The Enhanced Doctor

Chapter 1296: Chapter 1296: Acromegaly?

"Director Liu, do you think the likelihood that he has depression is high?"

When they were taking the patient for an echocardiogram, the young man asked curiously.

"Little bro, with the situation as it is now, anything is possible." Liu Banxia said.

"And for me, what I’m most concerned about right now isn’t his possible depression or his OSAHS, but his obesity."

"From what I’ve observed so far, his weight must be around one hundred fifty or sixty kilos, right? It’s almost proportional to his height; his neck is so fat you can’t even see his chin."

"If someone gets this fat in a very short period of time, do you think his body can handle that kind of load? It’s not just the bones—his internal organs are under a heavy burden too."

"Uh... Director Liu, two years doesn’t count as short, does it?" the young man asked in surprise.

"If I let you eat as much as you want, indulge yourself, high protein, high fat, then it’s possible." Liu Banxia said.

"But don’t forget, he’s already showing some loss of appetite. Under those circumstances and still ending up with this kind of weight, I’m even suspicious he might have acromegaly."

"I didn’t dare mention that just now; we have to take it step by step. Judging from that family’s situation, it seems even more serious than how you were back then."

The young man scratched his scalp, a bit embarrassed; only now could he really feel just how excessive his past "care" for his girlfriend had been.

And it’s precisely because of this that he trusts Liu Banxia so much.

He’d taken his girlfriend to the hospital more than once or twice, and never had a doctor been as "nosy" as Liu Banxia.

Now when he thinks about it, he still gets scared. If he and his girlfriend had kept indulging themselves like that, in the future they’d have become a pathologically unhealthy couple, and who knows what might have happened.

In fact, he didn’t really understand a word of what Liu Banxia had just said, but that didn’t matter.

All he knew was that Liu Banxia seemed to have spotted some other disease in his friend, which meant his stubborn insistence on dragging this family in for a consult had really been wise.

As for why Liu Banxia hadn’t, as usual, clearly explained all the possible problems he’d noticed to the patient’s family, it was because of that family’s attitude.

They were genuinely here to seek treatment, and the patient already showed clinical signs of OSAHS, so there was no need to dump everything on them at once; that might just scare the family.

If people truly come for treatment and don’t resist examinations, you can take your time, reason things through, and figure out the patient’s true underlying cause. Pinpointing that is the real success.

Otherwise, if you keep changing your story, the patient’s family will feel a certain uncertainty. They won’t know if you’re just guessing blindly and saying whatever comes to mind to make money.

"Teacher Liu, what’s going on with that patient?" Xu Yino came over.

"We’re waiting for the test results." Liu Banxia said.

"I overheard just now that the patient’s family suspects he might have depression, but I feel like that’s not it." Xu Yino said.

"I haven’t had much contact with depression patients, but I do know a bit. Under normal circumstances, some people with depression often show overactive movement or behavior."

"Mm... let’s say that’s in the very early stage. But in his case, it’s been going on this long; you can’t really call it very early anymore, can you? Anyway, I think it’s definitely something else making him this fat in such a short time."

Liu Banxia gave her a surprised look and stuck up his thumb. "Not bad. Even though it was all eavesdropping, you still picked up a lot of information and gave a corresponding analysis."

"So the next part is simple: you’ll be the primary on this patient. Since you’ve made that judgment, you must have a corresponding line of thought. I’ll be watching."

"Teacher Liu, could we not mess around? I was just shooting my mouth off based on what I overheard." Xu Yino said gloomily.

"Who’s messing around? Your thinking is pretty much the same as mine. Tell me what other inclinations you have, and I’ll see if they match mine." Liu Banxia said with a smile.

Xu Yino bit her lip; she had to try hard to figure out whether Liu Banxia was teasing her.

After weighing it for five seconds, she gave up. Whether he was or not, the big demon king had asked, so she might as well talk.

"Teacher Liu, I just secretly observed the patient’s facial expressions and his features. I feel like his cranial shape has grown a bit broad, and his hands are kind of thick." Xu Yino said.

"Um, do you think it could be acromegaly? Acromegaly can also be accompanied by neuropsychiatric manifestations like depressed mood and poor concentration."

"And acromegaly can cause thickening of the upper airway mucosa and hypertrophy of the tongue muscles, which in turn leads to sleep apnea and snoring, right?"

Liu Banxia nodded with a squinting smile. "That’s exactly what I was thinking."

Xu Yino stared hard at him; she still needed to judge whether Liu Banxia was just playing with her.

It’s really because Liu Banxia has too many tricks up his sleeve, and the kind that’s impossible to guard against. How would you know when he’s teasing you? He might lead you further and further down some little path.

"Staring at me won’t help. From here on I’m just a puppet. Whatever you say, I’ll say; whatever tests you order, I’ll order. You figure it out yourself."

Xu Yino shook her head, turned around and ran to Liu Yiqing’s side, and even called Su Wenhao over.

She had to discuss this patient with her buddies; going solo she might fall into a pit. If she pulled in her buddies? Her defense stat had to go up a bit.

And as for Liu Banxia? Right now he was genuinely gratified.

Whether the patient actually had acromegaly or not, Xu Yino’s current performance was already very good. She wasn’t fixated on staring at OSAHS, and she also didn’t put the apparent depression in the primary position. That alone was a big success.

In the process of diagnosing a patient, there will be many external clinical manifestations, and some of these manifestations are related to each other, while others are isolated.

The diagnostic process is about putting those manifestations that can help with the diagnosis together, and then sorting out the causal relationships among them.

Taking this patient as an example, although there are depressive features, the triggering factors might be sleep quality, might be acromegaly, or more likely a result of the combination of these two conditions.

For now he could only see this much; the subsequent diagnosis would still have to depend on the test results. Now that Xu Yino was already able to notice these things, how could he not be gratified?

Even though this is just a single case and can’t fully represent her overall ability in handling patients, it still reflects certain issues to some extent.

"Teacher Liu, um, we think that after the echocardiography results come out, we can get the patient an X-ray to look at the sellar view, or do a CT scan to see whether there is a pituitary tumor in the skull." Xu Yino ran back over again.

"Give me a reason so I can explain it to the patient’s family." Liu Banxia said.

"I asked Li Hao; he said the heart sounds are muffled and there’s bradycardia, so it might well be cardiac enlargement and myocardial hypertrophy." Xu Yino said.

"And our current leaning is toward acromegaly, so the sellar view and pituitary are the primary targets for examination. Many patients with acromegaly have pituitary tumors, and the sellar view will also show changes."

"OK, I got it. I’ll explain it to the patient’s family that way." Liu Banxia nodded.

Seeing him agree so readily, Xu Yino instead became a bit hesitant. "Teacher Liu, are you sure you really aren’t just messing with me?"

"Why would I mess with you? It’s not like you’re giving me extra dishes." Liu Banxia said.

"Anyway, if you are messing with me, that’s wasting my work time, and I’ll go complain to Shimu."

Xu Yino threw out this fierce line, then ran off again to discuss things with her little buddies.

"What are you all up to?" Wang Chao curiously leaned over.

"That patient we just admitted? Her assessment is about the same as mine. I told her to take charge of the case, and she thought I was teasing her." Liu Banxia said with a smile.

Wang Chao frowned. "You sure you’re not teasing her?"

"Do I have that much free time? What kind of look is that?" Liu Banxia was very depressed.

"Tsk tsk, with you everything’s possible. Maybe you’ve already figured out what disease it is and you’re just testing them. Who can say for sure? I have to go help them too."

After Wang Chao finished speaking, he trotted over as well.

Liu Banxia was genuinely helpless. What was this? He’d been turned into the big villain, while that group had become the embodiment of justice.

What had originally been just an internal discussion among Xu Yino and her buddies started to expand after Wang Chao joined in.

Even Wei Yuan and Qi Wentai came over, whispering along with them.

"This is plotting a mutiny."

Watching them all so interested, Liu Banxia muttered to himself.

"Teacher Liu, the echocardiography results are out—cardiac enlargement and myocardial hypertrophy." At this moment Li Hao ran over with the report.

"Director Liu, does this mean he has heart disease?" the patient’s father asked nervously.

"We still need to study this further, but judging from his current presentation—broad facial features, broad palms—we also have to consider whether it’s acromegaly." Liu Banxia said.

"Acromegaly can also cause this series of problems he’s having now, so next we’re going to do a head X-ray and a head CT scan."

Hearing what Liu Banxia said, the patient’s father turned back and carefully looked at his son’s face and hands. Then he felt that his son’s face really did seem a bit broad, and his hands really were kind of big?

He didn’t hesitate; he nodded and agreed on the spot.

Whether it was or not, the urgent thing now was to get the tests done. It wasn’t that much money; he couldn’t afford to delay his son’s illness. They were already doing a brain CT—this must be quite serious.

"Reporting to the leaders: the patient has gone for X-ray and CT now." Liu Banxia walked over to Xu Yino and her gang.

Xu Yino curled her lips; she hadn’t expected that Liu Banxia would actually go with whatever she said.

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