The Enhanced Doctor

Chapter 1242: Chapter 1242: The Little Patient with Paralyzed Legs

(Thanks to songying_sy, Shuqianji, Want to Be a Lazy Idle Fish, Tianyue Lone Star, Reader 20191104170717352, Chui Ah Chui Tou Niu, Fujin, Old Bear Be Good, Don’t Make Trouble, The Wind That Night for the monthly ticket encouragement)

As for that male patient, everyone was furious after they found out what had happened. It was because of his appearance that he successfully took the place of Liu Yiqing’s brother.

Otherwise her brother would be the most hated person in the whole emergency center; now he can only rank number two.

"Doctor, doctor, come quickly, my son can’t stand up."

Liu Banxia was still chatting with Wang Chao when a mother in the waiting area not far away shouted in panic.

Almost like a conditioned reflex, Liu Banxia ran over directly.

"What’s going on?" Liu Banxia asked.

"I don’t know either, Yangyang just said he felt unwell, so I brought him to see a doctor. We only finished registering less than ten minutes ago, and now he can’t stand up." The child’s mother said anxiously.

"Don’t panic yet, I’ll first carry him to the exam bed, then we’ll do a check." As Liu Banxia spoke, he picked the child up and put him on the exam bed nearby.

"Don’t look at uncle. In a moment tell uncle whether you can feel uncle pinching your leg." After settling the child, Liu Banxia said gently.

The child nodded.

"How about here now, can you feel it?" Liu Banxia pinched lightly.

The child nodded.

That actually made Liu Banxia relax a bit; at least the child’s tactile sensation was normal.

"Come on, try to lift your leg hard, let uncle see how high you can lift it." Liu Banxia put on a relaxed expression.

The child tried very hard, but only managed to lift it a little.

"Come on, you can lift it higher." Liu Banxia encouraged him.

But even though the child tried his best, his little face turning red from straining, he still only lifted it that tiny bit.

"Xu Yino, do a physical exam." Liu Banxia said.

After speaking, Liu Banxia drew the curtain and walked outside.

"From the preliminary exam, tactile sensation is still there, but the deep tendon reflexes are very poor. Has the child had any other abnormalities these past few days?" Liu Banxia asked the child’s mother.

"No other abnormalities, just when we were about to land he said he felt uncomfortable. After we got off the plane we didn’t even go home, we came straight here." The child’s mother said.

"Were you flying domestically or coming back from overseas?" Liu Banxia continued to ask.

"Sydney, we came back from Sydney, we came back for the Spring Festival." The child’s mother said quickly.

Liu Banxia frowned. This had become a small situation during the Spring Festival period: some patients all had travel histories, and once they developed symptoms, the workup could be a bit troublesome.

"Doctor, how is Yangyang? This is the second time we’ve brought Yangyang back to China." The child’s mother asked anxiously.

"We need to do a thorough workup. We have to do a head and cervical spine MRI, and also run CBC, blood biochemistry, and urinalysis." Liu Banxia said.

"Right now with the child in this condition we can’t determine what’s causing it, and we can’t rule out the possibility of brain or cervical spine lesions."

"Has there been any outbreak of epidemic diseases over there recently? This information is very important for our next steps in diagnosis, think carefully."

"No, it’s summer there now, it’s quite hot, we’ve already cut down on outdoor activities." The child’s mother said.

Liu Banxia nodded. "Then let’s start with the tests and see. At the moment I can’t give you a definite answer either."

"Teacher Liu, the child has a bit of fever, heart and lung sounds are normal." At this moment Xu Yino came out.

"Order CBC, blood biochemistry, and urinalysis for the child, and then do an urgent MRI of the head and cervical spine." Liu Banxia said.

"Okay."

Xu Yino responded, then directly entered the orders and arranged for blood sampling.

"What’s going on with the kid?" Wang Chao asked curiously.

"Not clear yet. He has tactile sensation, but his deep tendon reflexes are poor. Both legs can only be lifted a little bit." Liu Banxia said.

"I just asked the child’s mother—they just came back from Sydney, and the child hadn’t shown any abnormal signs. He only said he felt unwell on the plane."

"I was wondering, I kept feeling like the mother and son both looked a bit worn out." Wang Chao said.

"Could it be some illness he picked up over there that’s only flaring up here? Wasn’t that what happened with the one you guys admitted yesterday? Is that possible?"

Liu Banxia shook his head. "The likelihood seems low, because the child’s mother said everything was normal over there. And besides, he only felt it when they were about to land."

"Based on what we have now, I’m leaning toward some kind of progressive paralysis. It might even ascend further, so we have to be very careful."

"No idea if he might have accidentally bumped his cervical spine while playing, but something still doesn’t add up, since his tactile sensation is intact."

"Sigh... it’s a mess. Let’s wait and see what the tests show. It’s a bit worrying; hopefully it’s not something they brought back from abroad."

Wang Chao did understand why he’d say that—having just diagnosed a similar case, if another one came in right away, it would make people feel exhausted.

And for illnesses brought back from abroad, there can be big obstacles in the diagnostic process.

"Anyway, right now I’m leaning in two directions: one is nerve compression, the other is intracranial infection. If the MRI comes back negative, then we’ll have to do a lumbar puncture." Liu Banxia added.

"These two possibilities really are the most likely." Wang Chao nodded.

"It’s not even the New Year yet and things are already like this. On New Year’s Day I think we should light a stick of incense and ask the heavens to bless everyone with peace, then we can have a quiet, stable Spring Festival."

"Do you think that’s possible? Even in the calmest year, we’ll still get traffic accident patients." Liu Banxia said.

"Honestly, I just hope there aren’t any major accidents. The minor bumps and scrapes are fine; with major accidents, the stress of receiving patients is huge, and it’s easy for other problems to crop up."

"You guys go eat first in a bit. I’ll stay and wait for the MRI results for this little patient. Based on past cases like this, I usually have a diagnostic inclination in mind."

"This time it’s not like that. For this child, whichever way it goes, it’s not a great outcome. But we still have to get the diagnosis, and that’s not easy."

"What’s going on with you? Why are you getting so discouraged on your own?" Wang Chao asked in surprise.

Liu Banxia twisted his mouth. "I don’t know if I’m still affected by that pregnant patient upstairs, or if it’s just my instincts messing with me."

"Anyway, I just feel like this kid’s situation is a bit complicated, not something we can diagnose easily. It’s a gut feeling—let’s bet a pig’s trotter on it. I hope I lose."

"You’re tripping over yourself to treat me to pig’s trotter—how could I possibly be polite about it? I’m in." Wang Chao said.

"Then let President Qi go eat first, you stay here with me and wait for the results." Liu Banxia said.

Wang Chao nodded, ran over to Qi Wentai, and told the first group they could head out for food.

"Can we count that as dinner?" Qi Wentai walked over.

"You guys can’t be this unserious." Liu Banxia said helplessly.

"Teacher Liu, what’s up?" Huang Bo came over too.

Wang Chao grinningly filled them in on what had just happened.

"Well then, it’s settled. I’m a staunch supporter of Teacher Li—one pig’s trotter." Huang Bo said.

"I’ve got to win this pig’s trotter. It would also mean this little patient’s condition is easy to handle." Shi Lei, who had squeezed into the group, chimed in.

During the Spring Festival, nobody wants to be dealing with difficult, rare diseases. All the more so when it’s a kid this young—you just hope he can have a happy New Year.

On the surface, everyone seemed super enthusiastic about the pig’s trotter, a bit unprofessional and goofy, but in reality it was an expression of their hopes for the child’s illness.

Sometimes a disease you can identify isn’t that frightening, especially when the child has only just fallen ill. What’s scary is when the illness is progressing but you still don’t have a clear cause—that’s what really eats at you.

Shi Lei and Qi Wentai led the group off to eat, while Liu Banxia and Wang Chao stayed behind to hold the fort.

They still had to receive incoming patients, but around noon it was usually trauma cases coming to the ER.

After another wait, Xu Yino called: the MRI was negative.

"See? We’ve ruled out nerve compression. What’s left is intracranial infection or meningitis, right?" Liu Banxia said.

"So do we go straight to a lumbar puncture for the child?" Wang Chao asked, frowning.

"Let’s first do a careful physical exam, check whether there are any rashes on the skin or marks from insect bites. Actually, it’s also a bit similar to that AIDP case I saw not long ago—should we do an EMG first?" Liu Banxia said.

"No, when the child gets back we still have to ask his mom if there’s a history of any preceding infection or diarrhea. That’s also possible. After all, AIDP can present in different ways."

Ding! Little patient with bilateral leg paralysis

Open task: child who has come to the ER on his own initiative, bilateral leg paralysis. The host judges that the condition will show progressive development and requires further workup to clarify the etiology. Task reward: to be issued based on diagnostic result.

After another short wait, Xu Yino came back together with the child’s mother.

"Now think carefully: over the past month, has the child had any vaccinations, or diarrhea, infections, and so on?" Liu Banxia asked quickly.

The child’s mother thought carefully, then shook her head. "Doctor, Yangyang has always been very healthy. What illness could Yangyang have?"

"Try not to panic yet. For now, the MRI result is negative—that’s good news. At least there’s no organic lesion. Huang Bo, take the child over and examine his skin carefully." Liu Banxia said.

"Okay, Teacher Liu."

Huang Bo responded and took the child in for the exam.

"What’s the child’s English name? Do you usually call him by his English name?" Liu Banxia asked the child’s mother, partly to help distract her.

"When we’re in China and at home we use his Chinese name. We only use his English name when we’re abroad." the child’s mother said.

"Sit over here and try to steady yourself. Do you need to contact anyone else?" Liu Banxia asked.

"Not yet. Let’s wait till we have some test results." the child’s mother said.

Liu Banxia nodded. At this point, anything he said would feel pointless—what mother wouldn’t worry about her child?

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