medical simulator

"Doctor Zhou, you are an expert. I came here specially for you. My foot has been in pain for several years, and it hasn't healed."

"Some people say that my feet need to be operated on, and others say that I need more physical therapy, but I have done physical therapy and massage many times. It was effective at that time, but the root cannot be removed." Le, a middle-aged woman. Ha ha, looks like an optimist.

Zhou Cheng came in from the other party, and he probably understood what the situation was like, so he said, "Auntie, your foot hurts. When you are standing, it hurts a lot, right? When you sit, it will be better?"

"Yeah, yes, yes, doctor, you are right." The middle-aged woman took off her shoes, which were hard-soled sandals and slippers, then raised her legs and pointed out the exact location to Zhou Cheng , probably in the center of the sole of the foot.

"It's here, even if you press it, it still hurts." The middle-aged woman gasped as she pressed.

Seeing this, Zhou Cheng smiled, put on the mask, changed a pair of gloves, and muttered in a low voice, it can be regarded as seeing a common disease, this is plantar fasciitis, a very common disease, frequent In middle-aged and elderly people, it is caused by the adhesion of plantar fascia.

However, even though he was hesitant, Zhou Cheng did a physical examination carefully, and then pressed the aunt's chubby feet, and found that the bones were fine.

Then I stood up and said, "Have you ever been injured? Have you ever taken any pictures?"

Empirical theory cannot be generalized. Although the possibility of plantar fasciitis is the greatest, in fact, it is still necessary to exclude spontaneous fractures, calcaneal arthritis and other differential diagnoses.

"It was taken, but I didn't take it. The doctor said it's okay. But it just hurts." The aunt stopped her foot, and then looked at Zhou Cheng eagerly.

Zhou Cheng also returned to his seat, took her medical records, began to write a physical examination, and then said: "I will prescribe some medicines for you, if you can follow the prescriptions, the pain can be relieved quickly, but, You have to keep using it."

"Okay, okay, you take it, I must remember it carefully and take it on time. My daughter-in-law just had a grandson. I hugged him for an afternoon a few times before. Oops, my feet are almost useless. I lay down for two days to get better. , I’m going to see a doctor immediately.”

"Alas!" The middle-aged woman looked happy and disappointed at the same time.

Zhou Chengcheng said: "After you go back, you buy a few pairs of good sports shoes, and you tell the shopping guide that they are the kind of shoes specially designed for running by athletes, and you should wear these shoes."

"Second point, don't eat too greasy food after you go back, only eat lean meat."

"Third point, your food intake should be reduced to at least a quarter of what it is now, and you should eat less and more meals. For example, if you eat three meals a day, change it to four meals. Each meal should not be too much. "

"Fourth point, you can go to the nutrition department to see if they have a diet for you. If you can control your weight and stick to wearing good, soft-soled shoes, your pain will be relieved a lot."

"Then if you continue to insist on foot soaking and physical therapy, then the pain will be gone, and it is not impossible."

The middle-aged woman opened her mouth wide: "This is the prescription. I thought there was medicine? I won't take it? Are you hungry?"

"You will be hungry, but it will be fine after a while. Eat less frequent meals, eat less fat meat, and eat less staple food. Otherwise, if you don't lose weight, this pain will always exist. And in the future your There will also be problems with the joints, and major surgery will be required at that time." Zhou Cheng said with a smile.

It's not alarmist talk. After seeing the weight of the aunt when she came in, he probably guessed what the problem was. In fact, this kind of plantar fasciitis can also occur in some thin people.

It is more common in women, and it is more common in young women.

High-heeled shoes, hard-soled, hard-soled stilettos that violate the arch of the foot, are simply natural raw materials for plantar fasciitis, and do not require any special cooking methods.

Even if the accident does not occur, the stress may accumulate to the tibia, and then a stress fracture will occur.

"Hey, what's the point of eating meat if you don't eat fat here. Let me tell you, Dr. Zhou, I think the meat is delicious, and the lean meat is all chai chai. How to eat."

"Then you can eat eggs, just eat egg whites, or eat beef, the fat content of fish is a little bit high."

With that said, Zhou Chengcheng finished writing: "That's about it. Remember to stick to it when you go back. It's more cost-effective to spend money on a few better pairs of shoes than taking medicine, and you will be able to hold your grandson when the time comes. After you lose weight, you will lose weight." , I will be much more relaxed..."

When it came to holding a grandson, the middle-aged woman nodded seriously: "That's fine, I will try it for the sake of my grandson, otherwise Sister Wang will say, I don't have a grandson, and my son will not care about me in the future."

With that said, she picked up the medical record and left, opened it and looked back, "Doctor, I know your name, don't you?"

Zhou Cheng smiled and didn't answer, but Ziyi went up and explained: "There are some incomprehensible characters, which are Latin characters or abbreviations. Not all characters are incomprehensible."

"Then I'm relieved." She turned around and went out. It could be seen that she had a good personality.

Probably without a grandson, she is so optimistic, it is impossible for her son to ignore her...

After Ziyi brought in the next patient, he asked Zhou Cheng: "What is the diagnosis of the aunt in front? Doctor Zhou, I also occasionally feel pain in my feet."

Hearing this, Zhou Cheng turned to look at her shoes, and said, "You don't need to buy flat shoes, just wear more nurse shoes, and you don't need to lose weight."

"While wearing high heels can make people look beautiful, it can also hurt your feet. We must pay attention to protecting them. Our orthopedic joint surgeons have never taken the elevator to take the stairs, just to protect our knees." Zhou Cheng explained carefully.

Ziyi asked in astonishment: "If you don't even climb the stairs, don't you want to keep fit?"

"Fitness, but we orthopedic doctors never do squats that hurt joints. We prefer swimming, low-speed jogging, and seldom use treadmills. Even if we are lifting weights, we will choose single-joint exercise. It’s not like choosing a multi-joint movement method.”

"Exercise is also particular. Look at the muscles you are exercising, and then find a more scientific exercise method in a targeted manner, otherwise."

Before Zhou Cheng finished speaking, he looked at the two young girls who had just come in. From their attire, he estimated that these two girls also danced, or they were doing aerobics at home or something.

"Hello, what's wrong with you?" Zhou Cheng asked.

"The back of the knee is uncomfortable. It's been several weeks. I went to other places before and said it was going to be operated on. I was a little scared and didn't do it. But recently, it still hurts. When I squat down and stand up , especially painful."

"Then I happened to see Dr. Zhou's outpatient clinic, so I came here." The elder sister who spoke was not very old, she should be around 20 years old, and beside her was a girl of seventeen or eighteen years old, who was somewhat similar to her, and should be It's my sister.

"Do you both have knee pain? Are you dancing Pamela at home?" Zhou Cheng asked tentatively.

According to the literature he has learned, girls in the city currently have a high rate of chronic knee joint injuries due to various factors such as maintaining their figure and doing aerobics.

And Pamela is a relatively common type of aerobics...

"Yes." Both sisters nodded at the same time.

Then my sister reacted and asked: "This is our MRI. Some doctors said that we are naturally thicker, and then we need surgery to cut it off, and then the pain will be fine."

She was still quite alert and didn't say which doctor it was.

However, even if what they said was incomplete, Zhou Cheng also knew that this was a very common meniscus in the field of sports medicine. The disc-shaped meniscus was easy to rupture and belonged to an abnormal meniscus.

However, after Zhou Cheng read the film carefully, he found out: "Hey, your meniscus is still relatively good. It is not broken. Why do you need an operation? What did the doctor who showed you before say?"

"Here." My sister took out the MRI report again.

Then I saw, on the report sheet, the words "suspicious meniscus injury" were written!

Well, Zhou Cheng probably understands that this is a medical doctor, that is, when Zhou Cheng participated in the annual meeting of orthopedics in Hunan Province, the old professor at the Second Affiliated Hospital of Hunan University criticized him for only reading the report card when seeing a doctor. that kind of existence.

Seeing Zhou Cheng's flickering expression, the girl asked anxiously, "Doctor, is our situation very serious?"

Zhou Cheng shook his head: "No, your knee joints are quite normal from the MRI. However, in order to make a more accurate diagnosis, I need to do a more systematic knee joint examination on you."

Simply looking at the report is a report card doctor.

It is not advisable to simply watch films, even film doctors.

One of the reasons why clinical doctors cannot be replaced temporarily is that there are many factors involved in diagnosis, which are not one-to-one correspondence.

Zhou Cheng then went to do the physical examination. After a while of operation, Zi Yi was completely dazed, not knowing how to draw a pen.

That's it, if you write down the physical examination of the knee joint in detail, including Zhou Cheng's key examinations, it will take at least four to five hundred words.

It is not common for ordinary medical students to understand such things as inner and outer Maxwell's sign, hyperextension and flexion pain, patella pressing pain, pain point examination, inner and outer stress test, etc.

In fact, the two of them only signed up for one number, so they only need to write a medical record. After finishing writing, they said: "In your situation, just take a good rest for a while, don't continue dancing, if you don't rely on this If you eat, rest, and control the frequency in the future."

"During this time, if you want to keep fit, choose a more soothing way of exercise like swimming."

"Then, shall we have an operation?" My sister hurriedly asked, this was the question she was more concerned about.

Zhou Cheng shook his head and said cautiously: "My personal opinion is unnecessary. You can also refer to the opinion of your previous doctor."

It is not kind to tear down the stage.

However, it is also necessary to give personal opinions.

But my sister said: "Doctor Zhou, then I must trust you. You are a great doctor in Shanghai, and you must have a lot of knowledge."

"Can I add you on WeChat, I can ask you some questions in the future." She blushed a little boldly.

Zi Yi was also taken aback.

Zhou Cheng smiled and said: "Thank you for your trust. Our doctors have clear rules that we cannot give out contact information casually, because we are afraid of causing corruption, and we will not be able to explain clearly at that time, so let's avoid such misunderstandings." .”

The two sisters hurried out.

Originally, it was a bit too much to have the courage to ask Zhou Cheng on WeChat, but now that Zhou Cheng refused, they were too ashamed.

Only a clear and beautiful voice came in from the door: "Sister, have you taken a fancy to this handsome big brother?"

"Me? I didn't. I just asked questions about fitness." My sister retorted.

"Oh, that's good. I think he is so handsome. I like her a little bit. He will be my new idol in the future." The younger sister breathed a sigh of relief.

Zhou Cheng: "..."

What the hell?

Zi Yi looked at Zhou Cheng again very curiously. He is tall, handsome, highly educated, and strong. He is definitely a very high-quality boyfriend.

"Doctor Zhou, these two beauties are pretty good-looking, why don't you add them on WeChat?"

"The hospital doesn't have a clear rule that doctors can't give patients contact information?" Zi Yi asked tentatively.

Zhou Chengcheng simply said: "Oh, I usually don't send WeChat messages to patients."

"Then can I add your WeChat account? Dr. Zhou?" Zi Yi then hurriedly asked expectantly, taking advantage of the opportunity to take over the question. Most men probably wouldn't refuse.

Zhou Cheng narrowed his eyes slightly: "Doctor Zi, do you want to discuss academic issues with me? If so, we can have a face-to-face meeting now."

Although Zi Yi looks good, she lacks a kind of temperament. It doesn't mean that she is not good enough. It can only be said that everyone's experience is different, and the people they meet are different.

In terms of cuteness, Ding Dian can hang her and hit her, Zhou Cheng thought to himself, if there is a comparison, it is much more appropriate for him to tease Ding Dian than Ziyi.

In terms of knowledge, she is not as good as An Ruo before, and in terms of being well-behaved and sensible, Tan Min is better than her.

Besides, if it wasn't for An Ruo, if Zhou Cheng was looking for a girlfriend now, there would probably be many people who would introduce him to girls from Kyoto and Shanghai, daughters of rich families, good-looking girls, education background, knowledge, or careers. able to reach.

Ziyi didn't reply.

Zhou Cheng continued: "What kind of physical examination did I just do?"

Ziyi continued not to answer, her face turned slightly pale.

Zhou Cheng continued to ask: "These two girls just now, what is the diagnosis they might consider? What are the differential diagnoses? Why did they consider meniscus damage in the MRI just now?"

"What do you think about the definition and diagnostic criteria of a discoid meniscus?"

Ziyi walked out the door, a little angry: "Doctor Zhou, I don't even know."

Zhou Cheng also ignored her anger, it doesn't matter whether Ziyi came here to be his assistant, she voluntarily, or someone arranged, it doesn't matter, you and I came to study, at least you came here for this reason.

If you don’t ask doubts, if you don’t understand the basics, and if you ask irrelevant questions, then what are you doing here?

I haven't done a good job on the surface, so I might as well bring Fang Yun here, maybe I can really discuss some issues.

Next, Zi Yi was honest, although her voice was still very sweet, but it seemed that she was really angry, as if she was doing business.

Zhou Cheng was happy to see that Ziyi was so serious about his work, and then he devoted himself to seeing the doctor.

The patients who came here were all kinds of strange things, every sub-specialty had them, and Zhou Cheng even saw two children who had relapsed after bone tumor treatment. The parents of the patients were almost desperate, so they brought them to Zhou Cheng to ask if there was any comparison. Good rescue plan.

Zhou Cheng gave several suggestions, but they were all told to go to Shanghai or Shashi.

It's not that Zhou Cheng is unwilling to do it in Chang City. The main reason is that the development of the pathology department in Chang City is not mature enough. Without the assistance of the pathology department, Zhou Cheng dare not do it recklessly. Cheng was also very helpless, looked at the two families, and left almost in despair.

I don't know what choice I will make in the future, whether to give up or continue to seek medical treatment.

Then, Zhou Cheng also saw a lot of patients who obviously needed surgery, but refused to do it. Some of them did it for money, while others were out of fear of the surgery. Therefore, taking medicine can help, But it is absolutely impossible to do surgery.

Moreover, there were those who forced Zhou Cheng to prescribe some painkillers, but Zhou Cheng could only agree, and Zhou Cheng did not prescribe other hormonal drugs that were within the rules.

Perhaps it was because of Zhou Cheng's relatively high reputation, although the patient was angry, he didn't make a big fuss.

However, for the last patient, after Zhou Cheng told him not to have surgery in his current situation, the patient started to make a fuss.

"Doctor Zhou, you have to see clearly. I am in such pain that I can't live (er). If you make a wrong diagnosis and treatment, then I will trouble you." The patient is a A man in his 40s, thin and shrewd looking.

He was injured in a car accident before, and this time he came for a follow-up visit. He wanted Zhou Cheng to give him a leave note for one or two more years, saying that he was not suitable for work.

Zhou Cheng only said: "I'm just making some suggestions based on your current symptoms and your auxiliary examination. Your current situation, the bone healing is possible, does not match the signs you described at present."

"Your current situation does not require surgery or other special treatment. If the pain is severe, I suggest you go to the pain department to see if there are other pain factors."

"If it's just because of the fracture two years ago, then the current level of rehabilitation does not support such a strong pain."

When the man heard this, he became annoyed: "Doctor Zhou, what do you mean by that? Do you think I'm faking it? You're not the one who co-authored the pain, right? I'm in pain? I just came to see the doctor, you, I'm here to see Did you solve the problem?"

But after finishing speaking, his tone softened again: "I can't stand the pain, I want to rest. But the unit needs your doctor to issue a certificate for me, please write one for me, please help, it's troublesome."

Speak politely though.

But Zhou Cheng shook his head: "Sorry, your temporary objective information does not allow me to write you such a long leave note. At most, I can only suggest to you to rest for half a month, review, and then according to the situation of the review, see if it is appropriate. An extended break is needed."

"What's the use of half a month? I come to see you once every half a month, and you're bothered, and I'm also troubled. Doctor Zhou, just give me a one-year prescription. That way you'll save trouble, and I'll be troubled too. "

"I can't bear the pain at all. Where can I go to work? Just help me." The patient had a painful expression.

"I'm sorry, I can't do anything. If you feel the pain is serious, I suggest you go to a higher-level hospital, or go to the pain department, or go to Kyoto or Shanghai to see." Zhou Cheng continued to give advice, such a person, in fact, the purpose very simple.

Lao Lai, he fell in love with the driver or someone who hit him, and wanted to get something for nothing!