Practicing Medical Skills in a Small Clinic-Chapter 78: The Dangers of Excessive Calcium Supplementation
Xie Guiqiu had just left not long ago, and the afternoon rush for buying medication and seeing a doctor at the small clinic started once again.
However, there were still no patients with external injuries. Forget about cutting tumors or draining abscesses, there wasn’t even anyone with cuts or bruises requiring basic suturing.
Headaches, minor fevers, indigestion, diarrhea, high blood pressure, skin rashes... all just minor ailments.
Patients with high blood pressure typically just get their blood pressure checked and then buy two bottles of hypertension medication.
Some simply come to have their blood pressure checked without buying medication because they have insurance and can’t get reimbursed for medications bought at Sunshine Clinic.
Going to designated pharmacies or health service stations to get medicine can be reimbursed, so they hardly have to spend any money.
If only Sunshine Clinic could get the collective procurement qualifications, that would be great.
Because once you’re on the collective procurement platform, you essentially get the insurance fixed-point qualification too.
By then, when Boss Zhao comes back from treating his heart disease, he probably wouldn’t dare to come within 200 meters of Sunshine Clinic. There’s no other reason, mainly because he fears seeing that dazzling insurance fixed-point metal plaque, which might trigger his heart disease to relapse.
He has been running his clinic for over twenty years and still hasn’t obtained this qualification.
Even the reportedly well-connected Jinkui Clinic hasn’t gotten the insurance fixed-point qualification. The difficulty of this can be imagined.
Busy until five thirty in the afternoon, customers still kept coming in an endless stream.
They weren’t all rushing in at once.
They just came in one or two at a time.
Some came to see the doctor, some came to buy medicine.
Seeing the health supplements and tonics behind the counter gradually decrease, Li Jingsheng couldn’t be happier.
The constant flow of cash would make any business owner feel happy.
"Sister Tang, why don’t you go pick up the kids first? You might have to come back for extra work later."
Li Jingsheng couldn’t handle it all by himself.
"Alright!"
Tang Ping grabbed a thin jacket without changing clothes and hurried out.
Li Jingsheng was left alone to diagnose patients while also managing and attending to those who wanted to buy health supplements and tonics, busy to the point of sweating profusely.
After all, this is all money, so of course, he wouldn’t want to miss serving any customer, allowing them to leave without a purchase.
"Doctor, do you have any calcium supplements for children here?"
A middle-aged woman carrying a handbag asked.
"Yes, just wait a moment. Let me finish prescribing this gentleman’s cold medicine, and then we can discuss your needs in detail. Calcium supplements for children need to be taken seriously and scientifically. Otherwise, it may cause their bone lines to close prematurely, making it difficult for them to grow taller."
Li Jingsheng wasn’t merely trying to scare the woman.
It’s true that excessive calcium supplementation can have adverse effects.
Normally, boys can grow beyond the age of 18, while for girls, their growth typically stabilizes after reaching puberty. That is, after experiencing first menstruation around 13, they usually stop growing around 16 or 17.
"You’re indeed professional! When I went to a big hospital to buy calcium tablets for my child, the doctor said the same thing. Other pharmacies never mention this."
The woman’s thumbs shot up in praise of Li Jingsheng. She found a chair and sat down in front of the counter.
It seemed that Li Jingsheng’s professional response immediately earned her trust and favor.
The man buying cold medicine also gained a few more layers of trust in this small clinic upon hearing this.
There’s a reason crowds gather.
Upon hearing others praise a certain shop, one’s subconscious naturally develops a better impression of the place.
Praising oneself ten times isn’t as effective as someone else praising once.
Li Jingsheng prepared two boxes of cold medicine for the man. In fact, dispensing loose medicine could yield better results and more profit, but the regulations are currently very strict.
Along with some patients who play smart and take medicine indiscriminately.
Although prescribed to be taken twice daily, once in the morning and once in the evening, a patient might not feel the expected effects after one dose, and impatiently take another around midday instead of waiting until the night.
Each medicine’s metabolism rate is different.
Taking doses close together can easily lead to problems.
Li Jingsheng, being a cautious person, used to sell some loose medicine, packaged strictly according to requirements, with the names and doses written clearly on the bag. However, after realizing the significant risk, he preferred to earn less by selling only boxed medicine.
After finishing with the cold medicine and sending off the male patient, Li Jingsheng came over.
With an apologetic smile, he said, "Sorry for keeping you waiting!"
"No problem, I’m already off work! Just recommend a good calcium tablet for me, please."
The woman said.
"How old is your child?"
"Eleven." 𝚏𝗿𝗲𝐞𝐰𝚎𝕓𝐧𝚘𝘃𝗲𝐥.𝐜𝚘𝕞
"Is it a little boy or a little girl?"
"A little girl!"
She replied with a smile.
When parents come to buy medicine for their children without bringing them along, Li Jingsheng usually doesn’t ask directly if the child is a boy or girl.
Due to societal biases, some people might feel embarrassed having daughters.
Asking directly might upset them.
If a customer gets upset, they likely won’t visit again.
"What’s the reason for wanting to supplement calcium? Is it to help her grow taller, to address calcium deficiency, or just for overall health?"
In Li Jingsheng’s experience, parents who merely want to supplement calcium for their children are quite rare.
Either they want the child to grow taller, or it’s because the child is showing symptoms of calcium deficiency.
Such as osteoporosis.
This parent previously mentioned taking the child to the hospital to see a doctor, presumably there’s some issues why they’re here to buy calcium tablets.
And most likely, they’ve already taken some calcium tablets.
Doctors in big hospitals love prescribing calcium tablets for children, especially pediatricians.
Everyone knows, taking calcium tablets doesn’t harm, plus doctors earn a little commission from prescribing medication.
Everyone’s happy.
"About three or four months ago, the child kept complaining about leg pain. I was worried there might be an issue, so I took her to the children’s hospital. After the doctor asked about the situation, they said it might be because the child is growing. The doctor said the age of 11 is a rapid growth stage for children, and due to the fast growth of bones, knee joint and shin pain is common. They prescribed us two boxes of calcium tablets to take at home."
Indeed, it’s almost what Li Jingsheng guessed.
The lady’s daughter went to see the doctor because of leg pain.
Pain in the knee joints and shins during a child’s growth is indeed very common.
Li Jingsheng asked up to this point, and there were hardly any issues.
Just prescribing two boxes of children’s calcium tablets would be fine.
However, considering the child has already taken at least two bottles, this dosage should be sufficient.
If they continue, there’s a risk of over-supplementation.
"How big were the two bottles of calcium tablets prescribed at the hospital? How long did she take them in total?"
"The hospital prescribed two bottles of calcium tablets, and the doctor told us that children’s calcium needs are much higher than adults, recommending two tablets a day. She took them for about two months. Later the child still complained about some leg pain, so I bought two more boxes of calcium supplements at the pharmacy for her, heard that calcium supplements are more effective. I saw the report about you and Sunshine Clinic in the newspaper, and out of trust, since I was passing by after work, I decided to come in."
The lady explained the situation thoroughly.
"Do you have calcium supplements here? A bit more expensive is fine, preferably imported ones."
"Yes, we have calcium supplements! These are all oral calcium supplements, imported ones need to be ordered, and take about half a month to arrive, they’re quite expensive. But since your daughter’s leg pain persists, I think you should bring her over for a check-up before deciding on calcium supplementation. Over-supplementing calcium can be very harmful, it can inhibit the absorption of iron, zinc, and magnesium, cause hypercalcemia, leading to hypertension, arrhythmia, and other diseases, it might even damage the kidneys.
Your daughter has taken so many calcium tablets and supplements in a short period, I advise you to be cautious about continuing to supplement her with calcium."
Li Jingsheng would love to sell two boxes of calcium supplements, the profit is quite considerable.
But this might lead to the little girl’s over-supplementation, posing health risks, he never earns money against his conscience.
Better to be a bit poorer than to earn such unethical money.
Otherwise, he could never have peace of mind for life.
"I didn’t know supplementing with calcium could be so harmful, it’s scary. Oh my, I had no idea before!" The woman was a bit panicked hearing this. "My daughter took two bottles of calcium tablets, and three boxes of supplements, is it not a problem?"
"As long as she doesn’t continue taking tablets and supplements, there shouldn’t be major issues. Children’s metabolism is fast, their calcium needs are high, and even if you give her a calcium tablet, she can’t absorb it all, most will be excreted through bowel movements and other ways."
Li Jingsheng comforted the thirty-six or thirty-seven-year-old mom as much as he could.
"What time do you get off work here? I’ll bring my daughter over soon, can you help check her?"
"No problem, as long as it’s not too late, I can wait for you at the clinic. If I’ve already closed, you can call me. Also, dietary supplementation is actually better than direct calcium tablets for children. Unless the calcium deficiency is serious, then you can combine dietary supplementation with tablets or supplements."
Li Jingsheng offered guidance on calcium supplementation for children with what he knows.
"Thank you, thank you! I can bring my daughter in about twenty minutes. Please wait for me a bit."
After speaking, she hurriedly left.
Li Jingsheng instinctively felt the little girl’s leg pain might not be due to calcium deficiency.
Because with all those calcium tablets and supplements, it should have been supplemented by now.
He must carefully examine the child later.
It’s just that, in pediatrics, he’s not very skilled, and he’s somewhat of an amateur in orthopedics too; if he really can’t diagnose it, he’ll have to ask the parent to take the child to a big hospital for a check-up.
After a dozen or so minutes, a woman holding a crying child walked in.
Li Jingsheng was preparing medicine for a customer, hearing the child’s cries, he thought the lady brought her child.
He looked up and realized it was another unfamiliar woman.
She was robust, carrying a girl more than three years old.
"Doctor, Doctor, my daughter just fell off the couch, seems like her right hand got hurt, please have a look."
Judging by this situation, she should be a local resident.
After his little clinic gained some reputation, business certainly picked up.
Local residents willing to come in, that’s the best evidence.
"Please have a seat for a moment, I’ll be done soon."
Li Jingsheng saw the girl was crying miserably, but her voice was loud and clear, the situation wasn’t immediately life-threatening.
The reception had to go in order.
"Can’t you treat my daughter first? She’s crying so hard. Aren’t doctors supposed to have empathy?"
The woman’s words were quite sharp.
Understandable.
If any family’s child got hurt, parents would be anxious.
"Sorry, this gentleman has been waiting for a while, I have to finish preparing his medicine first. Your daughter can wait a few minutes, it should be okay."
Li Jingsheng patiently explained.
"What do you mean my daughter can wait a few minutes? Are you blind? Can’t you see her right hand is hurt, she’s in so much pain? With your attitude, I must be out of my mind to come to your clinic."
The woman cursed and left.
Some women, either because their family has some money or a bit of power, can be really arrogant and unreasonable.
