The Enhanced Doctor

Chapter 1161: Chapter 1161: The Allergens Remain a Mystery

(Thanks to book friends 20180419160952146 and Bamboo731 for the monthly ticket encouragement)

Allergy is a common symptom.

But if an allergy becomes severe, it can potentially endanger a person’s life.

Among the patients Liu Banxia has received, there have already been several with extremely severe allergies, and in every case, tracking down the allergen has been very labor‑intensive.

For example, that patient with an immunological disease messed up her endocrine system because she took birth control pills. And that patient allergic to copper—turns out the problem was her IUD.

This patient, even before a formal history-taking, you can tell her situation is definitely very complicated.

Someone with a highly sensitive constitution will be extremely careful in daily life, keeping all possible allergenic factors far away from her.

Her boyfriend naturally knows this too, so he’s just as careful.

Yet even so, an allergic reaction still occurred.

Such a severe allergic reaction plus pancreatitis could really cost this patient her life.

"Teacher Liu, should we add another allergen panel and a rheumatology/immunology package?" Xu Yino asked.

Liu Banxia nodded. "After she finishes her CT scan, I’ll ask her again. Where’s her boyfriend? I’ll talk to him first."

"Teacher Liu, aren’t you going to eat first?" Xu Yino asked.

"I’ll go after I finish questioning him. It’s not like this bit of time will make a difference anyway," Liu Banxia said.

Xu Yino quickly waved, calling the patient’s boyfriend over.

"Doctor, is there something going on that you need to contact her parents?" the patient’s boyfriend asked hurriedly.

"Not for now, but we do need to have her family’s contact information ready. You two aren’t married yet, so for key decisions we have to defer to her parents," Liu Banxia said.

"Right now I mainly want to ask you how her allergic symptoms started. It was at her home, right? Is there anything you might have brought with you that could trigger her allergy?"

"It shouldn’t be. We’re both very careful. Everything in her home is stuff she picked out herself, and I... I also took a shower," the boyfriend said.

"And then?" Liu Banxia asked.

"Then... we hadn’t seen each other for a long time, and this time I came back on leave," the boyfriend said after hesitating slightly.

"Come on... just say it straight, don’t make us guess. You talk to Teacher Liu, I’ll take the patient for the CT," Xu Yino said helplessly.

The boyfriend gave her an embarrassed look; some things are just hard to describe openly.

"Now think carefully: between her abdominal pain and her allergic symptoms, which started first?" After Xu Yino left, Liu Banxia asked.

"At first her stomach hurt a bit, but she’s been like that lately—it hurts for a while and then stops, so we didn’t pay much attention," the boyfriend said.

Liu Banxia frowned. "And then?"

Another "And then?" left the boyfriend feeling very awkward.

"Foreplay, intercourse, afterplay—during which of these three stages did the allergy appear?" Liu Banxia broke the process down a little.

"Intercourse."

This time the boyfriend didn’t hesitate, just spoke in a very low voice.

"Did you use any drugs or items?" Liu Banxia pressed further.

"No, we didn’t use anything," the boyfriend said quickly.

Even though he was worried about his girlfriend, being questioned by Liu Banxia like this still had him blushing and his ears burning.

He also couldn’t figure it out—treating an illness is treating an illness, why ask for so many details? How is this something you can talk about in public?

Liu Banxia didn’t care what he was thinking. Right now he was focusing hard in his own mind.

They had to identify the allergen—this was a crucial step.

Allergens originating from the patient herself could basically be ruled out, because if it were intrinsic, she should have shown some degree of allergic reaction earlier.

But the two of them were apparently stark naked at the time, they didn’t use any medication or devices, and her boyfriend had already showered—so what was this allergen?

He’d known this would be a tough problem to crack; now that he’d clarified the detailed situation, he felt even more at a loss.

"Doctor, is it very dangerous?"

Seeing Liu Banxia silent in thought, the boyfriend asked.

"You’re her boyfriend—you should know allergic reactions can be very dangerous, right?" Liu Banxia shot back.

The patient’s boyfriend nodded. "So when we’re together we’re always really careful, and we almost never eat out. We just buy stuff and cook at home, because we’re afraid that if she gets too tired she’ll be more prone to allergies."

"But although she’s had allergic reactions before, they’ve never been this intense. At worst she’d sneeze and get some rashes, take a few meds, rest for a couple of days and she’d be fine."

"You’ve noticed her allergy is more severe this time, so I can tell you now: if we can’t find the allergen that triggered this episode, as the number of attacks increases, the reactions will get more and more serious." Liu Banxia said seriously.

"In the end it can progress to severe laryngeal edema, and the patient won’t be able to breathe. A bit later, in order to protect her, we’ll need to do airway protection in advance."

"That means we’ll intubate her first, using the tube to secure her breathing. If she really develops laryngeal edema, and we wait until then to try non-invasive intubation, it’ll be incredibly difficult. We may not even have that much time."

Liu Banxia’s words gave the patient’s boyfriend a real scare. He’d seen what breathing difficulties look like, but hadn’t expected it could get this serious.

"Go over and keep her company for now. The admission paperwork’s all done, right? Given how she is now, don’t expect her to be discharged today. Our top priority at the moment is to identify the allergen."

"As for the symptoms she’s showing now, they’re basically early-stage pancreatitis. We can control that by adjusting electrolytes and other measures, so that part you don’t need to worry too much about."

"Doctor, isn’t pancreatitis also very dangerous?" the boyfriend asked.

"It is. But we have corresponding management strategies, like fasting, gastrointestinal decompression, prokinetic drugs to reduce bloating, and so on." Liu Banxia said.

"Her case is actually quite manageable; it just needs some time. During this period you’ll need to take good care of her. But my personal recommendation is that her parents should be informed."

"Pancreatitis isn’t appendicitis; it’s life‑threatening. Her allergic reaction is also very intense. If we can’t figure out the cause, that’s life‑threatening too."

"This isn’t the usual doctor’s trick of exaggerating things to scare people. I’ve already been very restrained in how I’m putting it; her actual condition could be far more serious than we’re estimating."

"If it’s inconvenient for you, our hospital can contact her parents and talk to them. Don’t put any burden on yourself about this; we still have to wait for our test results."

"Okay, I’ll contact them myself." The boyfriend nodded.

"By the way, don’t overthink those questions I just asked you. We were only trying to reconstruct how the illness developed and what the possible allergens might be." Liu Banxia added.

The patient’s boyfriend looked a bit embarrassed again; he was actually a slightly shy guy.

"Got another big case? Are you in a rush to eat? If not, listen to me ramble for a bit." Liu Banxia walked into Xu Hui’s office.

"What, is it harder to diagnose than that Wilson’s disease patient of yours?" Xu Hui asked with a smile.

"If I say it’s many times harder, you probably won’t believe it." As she spoke, Liu Banxia gave a brief summary of this patient’s situation.

"This guy... this is a real headache."

After listening to Liu Banxia’s account, Xu Hui’s brow furrowed as well.

"Based on what you’ve described, the only external factor is her boyfriend. She can’t be allergic to her boyfriend, right?"

"Funny you mention it. I honestly did worry about that, I just couldn’t say it straight to the kid." Liu Banxia said.

"Could it be that some substance accidentally got on his body, and a simple wash didn’t completely clean it off? Then that triggered her allergic reaction?"

"What kind of substance would that have to be..." Xu Hui said with a wry smile.

"Still, what you said is possible. They hadn’t seen each other for a long time, and once he got back they were in a hurry, maybe he just did a quick, sloppy rinse."

"Once the allergen panel comes out, we’ll compare them item by item. Could it be that her boyfriend ate seafood, or some other food that can trigger her allergies, left some residue in his mouth, and the kissing then set off her reaction?"

"That’s also a line of thought, can go in as a backup option. After she’s done with the CT, we’ll sit down with her boyfriend and ask him properly."

"Let’s not ’we’; you handle it yourself. Just hearing you describe this patient is giving me a massive headache. And right now the allergen screening only covers common substances—if it’s something that isn’t on the panel, we have no way of knowing."

"And she’s got a hyper‑sensitive constitution. In that case she can react to a lot of substances, common and uncommon. It’s really not that easy to track down."

Liu Banxia bared her teeth in a grimace; for allergy patients, that’s the biggest problem.

It’s not like that copper‑allergic patient—at least there was a clear clue, and you could follow the trail.

This patient’s allergen positivity rate is bound to be high, because a so‑called hyper‑sensitive constitution means you tend to be allergic to dust, pollen, seafood, and so on.

So how are you supposed to investigate that?

Like Xu Hui said just now, allergen exposure through kissing is a possibility worth considering.

It’s just that personally she felt the probability was still pretty low. Her boyfriend had obviously been preparing for this day for a long time; he shouldn’t have eaten things he knows would trigger her allergies.

But they still had to verify everything. It’s also possible he ate something by accident.

For example, nut allergies you often see on TV—there are very few such patients in China, but that doesn’t mean they don’t exist.

Right now this patient’s allergy is like a riddle. It looks like a very routine symptom, yet it’s actually far more dangerous than her pancreatitis.

Pancreatitis can be controlled and adjusted. With an allergic reaction, if you don’t even know what new allergen has been added to the list, what can you do?

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