The Enhanced Doctor

Chapter 1265: Chapter 1265: Osteosclerosis Disease

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Ding! Consultation task completed

Gained 100 experience points, Glory Points +20

Liu Banxia sighed inwardly. Because of a minor oversight on his part, he hadn’t made the diagnosis at the first possible moment, so the task reward was this low.

But his mind wasn’t on that now. He just hoped that the night he’d delayed wouldn’t cause the patient to suffer more pain.

As he was arranging for the patient to be transferred to the sealed isolation ward that had already been prepared, his phone rang.

"Doctor Du, is something up?" After answering, Liu Banxia asked.

"That kid’s CT scan is out. Come down and take a look. The reduction at the fracture site in the hand is pretty good, but there’s a problem with the head CT." Du Fancheng said.

"Okay, I’ll come down right away." Liu Banxia hung up as soon as he finished speaking.

He left the situation here for Liu Yiqing to handle and headed straight downstairs. That little patient’s condition didn’t seem optimistic; otherwise Du Fancheng wouldn’t have called him like this.

"Take a look at the images first." Du Fancheng turned the computer screen toward him.

Seeing what was displayed on the screen, Liu Banxia’s brows furrowed. The density of the child’s parietal bone looked a bit high.

This was an abnormal finding.

"Doctor, how is it?" the child’s father asked from the side.

"You need to be mentally prepared. The situation isn’t very good." Liu Banxia said.

"Judging from the examinations we have so far, it’s very likely osteosclerosis, also called primary osteopetrosis. I’ll contact the orthopedics doctors now and have them come over to take a look."

"Doctor, are all these problems caused by this disease?" the child’s father asked again.

Liu Banxia nodded. "Osteosclerosis is due to excessive bone growth, which may be causing a certain degree of compression on his intracranial nerves."

"We’ll also draw blood later and run a blood test. Generally, after onset, serum acid phosphatase tends to be elevated. This disease is what has led to his reduced hearing and his tendency to fracture easily."

"Let me contact orthopedics to come over and take a look at the images, to avoid any error in my judgment. Based on the current situation, he still belongs to the mild type."

After speaking, Liu Banxia took out his phone again and directly dialed Wu Mingyu.

There wasn’t much going on today, so after receiving his call, Wu Mingyu came over quickly.

"It basically fits. Increased density and thickening of the parietal bone, plus his hearing is already affected—that’s osteosclerosis." After going over it, Wu Mingyu said.

Ding! Consultation completed

Gained 100 experience points, Glory Points +5

"Doctor, can this disease be treated? Would it help if he eats less calcium?" the child’s mother asked.

"As for this disease, there are currently many experimental therapies internationally. But if you want treatment, the only effective one is hematopoietic stem cell transplantation." Wu Mingyu said.

"In daily life you also need to be careful, try your best not to let the child bump into things; fractures are very easy. For now, it doesn’t seem to have too great an impact on the child’s growth and development. As for his hearing, at least it still leaves us quite a bit of time."

The couple were somewhat stunned. Even if they didn’t understand much, they had heard of this before. If such a treatment plan was already needed, their child was actually in great danger.

"Can’t he take other medicine? Even if it’s more expensive."

After a moment of silence, the patient’s mother asked.

Wu Mingyu shook his head. "Hematopoietic stem cell transplantation is the only feasible option. This counts as a kind of genetic disorder. Think it over, see if you need to have the hematology doctors come over for a consultation."

For some conditions, you can choose to offer a bit of comfort and explain slowly, but for the child’s current disease, there really is no other option.

How the child’s condition will progress next is, in fact, partly a matter of luck. It might end up only affecting hearing, but the future really is hard to predict.

Even in mild cases, as the child’s cranial bones become denser and thicker, there will more or less be other impacts.

Mild osteosclerosis is considered an autosomal dominant hereditary disease, and in many cases it’s asymptomatic, only discovered incidentally when X-rays are taken.

Given this situation, Liu Banxia didn’t have any words to comfort the couple. Because the clinical signs were too clear, whether they did blood sampling for a definitive diagnosis wasn’t actually that important now.

The main symptoms of this disease were already manifest in the child and were enough to support a diagnosis.

In fact, they hadn’t told them everything yet, worried they wouldn’t be able to bear it.

Because the process of hematopoietic stem cell transplantation is also very painful. It’s torture even for adults, let alone a child.

"How’s that tetanus patient upstairs doing?"

Once the couple took the child outside to think things over, Du Fancheng asked.

"In isolation in our Second Department. Although the incidence of tetanus is also fairly high, I really didn’t expect that I’d actually run into a case myself." Liu Banxia said.

"You’re not sitting here regretting that you didn’t notice it yesterday, are you?" Du Fancheng asked curiously.

Liu Banxia shook his head. "At the very beginning, yeah, I did a bit. But now I don’t think that way anymore. It was his wife who knew that needle had been poked into the soil in the flowerpot. Given the situation at the time, we could only focus on his diabetic foot."

"Looking at it now, it’s kind of a lucky hit. The debridement on his foot was done very thoroughly. Now it depends on how much the toxin affects him. As long as it doesn’t trigger a lung infection, he should be fine."

"Honestly, this all comes down to carelessness in everyday life. If we hadn’t studied medicine and ran into something like this, we’d probably have handled it about the same way."

"But this whole process is pretty torturous, isn’t it?" Du Fancheng asked.

Liu Banxia nodded. "According to Su Hongbo, that’s how it is. I’ve actually never treated a tetanus patient before. The main problems are spasms and lung infection. Laryngeal spasm easily leads to suffocation, and lung infection is pretty much the same idea."

"Right now the toxin has already bound to the central nervous system, so detox drugs won’t do much. The next few days are when the symptoms will be at their worst."

"Isn’t it dangerous to keep him in your Second Department?" Du Fancheng asked.

"The treatment plan is clear; most of what we’re doing now is symptomatic treatment," Liu Banxia said.

"If we put him in the ICU, we’d have to set up isolation inside the ICU as well. It’s a big production, and honestly it’s more convenient to keep him in the Second Department."

"I’ll go upstairs and take another look. Xu Hui and Liu Yiqing are there. For that little patient, if we’re considering hematopoietic stem cell transplantation, we should let the Hematology Department in the inpatient unit know."

"All right, go take care of that first. Leave things here to me," Du Fancheng agreed.

Liu Banxia hurried back upstairs again; the condition of this tetanus patient weighed on his mind too.

"You finished downstairs?" Xu Hui asked.

"Yeah, done. A little patient with osteosclerosis," Liu Banxia answered offhandedly.

"Zhou Qian, the nursing for this patient is going to trouble you all a bit. There are more things to watch out for, and it’s not quite the same as the patients you usually care for."

"Director Liu, don’t worry. We do need to build up more nursing experience," Zhou Qian said.

"First day of the New Year, and we’ve already admitted two such patients. Everyone has to start getting busy ahead of time," Liu Banxia said.

"Director Liu, let’s put his wife’s companion care on time limits, otherwise I’m afraid she might slip up at some point," Zhou Qian said.

"Okay, you handle those arrangements," Liu Banxia nodded.

In truth, he still felt a bit unsettled inside; the back-to-back confirmations of these two cases had affected him.

Strictly speaking, he had no clear grip on the prognosis for either of these patients.

Tetanus is very dangerous, with a high mortality rate.

Even though his debridement was very thorough and the problem was caught relatively early, the toxin has already bound to the central nervous system.

All they can really do now is adjust symptomatically; it doesn’t even quite count as treatment. Whether it’s sedatives or muscle relaxants, all they can do is improve things a bit.

The patient still has a real chance of deteriorating further. For the patient, it largely comes down to his own resilience.

And that little osteosclerosis patient? His situation isn’t exactly rosy either.

The disease has already exerted its impact; the cranial vault bones are showing symptoms, and hematopoietic stem cell transplantation is the only way out.

But is that way out actually broad and easy to walk?

Of course not.

First, you need money—quite a lot of it. Second, the outcomes after transplantation are far from guaranteed.

So the whole thing becomes rather agonizing; it’s not like a tumor where you can cut it out and then, at worst, go through some chemotherapy, which is comparatively straightforward.

"Teacher Liu, I checked: the patient’s vital signs are fairly stable right now, and the neck rigidity has eased after medication."

At that moment, Liu Yiqing walked over.

"The next few days are critical. You all need to allocate your time properly. I’ll prepare the corresponding emergency plans and the medication protocols," Liu Banxia said.

"Teacher Liu, I just heard you mention possible tracheotomy. What exactly is going on there?" Liu Yiqing asked.

"That’s something we’d only do if he develops a lung infection and his breathing is compromised. The difficulty is that we can’t clearly judge at what point we’re justified in doing it."

"The procedure itself is fine, but postoperative nursing is a real headache. His treatment course for the underlying condition will be so long that he’ll be very prone to infection, and treating those will be even harder."

Liu Yiqing nodded; with that, she understood.

The threshold for that judgment really is fuzzy. Looks like if this toxin triggers pulmonary complications, things will get very serious.

They truly needed to be extra vigilant over the next few days. With a critically ill patient like this, they might need to issue a critical condition notice to the family at any time.

For her, this was also a rare experience. After all, the chances of encountering a tetanus patient aren’t that high, and it could give them a lot of valuable treatment experience.

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