Chapter 627: Chapter 263 Director Zheng Asks for Help, Treating Illness Doesn’t Necessarily Require Getting to the Root of the Problem_3
Director Zheng wasn’t rushing him, but he was concerned that the patient and his family had been left waiting for too long, which could lead to dissatisfaction.
They needed to see that the doctors were making efforts to diagnose and treat the patient.
Not that they were sleepwalking through it.
“Currently, we’ve only determined that the patient has hypokalemia due to alkali poisoning, but we still need to further diagnose and discuss the underlying causes of the patient’s diabetes insipidus and diarrhea.”
Zhou Can delivered some solid findings.
“As expected from the youngest and most promising doctor in our Digestive Internal Medicine department, your diagnostic ability is exceptionally strong. You’ve quickly identified the patient’s hypokalemia caused by alkali poisoning, impressive. I too spent a lot of effort and a great deal of time to reach this conclusion. It seems that the vitality of you young people is indeed powerful!” Zheng Hongtao couldn’t help but praise.
“You flatter me! Since both of us have diagnosed the patient with hypokalemia caused by alkali poisoning, it indicates that our previous diagnosis is essentially correct. As long as we identify the cause of the alkali poisoning, I believe we can make a significant breakthrough.”
Zhou Can was filled with enthusiasm for diagnosing this highly challenging disease.
It was like conquering a city, breaching the walls step by step.
Now, they had essentially breached one defense of the enemy city; identifying the cause of the alkali poisoning would be like tearing open a fissure in the city’s main defenses.
This would then be the breakthrough point in treating the disease.
Huang Liang might be a senior resident doctor about to be promoted to attending, but in this level of diagnosis and treatment, he could not contribute any strength.
He could only stand silently listening on the side.
“Alkali poisoning leads to the movement of hydrogen ions out of the cells, causing a potential difference inside and outside the cell, and the passive movement of potassium ions into the cell, resulting in hypokalemia. What can be done to correct the alkali poisoning?”
Zhou Can’s first thought was treatment.
Some causes could not be thoroughly investigated; treating first and investigating later is a common clinical approach.
This is also known as symptomatic treatment.
It means that once a problem is identified, one could try to correct it for the patient first and then observe the body’s response.
Often, the body may just have a minor error in its entire operating system. Correcting it with medication or other methods can allow the body to return to normal functioning, which is also a valid approach.
This is almost the treatment mode for many chronic diseases where patients need to take medication for life.
In essence, the doctors know that something minor in one of the patient’s three major systems is malfunctioning, but they haven’t found the specific cause. At this point, using medication to forcibly intervene and help correct the error is chosen, ignoring the cause of the error.
The human body is miraculous in this way.
Even if the original cause of the error can never be identified and cured, it does not affect the treatment outcomes with the help of medication.
For instance, people with diabetes just need to have regular insulin injections.
Doctors know that insulin secretion is problematic, but the specific causes are varied and, limited by medical and technological levels, are impossible to fully ascertain.
Ultimately, chronic diseases such as diabetes and hypertension almost invariably require lifelong medication.
“The patient has already received routine intravenous potassium supplementation at another hospital, but it still failed to correct the hypokalemia.”
To correct the alkali poisoning, they needed to start with the symptom of diarrhea.
Zhou Can began to refocus his thoughts on the patient’s diarrhea problem.
Initially, the patient presented with abdominal bloating, which then progressed to severe diarrhea after more than a month.
“Director Zheng, is it possible to perform a small intestine perfusion test on the patient? It would help to identify the type and underlying causes of the diarrhea.”
After thinking for a moment, Zhou Can made the suggestion.
“So your diagnostic approach is still to start with the diarrhea?”
Zheng Hongtao’s eyes sparkled.
When unable to find the cause of alkali poisoning, adopting a new angle targeting the disease itself is also a good method.
“You know the proverb, ‘He who ties the bell must untie it.’ By retrospectively investigating the type and underlying causes of diarrhea, we may solve this enigmatic and complicated case,” Zhou Can said with a smile as he nodded.
Director Zheng immediately discussed with the patient and family that the disease was difficult to diagnose and suggested the patient be admitted for further observation to allow doctors to investigate the cause.
The small intestine perfusion test required planning and a significant amount of time to observe the entire intestinal tract’s function.
Having had ineffective treatment at another hospital, the patient naturally understood that the disease was difficult to cure.
Now, after discussing with these two doctors, it seemed they were making some progress. Seeing this, the family readily agreed to the hospital treatment.
The beds in the Digestive Internal Medicine department were, as usual, in high demand.
They first arranged for the patient to be kept under observation and started the small intestine perfusion test, waiting for a new bed to become available before arranging hospital treatment.