The Enhanced Doctor

Chapter 1197: Chapter 1197: Trouble

(Thanks to Fujin for the monthly ticket encouragement)

"Teacher Liu, with the pain like this, isn’t it more prudent to do an enhanced CT?"

Seeing Liu Banxia hesitate and not speak, Huang Bo tentatively asked.

"Have you always had this constant kind of pain?" Liu Banxia asked the patient.

"At the beginning, it was a pulling pain, but now it’s a full-blown pain." The patient said.

"How many days has it been roughly?" Liu Banxia continued to ask.

"About four or five days, it’s really unbearable." The patient said.

"Currently, we’ve preliminarily ruled out the possibility of kidney stones, and the CT scan results were also negative. We can also temporarily rule out organic lesions of intra-abdominal organs like the kidney, appendix, gallbladder, and pancreas." Liu Banxia said.

"From your medical history and current symptoms of pain, I preliminarily judge that the possibility of chronic renal embolism is relatively high. But to confirm, you’ll need an angiography."

"This kind of examination is an invasive test. We need to introduce a contrast agent into your blood vessels and then use a CT to scan. If there’s an embolism, we’ll be able to see it directly."

"Do it, do any tests you need, as long as it can stop the pain."

Just as Liu Banxia finished speaking, the patient shouted.

"Alright, you’ll need to do a sensitivity test, and there will also be a signing confirmation procedure. If it’s an embolism, we’ll see if medication anticoagulation and thrombolysis are appropriate or if minimally invasive intervention is needed." Liu Banxia said.

The current indication for the patient to do an enhanced CT is justified. The pain is so severe that even the muscles in the waist are showing signs of spasm; just imagine how painful it must be.

Huang Bo took the patient away, and Liu Banxia hesitated for a moment but still didn’t notify Wu Wenlin.

Although there is an indication, there is no definitive diagnosis yet. After the diagnosis, based on the angiography results, we can have Director Wu look at whether thrombolysis or minimally invasive surgery is needed.

Wu Wenlin isn’t like Wang Huan and Xu Hui; even if there’s no patient consultation request, you can call him over for a chat.

Just as he thought of this, Wang Huan came over.

"Today’s work in your internal medicine department seems quite relaxed." Liu Banxia said.

"It’s okay, most of it is surgical work. After all, it’s the New Year, people generally avoid going to the hospital unless necessary." Wang Huan said.

"Year by year, it passes so quickly. It feels like last Spring Festival just ended." Liu Banxia said.

"Next year, when both your kids grow up, you’ll be very busy. Leaving aside other things, just watching them to stop them from climbing around will take two or three people." Wang Huan said.

"Shifts are needed, otherwise, anyone watching them constantly would burn out. Is your daughter still troublesome, crying at the drop of a hat?"

Liu Banxia helplessly nodded, "She only behaves when we just get home, probably curious about Tang Dou. But now it doesn’t help much, because when she cries, it’s often just because she wants to cry."

"By the way, there’s a patient case I need to discuss with you, back pain, initially suspected as kidney stones. There are some in the right kidney, but weirdly the left side of the back is also hurting now."

"The CT scan of the abdomen was negative. I suspect it’s a chronic renal embolism. Do you think that’s likely? There’s been about a four or five days pain history."

"More or less, right? Have you arranged for the enhanced CT? Sometimes you can’t just save money for the patient. If it’s a renal embolism, it carries a big risk." Wang Huan asked.

"It’s scheduled, along with a blood panel and biochemical tests, just waiting to see the results." Liu Banxia said.

"Dr. Liu, Dr. Liu, here’s my lab report, could you have a look and tell me what’s wrong with me?"

As soon as Liu Banxia finished speaking, a patient came running over with a lab report.

"I thought you weren’t going to get the test done, let me see it. Why has it been delayed for so many days?" Liu Banxia asked after taking the lab report.

This patient wasn’t anyone else; it was that Wilson’s disease patient.

Normally he should have come back for a review around the 28th, but this guy didn’t show up, and his phone couldn’t be reached.

"Went back to my hometown with my mom, somehow ended up losing my phone. Luckily it was second-hand when I bought it, so I didn’t feel too bad." The patient said.

"Alright, we can confirm the diagnosis; it’s Wilson’s disease. Are those involuntary movements still happening? Are they frequent?" Liu Banxia asked.

Ping! Task completed for the patient with neck twitching

Gained 200 experience points, Glory Points +3

This task is rated as flawless, gaining 200 experience points, Glory Points 3 points +3 points

Liu Banxia sighed internally. A complicated Wilson’s disease diagnosis was made, but the system didn’t offer much reward.

The bottom line is, maybe it was because he delayed the patient’s diagnosis.

Because a more convenient diagnostic method wasn’t used, instead opting for medication first to see the effect. Although it saved the patient money, it didn’t meet the system’s objective standards.

"Dr. Liu, I feel much better. It’s just that I have to be careful with everything I eat, such a hassle." The patient said.

"You also have to avoid certain foods, otherwise these medications will be in vain and money wasted. You should report to that property company later; if you had come earlier, you might have earned some overtime pay during New Year’s." Liu Banxia quipped.

The patient grinned shyly, "I actually thought about it, but I felt if I did get overtime pay, it would seem a bit shameless."

"It’s a big company, and you got the connection to help me. I figured I’d wait until after the New Year’s holiday was over and then start working steadily."

"You’ve thought quite a bit. Just work steadily when you get there, don’t worry about anything else," Liu Banxia said.

"Hurry home, it’s the holiday after all, celebrate properly at home. Your illness is not a big deal, as long as you pay attention and with medication to help control it, you’ll be just fine."

"Thank you, Dr. Liu. Should I get some medication prescribed?" the patient asked.

"I’ll prescribe you some. In the future, make sure to get regular follow-ups, or if you notice any changes in your body, come in right away. Being cautious can prevent big mistakes," Liu Banxia said.

The patient nodded, feeling genuinely relieved.

He doesn’t understand these things, even if his health improves, he fears it’s just a dance disease. Now, Liu Banxia has given a diagnosis, and he truly felt relieved.

Having gotten his medication and thanked Liu Banxia, the patient left.

He had inquired about his previous check-up and found out he saved quite a bit of money. If it had been another doctor, they probably would have directly ordered multiple tests.

Not to mention arranging a job for him; this job is much better than handling goods deliveries.

"He is quite lucky; if not for the car accident, his condition might have progressed to late-stage," Wang Huan remarked.

"That’s fate; a car accident is seemingly not a good thing, but it helped diagnose his ailment, which is a blessing," Liu Banxia laughed.

"Otherwise, there’s the saying about misfortune turning to fortune. Sometimes you can’t jump to conclusions too quickly, or it’ll cause problems."

"Teacher Liu, there’s something unusual," Huang Bo suddenly came running back.

"What’s wrong?" Liu Banxia frowned and asked.

"The angiography results are negative," Huang Bo said with a worried expression.

"What? It’s not renal embolism?" Liu Banxia was stunned.

He had considered directly consulting Wu Wenlin, but hadn’t thought it wouldn’t be renal embolism. The signs seemed so clear, the patient was in so much pain, how could it not be?

Huang Bo hurriedly ran to the computer and brought up the angiography images.

"Brother Wang, this is really troubling now, what’s your take?" Liu Banxia glanced over and asked.

"It is troubling indeed. Is the patient still in pain? Could the embolism have moved away on its own?" Wang Huan asked.

"I don’t think so; even if it moved, it shouldn’t present like this, right? He’s still in pain, which is why I hurried back," Huang Bo said.

Liu Banxia was feeling overwhelmed; even though Huang Bo had come back early to inform them, the current situation still left them unable to make a judgment.

The two most likely diagnoses had been ruled out, and all other organs in that area appeared intact, so why was there pain?

"We really need to research this patient’s case thoroughly. Huang Bo, see who is available and gather them, let’s analyze together," Liu Banxia said.

"Alright, I’ll go prepare," Huang Bo nodded.

"Do you have any ideas?" Wang Huan asked.

Liu Banxia grinned awkwardly, "Brother Wang, honestly, I have no idea right now; to be precise, I have no lead whatsoever."

"The patient’s pain isn’t faked; he’s cramping from the pain, he couldn’t even allow percussion during examination. With this kind of pain, I’d think it’s kidney stones or renal embolism."

"Pain is located in both sides of the lower back, and even if it’s referred pain, it shouldn’t deviate this much, right? All other organ CT scans are negative."

"Indeed, it’s quite worrying. I’ll join you in researching it; otherwise, I might not escape this either," Wang Huan said.

"That’s right; it’s not appropriate to rush to consult Teacher Wu without some certainty. It’s not that we can’t ask, it’s just that we need to gauge our approach," Liu Banxia said.

Wang Huan nodded, understanding Liu Banxia’s considerations.

This is a process, akin to playing cards; you can’t just throw out the ace right away.

If after consultation and examination they are still at a loss, then they can consult with Wu Wenlin or others for a multidisciplinary meeting.

Because although the patient manifests as back pain, the actual ailment may not necessarily fall under a specific department.

Currently, even Wang Huan felt troubled after hearing Liu Banxia’s description; he couldn’t confidently grasp the situation.

His judgment aligned with Liu Banxia’s, leaning towards renal embolism. Even if bilateral renal embolism has a low incidence rate, it doesn’t mean it’s nonexistent.

Following Liu Banxia to the small meeting room, everyone seemed to take this consultation seriously; Huang Bo was earnestly writing the patient’s information on the whiteboard.

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