CHAPTER 344: 344 WEIRD HYPERTENSION

The firefighter’s surgery was very successful. Although part of the lower lobe of his lung had to be removed, which would affect his future life, the impact had been minimized as much as possible.

While waiting for the surgery, the Binhai Second Hospital’s Emergency Center also admitted three burn patients. These were patients with minor burns who had been redirected here; the more severe cases were all sent to the city hospital. This was because Xie Chunli, a specialist in burn treatments, was stationed at the city hospital, and his technical skills in this area were very solid.

Liu Banxia personally supervised the debridement for these three burn patients. Debridement for burn injuries is an extremely challenging technique.

"Well, I’m very satisfied. You all did a great job this morning," Liu Banxia said with a smile. "The number of patients is increasing, and their conditions are becoming more demanding. I hope you all can continue to work hard. I’ll be spending the National Day holiday here in the hospital with you."

"Teacher Liu, if you hadn’t mentioned it, we really wouldn’t have given it much thought. But now that you bring it up, it feels quite heartbreaking," Miao Rui said.

"Haha, let’s focus on the present. This is just the beginning. The further we get into the holiday, the more alert we need to be. Pop quiz: which type of patients do we usually see more of during the holidays?" Liu Banxia asked with a smile.

"Alcohol intoxication," Xu Yino raised his hand.

"Cardiovascular and cerebrovascular issues," Huang Bo quickly answered.

Liu Banxia nodded. "Close enough. But if you ask me, here in Binhai City, we get the most patients from out of town. Alright, time for lunch!"

Seeing Liu Banxia stroll towards the cafeteria with his hands behind his back, the interns were once again dumbfounded. What was that about? A brain teaser? Even if Binhai City gets a lot of tourists during holidays, that was a bit of a stretch.

But there was nothing they could do; that was just Teacher Liu for you—so offbeat.

Zhou Li was amused by the interns’ confused muttering, torn between fondness and frustration for Liu Banxia. However, it had to be said that even though Liu Banxia was often playful, he was always very meticulous during procedures. She had watched the debridement process earlier that day. If any aspect wasn’t up to standard, Liu Banxia wouldn’t let it slide or save his comments for later; he would call it out directly and sharply.

Regarding Liu Banxia’s return to work, the happiest person had to be Zhou Qiang from the cafeteria. He had been eagerly awaiting Liu Banxia’s return, wondering who else he could sell his chicken legs to.

As expected, Liu Banxia arrived and bought eleven chicken legs, in addition to his own tray piled high with food.

"Starting tomorrow, you’ll need to eat in shifts, groups of four. Otherwise, when we get busy with patients, it’ll be too chaotic to manage," Liu Banxia said.

"Teacher Liu, will those of us on the second dinner shift still get rewarded with chicken legs?" Xu Yino asked.

"If a reward is deserved, then of course you’ll get one. But you all really should pay a bit more attention. It seems like you’ve all put on a little weight since you started here. If you don’t believe me, take a look at each other," Liu Banxia said.

Hearing his words, the others were mostly unfazed, but Xu Yino and Liu Yiqing became visibly flustered, checking their reflections on their phones for a long time. Finally, they had to reluctantly put their phones down; they had indeed gained some weight.

"Back when you were in school, you didn’t move around much and probably ate whatever was quick and easy. Here, you need to seize every opportunity to eat and rest, so it’s normal," Liu Banxia explained with a smile. "But don’t worry, once things get busier, you’ll slim down again. Especially after you officially graduate and join the hospital family, losing weight won’t be a concern."

"Teacher Liu, how much busier do you think it will get? Right now, our patients make up half of the internal medicine ward and about two-thirds of the surgical ward," Miao Rui asked.

"It’ll be similar to the inpatient department. During peak times, extra beds are even placed in the corridors. That’s why it was designed that way, which cost the hospital a fair bit of money," Liu Banxia casually replied. "So, just imagine: so many patients, and so few doctors. You’ll have to figure out how many each of you will manage. It’ll be incredibly busy then, especially during the New Year. Seeing all those patients in the corridors is heartbreaking."

"This is from my memories of residency in the inpatient department. Consider this a heads-up: you need to prepare for the arduous struggle ahead. This is a tough battle, and one that will be ongoing."

"Look, you’ve scared them all. What will you do if they run away?" Shi Lei said with a laugh.

"Haha, if they’re going to desert, it’s better to do it sooner rather than later. Once they truly enter this profession, they won’t be able to run away even if they want to," Liu Banxia said nonchalantly.

The interns’ faces turned a bit grim, except for Qing Kewa, who didn’t quite grasp the implications. After all, she would be returning to Russia, where things were very different from here.

The meal left the interns with a whirlwind of emotions; dealing with Liu Banxia, who loved to tease people, was genuinely challenging.

"Ah, Brother Liu, what brings you here?" Liu Banxia had just returned to the emergency center when he saw Liu Haibing.

"I heard you started work today. A friend’s child has been diagnosed with hypersomnia. Could you take a look?" Liu Haibing asked.

"How old is the child? Has the diagnosis already been confirmed?" Liu Banxia asked, furrowing his brows.

Liu Haibing nodded. "It’s the child of one of my foremen. He’s over there; why don’t you go take a look?"

"If it’s confirmed, it will be very difficult to manage," Liu Banxia said, offering a word of caution.

Having patients recommended to him was an acknowledgment of his abilities. However, he wasn’t omnipotent, especially since hypersomnia was often a condition with no identifiable cause.

The patient, a sixteen-year-old, didn’t look very old. The young man appeared quite alert, though his expression was flat.

"How long has it been since the diagnosis? What are his usual symptoms?" Liu Banxia asked.

"He was diagnosed almost four years ago, but it didn’t affect his life much back then. Even though he tended to sleep a lot during the day, his school was understanding, and he would study diligently when he was awake," the child’s father answered. "It worsened after this year’s Spring Festival. At first, he just slept more during the day, mostly concentrated in the afternoons."

"Now, there’s no specific time. He can fall asleep at any moment. He might fall asleep while eating or even in the middle of a conversation."

"This bag contains all the scans and diagnostic reports from various check-ups. We’ve even consulted a traditional Chinese medicine practitioner, all to no avail. We... look, he’s getting sleepy again."

Just as the father was speaking, the child yawned, slumped onto the bed, and fell asleep, even snoring softly.

"Please don’t worry yet. Let me look at those scans first," Liu Banxia said.

He knew that if there were any abnormalities on the scans, so many previous examinations would surely have detected them. However, reviewing them was standard procedure; even if some scans were old, they could serve as a basis for comparison.

"Has the child’s blood pressure usually been high?" Liu Banxia asked after a quick look at the reports.

The child’s father nodded. "Other doctors said it might be because he sleeps too much, and he’s also a bit overweight now. But he doesn’t have diabetes or heart disease."

"Well, regardless of our examination approach, we need to be thorough. Besides, your most recent check-up was over two months ago," Liu Banxia said.

"Alright. Brother Liu said your medical skills are excellent. If you can cure my son’s illness, you’ll be our family’s savior," the child’s father responded. "I didn’t even tell my wife about this visit. We’ve had our hopes dashed too many times before. I didn’t dare tell her; otherwise, if there’s no improvement with the boy, she might not be able to take it."

Liu Banxia nodded. "Since Brother Liu brought you here, we will definitely do our best. Dr. Liang, please take the child’s blood pressure and then run a blood test."

"Dr. Liu, is hypersomnia really that hard to treat?" Liu Haibing asked curiously.

"Indeed. And it’s a condition where the cause often can’t be found. As long as there are no organic brain lesions, insufficient sleep can be ruled out as the cause, and episodes occur frequently every day, a diagnosis can be made," Liu Banxia explained. "I see from his records that previous doctors prescribed Methylphenidate, which is a stimulant, but it doesn’t seem to have had much effect."

"Dr. Liu, his blood pressure is quite high: 180/110 mmHg," Liang Xiaolin, who had just finished taking the blood pressure, hurriedly reported.

"That high? Hasn’t the child been given antihypertensive medication?" Liu Banxia asked.

"Yes, every day. We’ve switched medications several times. He’s currently on amlodipine; they said it provides long-term control, but it doesn’t seem to be very effective," the child’s father responded with a bitter smile.

Liu Banxia frowned. Amlodipine was a third-generation drug with a half-life of 35 to 50 hours, yet it had proven ineffective for this child.

"What worries me most right now is the child’s hypertension; it’s quite dangerous," Liu Banxia remarked. "And given his current condition, he’s likely had this for a long time. If it’s not controlled well, the consequences of this hypertension could be even more severe than those of the hypersomnia."

DING! Task Assignment: Strange Hypertension

Open-ended Task: The patient presents with hypersomnia and severe hypertension, which has captured the Host’s attention. Further examination is required to determine the underlying cause. Task rewards will be issued based on the diagnostic outcome.

Even though a task had been issued, Liu Banxia didn’t feel the slightest bit happy. He had figured out how these task assignments generally worked, and it seemed this young patient’s situation was likely not optimistic. If it were a straightforward condition, the System usually wouldn’t even issue a task these days; he would just treat it, and receive experience points and rewards afterward.

And what about hypertension? Its nickname is ’the silent killer.’ Like diabetes, it doesn’t initially seem like a terrifying disease, but it can lead to many complications. This patient’s high blood pressure couldn’t even be controlled with medication, which indicated just how complex this single aspect was.

However, the next steps in diagnosis and treatment would have to depend on the blood test results.

With such severe hypertension, if not properly controlled, it could easily lead to organ damage and pathologies in the heart, brain, and kidneys—such as myocardial infarction, stroke, or kidney failure. These were all life-threatening conditions, hard for him to ignore.