With a sad look on his face, Felipe asked the core question that concerned him the most and had troubled him for many years.
Because Zhou Qiao also told him just now that diabetes is mostly caused by obesity. If obesity is not solved in one day, diabetes will probably be difficult to completely control.
Old mother Taylor also looked over with burning eyes.
Diabetes was unplanned, weight loss was the purpose of their trip.
Zhou Qiao pondered for a moment. In fact, he had been thinking about this issue since he diagnosed the patient yesterday. Considering the patient's weight and history of obesity, other weight loss methods are unlikely to be effective. Only gastrectomy surgery can truly achieve success. Hope of losing weight.
No matter what kind of medicated diet, diet, or exercise, it is almost impossible!
Moreover, the other party's physical condition is very poor and he cannot do strenuous exercise. If he really wants to do those strenuous exercises, if he does not lose weight, he may die!
The other person's obesity is life-threatening!
It may be while sleeping, it may be while walking, it may be that you fall and cannot get up. You are somewhat lucky to be alive till now.
Therefore, Zhou Qiao solemnly recommended this method.
After gastric resection, supplemented by medicinal and dietary conditioning, it should be feasible!
As for gastric resection surgery, although he has never done it, doesn’t he still have medical wisdom?
Although the poor medical mystical points are not many, they still have to be spent!
"Gastrotomy surgery?" Felipe and Taylor were both a little nervous. This was going to be an operation!
"Yes, this operation has many benefits, and it is especially suitable for Felipe's condition..."
Zhou Qiao began to explain the relevant knowledge, describing its advantages and its scope of application.
This kind of surgery was carried out by Edward Manson in the United States as early as 1966 for some obese patients, including sleeve gastrectomy, gastric bypass surgery, etc. The principle is to achieve the purpose of weight loss by controlling the patient's gastric capacity.
Among them, vertical sleeve gastrectomy removes most of the outside of the stomach, creating a narrow gastric sleeve.
Gastric bypass surgery divides the stomach into two parts, one of which is directly connected to the small intestine, bypassing the remaining stomach.
It is especially suitable for the following groups of people:
One is severely obese individuals: BMI greater than 40 or BMI greater than 35 and associated with related diseases (such as diabetes, hypertension).
The second is individuals who fail to control their weight through non-surgical methods: For those who still fail to successfully control their weight after trying a variety of non-surgical weight loss methods, gastric resection surgery is a very good option.
The third is the existence of obesity-related diseases: gastrectomy surgery can be an effective way to improve many obesity-related health problems, such as type II diabetes, hypertension, and sleep apnea.
Felipe was right about all of these!
Zhou Qiao told them that there are many treatments for diabetes, including changing eating habits, exercise, drugs, insulin treatment, metabolic surgery, etc., but gastric resection, especially "sleeve gastric surgery", is also one of them.
Moreover, this kind of surgery is currently known to be one of the methods that can effectively cure type II diabetes, and has been included in the diabetes treatment guidelines.
For simply obese patients with a BMI ≥ 37.5, active surgery is recommended;
32.5≤BMI<37.5, surgery is recommended;
27.5≤BMI<32.5, difficult to control with lifestyle changes and medical treatment, and meeting at least 2 components of metabolic syndrome, or with comorbidities, surgery may be considered after comprehensive evaluation.
…
Zhou Qiao's lecture lasted two full hours!
He made a comprehensive assessment of Felipe's condition through the physical examination report and used data to speak, and then introduced the specific process of the operation in detail and analyzed the various pros and cons after the operation.
Since he was going to do this surgery, he issued an exchange order when he was talking about it. After spending 15 medical points, he exchanged it for a master-level gastrectomy surgery!
Then, he spoke more eloquently and eloquently.
Taylor listened and listened, and couldn't help but smile with relief and expectation.
She felt that Zhou Qiao's skills were really good, even though she couldn't understand most of them!
However, with her more than seventy years of life experience, she felt the extreme care and rigor in Zhou Qiao. It was reassuring for such a doctor to perform surgery!
Zhou Qiao's age disadvantage can be ignored with such professional and meticulous expression.
Although Felipe is forty-two years old, he is still a mama's boy. When his mother nods, he nods too.
In fact, another very important point that impressed Taylor was that among obese people, patients who did not undergo surgery had an 8-fold increased risk of death compared with patients who underwent bariatric surgery; while patients who underwent bariatric and metabolic surgery were less likely to die. For those who underwent surgery, the relative risk of death was significantly reduced by 89%.
The risk of this surgery is relatively low.
Taylor felt that surgery was imminent, otherwise it would really be life-threatening!
What would she do if her son died?
After the patient and family agreed, Zhou Qiao asked Ava to call Community Medical and make an appointment with the other party's operating room and anesthesia team.
Because this surgery is laparoscopic, it requires general anesthesia.
Usually during laparoscopic surgery, carbon dioxide is injected into the patient's abdominal cavity to form pneumoperitoneum, which facilitates the operation of various medical devices. At the same time, when the abdomen bulges, it will affect the patient's breathing and require ventilator assistance; in addition, general anesthesia is safer for the patient and has a better experience. When "asleep", there will be no tension, fear, anxiety, etc. .
Elderly patients can better detect hemodynamics under general anesthesia, detect abnormalities and deal with them in time.
They were very lucky, and the surgery was scheduled for 1 pm the next day. Zhou Qiao suggested that Felipe stay in the ward of Iris Clinic tonight to complete some pre-operative preparations and monitoring.
Taylor also stopped going home and stayed in another bed in the same ward.
At night, when the mother and son fell asleep, they were inevitably uneasy, but at the same time they were also endlessly longing for it.
Since there were patients in the clinic, Zhou Qiao and Elena restrained themselves a little.
After deducting 15 points from his Medical Mystery Point account and making additional payments in the past few days, the balance in his account now remains at 154 points.
He thought that if he had time, he might as well go find Luo Ya, because if he exchanged the kidney capsule, Elena would definitely not be able to withstand his offensive.
If you give it to Elena too...
It's not that he hasn't thought about it, but it would be equivalent to strengthening both sides at the same time, which would not be helpful in creating medical mystery points.
The reason why I redeemed it for the master-level one was because I wanted to use it sparingly.
The other thing is, for this kind of surgery, a master-level one is enough!
It would be too wasteful to use the perfect one.
The master level is no less than that of senior experts such as the Mayo Clinic and the University of California Medical Center.
Naturally, they are by no means inferior to experts from domestic Union Medical College, West China, Zhongshan, Ruijin, Tongji, Xiangya and other hospitals!
Even better!
After recuperating all night, Zhou Qiao asked Ava to call one by one the next morning, changing the time of the clients who had originally made appointments from 1 to 2 pm, and explaining to them that it was because of emergency surgery.
Fortunately, most customers understand and say they will come later or make an appointment at another time.
After lunch, Zhou Qiao hung a sign outside the clinic: "Dr. Zhou is performing surgery at the community hospital and is temporarily closed."
Then, he took Elena, Ava, Taylor, Felipe, mother and son to the community hospital.
Since the distance was relatively close, Felipe insisted on walking over. However, when he comes back, he will probably have to call an ambulance or just be pushed back on a hospital bed.
When they arrived at the community hospital and entered the operating room, they were spotted by a short, fat, bald old man.
The other person has gray hair on his temples, a hooked nose, and deep eyes. He is Kainz, the owner of the Red-billed Gull Clinic.
Kainz was talking to a staff member from the community hospital. He was stunned when he saw this scene: "What the hell? The Iris Clinic actually performs surgery? How can a young doctor who has just graduated have such a level?"
