Chapter 143 143 Slow Pulse & Stir-fried Bullfrog Bodyguard & Astringent Pulse...
Soon, all departments began to prepare for the transportation of patients in an orderly manner, and sent Shen Heping to the intensive care unit. Old Wang also followed the person in charge to handle related matters. Jin Yue finished the chores downstairs first, and when he went upstairs again, all the admission procedures had been completed, and all that needed to be drawn and checked had been drawn and sent for inspection. All they had to do was wait for the results.
After Jin Yue disinfected himself, he changed into sterile clothes and entered the ICU to treat Shen Heping.
Shen Heping was lying on the bed at this time, his eyes half open and half closed. In less than two months, he had lost at least 20 kilograms. His previously chubby belly had now become much flatter, his eye sockets were even a little sunken, his face was gray, and he looked extremely decadent.
"Shu...yes...yes...I'm sorry." He squeezed out a few words with difficulty.
But Shu Jinyue didn't care what he said. Saying "I'm sorry" and "I hate you" had the same effect in her ears - a fly buzzing.
She was just observing. Both his expression and tone showed that his condition was not good. In the words of traditional Chinese medicine, he had entered a state of "loss of consciousness" and would soon be in a state of false consciousness, which is what ordinary people often call "last breath of life". No wonder the city hospital did not recommend that they transfer to another hospital. They were not exaggerating to keep the patient. His condition was really not optimistic.
It's rare that just a low-grade fever can make him so sick.
Shu Jinyue first flipped through his medical records and learned the ins and outs of his illness, which was the same as what Xie Meitao had said. He also learned about the treatment process that Xie Meitao was not very clear about: emergency surgery first, the operation process was compliant and smooth, and then anti-infection was given after going down. After the infection index dropped, he was about to be transferred out of the general ward, but suddenly he was found to have a low-to-moderate fever, so he continued to take anti-infection, but it was not effective. Then he increased the dosage of antibiotics and used combination drugs, but the fever still did not go down. He also gave him hormones, but it still did not work. So he started to check the cause of the disease, and did all kinds of examinations all over his body. All systemic diseases were checked, but there was nothing wrong... At this time, it had been more than 40 days since Shen Heping was admitted to the hospital, and his mind began to become drowsy and drowsy.
Also included was a record of a conversation between the attending physician and Xie Meitao, in which the physician informed her that her condition was worsening and there had been no progress in treatment. Staying there might not bring any relief and would cost a lot of money. If she left the hospital and returned home, her survival might not be long. He hoped that her family would consider this carefully. Old Wang also saw it and whispered, "This is to tell them that if they stay in the hospital, they may lose both their money and their lives. If they go home, they will have to prepare for their death. It is really difficult to choose whether to stay in the hospital or go home."
However, Jin Yue really wanted to say that he didn't need to speak so quietly, because Shen Heping had fallen into a coma again and couldn't hear what they were saying at all.
“Let me take your pulse first.” She sat down on the bed, grabbed Shen Heping’s hand, and placed three fingers on his wrist.
The next second, Jin Yue frowned.
His pulse was different from that of all the patients with long-term fever she had seen. Although they all had fever, Xiao Huzi had a rapid and strong pulse back then, Aunt Wang had a floating and rapid pulse last year, but Chen Heping now had a slow and slow pulse.
Regarding the slow pulse, Jin Yue always remembered the pulse formula her master taught her: "It is like the dancing of willow trees in the wind in early spring, or like the gentle breeze blowing the willow branches [1]".
It sounds very vague and abstract. What does it feel like when the willows in early spring are blown by the wind? How should I describe it? She really didn't understand it in the first two years of her clinical practice, but gradually, as her clinical experience increased, the abstract feelings began to become concrete, and she understood the feeling that could only be understood but not expressed in words.
This is the pulse condition of Shen Heping at this time.
The main diseases of slow pulse are also very complicated. The most common one is spleen deficiency. Clinically, many patients with weak spleen and stomach have this pulse condition. The second is severe deficiency of qi and blood, which is more common in people in the postoperative convalescent period, or thin people, and postpartum women. Another is heavy dampness. Spleen deficiency and dampness will block the qi and make the pulse unfavorable. Of course, the classics cannot be forgotten. The pulse condition of solar stroke is slow pulse, which happens to be a point overlooked by many clinicians.
"How is it?" Old Wang asked a little anxiously.
Shu Jinyue explained his reasoning process again, "We need to think carefully about the specific situation."
Old Wang also sat down on the other side of the bed quickly and grabbed Shen Heping's other hand to lift him up. Ever since Jin Yue cured his wife's illness, he has become more interested in Chinese medicine. Whenever he has the chance, he will find Jin Yue to learn and exchange ideas. But after all, he has studied clinical medicine for decades, and it is difficult to change his mindset. Zhao Wanqiu put in a lot of hard work to switch to Chinese medicine. Old Wang is too busy now and can't spare so much time to study systematically. Knowledge is fragmented, and he understands a little and doesn't understand a little.
Therefore, he could not describe the "image of willows dancing in the wind in early spring" at all. "I could only feel that his pulse was beating slowly and he had no strength."
Jin Yue smiled and said, "You will get the feeling after you do it more often."
Old Wang frowned, "By the way, what's his situation?"
"If you say he has a spleen deficiency, his family members said he usually has a good appetite, and they haven't heard him complain of bloating or diarrhea, right? If you say he has a qi and blood deficiency, he is quite fat, at least he was fat before he got sick. His recent blood tests showed no anemia, and his complexion is not yellow."
The two most common causes were ruled out. Shu Jinyue frowned. Could it be due to dampness or sunstroke?
Dampness and sunstroke may both cause low to moderate fever!
That’s right! He still has a fever! His main symptom is fever!
Shu Jinyue's heart moved, and she felt that she must have caught something. But at this moment, someone came to the door and said that the results of the inspection done by the leaders in the morning were out, and some of the data were not good, so they came to ask for her opinion on how to deal with it.
Shu Jinyue didn't want to run around, so he had to go out first, "Teacher Wang, please help me keep an eye on it."
Because he had promised those leaders on the spot in the morning that he would inform them as soon as the results were out, Shu Jinyue wanted to show that his hospital was efficient and the staff was professional, so of course he wanted the results to be as fast and accurate as possible.
“Have the results been reviewed?”
"The director personally reviewed it."
Jin Yue naturally believed in Aunt Wang's professional ability. She took the abnormal lists and looked at them. One person's transaminase was relatively high, two people had high uric acid, another person had high white blood cell count, and two people had low platelets... If you look at them individually, they are not a big problem, but for patients, it has nothing to do with who they are as leaders. As long as they come to Jin Yue's hospital for treatment, Jin Yue will treat them with caution.
"I'll take the order first and give them a call."
Fortunately, they had left their phone numbers in the morning, and Shu Jinyue was not afraid of the trouble and personally called each of them one by one to explain the situation.
"Yes, the transaminase level is high. Its clinical significance may be liver disease, such as hepatitis or something like that. In addition, if you drink alcohol on a regular basis, further examination is recommended." Or prescribe Chinese medicine for conditioning, but Jin Yue remembered that this man was not easy to talk to and had a quick temper. She didn't want to involve him too much on the phone, so she simply suggested further examination.
The other party was a little unhappy, but after all, he was the one that Hu Guizhi protected, so he couldn't say anything. He just muttered: "My physical examination three months ago was still normal, how come it's elevated?"
It’s hard to say about Shu Jinyue. Three months is enough time to do a lot of things and for a lot of changes to occur.
"How about this, if you are free, come to our hospital one day and I will take a look at you?"
The leader didn't take it seriously when he heard it, "Okay, let's talk about it another day."
He hung up the phone.
Shu Jinyue: "..." As expected, one cannot easily call the leader, and it is best to contact the secretary. But those leaders vowed in the morning that Jinyue must contact them in person. She really regretted agreeing to this.
When dealing with these people, you don't know which of their words are sincere and which are just for show, so you have to be very careful.
Shu Jinyue gritted her teeth and administered the remaining vaccinations. As for those that showed no abnormalities, she would arrange for a smart and tactful doctor to deliver them to the leader's office tomorrow. She didn't want to administer the vaccinations one by one.
By the time I finished the call, it was already dark and past nine o'clock. Xu Duan had just come up from downstairs after finishing his work. He had not been idle during this period. He had been helping Jin Yue to look at things and make changes to what was inappropriate. After a day of trial operation, he had actually discovered many problems. He would first arrange for changes to be made, and for changes that he didn't know how to make, he would record them down and discuss them with Jin Yue when he got home in the evening.
"Let's go, let's go home first."
"Are you tired?"
Jin Yue nodded, not even having the strength to open his mouth to speak, "Are you tired?"
"good."
“I didn’t expect Aunt Hu and Expert He to come.”
Xu Duan glanced at her and said, "This shows that you are more important to them than you think."
If she was not so important, every minute of their time would be extremely precious, and it would be impossible for them to attend the opening ceremony of her unknown small hospital. Hu Guizhi even took the initiative to lean forward and was willing to let her take advantage of her.
"I was too narrow-minded before. I always thought I had to avoid suspicion. In fact, they just treated me as a junior. I was too cautious and ended up hurting their feelings."
The young couple was driving and chatting intermittently. Just as they returned to the entrance of Liuye Hutong, they saw two nannies standing there holding their children as a lookout stone.
The two little ones' eyes were slightly red. They were lying listlessly in the nanny's arms, but when they saw the familiar red car, they immediately started screaming with light in their eyes.
"What's going on?"
The two nannies laughed, "Dr. Shu didn't come back tonight, so they didn't sleep at all and didn't even drink milk."
According to their normal life routine, they should have finished their last meal of milk and fallen into a deep sleep by this time. As a result, because he didn’t see his mother, he refused to drink milk and couldn’t sleep.
Shu Jinyue's heart suddenly began to ache, feeling sore and swollen, as if his heart was being rubbed by two chubby hands and soaked in old vinegar.
This is her child!
Xu Duan was also feeling bad. He parked the car at the entrance of the alley, picked up his son, and shook the car hard. Little Xingxing finally laughed for the first time that night, and the two nannies breathed a sigh of relief at the same time.
This is the first time that the two children have been separated from their mother for such a long time since they grew up. No matter how busy Jin Yue is, she will never go home later than seven o'clock. Even if she can't go back, Xu Duan will be there. It is the first time that both parents are not at home at the same time so late as today.
Little Yueliang nestled tightly in her mother's arms, arching her back like a kitten that needed someone to touch her. When Jin Yue touched her head, she really felt comfortable and stopped whimpering.
When I got home, there was no one at home. Teacher Shu and my second brother and his wife had gone to help and they had not returned yet. "No wonder, all the rooms in the house are empty. No wonder they don't want to drink milk. They must be scared."
Shu Jinyue was sighing and didn't even bother to eat himself. He fed them first, and together with Xu Duan, they coaxed each of them to sleep before they started to make their own food. The two aunts simply fried two dishes when they took turns serving, and there was some left. Xu Duan quickly put some noodles in a pot, cut some ready-made sausages and bacon at home, stir-fried them, and paired them with some vegetables, and it was a meal.
The sausages were made by Teacher Shu under the guidance of Uncle Tian and they were delicious. The bacon was sent by Mother Li and was smoked very dry. It had a salty and fragrant taste and was just right with the clear soup noodles. Shu Jinyue ate two bowls by himself. "It would be too tiring to do this every day. Who can endure it?"
"Everything is difficult at the beginning." Xu Duan asked her to go back to the room to rest and look after the child. He washed the pots and dishes, and then chatted with the two nannies for a while. If they encountered this situation again next time, they could call Jin Yue and his factory. As long as they could spare the time, either he or Jin Yue would come back.
In the next few days, Shu Jinyue was still as busy as before. Once he was busy, he simply asked two nannies to take the children to the hospital. There were no patients on the fifth floor of the Qihuang Building for the time being, so the children could play there for a while, and there were clean beds for them to rest when they were tired. Jinyue took the time to go up and see them.
She was busy dealing with the big and small matters of the hospital, and also had to think about Shen Heping's condition. For now, she could only try to deoxygenate him for a few days. However, Xu Duan acted quickly and brought back two ordinary men on the third day.
I say ordinary because they are very ordinary in height, appearance and temperament, just like the tens of thousands of male workers living in Liuye Hutong. You can meet them on your way to and from get off work every day, but meeting them is just meeting. No one will have a deep impression of them because there is nothing memorable about them. Everything about them is average and ordinary.
"This person was introduced by Bao Wengui's comrade-in-arms. He just retired two years ago and hasn't been assigned a suitable job, so he's been working as a kitchen helper in Bao's store." What Xu Duan didn't say was that they were originally from the special forces, and when they were retired they encountered a million-man troop reduction. There were also many military-to-civilian cadres waiting to be resettled. They had no connections and couldn't find any ways out, so they could only choose a job on their own.
"Because they had stayed in the army for too long, they were not well adapted to life outside and ran into some obstacles. Later, Bao Wengui heard about it and asked them to help out in the store, which gave them jobs." Although it was completely unrelated to their previous jobs, the two of them were quiet and hardworking, and they just focused on their work, which made Sister Bao like them very much. When Xu Duan went to take the people away today, she felt sorry and was reluctant to see them leave. She even said, "When Leader Xu's children grow up a little, you should come back quickly and I'll give you a raise."
The more she thought about that scene, the more she wanted to laugh. It seemed that when she went to eat bullfrog in the past two years, she might have eaten the ones fried by two special forces soldiers.
"The one with darker skin is called Li Zhongyong, and the other one who talks less is called Zhang Shouyi."
The two men stepped forward and called out awkwardly, "Sister-in-law."
Shu Jinyue almost spit out a mouthful of water. Both of them were older than her, and she was a little uncomfortable with being called sister-in-law.
Li Zhongyong was a little bolder. He scratched his head and said, "Xu Tuan was the vanguard of our army. Everyone knows his name. Although we are older than him, we are a few classes later than him. Logically, we should call him brother."
So that's how it is. This Xu Duan is quite capable. He can conquer people with martial arts at such a young age. Yang Guozhu once said that they are several years older than him and they all know that a powerful new recruit has arrived. Some of them even come to challenge him to a duel.
A boy of sixteen or seventeen was forced to fight with a group of twenty-year-old veterans who came to his door, and he "beat" them one by one until they were convinced. But such a boy fell into a hunter's trap one night and could only look at the palm-sized sky. He was frozen to the point of hallucinations and heard her call of "Xiao Ba"... Sometimes, Jin Yue really felt that he was lucky to go out to look for cattle that day.
She met him, saved him, and saved herself.
Now that Yue Yi was moved, he would definitely take practical action after getting on the kang. I wonder if he also thought of that snowy night when he squeezed out "Su Su" from his throat again and again when he was emotional, and kissed her feet...
She hadn't thought about her missing toe for many years because she didn't run or jump often and had never worn sandals, so she had forgotten about it.
At this moment, when the not-so-attractive scar on her foot was kissed by his burning breath, her whole body turned into a puddle of water, as soft as if her bones had been pulled out. At the last moment, tears came out, and her eyes were still out of focus for a long time.
Xu Duan cleaned her up before cleaning himself. He turned around to see that she still had her eyes out of focus. He was a little worried because he had lost control and used too much force. "What's wrong? Are you feeling uncomfortable?"
“Very comfortable.”
Xu Duan raised the corner of his mouth. The people he was dealing with outside were becoming more complicated. Those old men who had some money liked to talk about dirty topics, and after drinking, they would tell the truth - they were unable to do it.
Every time they asked him "Is Mr. Xu like this too?" he would agree, "Yes, yes, yes, yes." But in fact, he was not. He was clear about his condition, which was very good, very good. And the praise from his partner is the greatest affirmation for him.
He is really not old yet and still has some strength left.
Shu Jinyue didn't know how many "brain plots" her three words brought to her. Ever since Li Zhongyong and Zhang Shouyi came to the child and began to protect the child's safety, she spent more time in the hospital. As early as the beginning of the construction of the hospital, they had been telling patients in the clinic opposite the San Department Store that they were going to move this year. With continuous publicity, coupled with her own reputation, after only four days of opening, many old patients came to visit, and the outpatient volume increased very quickly.
Because the location is spacious, there are many doctors with different specialties to choose from, and they can also decoct Chinese medicine for you, and you can even get a check-up anytime you want. Not only do the old patients come on their own, they also bring a lot of relatives and friends. Jin Yue originally expected that there would be only about 20 outpatient visits a day in the first week, but the number exceeded 400 in just four days!
This surprise was so big that Shu Jinyue didn't know what to say for a moment. She could only work harder and let the doctors under her work harder to improve their skills to repay everyone's trust in her.
***
That day, she followed Lao Wangtou to the ICU as usual to check on Shen Heping's condition, "How have you been these two days?"
After deoxygenation, he was able to breathe on his own and his oxygen saturation was also good, but the problem was still the same, low fever and drowsiness, so Jin Yue tried giving him two doses of Guizhi Decoction.
Anyone who has studied Chinese medicine knows that Guizhi Decoction is to Chinese medicine what aspirin is to Western medicine. It is a prescription that one learns on the first day of learning. It is known as "the best prescription of all time" and is specifically used to treat colds and sweating, also known as solar stroke.
Because Shen Heping was often drowsy, the consultation did not go smoothly, so Jin Yue planned to use Guizhi Decoction to test the waters first.
At this time, Shen Heping shook his head and opened his mouth with difficulty, “Still…still sleepy.”
Jin Yue checked his temperature registration form. The nurse measured his temperature every two hours. No matter whether it was day or night, morning or afternoon, whether he was awake or asleep, his temperature was always at a low fever level.
This is strange. If Guizhi Decoction is ineffective, then solar stroke is ruled out. Could it be due to heavy dampness?
But if it was heavy dampness, his face wouldn't be oily, his tongue coating wouldn't be thick or greasy, and his stool wouldn't be sticky. It doesn't look like that at all.
The more Shu Jin thought about it, the more he sat down beside the bed and felt his pulse, just like every day before, while Old Wang went to the other side.
"It's still the same slow pulse, nothing has changed."
"Hey, Jin Yue, do you think he may have arrhythmia now?" Old Wang suddenly asked.
"The bedside electrocardiogram I took on the day of admission showed a healthy sinus rhythm."
"Then... why do I feel that his pulse doesn't seem to have an even rhythm?" Old Wang could only think of the terminology of Western medicine. "What is this kind of uneven pulse called in traditional Chinese medicine?"
Shu Jinyue was stunned, and went over to grab Shen Heping's left hand. She had just grabbed his right hand. Soon, within half a minute, she discovered that the pulse in the inch area of Chen Heping's left hand was a not-so-obvious astringent pulse with a very slow pulse rate, sometimes beating heavily and sometimes lightly. Sometimes, when it should have beaten, it was a little late, about one-fifth of a second.
Most people cannot detect such a short period of time, but Shu Jinyue has felt so many pulses before, and her grasp of time is much more accurate than that of ordinary people.
"You are right. His pulse rate is indeed not right. Logically, he should have an irregular heartbeat. Let Xiao Zhao arrange a bedside electrocardiogram right now."
It's so cool to be the director of the hospital. With just one order, there's no need to ask for help from anyone or wait in line. The doctors and nurses in the ECG room will come over with the machine. After connecting several leads, the ECG paper will spit out from the machine.
Old Wang didn't wait for the machine to finish spitting out the paper. He picked up the half-spitted out drawing and looked at it. "No, the electrocardiogram is normal again."
Shu Jinyue took a look and saw that it was true. "I'll take your pulse. I'll say "inflict" and then you guys start."
She suspected that when she was taking the electrocardiogram, Shen Heping's heart rate happened to be normal again. She concentrated, held his wrist, and waited... OK, the dry pulse appeared!
"beat."
"Swish, swish, swish", the drawing came out. Jin Yue did not let go. She was sure that her pulse was still sluggish at this moment.
But strangely, the electrocardiogram showed normal results.
"So it seems that there is nothing wrong with his heart. Then what causes the uneven pulse rate?"
Shu Jinyue didn't say anything. She was still concentrating on taking the patient's pulse, her eyes fixed on the electrocardiogram chart with thousands and thousands of tiny grids.
"Logically speaking, the Cun area on the left hand is the pulse of the heart, right? Heart, his heart is fine, this..."
"The heart and small intestine are exterior and interior to each other."
Old Wang didn't understand, "What do you mean?"
Shu Jinyue did not answer but asked: "Does the duodenum belong to the small intestine or the large intestine?"
Old Wang was puzzled as to why she asked such a simple and basic question. With her comprehensive knowledge of both Chinese and Western cultures, this was not a problem at all. However, he answered smoothly: "The duodenum is the shortest, largest, deepest and most fixed segment of the small intestine."
Shu Jinyue smiled faintly, "I know what's going on."
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