A young, able-bodied teen was unlikely to develop blood clots.
Once the equipment and materials were accounted for, Professor Rudolf began disinfecting the surgical site.
Zheng Ren received a call from Old Chief Physician Pan and quickly left the operating room to meet the patient's parents.
Before he left, he instructed the professor, "Lil Fugui, once you have access, start with the thrombolysis."
Professor Rudolf mumbled an agreement.
For the professor, a thrombolytic procedure was a walk in the park. Hence, Zheng Ren was not worried. The procedure took anywhere between 30 minutes to an hour to complete.
If the effect was unsatisfactory, they would have to opt for a catheter-directed thrombolysis to remove the pulmonary embolism.
Zheng Ren got to the emergency ward in his scrubs.
Old Chief Physician Pan was aware of the patient's condition through Zheng Ren's updates. There was little he could tell the parents other than the critical condition she was in. He explained the treatment and probability of survival.
At the sight of Zheng Ren, Old Chief Physician Pan breathed out a sigh of relief.
The old doctor went up to help with the rescue. After all, the professor was a foreigner and there were protocols that he might not be familiar with. Although the professor was fluent in Mandarin, some drug names were very different after translation.
Zheng Ren greeted the parents and told them to have a seat. "The boyfriend said your daughter has had such symptoms before?"
The mention of the boyfriend instigated some angry shouts from the father. The mother wiped away tears as she tried to placate her husband.
Zheng Ren tapped his fingers on the table and said, "We're short on time. Please, speak clearly!"
The father was taken aback by Zheng Ren's sharp tone. After realizing his daughter's life was on the line, the man muttered some curses under his breath before sitting down.
"My daughter has always had a clean bill of health but when… When she got pregnant, she suffered from an elevated platelet count and that caused the venous thrombosis," the father revealed.
Pregnant? Platelets?
It was the first time Zheng Ren had heard of such a condition.
The System was able to provide a diagnosis but it would not reveal the disorder's mechanism. It was up to Zheng Ren to decipher how the puzzle pieces fit together.
"She's very headstrong. Previously, she had an incident in school and was rushed to the hospital. Who knew that she would…" the father's voice cracked as he let out a sigh. Tears streamed down his face.
"Which hospital was it?" Zheng Ren asked.
The patient's father mentioned a famous Class Three Grade A Hospital in Imperial Capital.
Zheng Ren thought for a moment before asking about the doctor who was in charge of the case. The name was given and Zheng Ren picked up his phone.
It was still early in the day to call Department Chief Kong.
There was a patient's life on the line so Zheng Ren's reasons were justified. Although a thrombolytic procedure was ongoing with Professor Rudolf at the helm, Zheng Ren figured he would rather be safe than sorry.
"Chief Kong, it's me, Little Zheng."
"Yes. There's a patient in emergency care here who has been to Imperial Capital, I need some information about her medical condition."
Department Chief Kong gladly acquiesced. Zheng Ren gave him the name of the hospital and the angiology department chief.
The patient's father watched Zheng Ren effortlessly obtain information about his daughter's admission in an Imperial Capital hospital. He trusted that his daughter was in good hands.
During the first hospital admission, the Imperial Capital doctor told them to watch out for a recurrence as it would be more severe. The doctor said only large Class Three Grade A Hospitals in Imperial Capital or Sorcery Capital would give their daughter a fighting chance against a second pulmonary embolism.
If the patient was elderly, they were unlikely to survive a second incident.
When the father heard it was the same disorder, he wanted to take a knife and have a go at her boyfriend.
There was still hope!
Zheng Ren hung up the phone. While waiting for Department Chief Kong's reply, Zheng Ren explained the surgical procedure to the parents.
Although the surgery was already ongoing, protocols were protocols.
He was a few lines in when Department Chief Kong called back.
Chapter 361 - Treatment Only
"Chief Kong, have you asked them?
"Oh, oh, right. Give me a minute to write it down."
Zheng Ren grabbed a pen and a piece of A4 paper as he spoke and wrote down the treatment the patient received in Imperial Capital.
They were all experienced doctors and would not beat around the bush. Although they were rather reserved, they got to the gist of things when they did say something.
The treatment process in Imperial Capital was similar to Zheng Ren's plan: an intravenous injection of low molecular weight heparin and thrombolysis. They were worried about thromboembolism, so they placed an inferior vena cava (IVC) filter to block blood clots.
Of course, the patient would need to undergo an abortion.
Due to her unique condition, her thrombocytosis could not be reduced if her pregnancy was not terminated. It would result in the continuous production of blood clots.
Zheng Ren hung up the phone relieved when he heard that their treatment process was similar to what he expected.
He continued to talk to the patient's family members and let them sign the consent form. Zheng Ren then handed over the preoperative briefing to Yang Lei, who was on shift, before returning to the operating room.
Professor Rudolf Wagner had already put on a surgical gown. He was sitting on a white bench while he waited, bored, for the thrombolysis to complete.
The patient's vitals had gradually stabilized; the oxygen saturation in his blood rose to 90%.
This was the reason why we should visit the hospital at the onset of the disease in order to receive timely treatment. If there was a slight delay, the recovery period would not be so simple.
"Lil Fugui, how long has the thrombolysis been going on?" Zheng Ren asked.
"We administered urokinase 15 minutes ago. Looks like it's almost done," Professor Rudolf Wagner said. "Boss, the surgical tools you chose are really poor in quality."
Zheng Ren was defenseless against the professor's criticisms on Changfeng Microinvasive Surgery.
He did not have the contacts of large importing manufacturers, thus he could not access the tools right away when he needed them. Even though Changfeng's tools were lower-quality replicas, they could ship them on schedule and their prices were more affordable.
That was better than nothing.
Sea City General Hospital did not purchase these surgical tools and consumables because they did not offer this surgery, nor did they have a vascular surgery department to perform this interventional surgery.
Therefore, they had no choice but to make a temporary purchase. This was the responsible decision for both the hospital and the patient.
Regarding the tools' functionality… Zheng Ren knew that they were inferior to those manufactured by international companies.
The professor's criticisms were reasonable.
Feng Xuhui was standing in the corner of the console room. His expression dropped when he heard what the professor said.
Chief Zheng better not stop using his company's products. He had to hold onto this lifeline no matter what.
"No worries. I can manage with these." Zheng Ren laughed before leaving to change and scrub in.
Feng Xuhui felt slightly relieved when he heard Zheng Ren's words.
'However, it was not a long-term solution. He had to report to Chairman Ma in the upcoming meeting so that they wasted no time and could start improving their craft and material quality,' Feng Xuhui thought.
After administeri
ng the thrombolytic agent, urokinase, for half an hour, Zheng Ren had finished scrubbing in and went to the operating table to prepare for surgery.
The lead door closed slowly. Zheng Ren got into position with the professor as his assistant.
IVC filter placement was generally a simple procedure. The most difficult part was the pulmonary embolism during the emergency rescue, and the patient had stabilized. Therefore, Zheng Ren did not go to the System for solo training and started operating right away.
The professor performed the puncture for the catheter to administer the thrombolytic agent. Zheng Ren inserted the 9F filter delivery sheath and placed the filter through it.
The filter manufactured by Changfeng Microinvasive Surgery was a replica of the Simon Nitinol IVC filter.
The filter was shaped like a mushroom, made up of two sections: the roof-shaped head and pyramid-shaped tail.
With a unique structure like that, it had a major advantage. The Simon Nitinol IVC filter was a fourth-generation filter, a modified creation that incorporated all of the benefits of the previous models.
The mushroom-shaped structure could block blood clots which would cause pulmonary embolism from passing through the filter.
Even though Changfeng's technology was more backward and crass, the filter was made with nickel-titanium shape-memory alloy without cutting any corners.
Zheng Ren was fine with that.
He turned on the radiation when the filter entered the femoral vein and was placed in the inferior vena cava.
Zheng Ren slowly pushed the filter along the inferior vena cava until it reached the lowest renal vein and turned it on.
This was because the blood flow and blood pressure at the lowest point of the renal vein could aid with the complete resolution of blood clots.
Most importantly, the placement of the filter in this manner would preserve kidney functions and prevent the risk of subsequent complications.
Zheng Ren started the pulmonary angiography after the filter was in place.
He was relieved to find that most of the emboli in the pulmonary arteries had dissolved.
After switching off the equipment, Zheng Ren left. The professor remembered that he was responsible for applying pressure for hemostasis post-surgery. He did not make the same embarrassing mistake last time by leaving with Zheng Ren.
Zheng Ren changed out of his clothes while they performed hemostasis.
The entire surgery took less than an hour. Most of the time was used for the thrombolysis treatment for the pulmonary arteries.
This was also because they discovered it early and managed to provide timely treatment.
Zheng Ren felt that this girl was really lucky to survive two pulmonary embolism attacks.
He could not help but wonder if she would learn from this experience so that in the future…
Who knew what would happen in the future. Zheng Ren was only responsible for treating the patients' diseases. He had no right to interfere with their personal lives.
If the patient's parents had no control over their own child, who was he to intrude?
Zheng Ren removed the lead apron after leaving the operating table and stored it into the System. He then approached Old Chief Physician Pan and stood beside him.
"You brought her here?" Old Chief Physician Pan asked.
"Yep." Zheng Ren nodded. "I went out with Yiren for a meal and saw this girl suffering from an acute pulmonary embolism, so we brought her back for emergency rescue."
"She's very lucky," Old Chief Physician Pan sighed. "How did she get it at such a young age?"
"Likely from her pregnancy. Her platelet levels were elevated, resulting in the acc.u.mulation of small emboli in the lower extremity arteries. These emboli traveled into the bloodstream and lodged in the pulmonary artery," Zheng Ren replied.
Old Chief Physician Pan had encountered a case similar to this, but the surgical treatment was not as advanced back then, so they could only treat it with thrombolysis.
In fact, most of the patients passed away before they were even diagnosed with pulmonary embolism.
The advancement of medical techniques had allowed physicians to treat many diseases that were incurable in the past. Old Chief Physician Pan was deeply moved by this.
The patient was sent to ICU upon the completion of hemostasis.
Zheng Ren felt rather embarrassed. He had been sending more patients to the ICU after he was transferred to the emergency ward.
Would the ICU turn into a personal care unit for the emergency ward?
Zheng Ren communicated with the ICU doctor before leaving to tend to the patient's family members.
The patient's father looked as if he had aged so much within those few hours. His crow's feet were so deep, looking haggard and sorrowful.
A successful emergency rescue should be a joyous occasion, but what about the future?
Only heaven knows.
Chapter 362 - Revealing True Emotions
Zheng Ren was briefing the patient's father on her condition, repeating some of the details such as pregnancy causing the girl's platelet levels to rise, which could be a life-threatening situation for her.
While he was talking, he sensed the sudden change in behavior from the middle-aged man.
Rage.
Resentment.
All of these emotions shot out of him like sharp blades.
What was happening?
While Zheng Ren was still in a daze, the patient's father charged toward him.
Both of them were standing rather closely. If this happened in the past, Zheng Ren would never have been able to react on time.
Nonetheless, after being in the System for such a long time, Zheng Ren's reflexes had improved unknowingly.
He leaned his body to the side by twisting his ankle, avoiding the sudden attack from the patient's father.
What was he…
However, Zheng Ren quickly realized that he was not the man's target. He was charging toward someone else behind him.
His target was the boy who ate with the girl in the restaurant.
The boy looked rather honest, probably in his twenties.
He guessed that the boy intended to eavesdrop on the conversation between Zheng Ren and the girl's father, but was discovered.
He stared at him with open-mouthed shock and was slapped by the girl's father without resisting.
Slap!
A clear sound echoed. The boy was sent flying. His body ended up colliding with the walls.
"Son of a b*tch!" The patient's father had bulging veins on his forehead, like two vicious snakes.
He lifted his leg and kicked the boy's head, delivering blow after blow without reservation. He did not avoid his vulnerable areas either, determined to hurt him with every kick.
Zheng Ren hurried over to yank the patient's father away, grabbing him by the waist.
"Brother, brother. Calm down!" Zheng Ren pulled him away forcefully.
Zheng Ren was still under thirty. Furthermore, he trained in the System, so he was physically stronger than others.
However, it took him all of his strength to restrain the patient's overweight father.
Zheng Ren could feel the man's rage deep down inside him.
"Son of a b*itch, I'm going to kill you!
"Doctor, let go of me. I don't want to live anymore. I'll kill him and serve time!"
"Brother, please don't do that. Calm down, calm down." Zheng Ren was not good with words. There was only so much he could say.
Nevertheless, at times like this, no words could convince a father when his precious daughter was hurt.
'This was what a real father should be like. Too bad the girl was a disappointment,' Zheng Ren thought.
The young boy did not use this window to run away. Instead, he walked toward the middle-aged man determinedly and gave a deep bow. He said sincerely, "Uncle…"
"Don't you f*cking call me uncle. You can call other f*ckers uncle!" The middle-aged man roared furiously.
The boy looked shaken, but he quickly mustered courage. Zheng Ren could see the determination in his eyes.
"Uncle, please hear me out. Okay?" The boy continued to bow sincerely, his back bent at the lowest angle possible for any bow.
Zheng Ren could feel the middle-aged man's resistance slowly fade in his arms and finally calmed down after a minute.
The boy was still bowing to him in tears.
True emotions were revealed.
Genuine.
Sincere.
Zheng Ren gradually released his grip. The middle-aged man stood in front of the boy in silence, breathing heavily as if he was exhausted.
The boy bowed another dozen times. Zheng Ren could feel the strain in his back just by watching him.
Finally, he stopped. His face was covered in tears, but the determined expression remained unwavering.
"Uncle, you know that Little Wan and I had been together since university," the boy said.
The middle-aged man kept quiet and continued to breathe heavily.
"I didn't expect it to turn out this way the first time. I admit that it was my fault. I'm to blame for everything. It's all my fault.
"I also know that there's no point in apologizing.
"You told us to break it off back then, but I couldn't do it. I really like Little Wan, I do. I didn't go to the South after we graduated and followed Little Wan back to Sea City.
"I've worked really hard for the past six months. I'm confident that I can support a family."
The man moved his lips as if he was about to say something, but there was no sound.
The boy seemed to be immersed in his memories and did not notice the man's actions. His head was lowered, with tears rolling down freely.
"We are preparing to get married. I know that Little Wan cannot get pregnant, so I had been very careful after what happened last time. She had told me several times to try, thinking that you won't go against us if she got pregnant.
"But I rejected her. This is a life and death issue. I can't afford to take the risk. I also told my parents about our situation. Although they were not too happy about it, they approved of our marriage.
"However… Several days ago, the c.o.n.d.o.m we used broke. Little Wan just told me and threw it away before I had the chance to look at it. I was too careless to notice it. I'm sorry, I truly am sorry." The boy looked so lost. Zheng Ren guessed that this was probably why the boy was panicking in the restaurant.
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