The Enhanced Doctor

Chapter 1158: Chapter 1158: Indeterminate Indicators

(Thanks to Beyond the Imagination1, Fan Yun Fu Yu l, Four Seasons Demon God, wwh5448, Cool Ant, Colorful Bull Eating Tender Grass, Fat Monkey King for the encouragement with monthly tickets)

"Teacher Liu, why did you just tell him everything? If he’s really diagnosed with Huntington’s disease, how will he live on?"

When performing an MRI scan on the patient, Xu Yino asked worriedly.

"Sometimes, we need to hide the patient’s condition so that he can have a relaxed mood and achieve a better prognosis," Liu Banxia said calmly.

"But at times, what we can give to the patient is just a little bit of hope. With this hope, he will become very strong."

"The life of a lonely mother and orphan son, their emotional bond is their spiritual support. The mother thinks about her son, the son thinks about his mom; holding onto this, other difficulties no longer seem to be difficulties."

"Director Liu, do you suspect this patient might have Huntington’s disease?" Radiologist Wu Bo asked.

"It’s hard to say now, the initial diagnosis was Wilson’s disease, but the CT didn’t reveal anything, which began to lean towards Huntington’s disease," Liu Banxia replied.

"Considering the patient’s economic capacity, I haven’t suggested genetic testing. I’ll need your help to take a closer look; we can only see the surface, you’re the real expert."

"It’s really hard to say, if it’s early-stage Wilson’s disease, it might indeed not be detectable," Wu Bo frowned.

"Look at the scan images later. Even with signals, they need careful discernment, images and signals may not be very clear."

This matter needs serious attention, it’s not easy to diagnose. Mainly because the disease is in the early stages, genetic testing is the key."

"Alright, the images are out, you should have a look too," Wu Bo said after waiting for a while.

Liu Banxia was also carefully observing the relevant information on the screen, although he was not as knowledgeable in this area.

"It’s indeed hard to capture. Look, the caudate nucleus shows mixed high and low signals in T2-weighted images. It may indeed be Wilson’s disease, there’s no change in the brain sulci and ventricles," Wu Bo pointed at the screen.

"Is it possible to diagnose now?" Xu Yino asked hurriedly.

"This can only be considered a tentative judgment, right?" Liu Banxia asked with a frown.

Wu Bo nodded, "From the images, this is just an assumption; further examinations from you are needed."

"Teacher Liu, further examination means a liver biopsy, right?" Xu Yino inquired.

"Sigh... it’s troubling," Liu Banxia sighed.

A liver biopsy is invasive and costly, akin to a minor surgery. If done, a liver biopsy, why not just go for a genetic test to save the hassle?

"What do you plan to do?" Wu Bo asked curiously.

"I’m pondering it, I’m even thinking about directly giving chelating agents," Liu Banxia chuckled bitterly.

This decision is tough, also facing choices.

The patient’s attitude earlier seemed like he’s somewhat refusing further tests, not wanting to waste money.

Now it’s down to two paths: either the patient goes through genetic testing or liver biopsy, or diagnose and treat him for Wilson’s disease symptomatically.

The indications aren’t very clear, and the medications might cause some degree of harm to the patient’s body.

"Doctor, couldn’t you tell?" the patient asked after getting dressed.

"Although some signals indicate Wilson’s disease, they aren’t very clear," Liu Banxia replied.

"So with your current condition, there’s no direct diagnosis yet. This brings us back to the beginning, genetic testing remains, comparatively, the cheapest and least invasive testing method."

"No need, why waste money on that? I don’t even know how much longer I can keep earning, not a penny to waste," the patient said decisively.

Beside them, Xu Yino opened her mouth, wanting to speak but was stopped by Liu Banxia’s gaze.

"I’m also contemplating this situation, hence I plan to take a middle-ground approach," Liu Banxia said.

"Initially, I’ll treat this as Wilson’s disease, administering the chelator Penicillamine to metabolize the copper out of the body. Then, give Benserazide to adjust your muscle tone disorder."

"The prices of these two medications aren’t expensive; however, while taking these medications, your body indicators need monitoring because these drugs may have side effects despite treating the condition."

"Penicillamine is a by-product of penicillin, so I’ll need to do an allergy test for you. Taking this medication often causes gastrointestinal side effects, like nausea, vomiting, loss of appetite, abdominal pain, diarrhea, and so on."

"Benserazide, on the other hand, may cause tachycardia, dry mouth, constipation, urinary retention, and a series of anticholinergic reactions, of which you need to be cautious."

"Yet, after administering the medication, we can measure the copper protein levels in your body; if they normalize, your liver cirrhosis can improve as well."

"Alright, that’s settled then. Should have said it earlier, we wouldn’t even need to do this MRI, waste of money," the patient said with a smile.

"Don’t mind me, I have to stretch every penny nowadays. I know you’re all trying to help me, but I really have to save money to get by."

"No need to be so pessimistic. If it’s really Wilson’s disease, as long as you adhere to medication, have regular check-ups, it won’t greatly affect your life," Liu Banxia said with a smile.

"Besides, I personally strongly lean towards it being Wilson’s disease, otherwise I wouldn’t boldly prescribe medication for you. But you should stay at the hospital for observation tonight, we need to monitor you after the first dose."

The patient hesitated a bit, "Wouldn’t that cost a lot? Wouldn’t it be just like being hospitalized?"

"Observation is different from hospitalization. This is decided, I’m the doctor, and it’s final," Liu Banxia replied.

"How to communicate this to your mother is up to you, we won’t get involved. I’ll arrange someone to perform sensitivity tests now, and they’ll also tell you what foods you need to avoid, there’s a lot you can’t eat."

"Huh? More things I can’t eat?" The patient was taken aback.

"Of course, otherwise we’d be trying to flush things out while you’re putting more in. No matter how much you eat, it’d be wasted," Liu Banxia said with a smile.

"For instance, millet, buckwheat noodles, beans, shellfish, shrimp, crab, animal liver, blood, and dried vegetables, all those should be avoided."

"But you can eat some rice, white-flour foods, and fresh vegetables. Oh, eggplants, spinach, and pumpkins among fresh vegetables are also off the list."

"Alright, I’ll make you a list later, even if you’re craving so much you’d bang your head against the wall, you can’t eat these. You must quit alcohol entirely, not a single drop," he continued.

The patient smiled bitterly and nodded, "Can I eat meat?"

"Yes, you can eat pork, chicken, duck, and goose. Avoid copper products as much as possible, including cooking with copper pots. In the future, steer clear of copper," said Liu Banxia.

"After taking the medication for some time, you’ll see noticeable improvements. By New Year’s, you should come back for a check-up. Based on your body’s trace elements, we’ll adjust your medication."

"At that point, don’t be stingy with money, and think since you’re already on medication, you can stay at home and indulge. That would be disastrous, too much or too little won’t work," he continued.

The patient nodded a little sheepishly, "I really was thinking about it like that, but you saw right through me."

Standing nearby, Xu Yino grew more curious. The patient seemed jovial now, almost as if he wasn’t affected by the illness.

It was a completely different state from before entering the MRI room, truly remarkable.

"Doctor, I never finished middle school, not very educated," the patient mentioned while the nurse conducted the penicillamine sensitivity test.

"But thank you, you’re always thinking about me. I secretly searched you online, you’re quite amazing. About being sick, let’s not tell my mom, even minor ailments worry her."

Liu Banxia nodded, "You’ll have to control the situation yourself. We’ll only tell her your body’s trace elements are a bit unbalanced but can be adjusted."

"Thank you, I really appreciate it," the patient said sincerely.

"We’ll see the results later; your mom is coming over too, it’s your chance to show your skills," Liu Banxia said before leading Xu Yino away.

"Are we settling on Wilson’s disease then?" Xu Hui came over.

"It’s the only option, other tests are very costly. They don’t even want follow-ups, just staying home taking meds," Liu Banxia said with a wry smile.

"Ah... a penny troubles even the famous. No matter which of the two diseases it is, it’ll torment him for life," Xu Hui sighed.

He wasn’t present for the whole treatment but had come to understand quite a bit about this patient.

His understanding mainly came from the patient’s mother, who lamented their struggles due to a lack of education, having endured numerous hardships. Eventually settled into a driver role, without much stable work.

He couldn’t travel long distances, needed to care for his elderly mother alone at home, given her age.

After years of hard work, he finally purchased a small two-bedroom apartment last year, despite its remote location, at least it’s his own. He was planning to get married when this happened.

"We’ll see later if Old Qiu’s company or others have suitable jobs for him. At least he needs security for living expenses and medication," said Liu Banxia.

Though unaware of the patient’s exact situation, he could make a rough assessment from their conversations.

Seeing the mother and son laughing nearby, Liu Banxia felt relieved.

It’s up to the patient’s luck now; future tests cannot be well cooperated. Wilson’s disease has some indicators, following this direction should be okay.

In fact, similar cases occur during diagnosis. It’s somewhat reasonable inference, after all, it’s for the patient’s benefit.

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