The X-ray showed mild inflammation in both lungs. This aligns with the pneumonia diagnosis, but how to explain the chest congestion?

He stole a glance at Liu Banxia, who provided no response.

"Based on the current examination results, there is some inflammation in the lungs. Let’s wait a bit and compare it with the blood test results," Su Wenhao said to the patient.

"Besides the flu-like symptoms, fever, and chest congestion, do you have any other symptoms? Think carefully, for example, issues with urination or appetite?"

"Urination is normal. I drink hot water at home, but I eat less and don’t have much appetite. In other areas... there are no issues," responded the patient.

"When you asked me during the examinations if there was any pain anywhere, there wasn’t. Just fever whenever I drink water and sweat a bit, I feel better, and then the fever returns," the patient explained.

"Then let’s wait a bit longer and see what the blood test results show," said Su Wenhao.

He confirmed again with the patient to check if there was inflammation in other organs and tissues. The patient’s response and physical examination basically ruled out other possible conditions.

Originally, he wanted to consult Liu Banxia again, as it was a habit and reliance. But recalling what Liu Banxia just said, he decided to wait for the blood test results.

Although the patient’s lungs were inflamed, the current fever was quite severe. If the fever was indeed caused by pneumonia, it might be a difficult bacterium to deal with.

After waiting a while longer, the patient’s blood test results came back.

The myocardium enzyme and troponin indicators were normal, but the white blood cell count was slightly high.

This made Su Wenhao feel a bit relieved. He approached the patient and said, "At present, the blood test results show only a high white blood cell count, diagnosing your condition as pneumonia. We will give you an intravenous drip of levofloxacin shortly, and some paracetamol to reduce the fever."

"Doctor, will I be fine after finishing the drip?" the patient asked.

"This depends on the situation. You should stay in the hospital for observation tonight. Your fever is quite high, and you also have chest discomfort. We need to be extra cautious," Su Wenhao replied.

Hearing this, the patient looked a little troubled, "Stay in the hospital? Can’t I just get prescribed medication after the drip, or come back tomorrow for the infusion?"

"Pneumonia is a common illness now, usually curable with antibiotics. But in the past, it could be fatal," Su Wenhao said.

"Besides, with your chest discomfort, we need to observe and determine the cause. Hospital observation is the best and safest approach."

"You should contact your family. Although it’s the New Year, we have to treat any illness. If you’d come to the hospital instead of taking medicine at home, you might be well by now and enjoy the New Year peacefully."

The patient hesitated slightly and then nodded.

"I’ll prescribe your medication now, and you can have the drip here. We’ll see how the treatment works," Su Wenhao said.

"Doctor, how many days will I need the drip?" the patient asked.

"Judging by your fever and medical history, it might take about a week," Su Wenhao replied.

"But it also depends on what bacteria caused the pneumonia. If it’s from Mycoplasma or Chlamydia infection, it may take over two weeks."

The patient nodded and then went to get the prescription.

"Teacher Liu, why do I still feel a bit uncertain? Do you think it’s excessive to do a CT scan to check for pulmonary embolism?" Su Wenhao asked.

Liu Banxia also nodded frankly, "Based on the current signs, a CT scan is indeed a bit excessive. After all, the chest discomfort could just be a false sensation due to prolonged illness."

"Without clear patient requests or indications, we can only proceed from low to high level. It’s unavoidable; we must prepare for all possibilities."

Su Wenhao nodded, acknowledging this possibility.

The patient might seem compliant in the examination now, showing no resistance, but what happens afterward? Some patients might develop concerns.

Liu Banxia had reminded them several times to protect themselves properly.

Receiving patients is important, but self-protection must not be neglected. Without proper self-protection, there might be no chance for future patient encounters.

This protection doesn’t mean being overly cautious, but rather following the rules.

For this patient, the protocol is to conduct examinations from low to high levels.

Unless new pulmonary symptoms occur, a CT scan plain film is unnecessary. For now, treatment is the priority.

If the patient hadn’t mentioned chest discomfort, even an ECG would be unnecessary.

Indications are crucial; without them, you can’t do anything else.

After completing the payment, the nurses began the intravenous drip for him.

This is the standard treatment for pneumonia. If there are no problems after observing him overnight, he can come for the infusion and leave afterward in subsequent treatments.

"For now, this is the best we can do. Let’s be more attentive tonight," said Liu Banxia.

Su Wenhao nodded.

"Dr. Su, Dr. Su, this patient just experienced respiratory distress,"

As soon as he nodded, the nurse adjusting the patient’s infusion rate shouted and immediately removed the needle.

The patient’s condition indeed seemed concerning, struggling, and gasping heavily.

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