咩咩說不出的世界

1. 這位64歲肥胖的男性病人其高血壓及高血脂的病史已有十年，

(英譯) This obese 64 y/o male patient has a 10-year history of hypertension (HTN/HT) and hyperlipidemia.

2. 他一直都有在服用抗高血壓及抗高血脂的藥物。

(英譯) He has been taking antihypertensive agents and simvastatin.

3. 在八年前戒煙前，其煙齡已有三十多年，每天抽一至兩包。

(英譯) He used to smoke one to two packs of cigarettes per day (PPD), and did so for more than 30 years before quitting eight years ago.

4. 當他被診斷有第二型糖尿病時，

(英譯) When Type II diabetes mellitus was diagnosed.

5. 醫師開給他口服降血糖藥（metformin 850 mg，口服，每天一次）。

(英譯) An oral hypoglycemic agent (OHA)  (metformin 850 mg po qd) was prescribed.

6. 他規律地回我們門診作追蹤，

(英譯) He has had regular follow-ups at our OPD.

7. 但他血糖控制得不好，大約在200 至400 mg/dl之間。

(英譯) But his blood glucose control remains poor, ranging from 200 to 400 mg/dl.

8. 病人自己每天在家測一次血糖，

(英譯) The patient checks his blood glucose by himself at home once a day.

9. 他過去一個禮拜的血糖約為400 mg/dl，

(英譯) His blood sugar has been at about 400 mg/dl over the past week.

10. 他同時主訴有多尿、多喝和多吃的現象，

(英譯) He has also complained of polyuria, polydipsia, and polyphagia.

11.  但沒有發燒、意識改變、腹瀉或便秘等情況。

(英譯) . There has been no signs of fever, change in consciousness, diarrhea, or constipation.

12. 也未發現有視網膜病變、腎病變或神經病變等症狀。

(英譯)  Symptoms of retinopathy, nephropathy, or neuropathy have not been identified either.

13.  他的糖化血色素值為13%。

(英譯) His glycosylated hemoglobin level was 13%.

14.  在非胰島素依賴型糖尿病及血糖控制不好的臆斷下，

(英譯) Under the impression of non-insulin dependent diabetes mellitus (NIDDM) with poor blood glucose control.

15.  他住進我們的病房，以作進一步的評估及治療計畫上的調整。

(英譯) He was admitted to our ward for further evaluation and modification of his treatment plan.

1.  How old is the patient?

(Ans) The patient is 64-year-old.

2. Is his weight within the normal range?

(Ans) No, he is obese patient.

3. What kind of medical history does he have?

(Ans) He has a history of hypertension (HTN/HT) and hyperlipidemia.

4. What medication has he been taking?

(Ans) He has been taking antihypertensive agents and simvastatin.

5. Did he smoke? For how long? When did he quit?

(Ans) Yes, he used to smoke one to two packs of cigarettes per day (PPD), and did so for more than 30 years before quitting eight years ago.

6. Why did the doctor prescribe OHA for him?

(Ans) Because of he was diagnosed Type II diabetes mellitus.

7. Does he visit the OPD regularly?

(Ans) Yes.

8.  How is his blood glucose control?

(Ans) His blood glucose control remains poor, ranging from 200 to 400 mg/dl.

9. How often does he check his blood glucose?

(Ans) The patient checks his blood glucose by himself at home once a day.

10. How has his blood sugar been over the past week?

(Ans) His blood sugar has been at about 400 mg/dl over the past week.

11.  What are his complaints?

(Ans) He has complained of polyuria, polydipsia, and polyphagia.

12. Does he have a fever, change in consciousness, diarrhea, or constipation?

(Ans) No.

13. Is retinopathy, nephropathy, or neuropathy present?

(Ans) No.

14. What was his glycosylated hemoglobin level?

(Ans) His glycosylated hemoglobin level was 13%.

15. What does the doctor think the patient is suffering from?

(Ans) The doctor thinks the patient is the impression of non-insulin dependent diabetes mellitus (NIDDM) with poor blood glucose control.

N:

 Let me check your post-meal blood sugar. 

(中譯) 請讓我檢查你餐後的血糖。

P:

 OK.

(中譯) 好。

N:

 Which finger should I use?

(中譯) 哪隻手指可以用?

P:

 Use my ring finger, please.

(中譯) 請用我的無名指。

N:

 I need to sterilize it first. It'll hurt a little.

(中譯)  首先我必須先消毒。它會有點痛。

P:

 What's my blood sugar?

(中譯)  我的血糖多少?

N:

 Your blood sugar is 356. It's very high.

(中譯) 你的血糖是356。非常高。

P:

 Really? What's the normal blood sugar range for diabetic patients?

(中譯)  真的?多少才是糖尿病的患者正常的血糖範圍?

N:

 It should be controlled under 180 after each meal.

(中譯) 餐後的血糖必須控制在180以下。

P:

 I see. So what will happen if my blood sugar gets too high?

(中譯) 我懂了。那當血糖太高時會產生什麼影響?

N:

 It could result in eye, nerve, and kidney problems

(中譯) 它會導致眼睛、神經和腎臟的問題。

P:

 Is that so? How should I control the blood sugar level?

(中譯) 是那樣嗎?那我該怎麼控制我的血糖標準?

N:

 We have patient education lessons every day. Why don't you join us?

(中譯) 我們每天都有病患教育課程。你怎不參加我們呢?

P:

 Sure. I have many questions to ask.

(中譯) 好。我有很多問題想問。

N:

 You can also talk to your diabetic educator if you like.

(中譯) 如果你願意你也可以問糖尿病的衛教人員。

P:

 I will.

(中譯) 我會的。

N:

 The doctor will check on you later to see if your diet and medicine need to be changed.

(中譯) 如果你的飲食和藥物需要改變的話等一下醫生會來檢查。

P:

 Thanks a lot.

(中譯) 非常謝謝你。

N:

 May I help you?

(中譯) 有需要什麼幫助嗎?

P:

 Yes, I feel dizzy, and I can't see clearly.

(中譯) 是的。我覺得頭暈目眩而且眼睛看不清楚。

N:

 Do you feel thirsty, or that you need to urinate a lot?

(中譯) 你有覺得口渴或排尿很多嗎?

P:

 Yes, I'm very thirsty even though I keep on drinking water. Are all diabetic patients like me?

(中譯) 是的。即使我一直喝水也很渴。所有的糖尿病患者都會這樣嗎?

N:

  It depends on their blood sugar control. When did you eat lunch?

(中譯) 要視他們的血糖控制而定。你何時吃午餐的?

P:

 I had my lunch at 12:20 p.m.

(中譯) 我午餐十二點二十分時吃的。

N:

 What did you eat?

(中譯) 你吃了些什麼?

P:

 I had a chicken burger, a cup of sugar-free coffee, and a guava.

(中譯) 我吃了一個雞肉漢堡、一杯無糖的咖啡和一個芭樂。

N:

 Please try to avoid fried chicken. It's too greasy.

(中譯) 請避免吃油炸的雞肉。太油膩了。

P:

 Is there too much fat in it?

(中譯) 是因為含有太多脂肪嗎?

N:

 Yes. Next time you have a chicken burger, just eat half.

(中譯) 是的。下次有雞肉漢堡時，只能吃ㄧ半。

P: 

 All right. What about the guava?

(中譯) 好吧。那芭樂呢?

N:

 It's a low-sugar fruit, so it's fine to eat it.

(中譯) 它是低糖的水果，所以吃它是很好的。

P: 

 OK then, how many servings of fruit should I have with each meal?

(中譯) 好然後我一餐該吃多少份的水果?

N:

 You may have one serving of low-sugar fruit. One serving is about the size of a fist.

(中譯) 你應該吃一份低糖的水果。一份的大小大約拳頭大。

P:

 Did you say a fist?

(中譯) 你說拳頭大?

N:

 Yes. If you still have questions about your diet, please discuss them with your nutritionist.

(中譯) 是的。假如你仍然有問題關於你的飲食，請與你的營養師討論。

P:

 I will. Should I avoid snacks too?

(中譯) 我會的。我也需要避免吃點心嗎?

N:

 Yes, remember to drink lots of water after your meals.

(中譯) 是的，你用餐後記得喝很多的水。

P:

 Is that it?

(中譯) 就這樣?

N:

 Yes. Now please stay in bed. I'll check your blood sugar again later.

(中譯) 是的。現在請你待在床上。我等一下會再一次檢查你的血糖。

N:

  Good morning. Here is your after-breakfast medicine.

(中譯) 早安。這是你吃完早餐後的藥。

P:

 What's it for?

(中譯) 有何用嗎?

N:

 It helps to inhibit the absorption of glucose. Please take it within 15 minutes of eating your breakfast.

(中譯) 它幫助抑制吸收葡萄糖。請在吃早餐後十五分鐘內服用。

P:

 OK.

(中譯) 好。

N:

 Do you know how to control your blood sugar level now?

(中譯) 你現在知道該如何控制你的血糖值了嗎?

P:

 Yes, I shouldn't eat too much food that contains sugar.

(中譯) 是的。我不能吃太多含糖的食物。

N:

 What else?

(中譯) 還有呢?

P:

 I was told weight loss and exercise are helpful. But I am a couch potato.

(中譯)  我被告訴要體重減輕和運動是有用的。但是我是一個懶骨頭。

N:

 What do you mean?

(中譯)  什麼意思?

P:

 Watching TV and eating potato chips are my favorite pastimes.

(中譯) 看電視和吃洋芋片是我最喜歡的娛樂。

N:

 But they are not good for your health.

(中譯) 但是那些對你的健康不好。

P:

 I know. I just can't help it.

(中譯) 我知道。我只是很難節制。

N:

 Exercise can help control blood sugar levels.

(中譯) 運動可以幫助控制血糖值。

P:

 But I need to be motivated.

(中譯) 但是我需要被刺激。

N:

 How about finding a friend or relative to exercise with you?

(中譯) 那找一個朋友或親屬跟你一起運動如何?

P:

 All right. I'll try doing that.

(中譯) 好吧。我會做的。

N:

 Controlling diabetes requires you to be consistent with your diet and exercise.

(中譯) 控制糖尿病需要你的飲食和運動一致。

P:

 OK. Should I be especially careful with my feet?

(中譯) 好。我需要特別小心我的腳嗎?

N:

 Yes, wear shoes at all times to prevent injuries. Keep your feet clean and inspect them every day.

(中譯) 是的，為了避免受傷要一直穿著襪子。保持你的腳的乾淨並且每天檢查。

P:

 I'll remember. Thanks.

(中譯) 我會記住的。謝謝。

[A ] 1. N: How are you feeling now? P: ___

(A) I’m feeling a bit tired.
(B) Yes, I can feel it.
(C) It feels a little soft.

[C ] 2. N: May I check your blood pressure? P: ___

(A) I have a lot of pressure.
(B) But I don’t like shots.
(C) Sure. Go right ahead.

[B] 3. P: What can I do for my kidney? N: ___

(A) You could have some problems breathing.
(B) You will probably have to go on dialysis.
(C) You should become a kidney donor.

[B ] 4. P: I would rather go on medication than dialysis. N: ___

(A) People with kidney problems can give it a try.
(B) The dialysis will help you get rid of extra water.
(C) Fine. But you’ll also have to take medicine.

[C ] 5. P: Is organ donation popular? N: ___

(A) People usually donate during the holiday season.
(B) There is another way besides dialysis.
(C) Not really. It still scares a lot of possible donors.

[C ] 6. P: How do I know which treatment I need? N: ___

(A) Why don’t you trust yourself?
(B) I know you can do it!
(C) Leave it up to the doctor.

[A ] 7. N: Do you mind if I examine your dialysis fistula? P: ___

(A) Go ahead, but the doctor says it’s fine.
(B) When will the dialysis fistula come off?
(C) Of course. It’s over there, on the floor.

[C ] 8. P: Nurse, I feel as if I am being shocked by electricity. N: ___

(A) Oh no! That really sounds terrible!
(B) I should turn the dialysis machine down.
(C) That means the operation went well.

[B ] 9. P: How long should I continue doing these exercises? N: ___

(A) Don’t start them for at least two months.
(B) Keep doing them for up to two months.
(C) The doctor will tell you how long to do it.

[B ] 10. P: Is it OK for me to drink alcohol from time to time? N: ___

(A) You must drink, or you will become thirsty.
(B) Don’t drink anything unless you have to.
(C) The doctor has already cautioned you against it.

1. 病人的收縮壓為180，舒張壓為90。

(英譯)   Patient systolic pressure is 180, and diastolic pressure is 90.

2. 我將會幫你安排作靜脈腎盂X光造影。

(英譯)  I'll arrange for you to had an IVP.

3. 我全身疼痛。

(英譯)  My body hurts from head to toe.

4. 不洗腎的話，毒素將會在你體內囤積。

(英譯)   Without dialysis, toxins will accumulate in your body.

5. 接合處情況良好。

(英譯)   Anastomosis area in good condition.

6. 你需要作手部運動來使血管動脈化。

(英譯)   You have to do hand exercises to arterialize the vessel.

7. 要花兩個月的時間，瘻管才會成熟。

(英譯)  The fistula matures for up to two months .

8. 現在你右邊腎臟的功能不到百分之十。

(英譯)   Your right kidney function is now less than 10%.

Sentence

vocabulary

1. He’s suffering from [B ] disease. His left kidney is pretty weak.

A. history

2. Hemodialysis is the so-called [H ] wash.

B. renal

3. We need to test your blood and urine for [J ].

C. electricity

4. The [F ] is the part of your body between the chest and legs.

D. oxygen

5. Emily has just [G ] surgery on her eye.

E. toxins

6. Wind power can be used to produce [C].

F. abdomen

7. An arteriovenous [I ] is the connection of an artery and a vein. 

G. undergone

8. The [D ] mask will help you to breathe more easily.

H. vessel

9. This 34 y/o male patient, with a [A ] of hypertension, has been taking medication for four years. (Admission Note)

I. fistula

10. In order to [E ] out end-stage renal disease, the patient was admitted for further tests and treatment. (Admission Note)

J. rule

[C ] 1. Both of my legs are ________, and I feel a sharp pain when walking.

(A) swell
(B) to swell
(C) swollen

[B ] 2. The car was ________ in the accident this morning.

(A) examined
(B) damaged
(C) injured

[B ] 3. Scientists are looking for ways to ________ air pollution.

(A) block
(B) eliminate
(C) increase

[C ] 4. To become rich, you need to work harder. Fortune doesn’t ________ by itself.

(A) undergo
(B) mature
(C) accumulate

[B ] 5. If you can’t make it to the morning class, the afternoon class is also an ________.

(A) opportunity
(B) option
(C) ability

[A ] 6. My brother is a frequent blood ________.

(A) donor
(B) donate
(C) donation

[C ] 7. Although the patient is ________, his family still hasn’t given up on him.

(A) alive
(B) self-conscious
(C) brain dead

[B ] 8. The doctor used a stethoscope to ________ the sound of blood flow in the fistula.

(A) arterialize
(B) auscultate
(C) measure

[A ] 9. The students were ________ against taking drugs.

(A) cautioned
(B) removed
(C) prevented 

[B ] 10. The nurse had the patient ________ his urine output.

(A) recorded
(B) to record
(C) record

[A ] 11. The transplantation is ________. His body hasn’t rejected the new liver.

(A) successful
(B) punctual
(C) discouraging

[A ] 12. If your kidney doesn’t function normally, you might need ________.

(A) IVP
(B) dialysis
(C) anastomosis 

[D ] 1.

(A) has
(B) having
(C) to have
(D) had

[B ] 2.

(A) leave
(B) undergo
(C) make
(D) rule out

[A ] 3.

(A) transplantation
(B) transplant
(C) to transplant 
(D) transplanting 

[B ] 4.

(A) in
(B) on
(C) over
(D) at

[C ] 5.

(A) knew
(B) told
(C) suggested
(D) claimed

[A ] 6.

(A) such as
(B) instead of
(C) include
(D) something like

N:

 Mr. Charles, how are you feeling now?

(中譯) 查爾斯先生你現在感覺如何?

P:

 I'm feeling very tired, and I have a headache. My body hurts from head to toe.

(中譯) 我感到非常疲乏，而且頭痛。我全身疼痛

N:

 I'm sorry to hear it, Mr. Charles. May I take your blood pressure?

(中譯) 查爾斯先生，我很抱歉聽到這些，請問我可以測量你的血壓嗎?

P:

 Go ahead.

(中譯) 請便。

N:

 Your systolic pressure is 180, and your diastolic pressure is 90.

(中譯)  你的收縮壓是180，而舒張壓是90

P:

 Oh, that sounds OK. My blood pressure can be as high as 220.

(中譯)  喔，聽起來還不錯。我的血壓甚至可以高到220。

N:

 Is your blood pressure always so high?

(中譯) 你的血壓一直這麼高嗎?

P:

 Well, no. It's only been like this recently.

(中譯)  不是，最近才這樣。

N:

 Have you been to a hospital for an examination or checkup?

(中譯) 你曾經去醫院做檢查嗎?

P:

 Yes, I have. I had a blood test, and the doctor told me I might have kidney problems.

(中譯) 是的。我有做過血液檢驗，然後醫生告訴我，我的腎臟可能有問題。

N:

 Is there anything else we should know?

(中譯) 還有其他可以告訴我們的嗎?

P:

 He said that I needed to go on dialysis. I also had an IVP done.

(中譯) 他說我需要洗腎。我還做過靜脈腎盂X光造影。

N:

 Did you take any medicine?

(中譯) 你有服用任何藥物嗎?

P:

 Yes. But my whole body is swollen, and I become short of breath easily.

(中譯) 是的。但是我全身浮腫，而且變成容易呼吸短促。

N:

 Let me check your breath sounds (checks his lungs with a stethoscope).

(中譯) 讓我檢查你的呼吸（用聽診器檢查他的肺）。

P:

 I'm still a little short of breath.

(中譯) 我仍然有點呼吸短促。

N:

 Don't take off the oxygen mask. I'll put up the head of the bed, so you can breathe more easily.

(中譯) 別拿下氧氣罩。我將墊高你的頭，讓你呼吸可以容易些。

P:

 Nurse, the doctor has told me that I have to go on dialysis for the rest of my life. Is it true?

(中譯) 護士，醫生告訴我，我必須洗腎一輩子。是真的嗎?

N:

 Yes, your kidney is damaged, and its function is now less than 10%. Dialysis is what you need.

(中譯) 是的，你的腎臟被損害，而且腎功能現在已經低於百分之十，所以你需要洗腎。

P:

 Can't I just take medication instead of going on dialysis?

(中譯) 我不能服用藥物來代替洗腎嗎?

N:

 Sorry, medicine won't help now. You need dialysis to eliminate waste and extra water.

(中譯) 對不起，現在藥物已經沒用了。你需要洗腎來消除廢物和積水。

P:

 I don't understand.

(中譯) 我不懂。

N:

 Without dialysis, toxins will accumulate in your body.

(中譯) 不洗腎，毒素將會累積在你體內。

P:

 Is there any other way besides dialysis?

(中譯) 除了洗腎，沒有別的方法嗎?

N:

 Yes, renal transplantation is also an option.

(中譯) 是的，腎臟移植也是個選擇。

P:

 But where can I find a healthy kidney for transplantation?

(中譯) 但是我在哪裡能找到健康的腎臟來移植?

N:

 It's possible to get a kidney from a living donor or from one who is brain dead.

(中譯) 從活的或腦死的捐贈者可能可以得到腎臟。

P: 

 Is organ donation popular?

(中譯) 器官捐贈普遍嗎?

N:

 Not really. Dialysis is still the most common therapy.

(中譯) 不，洗腎仍然普遍的治療方式。

P: 

 I've heard people talk about a belly wash and a vessel wash. What's the difference between the two?

(中譯) 我有聽見人家在說洗肚子和洗血管，這兩者有何不同?

N:

 A belly wash is dialysis through the abdomen, and a vessel wash is done through blood vessels.

(中譯) 洗肚子是洗腎經過腹部，而洗血管是經過血管。

P:

 I see. How do I know which therapy I need?

(中譯) 我懂了。我怎樣才知道我適合哪種治療方式呢?

N:

 I'll arrange for you to observe these two types of dialysis. Then, you can discuss them with your doctor.

(中譯) 我將會安排你去觀看這兩種洗腎方式，然後你可以和你的醫生討論。

P:

 Thank you.

(中譯) 謝謝你。