My Medical Skills Give Me Experience Points

Chapter 1448 - 578: Less Is More, Investigating the Cause of Illness (2)

How could merely separating two toes in the middle cause nerve damage?

Zhou Can couldn’t help but recall the patient’s postoperative wound condition again.

Could it be that the nerve distribution of the third toe of the left foot is on the side adjacent to the fourth toe? And then during the separation, the nerve got severed?

This possibility is quite high.

Of course, it could also be that the skin was pulled too tightly while suturing the wound, compressing the nerve. Additionally, postoperative localized hematoma pressing on the nerve is also a possible cause.

The patient clearly felt the third toe of the left foot pre-surgery, but now it’s numb, definitely caused by the surgery.

After studying this for a long time without much progress, Zhou Can decided to have another look during ward rounds tomorrow morning.

Hastily rushing to Cardiothoracic Surgery to help complete two major Level 4 surgeries is besides the point.

By the time he got home, it was already past eleven forty. After showering, Su Qianqian in a pretty lace-trimmed nightgown urged him to go to bed early.

"I’ve noticed that the recent surgical quality in the Emergency Department seems to have some issues, so I specifically asked the nurses to send me the surgical statistics report for the past three months to my email. You go ahead and sleep; I need to review it in detail,"

Zhou Can said apologetically.

His girlfriend went to the trouble of showering and wearing such a pretty nightgown, if he still couldn’t understand her intentions, then he’d be a fool.

It’s just there’s no choice, the work pressure is intense, and he fears he won’t have the energy tonight.

He sat on the sofa in the living room, opened his laptop, logged into his email, and opened the mail from Ye Tingting.

"Patient Wang Jian, 17 years old, male, underwent a ureterostomy tube replacement last Thursday, reported blood in the urine on the third day post-surgery. Surgeon Tang Wannian."

"Patient Zhou Yongbo, 54 years old, male, underwent a necrotic bone removal surgery in the face on September 8th. One month post-operation, he reported facial paralysis symptoms. Surgeon Fu Chachun."

...

It was shocking to see the survey report from Ye Tingting.

Patients were dissatisfied with the outcomes of surgeries, with numerous small issues being very common.

Almost all doctors in the department were involved.

Including surgeries performed by Zhou Can and Dr. Xu, the satisfaction rate wasn’t one hundred percent either.

But relatively speaking, it was much better than other doctors.

Zhou Can’s satisfaction rate ranked first, Dr. Xu was surprisingly pushed to second, and the gap between Dr. Xu and Zhou Can was fairly large. Ranked third was Dr. Cui.

Surgical satisfaction rate can also reflect a doctor’s surgical skill level.

Only high skill level, sufficient meticulousness, and rich experience can reduce the harm surgery brings to patients as much as possible, and prevent a large number of postoperative complications.

It seems that the Emergency Department’s surgical room has a long way to go to grow bigger and stronger!

The road is long and arduous.

Surgery, whether now or in the future, will always be the core competitiveness of the Emergency Department.

Raising surgical quality, Zhou Can alone is not strong enough.

Because truly managing and controlling will offend nearly all the doctors in the surgical room.

Even if some doctors closely associated with Zhou Can won’t resent him, other doctors are sure to be displeased.

Therefore, this matter needs to be discussed with the department leaders together.

...

The next morning, Zhou Can arrived at the emergency ward for rounds shortly after seven.

Besides the only problem of numbness, the female patient in Emergency Surgery bed 1 is recovering well in other aspects.

"How about today, do you feel any improvement?"

Zhou Can asked the patient concernedly.

"It seems about the same, still numb, no sensation."

She appeared quite worried.

"Has the nurse come by to change the dressing this morning?"

"No, she usually comes around eight-thirty in the morning to change the dressing."

"I’ll check it for you again."

Zhou Can put on thin disposable sterile gloves and gently spread her third and fourth toe of the left foot.

"Ah... pain, pain!"

She immediately cried out in pain.

"Honghong, bear with it, Dr. Zhou is examining to find and treat the problem," the patient’s mother comforted her daughter beside her.

Although she comforted her by speaking like this, her eyes were fixed on Zhou Can’s movements, appearing more anxious than the patient herself.

The heart of parents for their children is universally caring.

A mother’s love for her children is greater than the sky, thicker than the earth.

"Come, try to bend your toes."

During yesterday’s examination, Zhou Can only did simple touch tests with a cotton swab.

Having reviewed surgical records and pre-operative examinations later provided no answers. Hence, the examination intensity must be increased today.

Every examination performed by a doctor on a patient has a very strong purpose.

It’s certainly not like kids playing house.

She followed Zhou Can’s request and tried to bend the toes of her left foot; all five toes bent down together.

Because of usually lacking specialized exercise, toes more often resemble pampered princesses, wearing socks, wearing shoes, got thoroughly protected.

This also results in them far less agile compared to fingers.

If you study ancient apes closely, you’ll find their toes about as long as their fingers. As humans learned to use tools, progressing into stone age civilization, their feet gradually gained freedom.

Toes kept degenerating.

Thus, toes are much shorter than fingers. Moreover, trained toes can be as agile as fingers, capable of gripping and performing various high-difficulty tasks. Some disabled individuals who unfortunately lost their arms, after working hard, fully proved this point.

They can dress, eat, write, etc. using their feet.

Under such circumstances, their toes might be as agile as fingers.

Zhou Can used his hands to hold her other four toes, leaving only the third toe of the left foot.

"Try bending again, don’t be afraid of the pain."

She tried bending the third toe of her left foot, Zhou Can could noticeably feel the other four toes exerting force as well. But he held them.

He found the third toe of the patient’s left foot couldn’t bend well.

"Good! Try the fourth toe of the left foot!"

Next, Zhou Can conducted bending tests on the other toes of her left foot one by one.

His mood became especially heavy, as the third toe’s ability to flex was noticeably abnormal. If there was only no sensation pain-wise, but the toe could flex and extend, the situation would remain optimistic.

Currently, even the ability to flex is lost, indicating nerve damage includes motor nerves.

"Next, I will press your foot, close your eyes, if you feel anything normal, don’t speak. If sensory ability weakens or disappears, tell me promptly."

Zhou Can first pressed on her dorsal foot, gradually approaching the third toe.

"Stop, stop, the sensory ability weakened, weakened."

She hurriedly called to stop.

At that moment, Zhou Can pressed near a third of the distance from the base of the third toe.

After conducting some more tests, he had a clear idea.

"Thank you for your cooperation, I’ll continue to follow up or arrange further examinations."

Having examined meticulously, Zhou Can began checking the other beds.

When problems arose, he would earnestly record on his notebook which bed it was, what kind of surgery was done, what the problem was.

Finishing rounds, just as he was about to step out, he saw Fu Chachun coming to work.

The two merely nodded at each other.

Fu Chachun smiled in greeting when he saw others, but coldly glanced at Zhou Can, pretended not to see him, and directly entered the office.

He must be changing clothes.

It seems that Zhou Can calling him yesterday because of the toe numbness of bed 1’s patient made him quite upset.

He must believe Zhou Can is deliberately targeting him.

Zhou Can didn’t bother explaining, there was no need to.

While being a leader, one is sure to encounter quite a bit of resistance when accomplishing things. As long as it is genuinely for the development of the Emergency Department, everyone will eventually understand him.

Looking at the time, it was almost eight.

Gotta rush to the operating room to work, but before that, he planned to talk to Director Lou and Dr. Xu, and report the situation.

His phone rang at this moment.

Looking at it, it turned out to be Vice Dean Bai calling.

Usually, only during holidays does Zhou Can take the initiative to send messages to him with blessings; Vice Dean Bai rarely ever calls him proactively.

There must definitely be something important.