This miracle doctor just wants to be fired!

Inside the cardiology clinic.

The old man did not speak immediately after sitting down.

His daughter first placed a stack of medical records on the table, then took out several medicine boxes from her cloth bag and lined them up.

"Director Zhou, my dad has been getting weaker and weaker over the past six months. He used to be able to go downstairs and walk around twice every morning, but now he gets out of breath just by walking to the entrance of the community. In the last two months, he has also been having trouble sleeping at night. When he lies flat, he feels a tightness in his chest and has to use two pillows to support his chest."

As Zhou Cheng listened, he glanced at the old man.

The old man was very thin, with a pale face and light-colored lips. Even when sitting quietly, his breathing rate was slightly faster than normal.

"Professor Zhou, the patient has mild edema in both ankles." The graduate student who came with him to the outpatient clinic quickly examined the patient.

Zhou Cheng nodded and asked the old man, "What illnesses did you have before?"

"I've had high blood pressure for over ten years," the old man said himself, "and I also had a heart attack once."

Zhou Cheng frowned and asked, "When?"

"Seven years ago," the old man thought for a moment.

Zhou Cheng asked, "Have you had a stent implanted?"

"Yes, I did. I put two in." The old man nodded and pointed to the documents on the table. "The medical records are all here."

Zhou Cheng opened the foreign language department's documents.

The patient's coronary angiography was performed seven years ago, with one stent implanted in each of the right coronary artery and the left anterior descending artery.

I have had two follow-up coronary CTA examinations in the past two years, and there was no clear restenosis in the stent.

The most recent echocardiogram showed a left ventricular ejection fraction of 42%, left atrial enlargement, and moderate mitral regurgitation.

In general, the diagnosis given by the other hospital was not complicated: ischemic cardiomyopathy and chronic heart failure.

As for medications for treating coronary heart disease and heart failure, they are basically all available.

Currently, the "five golden flowers" for treating heart failure, in addition to veliciguat, include sacubitril/valsartan, metoprolol, spironolactone, and dapagliflozin.

This can be considered a standard treatment plan for heart failure.

But after a few minutes, Zhou Cheng's brows furrowed, and he looked up at the old man: "Do you take these medicines every day?"

The old man nodded.

The daughter hesitated for a moment, then said, "I eat almost everything."

Zhou Cheng was taken aback: "What does 'basically' mean?"

"It's just..." The daughter glanced at the old man, "He sometimes doesn't take his diuretics."

The old man immediately explained, "After taking that medicine, I have to go to the toilet a lot, which makes it inconvenient to go out."

Zhou Cheng shook his head slightly, then continued, "About how many times a week do you leak?"

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"Not many."

"several times?"

The old man was silent for a moment, then said, "Three or four times."

The daughter couldn't help but say, "It's not just three or four times! He won't eat whenever he goes out, and sometimes he won't eat at home because he finds it too troublesome."

The old man was somewhat indignant, "It's not like I didn't take it at all; the medicine wasn't taken on a monthly basis."

Zhou Cheng picked up the medicine box and glanced at the dosage on it.

"Your current symptoms do indeed indicate worsening heart failure. However, I still need to determine whether it's simply due to irregular use of diuretics, or whether there has been a change in the condition of your heart itself."

After he finished speaking, he asked, "Has your weight changed a lot recently?"

The daughter immediately pulled a booklet out of her bag.

"I've got it."

Zhou Cheng took it; the booklet contained daily records of weight, blood pressure, and heart rate.

Two months ago, the elderly man weighed about 60 kilograms on an empty stomach.

In the past week, it has risen to 62 kilograms.

Two kilograms.

For a heart failure patient who is already underweight, this is by no means a normal weight fluctuation!

When you first start gaining weight, it's mostly water weight that's being added.

Zhou Cheng then asked, "How's your urine output these past few days?"

"It's too little." This time, the old man didn't deny it.

"Do you cough at night?" Lu Ren continued, "Do you have a lot of phlegm?"

"There is a little bit, it's white."

Zhou Cheng put down the booklet, looked at the woman beside him, and slowly said, "She needs to be hospitalized."

The old man and his daughter were both stunned for a moment.

"Is it that serious?" The tension on the daughter's face became obvious.

Zhou Cheng shook his head. "It's not like there's an immediate danger to his life."

"However, your father has significant fluid retention and paroxysmal nocturnal dyspnea. Simply adjusting his medication in the outpatient setting would be too risky to manage."

"After admission, we will first intensify diuresis, then repeat echocardiography, renal function and electrolyte tests, and then assess whether the mitral regurgitation has progressed."

The daughter nodded repeatedly, but the old man seemed reluctant, frowning as he asked, "How long will you be hospitalized?"

Zhou Cheng said, "Let's see the diuretic effect."

"Can I be discharged in three days?"

"We cannot guarantee that right now."

The old man sighed, "There's still a row of scallions on the balcony that no one waters."

The daughter almost laughed in exasperation, "Dad, what time is it? You're still thinking about your scallions."

"I just planted those."

"Is the green onion more important than you?"

The old man thought about it carefully, "We can't ignore the scallions either."

Several people in the consultation room couldn't help but laugh.

Zhou Cheng smiled and said, "Let the other people in your family help you water it."

There is no one else.

"Then let your daughter go back and water it."

The old man looked at his daughter.

The daughter said helplessly, "Fine, I'll water it."

"Don't water it too much."

"..."

……

Zhou Cheng finished issuing the hospital admission certificate and checked the medication again.

Before leaving, the old man picked up the medicine boxes and suddenly asked, "Director Zhou, is my illness incurable?"

This time, his tone wasn't as relaxed as when he talked about the scallions on the balcony.

His daughter also quieted down and silently watched Zhou Cheng.

Zhou Cheng looked at the old man and said seriously, "Heart failure is a chronic disease that requires long-term management. We may not be able to restore the heart to its youthful state, but by taking medication regularly, controlling water and salt intake, and monitoring weight, most patients can maintain their condition in a relatively stable state. Your problem is not that there is no way to manage it, but that there are some things that should be done that you haven't done yet."

The old man glanced down at the diuretics in his hand, sighed, and then nodded. "Take them on time from now on. Even when you go out."

"Hmm." Zhou Cheng nodded. "We can't skip eating just because we're afraid of having to go to the bathroom."

"understood."

Zhou Cheng handed him the hospital admission certificate, "Go and complete the formalities first."

After the old man stood up, he turned around and emphasized again, "You really can't pour too much scallion on the water."

His daughter, suppressing her temper, helped him out of the consultation room.

After the clinic door closed, the graduate student whispered, "I think what the old man is most worried about is those few pots of scallions."

Zhou Cheng tidied up the documents on the table, shaking his head with a smile: "Many patients are not afraid of being hospitalized, but they are afraid of leaving their familiar lives."

"Some people are worried about their children, some are worried about their pets, and some are worried about their vegetables in the field."

"We doctors think it's just a few pots of scallions, but for the patient, it might be the most important thing he does every morning after he wakes up."

"So sometimes, we may not be able to understand the patients, but we must respect them."

The graduate student nodded, seemingly lost in thought.

……

By the time I finished looking at the last three plus signs, it was almost 1 p.m.

When Zhou Cheng walked out of the consultation room, the outpatient hall was still bustling with people.

Noon is one of the few times of day when staff at the hospital change shifts.

The morning clinic wasn't even fully closed yet, but people who came for the afternoon appointments had already arrived early.

The chairs in the hall were half full.

Some people were sleeping with their children in their arms, some were eating bread against the wall, and some elderly people were resting briefly on the bench with their medical examination bags under their heads.

Zhou Cheng pushed his way through the crowd and, just as he reached the elevator, saw Lin Feng standing there looking around with two lunchboxes in his hands.

"Director Zhou!"

Upon seeing Zhou Cheng, he quickly walked over. "The head nurse asked me to bring you your meal."

Zhou Cheng smiled: "Sweet and sour pork ribs?"

"That's all." Lin Feng handed over the lunchbox. "I left you some shredded pork with green peppers."

Zhou Cheng opened it and took a look.

There were more green peppers than meat, which is very much in line with the hospital cafeteria's consistent performance!