Chapter 256: Treatment of deafness, a hunky boy meets a violent mother

"Last night her child sneezed and started bleeding again. She came to my clinic in the middle of the night. After examination, I found purple ecchymoses on the back of the child's hands and feet. I then checked the child's mouth and found that there were sublingual and oral

I think the mucosal blood vesicles are most likely to be acute ITP. Because the child is still young, only 5 years old, the possibility of congenital T cell defects is low. In the end, my initial diagnosis was acute ITP caused by viral infection."

Li Jingsheng explained his diagnostic ideas in detail.

Dr. Wang is simply unable to intervene in such a difficult case.

That means Dr. Shao can participate.

Internal medicine actually tests clinical experience, clinical diagnostic thinking, basic medical knowledge, and case knowledge.

Only a doctor who possesses the above four advantages can become an excellent internist.

If you want to become a top physician, you need to have a high level of prescription and medicine on this basis, as well as be bold, careful, thoughtful, and good at careful observation. If you can also communicate well with patients and family members, it will be even better.

alright.

The breakthrough of many difficult cases may be due to a small thing that the patient or family reacts to, or a symptom that is difficult to talk about.

"I really learned a lesson today! I didn't think about it at the time. I was always worried that my child might break a deep artery and cause intracranial bleeding. Who would have thought it could be ITP!"

Dr. Shao looked at Li Jingsheng with a hint of admiration.

It has only been a few days since I came to Sunshine Clinic.

However, Li Jingsheng has already performed more than a little better than his old doctor in many fields of internal medicine.

Young, knowledgeable, and with top-notch clinical diagnostic thinking, such a young doctor has unlimited potential!

"Doctor, can you please check my child's ears? Recently, the teacher said that she cannot concentrate in class and is always distracted. I call her from behind, but she can't seem to hear her. I am worried that there is something wrong with her hearing?"

A mother in her thirties came to see a doctor with an eight or nine-year-old girl.

Basically, there are only a few types of patients who come to the clinic for treatment.

One type is those who are greedy for cheap, have poor or average financial conditions, and are afraid of spending too much money in the hospital.

The second category is for convenience, as you live close by and don’t have to queue up to see a doctor at the clinic.

In fact, before the Sunshine Clinic recruited doctors, people had to queue up for a long time to see a doctor.

But now there are three doctors on site, and the situation has been greatly improved.

Some elderly people don't know how to register, let alone where blood is drawn here and where examinations are done in big hospitals. They are afraid of going into the hospital. Their children are not around, so they come to the clinic for treatment.

Not to mention it’s cheap, and there aren’t that many complicated procedures.

The third category is out of trust, and may also be for reasons of convenience and benefits.

Basically these are the three types of patients.

This mother probably brought her daughter to the clinic to see a doctor in order to save time and money.

"Girl, please close your eyes!"

Li Jingsheng said to the girl.

She closed her eyes.

"How old are you this year?"

"Nine years old!"

"What grade are you in?"

Li Jingsheng deliberately lowered his voice.

"I didn't hear you clearly, please speak louder."

"I asked you what grade you are in?"

"Reading third grade."

"What's your name?"

Li Jingsheng deliberately asked from her right side this time.

No response.

"May I have your name?"

This time it was changed to the left side.

"Wang Chunlan!"

She can hear clearly.

Li Jingsheng felt confident.

"Okay, open your eyes! Have you felt any discomfort in your ears recently?"

"No! I just feel my right ear is a little itchy sometimes."

"Have you ever dug your ears?"

"Pick it with your fingers."

"Are you feeling uncomfortable elsewhere in your body?"

"No."

At this point in the consultation, Li Jingsheng basically concluded that there was something wrong with the little girl's right ear.

"Come closer and I'll show you your right ear."

He took a small flashlight and looked at the child's right ear. He could see that the ear was basically blocked by a black substance.

It doesn't look like blood, it feels like cerumen.

"Go lie down on the bed over there! There is a foreign object in your ear. I will use tweezers to help you take it out."

Two treatment options quickly appeared in Li Jingsheng's mind.

Use tweezers to take it out, or use 5% sodium bicarbonate solution to drop the ear, let the cerumen swell, and then wait a few days before letting the child come over to flush the external auditory canal.

The first method is efficient, fast and less expensive.

Children suffer less.

After he let the child lie down, he turned to Han Siying and called, "Siying, come here and help this little girl's head."

Now whenever she has time, she will go to the medicine sales area to sell medicines.

It's really busy over there.

Of course, what makes her so active is the considerable commission from selling drugs.

After she received the customer, she hurried over to help.

"I'm going to remove the cerumen from the child's ears. You have to hold her head steady and don't let her turn."

"clear!"

She nodded in agreement.

If the foreign body in the ear is pinched, the child will feel itchy or painful and will move around.

This can easily injure the external auditory canal and even the interior of the ear canal, including the tympanic membrane.

Safety is an issue that cannot be ignored.

After Han Siying held the little girl's head, Li Jingsheng carefully helped her remove the foreign object from the ear canal.

It feels extremely hard and stuck very tightly.

It may have something to do with the fact that little girls usually pick their ears with their fingers.

This will only cause the cerumen to get stuck deeper and tighter.

Because the ear canal will automatically secrete "earwax", especially oily ears, it will be more serious.

Under normal circumstances, the ear canal has a self-cleaning mechanism.

It will keep moving as we talk, chew food, etc., and automatically expel dirt from the ears.

It can be understood that it is a spiral movement mechanism.

It is precisely because of this special ability of the ears that we can ensure that our ears will never be blocked by earwax.

When the ear canal is blocked, the garbage inside cannot be transported out, and new earwax is continuously produced, which accumulates and eventually turns into this huge cerumen.

After a lot of effort, a huge piece of cerumen with a length of more than two centimeters was removed.

The little girl showed an extremely comfortable expression.

"Don't move, don't move, I'll show you again."

Li Jingsheng checked her again and found out some tiny cerumen, and finally the cleaning was completed.

Next, she checked her left ear and found a large piece of cerumen.

It's just not as blocked as my right ear.
To be continued...