The most enlightened doctor

At nearly ten o'clock in the evening, Yu Zhiming returned to the rental house in Zijinyuan carrying a bamboo basket and Gu Qingning holding a pot-bellied casserole.

Yu Xiangwan, who was at home, quickly stood up to greet her and took the casserole from Gu Qingning's arms.

"It's quite heavy. What's in it?"

"Return gift?"

Gu Qingning giggled and said, "Sister, this is Buddha jumping over the wall."

"The ingredients inside have been processed. It will be ready to eat after simmering it on low heat for ten hours tomorrow."

Yu Zhiming showed the contents in the bamboo basket to the fourth sister and introduced: "These are morels, morels, gallinobacilli, and Hericium, which are all relatively rare fungi."

"Tomorrow night, let Zhang Bai cook it and eat it."

Yu Xiangwan hummed, and asked loudly while carefully placing the pot-bellied casserole and the fungi in the bamboo basket.

"Qing Ning, are your parents satisfied with Lao Wu?"

Gu Qingning smiled and replied: "Sister, my parents are extremely satisfied. They also said that in addition to the normal dowry, they also want to add a large house of more than 200 square meters."

Yu Xiangwan smiled happily and said, "As long as you are satisfied."

"After the Spring Festival, when your parents and eldest sister come to Binhai, they can sit down together to discuss your marriage."

Yu Zhiming reminded: "Sister, you must be ahead of me. Your marriage to Zhang Bai has higher priority."

Yu Xiangwan smiled and said: "Zhang Bai and I are not in a hurry, we can still celebrate Zhang Bai's mother's anniversary."

"Lao Wu, you are shouldering the heavy responsibility of continuing the family lineage of our Yu family. My parents have been worried about it for several years."

These words made Yu Zhiming depressed.

At first, I was urged to find a girlfriend.

Now that I have found a girlfriend, I will definitely rush to get married.

The next step is to give birth to a child.

After giving birth to one, I am urging you to give birth to the second one...

Yu Zhiming suddenly had a headache and couldn't help but glance at Qing Ning's belly.

"Qing Ning, didn't you say you wanted to have three children? How about getting pregnant with three children at once..."

At nearly 8:20 the next morning, Yu Zhiming, who was suffering from backache and leg pain, rushed to the central building of the hospital.

It was discovered that Zhou Mo had arrived earlier.

"Zhou Mo, I came earlier because I wanted to go to the ward area first. You don't need to come so early."

Zhou Mo rolled his eyelids and said: "The assistant dares to arrive at work later than the boss? Do you want to be fired for entering the office with your left foot?"

"Doctor Yu, only if you stop curling yourself up can my little assistant dare to relax faster."

Yu Zhiming also rolled his eyelids and took an A4 paper handed over by this guy.

Above are the detailed home addresses of those leaders and colleagues on Yu Zhiming's annual gift list.

Zhou Mo also carefully marked the people who lived in the same community or who lived relatively close to each other.

Not only that, Zhou Mo also marked the addresses of these people on the city map printed on the back of the paper.

"Well done, very attentive."

Yu Zhiming praised him, took out a thick red envelope from his briefcase, and handed it to Zhou Mo.

"Today is the day to pay wages and year-end bonuses. As your boss, I have to be kind to you."

Zhou Mo took the red envelope, opened it, and found that it was 10,000 yuan in cash, and immediately smiled.

"Boss Yu, thank you for your generosity."

"I promise that I will do my job as an assistant wholeheartedly so that you will be less tired."

After a pause, Zhou Mo introduced again: "Doctor Yu, we only pay wages today. According to the hospital's practice, the year-end bonus will not be paid until around the 15th."

Yu Zhiming said oh and took out a thinner red envelope from his briefcase.

"This belongs to Qiao Lei, give it to him for me."

Zhou Mo took the red envelope and nodded.

Yu Zhiming changed into his white coat and got ready for work, when he suddenly remembered that there was one more thing he forgot to ask.

"Hey, Zhou Mo, your green plum yesterday..."

Seeing Zhou Mo's eyes widen, Yu Zhiming immediately changed his words and said, "Yesterday, the teacher and his ex-wife held a gathering of relatives and friends for Qi Zhen's return to China. Is there any news?"

"For example, a live show of love or something?"

Zhou Mo took a long breath and said, "You really confessed your love to me, and you knelt down on one leg to give me the ring..."

Yu Zhiming took a special look and didn't see the ring on her finger.

"Refused?"

Zhou Mo nodded, and said distressedly: "The situation was a bit confusing at that time. For some reason, my mind just twitched and I said I didn't like men."

"What do you mean?" Yu Zhiming didn't react for a while.

"It means that I publicly announced in front of dozens of people that what I like is not a man, but a woman."

Zhou Mo lamented again: "Dr. Yu, this is all your fault."

"After you proposed the bad idea of ​​finding a boyfriend with an abnormal orientation to marry, I have been thinking about the feasibility for the past few days."

"I didn't expect that out of nervousness and brain twitching, I would become oriented abnormally."

"So annoying!"

Yu Zhiming said seriously, "Zhou Mo, have you ever thought that maybe this is not a twitch in your head, but a true expression of your heart?"

Zhou Mo squeezed the joint of his right hand and made a crackling sound. His eyes were cold and he asked: "Doctor Yu, I didn't hear what you just said clearly. Can you say it again?"

Yu Zhiming took a step back and said, "I just said that if you pinch the joints like this, it may cause joint damage."

As he spoke, he backed away from the door, then said "I have to go to the ward for rounds", turned around and ran away...

Although he did not need to attend an outpatient clinic today, Yu Zhiming was still busy. It was not until nearly 9:40 in the morning that he had free time to check his salary income.

Today is January 7th, and yesterday was Sunday, so the salary payment is postponed until today.

He first took out his mobile phone and read two bank text messages.

The latest one stated that the transfer income was more than 210,000, which was his income from Ning'an Hospital last month.

The second bank text message stated that the transfer income was more than 2.77 million, which was the income of Huashan Hospital last month.

This number is within Yu Zhiming's estimate.

Last month, the Beijing Women's Club received 2.12 million, film and television star Zhao Zhiwen received 1 million, Qing Ning's cousin and uncle received 450,000, and two physical examinations organized by the Health Bureau received 300,000.

In addition to these, plus Yu Zhiming's income from his daily work at Huashan Hospital, project allowances, talent allowances, etc., the total income should be 4.34 million.

After deducting personal tax, hospital financial expenses, insurance, provident fund and other expenses, the actual amount was 2.77 million, setting a new record for Yu Zhiming's income.

Yu Zhiming took out his tablet and wanted to check the details of last month's income, when he heard footsteps and the sound of a wheelchair approaching.

Looking up, he saw Dr. Xiong Jing and a man in a wheelchair being pushed by a middle-aged woman who was breathing oxygen, appearing at the door of the big office.

"Doctor Yu..."

Doctor Xiong took two steps quickly, looking ashamed, and said, "I was the one who interrupted you yesterday. I was so anxious that I forgot that it was your rare rest time."

Yu Zhiming replied politely: "Dr. Xiong, there is no need to apologize. You are a doctor and have a parent-like heart. I can understand that."

"Let's check the patient's body first..."

The patient is 47 years old. He successfully underwent a heart transplant three years ago due to severe heart failure.

Dr. Xiong said that within the past week, the patient's heart function had declined significantly.

Today, it is less than half of the original number.

This is, heart failure has struck again.

A few minutes later, in the examination room, Yu Zhiming began to examine the patient with swollen lower limbs and difficulty walking, and found that his right ventricle was slightly enlarged.

At the same time, Yu Zhiming also felt that the heart was weak, especially the right ventricle.

He clearly felt that the blood pumping pressure of the right ventricle was much higher than that of the left ventricle.

Is this heart failure caused by pulmonary hypertension?

With this question in mind, Yu Zhiming conducted a detailed exploration of the patient's lungs along the pulmonary artery.

Not surprisingly, he found that compared with other parts of the body, the blood circulation in the patient's lungs was a little slow and the blood vessels were slightly bulging.

There are definite signs of pulmonary hypertension.

Yu Zhiming also made a quick examination of other body parts of the patient and found symptoms such as liver and kidney damage, splenomegaly, and gastrointestinal tract congestion.

Next, Yu Zhiming communicated his findings with Dr. Xiong Jing and the patients.

"Heart failure due to pulmonary hypertension?"

The patient didn't understand very much and said breathlessly: "Since the heart transplant, I have stopped working and focused on recuperating my body."

"In May, Dr. Xiong, I had a heart and physical examination, and you said I was in great health, like a young man."

"do you remember?"

Xiong Jing nodded and said, "Of course I remember."

"So, I was surprised that you came to me this time with such a bad heart condition."

"It's only been half a year."

The patient said with a bitter look on his face: "In the past six months, I didn't do anything else. I just looked at the scenery in Dali, took a walk, and took care of my body as usual."

Dali? !

pulmonary hypertension!

Yu Zhiming asked, "Is it the Dali Plateau area?"

Hearing this, Xiong Jing quickly took out his phone and checked it, and then looked speechless.

Most of the altitudes in Dali are two to three thousand meters.

For ordinary people, this height will not cause any discomfort, but for patients with heart disease, it is a height that may cause altitude sickness.

If it is a short-term trip, there is no big problem, but the patient stayed in Dali for half a year.

Although the patient feels no discomfort, long-term chronic hypoxia keeps the pulmonary arterioles in a long-term contraction state, which can cause hypertrophy of the smooth muscle of the pulmonary vessel media, vascular hardening, and form stable pulmonary hypertension.

Pulmonary hypertension increases the resistance to right ventricular ejection.

In addition, the increase in red blood cells caused by hypoxia increases blood viscosity and can also increase pulmonary circulation resistance.

This resulted in the patient's right ventricle having to do more work to satisfy the pulmonary circulation, causing slight changes in the structure of the right ventricle and symptoms of hypertrophy.

But this is not a long-term solution. The compensatory capacity of the heart is limited. After exceeding a certain limit, the structure and function of the myocardium will lose its compensatory capacity, which will lead to heart failure.

What's more, the patient's heart was originally transplanted and is very delicate and needs careful care.

After listening to Dr. Xiong’s detailed explanation, the patient was dumbfounded.

"I deliberately chose a tourist destination with good scenery and suitable climate to recuperate my body, but in the end I harmed myself?"

"Doctor Xiong, can I still be saved in this situation?"

Xiong actually glanced at Yu Zhiming first, then looked at the patient, and said thoughtfully: "Heart transplantation, heart failure, and liver and kidney damage, how to use medicine is a troublesome matter."

"All I can say is, do your best..."

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