My daily work as a doctor: My treatment value is increasing.

After returning from Linjiang City, Lu Renxin resumed his normal routine of going between the outpatient clinic, the ward, and home.

But today feels a little different. Why? Because tomorrow is Shen Yueru's birthday.

This is the first birthday that Lu Renxin and Shen Yueru have spent together since they started dating.

Shen Yueru longed for and hoped that her boyfriend would send her blessings and care as soon as possible.

But the day before her birthday, she couldn't see anything different on Lu Renxin's face.

So Shen Yueru subtly inquired, pretending to be casual, "What's the date tomorrow?"

Lu Renxin was looking at his phone and replied without looking up, "The 25th, what's up?"

Shen Yueru's heart sank, and she cautiously prompted, "Do you know what day the 25th is?"

"Number 25—" Lu Renxin drawled out the last syllable, finally raising his head and resting his chin on his hand as if deep in thought.

Shen Yueru's heart was in her throat. Her eyes were wide open, full of anticipation, hoping that Lu Renxin would give her the answer she had been longing for.

Lu Renxin found it both funny and cute; how could he forget his girlfriend's birthday?

The surprise was prepared long ago, but it couldn't be told beforehand, nor could it be discovered by Shen Yueru.

So he could only put on a blank expression and pretend he didn't remember: "It doesn't seem to be anything special. It's not our anniversary or any holiday."

Shen Yueru deflated instantly, her head drooping.

It was too obvious. Lu Renxin smirked, preparing to tease Shen Yueru: "Wait, I think I just remembered something."

Shen Yueru's hope was rekindled: "He remembered, he remembered."

The way she stared at Lu Renxin with such expectant eyes was really cute.

He said, "I had plans to have dinner with Liu Yichen after get off work tomorrow. I almost forgot, but thank goodness you reminded me. Thank you, honey."

Lu Renxin leaned closer to Shen Yueru and planted a heavy kiss on her right cheek.

But Shen Yueru was not happy. She felt disappointed. "That jerk forgot my birthday."

But she wasn't completely hopeless. After all, tomorrow was her birthday, and what if... what if he remembered her tonight?

Maybe I want to give myself a surprise tomorrow?

……

The next morning, Lu Renxin went to work as usual. Shen Yueru got up early, which was unusual for her, but she kept glancing at her phone absentmindedly.

Where are my birthday wishes? Still none?

The thought involuntarily popped into my mind: Had I completely forgotten my own birthday?

Shen Yueru kept trying to reassure herself, telling herself that it didn't matter if he really forgot, it was just a birthday.

I understand all the reasons, and my reasoning is clear enough.

But the indescribable sense of loss in my heart could not be hidden and gradually spread throughout my chest.

After all, it was Lu Renxin's birthday, and she had started preparing a month in advance to buy him the gift he had been longing for.

Shen Yueru did a lot of research online, and even secretly opened his shopping cart to write down the items he wanted to buy.

Finally, on her birthday, they prepared a cake and beautifully wrapped gifts, and the two of them spent a sweet birthday together.

She didn't want a birthday present, but rather the feeling of being remembered. A faint sense of loneliness weighed on Shen Yueru's heart, lingering there.

Lu Renxin was unaware of Shen Yueru's deep thoughts; he was already focused on his busy work.

The atmosphere in the consultation room was calm, and a constipated patient was sitting in front of me.

He has been seeing a lot of patients with constipation in his clinic lately. Anyone who has experienced it knows that constipation may not seem like a big deal, but it can be very uncomfortable.

I would squat on the toilet for hours on end, my anal sphincter ached, but I still couldn't defecate. My stomach was bloated, and I had a poor appetite.

Lu Renxin stared at the patient's colonoscopy results, his expression helpless.

The colonic mucosa has a smooth surface, but its color has turned black.

"Have you been taking laxatives?" Lu Renxin asked.

"Yes, yes, doctor, this is what I'm taking." He took out his phone from his pocket and showed the doctor the photo he had taken.

For young patients, constipation is often a lifestyle problem, mainly caused by a diet that is too refined, lacks dietary fiber, and does not drink enough water.

The solution is simple: adjust your lifestyle and eating habits.

For elderly patients, the cause is mostly illness or medication.

For example, systemic diseases such as hypothyroidism and diabetes can slow down the body's metabolism and sluggish intestinal peristalsis.

Some commonly used medications for the elderly can also cause constipation as a side effect, such as some antihypertensive drugs and iron supplements.

Therefore, many elderly people take laxatives or medications for a long time, such as Duphalac, prune juice, and small pink pills...

The pink pills in the patient's photo are imported, trendy little pink pills.

"I had constipation before I started taking this medicine. It would take me two or three hours to go to the toilet, and I couldn't stand it every time."

"Later, I had no other choice but to buy this medicine online. The seller told me it was very effective and would make me have diarrhea as soon as I took it."

The patient, whose face was covered in wrinkles, recounted the entire process of taking the medication, his expression showing great discomfort.

According to him, the effect was indeed very good when he first started taking it, but the effect gradually weakened later, but he still couldn't stop.

Before, even without taking it, I could always manage to poop a little bit after some effort, but now I can't poop at all without it.

I feel like my intestines aren't moving at all, and sometimes my stomach feels hard and bloated.

"I have to take eight pills at a time to get this medicine to work now." Tears welled up in the patient's eyes.

He really couldn't understand why he felt worse the more he took the medicine, even though he had already spent money and suffered.

Lu Renxin quickly comforted him: "Relax, you must stop taking this medicine immediately. Its main ingredient is bisacodyl."

Laxatives can be broadly categorized into several types: osmotic laxatives, stimulant laxatives, bulk-forming laxatives, prokinetic agents, etc.

In particular, stimulant laxatives should be used with caution, as long-term use can lead to melanosis coli and drug dependence.

The small pink pill in the patient's hand is a stimulant laxative.

Its main components can directly stimulate the nerves in the intestinal wall, and long-term abuse can lead to pigmentation of the intestinal mucosa.

However, long-term use can cause intestinal dependence, making it impossible to defecate on its own without medication.

If the stool cannot be expelled, the dosage can only be increased, which makes the intestines more dependent, thus creating a vicious cycle.

However, other medications are not very effective for patients these days.

After much deliberation, Lu Renxin decided to prescribe some medication with fewer side effects that was suitable for long-term use.

However, relying solely on these medications was probably not enough, so it was ultimately decided to add traditional Chinese medicine to his treatment.