Nie Yuan had already called the next patient's number, but when the door to the consulting room opened, the same two people came in.
Grandma is no longer as cautious and respectful as before, but walks in a windy and rather menacing way.
What's going on here? Tao Le was a little worried instinctively.
Grandma strode up to Nie Yuan and slapped the checklist in front of him:
"Doctor Nie, Meixin and I are so convinced of you, how could you do this!"
Nie Yuan was a little confused. He picked up the order he had just opened and looked at it carefully, but found no problems.
"Is something wrong?" he asked doubtfully.
"Why should such an old child undergo such a radioactive examination? Are you crazy about making money?" Grandma's voice rose three levels because of anger.
When she said this, Tao Le and Nie Yuan both understood.
It turned out that the family members had doubts about the radiation-containing examination.
Just ask if you have any questions, why do you need to add the last sentence? How disharmonious.
In the examination list just prescribed, static ECT imaging of the thyroid gland is a radionuclide scan, which requires the patient to be injected with imaging agent. There is indeed a little radiation.
Many patients have doubts about examinations involving radiation. When it comes to children, this doubt turns into anxiety.
Come to think of it, this grandma only took a careful look at the payment slip after she went out, and found out that there was radioactive imaging agent in it, and she couldn't accept it.
"Let me explain it to you first. First of all, this ECT examination is necessary. If you don't do it, there will be no way to make a diagnosis and no corresponding treatment." Nie Yuan said calmly:
"Moreover, this examination only costs less than three hundred yuan, which is very cost-effective."
But in this matter, the grandmother was unexpectedly stubborn.
"All other tests are fine, but if you have to put something radioactive into your child's body, you may get sick if you are not sick, and a minor illness can turn into a serious illness. Don't bully us for not understanding!"
Nie Yuan couldn't help but have a headache. The family members who were clearly reasonable and able to communicate just now suddenly became like this.
However, this radionuclide scan is a key step in confirming the diagnosis of this case.
There are actually several other conditions for the disease that he highly suspects, and they must be confirmed by ECT before a specific treatment plan can be determined.
A slight mistake can lead to a thousand miles of misunderstanding. Once the wrong treatment or cutting is done, it will be irresponsible to the child.
The moment he frowned, Tao Le could tell that Deputy Director Nie was holding back another big move, preparing to stun the elderly woman in front of him with a long list of medical terminology.
She has discovered in the past few days that Deputy Director Nie is very high-level, very capable, and full of warmth for patients, but when it comes to medical issues, he immediately becomes rigorous and meticulous.
She had no doubt that after a while he would definitely describe the symptoms he was considering, why he needed an ECT examination, and what symptoms each index in the results was meaningful for judging.
It's a pity that no matter how much he talks and how hard he hits, the lady in front of him can't understand it at all.
Not only do they not understand, this is not what they care about in the first place.
If something happens, the disciple will do his best. She has rich experience in dealing with this kind of elderly lady in her past life.
"Auntie," Tao Le said gently, "Actually, you may have misunderstood. The radiation from this examination is very small, and it only irradiates the thyroid gland, so it has little impact on the child's health."
She didn't lie at all. Static ECT imaging of the thyroid gland generally uses radioactive technetium for imaging. The radiation intensity is low. Moreover, the β-ray range in nuclide imaging is short, only 2mm, and there is basically no radiation to tissues other than the thyroid gland.
In addition, the half-life is only about 6 hours, and no side effects have ever been found clinically.
The dosage used by children is even lower than that of ordinary people.
Sure enough, she hit the core issue that the grandmother was most concerned about.
"Are you telling the truth?" Grandma looked at Tao Le with doubt on her face.
"Of course it's true." Tao Le spoke slowly, with sincerity on his face: "As long as you drink more water after the examination, the contrast agent will be completely metabolized in a few days."
"If this is really the case, then it doesn't matter if you do it?" Grandma seemed to be saying to herself.
"This depends on your choice. Our doctors can only make suggestions." Tao Le said: "But if we don't do this examination, we can't see what form the child's ectopic thyroid is, and our doctors don't dare to Just do whatever treatment you want.”
Doctors, whether they are Chinese or Western medicine practitioners, can only explain the situation to patients and their families and leave the right of choice in their hands. The most taboo is forced sales.
If you do that, even if you do it with good intentions, the other party may not appreciate it, but it will easily be seen as having ulterior motives.
Now that Tao Le has explained the situation clearly, the rest depends on the family members themselves.
Fortunately, this grandma didn't mean to cause trouble. As soon as she felt relieved, she immediately agreed to have an examination.
They came and left just as quickly. Before leaving, they even said sorry to Nie Yuan.
As soon as the door closed, Nie Yuan asked Tao Lefa: "You just said that this child has ectopic thyroid gland. Is it a random guess or an inference made by yourself?"
The thyroid gland of most people grows 2-3cm below the Adam's apple and is distributed on both sides of the trachea. However, some people have congenital developmental malformations during the embryonic period and the thyroid gland grows to other places, which is called abnormality. The thyroid gland.
Tao Le laughed: "Of course it's the latter."
Nie Yuan also smiled: "Tell me what you think."
"The child's hypothyroidism was detected in another hospital, coupled with the poor physical development, indicating that the child's hypothyroidism is highly likely to be congenital."
Tao Le expressed his own ideas for solving the problem: "Congenital hypothyroidism, although there are multiple possibilities such as insufficient secretion of hormones by the pituitary gland, underdevelopment or hypoplasia of the thyroid gland, and insufficient iodine intake of the mother during pregnancy, these will not cause the patient to suffer from the disease." There is a lump under the chin."
"Maybe this mass is caused by other inflammations and has nothing to do with hypothyroidism." Nie Yuan said with interest.
Tao Le has certainly considered this possibility: "If the mass is soft and painful, it may indeed be caused by inflammation."
"But in fact, the mass is hard, painless, and can move with the swallowing movement. This rules out inflammation such as submental lymph node enlargement, periodontitis, and facial boils."
As Tao Le spoke, Nie Yuan gradually sat upright and his eyes became more and more focused.
He had heard of Xiao Tao's reputation before, and also knew that she had a different origin and was Zhou Jishen's apprentice.
But so what, medicine takes different paths, and Chinese and Western medicine are at odds with each other on many issues.
So he didn't quite understand why Xiao Tao was doing Western medicine instead of going to the Traditional Chinese Medicine Department.
This is simply a waste of their enthusiasm and resources in bringing in new people, and it is meaningless.
Unexpectedly, after actual contact, Xiao Tao was completely different from what he had thought before.
Needless to say, her attitude is respectful and serious. Even Corey's new interns are far behind her in this regard.
In addition, she was able to tolerate his various deliberate pickinesses. Not only did she have no temper, but she was also able to meticulously modify and implement them according to his requirements.
Well, as to whether his changed impression of Xiao Tao had anything to do with that nearly perfect cup of coffee, it definitely had nothing to do with it.
In any case, now he began to appreciate this little girl who had solid basic skills and knew how to draw inferences from one example.
(End of chapter)
