The Enhanced Doctor

Chapter 1298: Chapter 1298: Hidden in Plain Sight?

"Teacher Liu, the CT result for the patient is negative. Should we go to the ward now?"

After Liu Banxia and Liu Yiqing came out of the office, Xu Yino hurried over.

"Looks like there’s some trouble. Do you have any discussion results?" Liu Banxia asked.

"Everyone tends to think the patient’s obesity is the result of endocrine influence. Otherwise, with his diet, it’s impossible to have this weight," Xu Yino said.

"So what about the next examination?" Liu Banxia asked.

"No direction for now," Xu Yino answered bluntly.

"Currently, we lean towards it being the result of endocrine influence, but we also just discussed there are so many systems in the endocrine system. What system should we check first?"

"If I were to guess, I would choose not to tell you first," Liu Banxia said with a smile.

Xu Yino rolled her eyes. Now she was sure, actually during the discussion when everyone was still talking, the big devil in mind already had a second set of plans.

But he’s a bit naughty and didn’t say it at the time.

But what kind of direction could it be?

At this moment, Xu Yino saw Liu Yiqing’s hand reaching towards her neck.

"Thyroid?"

Xu Yino accidentally couldn’t control her volume.

"Why so loud? Yeah, it’s the thyroid. Our general direction is still on the endocrine aspect, right?" Liu Banxia nodded.

Xu Yino nodded, that’s what she just mentioned.

"Then isn’t it simple? Anyway, we’re going down the endocrine route. In my opinion, the most mysterious yet trickiest system in the endocrine system is the thyroid," Liu Banxia continued.

"Think about it, how much trouble have we encountered with the thyroid? Various symptoms vary. So we should check that first, right?"

"Uh... if you put it that way, it makes sense. Shall we do a manual check upstairs, or perform an ultrasound, or directly take a blood test?" Xu Yino hesitated and asked.

"Didn’t I say already? Follow your arrangement. Whatever order you say, that’s the order we’ll follow," Liu Banxia said with a smile.

"If you hadn’t mentioned the thyroid, we wouldn’t even have checked it. Look at how much authority you have, quite enjoyable, I think you should be very happy."

Xu Yino smirked, should she be happy? But why can’t she feel happy? So many people, yet one route less thought of?

"Eh? I figured it out, just because the patient is overweight, we habitually overlooked the thyroid issue."

After thinking for a while, Xu Yino suddenly blurted out.

"Because patients with thyroid issues mostly suffer from hyperthyroidism—eating a lot, yet being thin. Only a small number have hypothyroidism, and often it occurs in women."

"The second reason is also that the patient is quite overweight, so his neck looks thick, and we can’t really see if there’s any sign of enlargement in his thyroid."

"In such a case, I guess even if Teacher Liu did a manual check, he might not feel anything. Unless the thyroid is enlarged to a certain extent, right?"

Liu Banxia nodded, "I considered hypothyroidism too. The symptoms of hypothyroidism are much more complex than hyperthyroidism. But currently, it’s just our guess. How to inspect depends on your decision."

"Then what’s there to think about, just do a thyroid function test," Xu Yino said.

"But I’m curious, how does Qingqing know? Was she just told, or did she think of it herself? Be honest."

"Teacher Liu said it, how could I have thought of that?" Liu Yiqing replied earnestly.

"Just chatted about the patient’s situation to distract me a bit. But inspection is still the main determinant. We still can’t confirm if it’s hypothyroidism."

"She’s talking nonsense. I didn’t think of it, she brought it up," Liu Banxia chipped in.

Xu Yino looked at Liu Yiqing with a "ferocious" expression. But following her earlier thought, she leaned more towards hypothyroidism in her heart.

The process of diagnosis is sometimes quite magical. When desperately searching for clues, even an unclear direction can boost confidence.

Arriving at the VIP ward upstairs, once Liu Banxia came in, the patient’s group of family members swarmed up again.

"Earlier, I checked the CT and X-ray results downstairs. Current examinations do not support a diagnosis of acromegaly," Liu Banxia stated.

"Now I need to ask, does he usually experience hair loss? Is his skin dry and prone to flaking?"

"Have you noticed this?" the patient’s father asked others.

"Seems like we didn’t really pay attention, but he does lose hair. Doesn’t lack of sleep also lead to hair loss?" the patient’s mother said.

"Director Liu, so what exactly is Ming Zhe’s condition now?" the patient’s father asked.

The ones concerned are not just the patient’s family members; Wei Yuan and his group who came early are also interested.

"We’ve currently ruled out acromegaly, and our brain CT results are negative. For us, this is quite a satisfactory result." Liu Banxia said with a smile.

"After all, no one wants something growing in their brain that shouldn’t be there. After discussion downstairs, we now lean towards hypothyroidism."

"Many times when we encounter people with thyroid issues, it’s mostly hyperthyroidism. The incidence of hypothyroidism isn’t very high, but it doesn’t mean it doesn’t exist."

Hearing Liu Banxia’s words, the patient’s family members were still not entirely clear about the situation. But for the doctors, Wei Yuan and his group, after pondering a bit, showed an expression of sudden realization.

Now the situation is quite unified, and everyone’s attention turned to the patient’s neck.

But just relying on visual inspection, there’s no way to determine the condition of the thyroid.

This is especially because we’re in a VIP ward; otherwise, we could directly get closer to perform a physical examination.

Liu Banxia walked up to the patient and carefully examined them.

However, even with his good tactile sense, he couldn’t determine the condition of the thyroid.

Then he pressed firmly on the patient’s arm with his fingers, but did not leave any indentation.

The patient was very cooperative, basically just staying still and letting the doctors do as they liked, without arguing.

"Couldn’t feel anything, we’ll have to do a blood test to check the thyroid function." Liu Banxia said.

"When I pressed the arm just now, the skin felt slightly rough. But this test takes longer, and the results will only be out in the afternoon."

"It’s okay, go ahead with the tests. We’re already hospitalized, as long as the disease can be diagnosed." The patient’s father said.

Liu Banxia nodded and left the rest to Xu Yino.

"Big demon king, how did you think of it?"

As they walked out of the ward, Wang Chao asked directly.

"Actually, I was inspired by Liu Yiqing, who suggested it might be related to the endocrine system, and wondered if it could be the thyroid?" Liu Banxia said candidly.

"However, this situation is indeed rare, and there are many other possible conditions. Plus, with depression mixed in, it’s difficult to judge."

"Even though I didn’t feel the thyroid, from the skin’s tactile sensation and the presence of non-pitting edema, I think it’s close enough."

"But I think we should consider a third path. If nothing else works, we should tackle it as OSAHS. At the very least, we can let him get a good night’s sleep to see if there’s an improvement in his mental state."

"Teacher Liu, what needs to be done then?" Miao Rui asked curiously.

"It’s simple: intubate and use a ventilator. Blowing in oxygen will alleviate the airway obstruction." Liu Banxia said with a smile.

"But intubation is quite unpleasant, so we can only do this if we can’t find the condition through tests, or after we find it."

"Uh... why do we need to intubate even after diagnosing?" asked Huang Bo this time.

"Fool, medications take time to take effect. No matter the condition causing this, it requires time to improve."

"If his sleep is poor, it will definitely affect the treatment of the condition. So intubation tonight is necessary, no need to rush to find Doctor Du for a consultation."

"If it’s really the impact of hypothyroidism, maybe the situation will improve with medication. Therefore, I think intubation is unavoidable."

"Ah, worthy of being the big demon king." Wang Chao sighed.

"Now, I’m just guessing under the guidance of Liu Yiqing. Whether it’s actually hypothyroidism depends on the test results." Liu Banxia said.

"And as I said earlier, we also need to consider the conditions related to OSAHS. But things should be prioritized; right now, we need to examine his mental state first, then address the other issues."

Everyone nodded.

Today’s situation somewhat felt like not seeing the obvious.

If the patient were only overweight, without an accompanying thick neck, today’s diagnosis might not have been so laborious.

But there’s no helping it; even with a strong inclination now, we still can’t provide a clear diagnosis.

Like earlier with acromegaly, everyone was confident, but the test results had everyone gaping.

Symptoms have many overlapping manifestations, requiring careful differentiation. Only by identifying the subtle differences can a diagnosis be made accurately.

Relatively speaking, the likelihood of thyroid issues is indeed higher.

If this case is indeed a thyroid problem, it would be really interesting. Even if the chances are low, it’s still possible.

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