Chapter 23 Chapter Twenty-Three

The intern told me that Teacher Li stopped struggling, but she was still in pain, her eyes were wide open, and she was crying silently.I told the interns that you can go to the doctor on duty now and give the teacher 10 mg of Valium to put her to sleep.After thinking about it, I said, no, let’s take 20 mg. At four or five o'clock in the morning, the intern told me that the teacher's eyes were not open, but he was struggling very hard, and the blood oxygen concentration was always good.I told her: Don't worry about it.If you can't rest well, go to another room to sleep.You are also very tired, you must rest well, we still have a long way to go.Dr. Hao will come to make rounds tomorrow morning, and then we can decide whether to extubate or not.

On the morning of the fourteenth day, the intern happily told me that Dr. Hao said that the tube could be extubated, and asked me again if Teacher Li was all right.My heart has long been tempered into steel, and this gain or loss is not enough to cause me any disturbance.I didn't answer her question, but just asked her to continue to pay attention to Xiao Rui's body temperature, especially in the afternoon. Xiao Rui's body temperature still couldn't drop, so the same thing happened again on the fourteenth and fifteenth day.On the sixteenth day, I sent a text message to the intern in the morning when Xiaorui was awake and not on a ventilator, telling her how to detect early respiratory failure, heart failure, and kidney failure, and what to do if they appeared.At the same time, we will add medicine to protect the stomach today. Xiao Rui vomited too much during chemotherapy. He vomited blood once. If it happens again, "gastrointestinal failure" is likely to occur.In addition, Mr. Li has fallen asleep many times, so it won't be a big problem to use some mannitol to protect the brain.

In the early morning of the seventeenth day, Xiaorui suffered cardiac arrest.This was the second time she had suffered a cardiac arrest, the intern told me.She said that there are many teachers around to rescue her. Because of the need for cardiopulmonary resuscitation, Xiao Rui's shirt was torn open, and her chest was exposed.She said that the teacher is very shy, is that okay?I also asked the teacher that it was too painful, should we let it go? I firmly said that I will not let go, and everything will be worth it when the teacher recovers.I asked her to be optimistic about every step that other teachers rescued, she might use it.

Xiao Rui lived up to my expectations, she escaped this disaster. On the eighteenth day and the nineteenth day, Xiao Rui had cardiac arrest once a day.I never gave up, I never panicked, and I never wavered in our determination to win.But on the 20th day, when the intern told me that the whole hospital had consulted in the morning, and some laboratory tests had come out, and that Mr. Li had dic (disseminated intravascular coagulation), I have to admit, I was a little shaken. . The so-called dic, described in the simplest terms, is that the blood in the capillaries of the whole body is coagulated.You can imagine the consequences of blood coagulation all over the body. The organs will fail one by one without blood, and the death rate is extremely high.Although I was very conscientious when I was a surgeon and rescued countless patients, I have never successfully rescued a patient who developed dic and developed to failure of more than 3 organs.

Xiao Rui already has respiratory failure, and her lungs can't even breathe normally. Only with the help of a ventilator can she barely maintain the blood oxygen concentration at a normal level.Her heart has stopped fighting many times. Isn't this heart failure?In addition, she also had gastrointestinal bleeding yesterday, and her gastrointestinal tract began to fail. Only her kidneys can barely function with the help of drugs. What other organs in her are considered to be working normally?She often fell asleep, and her brain was actually failing.The disease attacked the city and occupied the viscera. We no longer have any reliable bases. How can we counterattack?

I was in a trance for a while, ignoring the intern asking me what to do next.During this period of time, everything I said was being fulfilled, and the little girl regarded me as a demigod.But she doesn't know that my god is also shaken now. But I can't waver, I will never allow Xiao Rui to disappear in front of me. So I asked the intern if he had used heparin, which is a drug that can prevent blood clotting, and the intern said that Dr. Hao had already used it.I thought about it and said, maybe we can try streptokinase, if heparin can stop the blood from clotting, this drug can dissolve the blood that has already clotted.

But this is not a routine usage, because this drug is usually only used in stroke and cerebral thrombosis, and the two situations are different, and there is a big difference.The cerebral thrombus was many times larger than the capillary thrombus that appeared in Xiao Rui's body.The risk of using this drug is very high. If the blood fails to coagulate and hemorrhages, the consequences will be dire. But even if we don't use this medicine, the dic that appeared on Xiaorui's body will eventually turn into hemorrhage.That's because the blood coagulates too much, all the elements used for blood coagulation are used up, and the remaining blood cannot coagulate and can only bleed profusely.

In professional terms, dic is first hypercoagulable, then hypocoagulable, and hypercoagulable is Xiao Rui's current state. In this case, the doctor will usually issue a critical illness notice and tell the family members to have the mentality to do the funeral. get ready.When multiple organs fail and enter a low coagulation state, the doctor will inform the family members that they are about to prepare for the funeral. What's even more frightening is that Xiao Rui doesn't have much blood to bleed now. Her newly transplanted bone marrow hasn't functioned yet, and the original blood has been exhausted. All the active ingredients in the blood are pitifully thin, and the situation is very critical.

I hesitated for a second and decided to use it.I know it's risky, but I have no way out.I thought that I told the intern that she might not understand, so I told Xiaorui that I planned to give her this medicine and asked her to notify Dr. Hao, and told her that the hospital where she worked might not have it. If the doctor can't find it, I'll send it by plane. Xiao Rui only replied with one word: "Yes." I feel that if God arranged for me to meet Dr. Hao, we would definitely become friends, because he also decided to use it, and got the medicine from another hospital before 12 noon.

The intern was very happy when he saw the medicine, and asked me if it was a special medicine, and if the medicine was available, the teacher would be saved.I can't answer this question accurately, I can only tell her briefly and observe. From the twentieth day to the twenty-first day, Xiao Rui's heart stopped beating three times.At 5 o'clock in the morning on the 21st, it was the seventh time that her heart stopped beating.I have to admit, that heart stop was the one that worried me the most, and I was shaken again.The intern told me that Dr. Hao had been resuscitating for half an hour, but the heartbeat still hadn't recovered, so he was going to give up (usually the doctor would declare him dead if the heartbeat still hasn't recovered after 15 minutes of resuscitating).

I guess the intern cried when he said that.She went on to say that she felt it was her own responsibility. The teacher's heartbeat stopped because she fell asleep, and she didn't hear the monitor for a long time. I don't have time to reassure her that it's none of her business.At that moment, I didn't know whether I should let Xiao Rui go, but I only wavered for a second, no, maybe 0.01 seconds, I was racing against death, and I didn't have time to waver.I said to the intern: Didn't I let you learn cardiopulmonary resuscitation?Now you can use it, as soon as Dr. Hao gives up, you will start CPR immediately.Plug the teacher's mobile phone into the earphone and put it in the teacher's ear, and I want to talk to her. I only said one sentence when I dialed the phone, but I said it many times, and that sentence was: "Xiao Rui, I won't let you die!" I don't know if it was the intern's CPR that helped, or my words.In short, after I shouted for 15 minutes, that is, 45 minutes after Xiao Rui's heart stopped beating, her heartbeat miraculously recovered. This is definitely a miracle, and the conscientious Dr. Hao also announced that Xiao Rui was dead psychologically, but we snatched Xiao Rui back from the hands of the god of death.To this day, I don't understand how we did it.I asked Xiao Rui this question afterwards, and she said she didn't know either, but what she knew was that she really heard my words. On the 22nd day, when her heartbeat stopped twice again, I was calm. At this time, I believed that we could overcome any difficulties. On the twenty-third day, when she started complaining to me about the bruises and bruises on her body from the daily CPR, I couldn't have been happier.She can complain that her spirit is much better, and the bruises on her body indicate that the viper streptokinase has finally started to work. It is the twenty-fourth day to stop using streptokinase in Pit Viper.On that day, I finally received the first good news since the war started. Her white blood cells, platelets and red blood cells began to rise. This is good news that can fundamentally change everything. It means that the bone marrow transplanted into Xiaorui has finally begun to grow, but I am still a little apprehensive.I am afraid that it is an illusion caused by blood transfusion, because this does not conform to the general rules of bone marrow transplantation. If the transplanted bone marrow has not grown for so long, those seeds of hope should have withered long ago.I was even more afraid that it was a misunderstanding caused by a mistake in the test, so I asked Xiao Rui to have another test on the 25th day. This time the test value was a little higher, although it was only a little bit. When I asked the intern to send every number on the test sheet and confirmed that every number was accurate, I did something that I have never told Xiao Rui—I hid and cried alone one game.From the silent shrug of my shoulders at the beginning to the painful tears at the end, I finally vented my hysteria.I didn't cry when Xiaorui showed dic, I didn't cry when Xiaorui had cardiac arrest, I didn't even cry when Dr. Hao thought she was dead, but this time I cried like a child.I finally know that it is not only pain that can make people cry, a little glimmer of light in the dark, a little hope can also make people shed tears of excitement. But I only gave myself about 5 minutes to vent. I know it's not the time to toast and celebrate. We still have a long way to go before the final victory. I can't take it lightly.