Healing Doctor

Chapter 769 The Fatal Pleural Reaction

Even in a semi-sitting position, Ji Xiang felt that he was having more and more difficulty breathing.

Countless golden stars danced before his eyes, and Ji Xiang vaguely saw Meng Qingfei's figure.

"Hallucination, this must be a hallucination caused by lack of oxygen!" Ji Xiang said to himself.

With each breath Ji Xiang took, there should have been enough oxygen, but the air encountered an obstacle when passing through the alveolar membrane.

Ji Xiang also knew that it wasn't a problem with his own bodily functions, but rather that the air escaping from the ruptured lungs was compressing the lung tissue, preventing oxygen from passing through the alveolar membrane, respiratory membrane, and capillary blood for oxygenation, thus increasing the oxygen content in his blood.

But no matter what, he just felt like he was broken.

In a daze, Ji Xiang no longer saw Meng Qingfei, but felt as if he were a damaged mech in battle, with all his parts falling to the ground with a clatter, and he could clearly hear the sound of the parts hitting the ground.

Ji Xiang had experienced many times the pain, the despair, the despair, the horror and the eeriness.

However, when he experienced the pain of traumatic hemopneumothorax, those previous pains seemed insignificant.

The strength in his body quickly drained away, and Ji Xiang slumped into a seat, leaning against the back of the 120 emergency room doctor.

"Young man, breathe evenly, not too deep or too shallow, don't be nervous." The 120 emergency room doctor kept telling Ji Xiang the precautions.

Especially the tension.

Ji Xiang also knew that even normal people could experience difficulty breathing due to emotional stress.

If I were an emergency room doctor, I would also tell the patient not to be nervous.

but!

When you try to empathize with someone, you feel an overwhelming terror descending upon you, as if you are on the verge of death, unsure if you will even be able to catch your breath.

How could I not be nervous?

No matter how hard Ji Xiang tried to force himself to be calm, he couldn't help but feel nervous.

"Roar~"

"Hooray~~"

A faint growl came from Ji Xiang's throat.

He knew this was caused by the trachea starting to spasm; if it were an elderly person or someone with underlying medical conditions, it might have already started asthma.

Several diseases piled up...

The consequences could be disastrous.

"This is fucking awful!" Ji Xiang cried out in his heart.

Ji Xiang even felt that if he continued in this state, it would be better to die.

"Young man, don't be nervous. It's just a simple minor ailment. We'll take you to the hospital and have a tube inserted to release the air," the 120 emergency room doctor reassured Ji Xiang.

"Don't worry, your blood oxygen saturation is still 91%, and your trachea isn't shifted. If things really get too bad, I'll use a syringe to help you remove the air."

"Don't be nervous, I'm here."

The 120 emergency room doctor kept comforting Ji Xiang.

However, Ji Xiang only had one thought in his mind—try having a hemopneumothorax if you dare!

Easier said than done.

He was too exhausted to even think about his earlier questioning of Meng Qingfei in the emergency room. Stars were flashing before his eyes, and Ji Xiang even vaguely saw a bright light.

Ji Xiang didn't know what the Great Brightness meant; he was too incapable of thinking about it.

Fortunately, the ambulance driver was experienced, and the private cars along the way were also very cooperative, so there was no delay, and we sped all the way to the hospital.

"Traumatic hemopneumothorax!" the 120 emergency room doctor yelled. "Hurry!"

He had already called the emergency department from the car, but the 120 emergency doctor still yelled at him.

The stretcher was wheeled away immediately. The doctor following the stretcher glanced at the blood oxygen level, then listened to the patient's heart and said calmly, "It's nothing serious. Why does it look so serious? This young man is being too dramatic."

He spoke softly, seemingly communicating with an emergency room doctor, but Ji Xiang heard him.

If the blood oxygen saturation is 91%, then there's really nothing to worry about. You can go to the thoracic surgery department for a closed thoracic drainage in a bit.

If he could truly empathize with someone, Ji Xiang would definitely think this way.

But now!

Ji Xiang had already started cursing under his breath.

Ji Xiang, who is usually gentle, elegant and composed, has started cursing!

"Get an X-ray quickly, then put the tube in as soon as possible," the emergency room doctor replied.

The gurney rumbled, and Ji Xiang had heard many doctors say similar things—the sound of emergency gurneys was the most annoying thing.

Now Ji Xiang feels that if he hears that sound again in the future, he might experience coronary artery spasm and suffer a heart attack instantly.

"Young man, stand still, it only takes a few dozen seconds."

The thoracic surgeon comforted Ji Xiang.

Ji Xiang was speechless at this moment. He felt like a dead fish that had been thrown ashore, his eyes rolled back, unable to even struggle.

The thoracic surgeon was fairly reliable. Although he thought Ji Xiang was being dramatic, since there were no family members around, he stayed in the room with Ji Xiang wearing a lead apron to prevent Ji Xiang from falling when changing positions.

A standing X-ray was taken at a 45° angle, and the thoracic surgeon leaned over to take a look.

"Not much blood, 60% lung compression, not bad," the radiologist said casually. "Looking at the patient's condition, I thought he was going to die."

"Hey, who would have thought a young man could be so dramatic? A few days ago I met a patient whose lung tissue was 85% compressed. I offered to admit him, but he refused, saying he felt nothing at all and wanted to go cycling."

The thoracic surgeon said, glancing at Ji Xiang.

Ji Xiang was filled with tears.

Am I being dramatic?

That seems to be the case, but I can clearly feel all these negative feelings!

The feeling of impending death is getting stronger and stronger, to the point that my thoughts are becoming muddled.

Only one sentence kept swirling in Ji Xiang's mind—individual differences.

Ji Xiang never imagined that individual differences could be so severe. A pneumothorax with less than 80% lung tissue compression made him feel like he was dying.

Do not!

It's to the point where I don't want to live anymore...

That's what they said, but the thoracic surgeon didn't waste any time and quickly took Ji Xiang back to the ward.

"Are you ready?"

Upon returning to the ward, the thoracic surgeon immediately asked.

"Ready!"

The nurse said simply and directly.

Ji Xiang was too weak to sit, and lying down made it even harder to breathe. No matter what position or posture he was in, he was in terrible pain.

His eyes had lost their light as he watched the thoracic surgeons quickly packing up the incision kit, while nurses assisted in preparing the closed thoracic drainage bottle.

The scalpel, sterile drape, incision kit, chest tube, and saline solution were all poured into the chest bottle. Everything was done in an orderly manner, which suggests that this hospital is quite professional.

However, Ji Xiang felt the power of relativity.

The thoracic surgeons were highly professional, and the nurses cooperated perfectly.

Ji Xiang felt that all their actions were like slow motion, playing frame by frame, which was extremely irresponsible to the patients.

Oh shit!

Ji Xiang knew that this was a false perception he was experiencing while near death, but the perception was so clear and real.

"Give me an injection, and don't move around." The thoracic surgeon said coldly, holding the syringe after disinfecting the wound.

Yes, Ji Xiang felt that the doctors in the thoracic surgery department were indifferent.

He even felt that the thoracic surgeons' expressions were somewhat ferocious. Hurry up and do it!

The needle pricks felt like mosquito bites, with no pain whatsoever, but the little monster inside Ji Xiang's heart was growing and roaring wildly.

There was no pain when it was cut open.

The muscle tissue was bluntly dissected until the hemostat touched the pleura, at which point Ji Xiang's entire body suddenly stiffened.

The parietal pleura acts like a switch; the slightest touch renders Ji Xiang immobile.

"Just bear with it!" the thoracic surgeon said. "Just one poke, it'll be fine."

Ji Xiang, covered in sweat, mustered all his strength to utter a soft "hmm".

He had performed closed thoracic drainage during his internship, and Ji Xiang had also said the same thing that the thoracic surgeons had said.

Indeed, some patients will struggle violently the moment their pleura is punctured.

But as soon as the closed chest drainage bottle is connected, the gas and blood are expelled, and the feeling of being on the verge of death will disappear.

"It's the last step!" Ji Xiang encouraged himself.

The hemostats were a bit cold, and the lights in the treatment room were dim.

The next second, a "puff" sound came, accompanied by a hissing sound of air leaking out.

"Aww~~~"

Ji Xiang let out a scream.

He was like a fish, thrown up and then slammed heavily onto the examination bed in the treatment room.

"Too young, too healthy, the pleura and intercostal muscles are severely tense." The thoracic surgeon sighed. "We'll insert the chest tube soon."

Before Ji Xiang's eyes lay a bright and clear future.

He didn't hear what the thoracic surgeon said at all.

The pain was excruciating; Ji Xiang never imagined that the moment his pleura was punctured, he would feel like he had died once.

The thoracic surgeon used hemostatic forceps to clamp the chest tube and insert it into the incision that had been cut and bluntly dissected.

"snort!"

The thoracic surgeon exerted force to insert the chest tube.

But just as he said, Ji Xiang was young, his muscles were taut, and his pleura was taut, so the thoracic surgeons couldn't insert the chest tube in one go.

"Damn it!" the thoracic surgeon said, somewhat annoyed.

He almost dropped the equipment after hearing Ji Xiang's screams.

"Brother Wang, the old chest tubes with inserts were so useful, why are they gone?" the nurse asked softly, feeling a little sorry for them.

"They say there's a problem with the procurement of high-value consumables, or maybe the medical insurance won't reimburse it or something. Every time we use one, we lose our bonus..." the thoracic surgeon said dejectedly, his voice growing softer and softer until it was barely audible.

But Ji Xiang could guess what he was talking about.

Ji Xiang almost burst into tears.

If you have money, you can use a chest tube with a steel core!

There was once a high-value consumable material where the chest tube had a steel core inside, making the tube essentially rigid and incredibly easy to insert into the chest cavity.

Nowadays, thoracic surgeons use hemostats to clamp the chest tube and insert it using the metal part at the tip of the hemostat.

The latter requires force to push, otherwise it won't go in.

Ji Xiang was in pain and had difficulty breathing, tears streaming down his face.

Damn surgery, just get this over with!

"Bear with it, it'll be soon." The thoracic surgeon used the word "soon" again.

Ji Xiang wanted to say, "You'd better shut up and hurry up and put the chest tube in."

But the next second, the thoracic surgeon used his physical strength to thrust in hard.

Ji Xiang's body moved a few centimeters, and he even felt the examination bed beneath him move with the force of the thoracic surgeon.

Although the force was sufficient, the chest tube still couldn't be inserted.

Both Ji Xiang and the thoracic surgeon fell silent.

Ji Xiang was drenched in cold sweat, as if he had just taken a shower, and was trembling uncontrollably.

It was truly agonizing; Ji Xiang even considered stopping his empathy and returning to Meng Qingfei's side.

But Ji Xiang didn't back down. He only had a fleeting thought before he stopped himself from going back.

The empathy continues.

After three agonizing attempts, Ji Xiang even felt that the thoracic surgeons would break his ribs before inserting the chest tube into his chest cavity.

"Even the chest bottle!" The thoracic surgeon's voice rose several decibels.

Finally, Ji Xiang heard the bubbling sound coming from the chest bottle.

He knew very well that the air in his chest cavity had been expelled, the pneumothorax was cured, the lung tissue had expanded, and the subsequent healing was a minor matter. The most important thing was that he would no longer have to suffer.

however!

Because of his near-death experience, Ji Xiang forgot one thing—what kind of patients he encountered in the emergency room.

As the air in his chest cavity was expelled, Ji Xiang's body relaxed for a moment, but then even more severe symptoms swept over him.

I had no strength left; even the strength to breathe was suddenly taken away.

I couldn't open my eyes, my whole body was itchy, and my heart felt like it was pounding in a big cavity, with a thumping sound right next to my ears.

Moreover, his heart was beating faster and faster, and Ji Xiang felt that his heart rate had reached about 180 beats per minute.

The situation was even more serious than before, but Ji Xiang entered a state of tranquility instead.

He seemed to have left his body, and his whole being became quiet.

Is this what traumatic shock is like?

Shock may result from gas and fluid loss after closed thoracic drainage, vagal nerve dysfunction, and misjudgment by the body.

It should be.

Ji Xiang never expected that a minor procedure, which didn't even qualify as surgery, would cause him to go into shock!

"Huh? What's wrong?" The thoracic surgeon looked at Ji Xiang with a puzzled expression.

"Something seems wrong."

"Put him on cardiac monitoring," the thoracic surgeon said. "Get Sabo over here quickly."

Sabo...

I haven't heard the name Ji Xiang in a long time.

Sabo wasn't in the emergency department of the Second Affiliated Hospital; I met him there during my internship.

Its full name is Saab CPR machine, which uses a machine to replace manual chest compressions.

I never imagined that one day I would have to use Saab myself.

This thing is indeed good, but it has only one drawback—it's very expensive.

While Ji Xiang was lost in thought, the electrocardiogram monitor was already connected, and the thoracic surgeon frowned as he looked at the readings.

"Administer 5mg of dexamethasone."

"Are you allergic?" the nurse asked.

"Let's take it in and get some adrenaline ready," the thoracic surgeon said. "It should be fine, just a pleural reaction. It doesn't look serious, but we should still be careful."

"It's rare to see patients like this," the young nurse asked, puzzled.

"During pleural puncture, patients may experience a series of reactions such as dizziness, chest tightness, paleness, sweating, and even fainting. Pleural reaction is a relatively serious complication during pleural puncture, but it can be significantly reduced through nursing interventions."

"..."

"I heard this question on your nursing department's exam. Didn't you memorize it?"

"No time..."

The nurse stopped talking and kept her head down, busy with her work.

After the medication was injected, Ji Xiang felt much better, though he didn't know how much time had passed.

This kind of improvement isn't the gradual, slow recovery from illness, but rather a sudden, dramatic improvement, as if the person has escaped a near-death state and is now full of energy.

"Doctor, I think I'm alright now," Ji Xiang said tentatively.

"You scared me!" The thoracic surgeon breathed a sigh of relief when he saw that Ji Xiang was speaking fluently. Although the vital signs on the monitor had not fully recovered, he knew that everything was alright.

"I'm fine..."

"Are you alright?" The thoracic surgeon leaned against the windowsill with his arms crossed, taking a break while chatting with Ji Xiang.

Although Ji Xiang appeared to be fine, the thoracic surgeon dared not leave, for who knew what might happen next.

"When I was doing my internship, I was rotating in the thoracic surgery department. A classmate was removing a patient's chest tube, which is just pulling the tube out and tying it back with a pre-installed suture. Such a trivial procedure, but something went wrong."

"Huh? What happened?" Ji Xiang knew that removing the chest tube was simple, because he had always done similar things during his internship.

Although he had just been pulled back from the brink of death, Ji Xiang had already caught Shen Lang's gossip syndrome, and his ears had unconsciously perked up.

"After the chest tube was removed, a small amount of bright red blood gushed out of the incision, and the patient suddenly fainted."

We were terrified at the time, and a patient's family member immediately went to find the doctor.

I immediately applied pressure to the wound, and the bleeding stopped. The bleeding was about 50ml. I immediately measured the blood pressure, which dropped sharply to 90/50mmHg.

The teacher rushed over and immediately began administering intravenous fluids and subcutaneous epinephrine. The patient's blood pressure subsequently dropped to 50/30 mmHg, and he became unresponsive. Cardiopulmonary resuscitation (CPR) was immediately initiated, but failed half an hour later, and he was pronounced clinically dead.

"Holy crap!!!" Ji Xiang exclaimed in surprise.

"The final diagnosis was a pleural reaction." The thoracic surgeon's eyes were fixed on Ji Xiang. "The possibility of a pleural reaction occurring after tube removal is extremely low, about the same as winning the lottery."

"My teacher also said that he had worked in thoracic surgery his whole life and had never encountered a similar situation. But when he did, it was 100% certain."

The thoracic surgeon put it simply, but Ji Xiang understood what he meant.

"Why are you, a grown man, so nervous?" the thoracic surgeon complained.

"Nine out of ten men are the ones who groan and moan when it comes to the same thing. If men were to give birth, the population would be reduced by at least half," Ji Xiang retorted.

"..." The thoracic surgeon chuckled, "What you said is true. Women are really good at enduring pain. Some people say it's because they have a high pain threshold."

"Perhaps races with high pain thresholds for men and low pain thresholds for women have already gone extinct."

Ji Xiang is really better now; he even has the energy to chat and laugh with the thoracic surgeon.

Even though he still spoke weakly, he was full of energy to talk nonsense.

Next, Ji Xiang asked many questions about cases of sudden death of patients who had their chest tubes removed during his thoracic surgery internship.

The thoracic surgeon, having just recovered from his initial tension, chatted idly with Ji Xiang, discussing a great deal of things.

These were all clinical experiences, and Ji Xiang wrote down everything that needed to be written down.

Although I probably won't have the chance to work in thoracic surgery in my lifetime, it will be a useful reference should I ever encounter such an opportunity.

Pleural reaction and shock, although the probability of them occurring is not high, is like buying a lottery ticket: as long as no one cheats, there will always be lucky ones.

This kind of "luck" doesn't seem so good.

After a while, Ji Xiang gradually fell silent.

As the excitement following the near-death experience gradually subsided and his hormone levels decreased, Ji Xiang felt his chest tube stabbing his lungs with every breath.

I feel a bit uncomfortable, a bit unwell, and there's also pain caused by the chest tube compressing the intercostal nerves.

Ji Xiang knew, of course, that his experience was the result of a series of coincidences piecing together, and that patients with so many symptoms were extremely rare in clinical practice.

With his vital signs stabilizing, the thoracic surgeon was relieved and let Ji Xiang carry the IV bag himself.

"Note that the bottle should be positioned lower than the chest wall, otherwise the water inside will flow back into the chest cavity."

"Yes, I know." Ji Xiang skillfully picked up the hook on the chest bottle and followed behind the doctor.

"It's alright, you scared me just now," the thoracic surgeon said, still shaken. "When bad luck comes, if you're unlucky, I'm unlucky too."

"Doctor, can't we take preventative measures in advance?" Ji Xiang asked.

"How do we prevent it? Most thoracic surgeons will never encounter this in their entire lives, and we still have to go to the ICU to prepare in advance?" The thoracic surgeon seemed to have a lot of complaints. He hesitated for a moment, "I chose the wrong profession in this life. If there is a next life, I will never be a doctor."

Ji Xiang smiled.

Upon arriving at the ward, Ji Xiang's eyes flashed with light. The next second, he opened his eyes and saw the system NPC.

"Teacher, I'm back." Ji Xiang hadn't finished speaking with the thoracic surgeon when he suddenly saw the system NPC and paused for a moment.

"Put your hands down, don't make that gesture of carrying a bottle on your chest, it looks uncomfortable," the system NPC reminded Ji Xiang.

Ji Xiang paused for a moment, then laughed and rubbed his hands together vigorously.

"Are you feeling the severity of the pleural reaction?" the system NPC asked jokingly.

"It's not just the pleural reaction; the hemothorax and pneumothorax are also very uncomfortable. When they were lowering the chest tube, it felt like torture." Ji Xiang sighed. "Teacher, if only I could stay healthy."

"Yes, it will," the system NPC said.

Ji Xiang stared intently at the system NPC, as if he had overheard some secret.

"This is how patients feel. If you encounter a similar situation in the future, never think it's nothing." The system NPC began to instill a worldview again.

Ji Xiang instantly activated his passive skill, blocking the system NPCs' cramming-style indoctrination.

After an unknown amount of time, the system NPC said with a smile, "There aren't many cases of patients dying from pleural reactions after tube removal. According to my statistics, although it's more common than heart tumors, when I was the director, I would only encounter it 2-3 times a year at most."

"so."

"We still need to pay attention to what needs to be paid attention to. Grasping the details in the process is part of clinical experience." After the system NPC finished speaking, he waved his hand.

Ji Xiang returned to reality.

The sound of the flatbed cart still seemed to echo in his ears, but Ji Xiang's heart was no longer that of the person he had just been.

"Xiao Ji, do you know what the patient's problem is?" Meng Qingfei asked.

"A rare pleural reaction."

"..." Meng Qingfei was stunned for a moment.

Ji Xiang just looked so anxious, how come he suddenly gave a clear diagnosis?

Moreover, judging from his appearance, he seemed to be very certain of himself, and perhaps he had something difficult to say.

(End of this chapter)