As arrangements had been made, Du Heng tidied himself up and went to a restaurant near Provincial First Hospital to wait.
However, a car accident victim with a shattered arm was unexpectedly rushed into the emergency room. Ma Zichen’s father was called back for a consultation and had to perform emergency surgery.
Du Heng was rather stunned; all preparations were complete, but his guest couldn’t make it. Still, he couldn’t get angry or assign blame in this situation. He had to be understanding. After all, doctors couldn’t control when a patient arrived. After pondering for a moment, since he was already at Provincial First Hospital, he decided he might as well call Xu Pinglin and treat him to a meal. After all, Xu Pinglin’s name was also on the list of those who had signed his recommendation.
"Director Xu, do you have time tonight?"
"Doctor Du, I do have time. What is it?"
"It’s nothing much, I just wanted to treat you to dinner to thank you."
Once Xu Pinglin heard Du Heng’s explanation, he knew what this was about. He laughed and said, "Doctor Du, you’re too polite. You cured my chronic ailment, and I haven’t even treated you to a meal yet. Why would you treat me? Tell you what, let me host. Where are you now? I’ll come find you."
"Haha, I’m just at the restaurant outside your Provincial First Hospital."
"Great, I’ll be right there."
Xu Pinglin had just hung up the phone and was preparing to change out of his white gown and leave work when there was a knock on his office door.
An intern entered and said anxiously, "Director, Doctor Hou is looking for you. There’s a patient he’d like you to see."
Xu Pinglin put the white gown he had just taken off back on and said decisively, "Let’s go take a look."
As soon as he entered the doctors’ office, Xu Pinglin asked, "Xiao Hou, what’s the situation?"
Hearing Xu Pinglin’s voice, the three doctors gathered around the computer immediately made way for him.
Xu Pinglin sat down and began to review the medical record, urging, "Xiao Hou, explain the situation."
The doctor known as Xiao Hou began, "The patient, Chai Yi, is fifty-six years old and has suffered from gastric ptosis for over ten years. He came to the hospital on April 14th with a swollen lower abdomen, having not dared to eat for three days. At that time, the patient didn’t opt for hospitalization and instead took some medicine home. He was brought back to the hospital by his daughter around noon today. His lower abdomen is as distended as that of a woman four or five months pregnant."
Xu Pinglin quickly scanned the medical record on the system and, turning to Xiao Hou, said, "Continue."
"When the patient first arrived today, he appeared haggard and was gasping for breath. Any slight movement would cause him to pant heavily and sweat profusely. According to the patient, his condition worsened this morning. After taking the medicine I prescribed him last time, his lower abdomen became even more distended. When he stands or walks, he experiences soreness and weakness in his waist. We just got the X-rays back; it’s severe gastric ptosis."
Hearing that the X-rays were ready, Xu Pinglin pulled them up on the screen and examined them carefully.
"Did you administer any medication?"
"I tried two different medications for gastric ptosis and also an anti-bloating medication, but none of them worked. In fact, his condition worsened."
"Have you confirmed which medicine he actually took?"
"Yes, I have. His daughter brought in the two boxes of medicine he’d been taking, which is why I didn’t dare use those types again."
Xu Pinglin’s gaze returned to the medical record.
The medication wasn’t working and was actually making things worse. With his gastric ptosis so severe now, surgery was the only option.
For mild cases of gastric ptosis, conservative treatment involving dietary therapy and medication is usually adopted. For slightly more severe cases, minimally invasive surgery can be performed to place a gastric support to alleviate the symptoms. In extremely severe cases, a gastrectomy, or stomach reduction surgery, can be done.
With a plan forming in his mind, Xu Pinglin stood up and instructed Doctor Hou, "Alright, let’s prepare for a gastrectomy."
Unexpectedly, Doctor Hou said, "Director, we can’t do that."
Xu Pinglin was surprised. "Why not? Are the patient or his family unwilling? Conservative treatment can no longer control his condition, so how can we not operate? Or is it because of the surgical fee?"
"No, Director. It’s because the patient has severe gastric bloating and also a clotting function disorder."
Before Doctor Hou could finish, Xu Pinglin frowned. "A clotting function disorder? When was that discovered? Why isn’t it in the medical record? This is sloppy work!"
Startled, Doctor Hou quickly pulled the keyboard closer to add the information to the record, explaining, "I suggested a gastrectomy to him half a month ago, and that’s when he told me he had a clotting function disorder."
Xu Pinglin didn’t pursue the matter with Doctor Hou further. He stood up, making way for him at the computer. "Then contact the Hematology Department. Have them come for a consultation to see if this issue can be corrected. If it can, we’ll proceed with the surgery."
Doctor Hou typed a few characters, finishing quickly. Hearing Xu Pinglin’s instructions, he said hurriedly, "Director, perhaps we should go see the patient first. His condition is deteriorating rapidly. I’m afraid he can’t wait for the clotting issue to be corrected before surgery."
Doctor Hou was also an attending physician, so his assessment of the patient’s condition was generally reliable.
"Alright, let’s go check on the patient first."
Xu Pinglin led several people briskly towards the hospital room. The resident doctors, Residents, and interns who had been loitering in the hallway also tagged along quietly.
By the time they reached the area outside the hospital room, their group had swelled to nearly ten people.
Xu Pinglin glanced at them but said nothing. He’d started out the same way, after all.
Of course, they were just there to observe from a distance; they wouldn’t actually go inside.
However, the moment Xu Pinglin saw the patient, his eyes flickered with surprise.
This wasn’t like being four or five months pregnant; this looked more like carrying twins almost at full term!
He gently pressed the distended, ball-like lower abdomen; it felt empty and soft, like pressing a balloon.
Moreover, the patient was gasping for breath like an ox and struggled to speak; an auxiliary breathing device was already in use.
Xu Pinglin briefly questioned the patient. Finding that his account matched Doctor Hou’s explanation, he then left with the others.
As soon as they stepped out of the hospital room, Xu Pinglin’s expression became solemn.
"Has the anti-bloating medication had no effect?"
"None. His abdomen is even more distended than when he first arrived, so I haven’t dared to give him any more medication."
"What about other methods?"
"I had the family members massage him lightly and also gave him a hot water bottle, but neither seems to have had any effect."
"So, no passage up or down?"
"He isn’t belching, and he hasn’t passed any gas from below."
The gastrectomy could wait, but this gastric bloating had to be resolved first.
Generally, medication, light massage, walking, or using a warmer pad can quickly promote passage of gas from above and below. But now, none of these methods were working, and using more medication would only aggravate the bloating, so he dared not use more.
Walking was even more out of the question. The patient was panting so heavily that even breathing while lying down was difficult; walking a few steps might be unbearable for him.
There was, in fact, another method: using a gastroscope to help the patient release gas from the upper tract. But with his current severe panting, that wasn’t an option either.
This was incredibly frustrating! This wasn’t some rare or complicated disease, but it gave one the feeling of a tiger trying to eat a hedgehog—powerful yet unable to find a way to act.
Back in the office, Xu Pinglin took out his mobile phone and called his department Director, who was attending a meeting out of town. After a lengthy explanation of the situation, the Director, having no better solutions himself, advised Xu Pinglin to arrange a consultation with other departments.