My Medical Skills Give Me Experience Points

Chapter 1597 650: Hearing Loss Patient, Effects of Vascular Changes on Nerves (Part 2)

Zhou Can wrote a note and handed it to the nurse.

The note must be issued by the consulting specialist for the appointment to be added.

Because the window registration staff doesn't have this authority.

If they dared to randomly add appointments, they'd be scolded by the consulting specialists. No one would be that foolish.

Zhou Can's consultation fee, now that he has been promoted to attending physician, has increased to 16 yuan.

The associate director's fee is 21 yuan.

The special expert fee is the most expensive, the cheapest being 50 yuan, which is the worst. Slightly better ones start at 300 yuan.

Zhou Can himself didn't lack money, plus he was born with a heart of compassion for medicine, and he had repeatedly declined the hospital's offer to upgrade him to a special expert fee.

Clearly, his skills are superior to those of special experts, yet he only charges patients 16 yuan.

This was increased to the level of an attending physician only after being forced upon promotion.

Otherwise, the fee would be even cheaper.

Once the appointment was added, the patient quickly came in.

There were three people in total.

The patient was a young man around twenty years old, with the other two presumably being his parents.

Zhou Can believed he was not particularly skilled in diagnosing hearing impairment.

This is usually advised to be treated in the ENT department.

"Please have a seat! Has the hearing completely failed?"

Zhou Can gestured for the patient to sit down.

The young man could lip-read.

Many individuals with hearing disabilities can guess what the other person is saying by observing the movement of their lips.

This counts as a special skill they are forced to develop.

"Yes, my child was fine when he was born, but later when he was over two years old, he climbed onto the table when we weren't paying attention and fell down. At the time, there wasn't much of an issue, just a bruise on his head. Gradually, we noticed something was wrong with his hearing. Initially, we had to speak loudly for him to hear.

Later, even shouting in his ear didn't work.

We truly regret not watching him closely enough at the time to prevent him from climbing onto the table. It would have been much better. For years, we've been seeking medical help everywhere. His studies, work, and life have all been severely impacted.

Now, he is at the age to find a partner. We've introduced several girls, but as soon as they hear he has hearing problems, they shake their heads and are unwilling even to meet him.

It's frustrating!"

The young man's mother sighed and recounted the incident.

A child is naturally unaware of dangers, so parents must be vigilant.

Many tragedies happen in an instant.

Like this couple, they appear to be in their forties, and both have graying hair.

Ever since their son was injured and developed hearing problems, their lives have been profoundly affected.

The parents live in regret, constantly worrying about their son's illness, unable to experience happiness, fearing their days are filled with agony.

"Have you visited the ENT department?"

"Yes, we've visited ENT, neurology, and neurosurgery in major hospitals. All doctors say there's nothing they can do. Later, we heard cochlear implants might help, but tests showed they were not suitable. The doctors said my child's hearing is entirely lost."

At this point, the young man's mother started to shed tears.

"Don't worry, let me take a look first. You have done various tests, right?"

"We've done many tests! We have several bags full of scans. The older ones are at home, but we brought the latest scans from the past few years."

The father raised a white plastic bag in his hand.

Inside, there were thick check-up materials.

"Alright, let me take a look. If the tests have diagnostic value, there's no need to repeat them here."

Zhou Can aimed to save money for the patient's family.

Taking the bag, he began to carefully review the patient's brain and ear conditions.

Both ears lost hearing simultaneously, and after the injury, the hearing was present initially but later disappeared.

This indicates the condition didn't happen immediately but progressed.

There are specific neural areas in the brain responsible for hearing.

Based on clinical experience, Zhou Can preliminarily deduced that maybe the auditory nerve was injured back then but wasn't treated timely, eventually leading to complete functional loss.

Specifically, the diagnosis must rely on imaging, neural signals, and ear examinations.

After reviewing, the head CT scan of the patient revealed no abnormalities.

Even two high-definition MRI scans from major hospitals showed no issues.

No wonder so many hospitals said it couldn't be treated.

Zhou Can also found this case rather tricky.

"How about doing a head ultrasound to check the blood flow status?"

After pondering for a moment, he discussed with the family.

"Alright, we'll follow your lead."

They had visited so many hospitals that they knew how to cooperate with doctors.

Many doctors, when faced with non-cooperative families, adopted defensive medicine or 'advised to leave'.

This couple likely experienced that as well, and they wised up.

Zhou Can chose to start from the blood supply in the head, exploring an alternative diagnostic pathway.

Since the patient was injured at two years old, and now he's over twenty. Nearly twenty years have passed. Ordinary injuries would have healed long ago and hardly leave any traces.

Nerve damage tests are extremely challenging.

Unlike bone, muscle, or vascular injuries, where problems are apparent on scans, nerve issues usually require neural signal and electromyographic tests.

This patient underwent EEG and neural tests.

The neural signals on the hearing pathway had disappeared.

Based on Zhou Can's experience, an injury typically wouldn't sever a nerve directly.

Given the rigid skull and dura mater that protect the brain, coupled with thin brain cortex and a small amount of subcutaneous tissue as buffers.

Plus, the head is round.

Thus, the chances of severing brain nerves from a fall off a table are minimal.

Zhou Can suspected there might be issues with the blood vessels instead.

But again, CT and MRI scans showed no problems, mainly due to the long duration—the evidence had vanished.

After ordering a head ultrasound, Zhou Can personally led the patient to the ultrasound room for an examination.

"Dr. Xing, can you help with some overtime?"

Zhou Can opened the ultrasound room door and spoke to the doctor inside with a smile.

"No problem, if Director Zhou asks, adding one shift or even ten is a must." Dr. Xing responded cheerfully.

"Really? That's great; I was about to discuss having you add a few more shifts!"

Zhou Can said happily.

"Ahem... Director Zhou, just joking. Adding one shift is fine, but if I add ten, my partner at home might cause a scene every day."

Dr. Xing, in his thirties, instantly showed a bitter expression.

The workload for doctors in the ultrasound room is considerable, but they benefit from punctual clocking out—leaving when the time is up.

Afterwards, they don't need to return to the hospital for overtime due to calls.

For clinical department doctors and nurses, returning to the hospital late at night for emergencies is commonplace.

Moreover, the wages for technical departments are decent.

Neither high nor low.

The key is they bear no significant risk responsibilities.

The young man's head ultrasound began swiftly, with Zhou Can focusing intently on the screen, his gaze sharp like a hawk.

"Don't move, don't move, just at this spot. The blood pathway seems to have changed; do you see that?"

Zhou Can questioned Dr. Xing.

After scrutinizing the screen for a while, the latter smiled wryly, "To be frank, don't blame me, although I conduct ultrasounds daily, I truly can't identify such subtle changes in the blood pathway of the head. My skills are just enough for earning basic pay sitting here, unlike your top-notch expertise."

Dr. Xing couldn't find any issues after scrutinizing for a while.

"You should aspire more; an ultrasound doctor can also be exceptional. In future check-ups, try studying more closely."

Zhou Can spoke to him in a way that was not critical but more encouraging and enlightening.

"Print this out; I definitely feel there's an issue. The change in his head's blood pathway might be related to his fall back then."

Zhou Can seemed to have identified the reason for the young man's hearing loss.

But concretely, it requires further deliberation to devise a treatment plan.

Changes in blood routes are uncommon but not unheard of.