CHAPTER 468: 468 UNUSUAL COLD PATIENTS

Liu Banxia had a good night’s sleep, despite worrying about a patient with cirrhosis. This was commonplace in the hospital. The patients he was seeing were just a fraction of those Zhou Fang was handling for the entire Second Hospital.

After breakfast, Liu Banxia headed straight to Tang Feifei’s ward.

"How are you feeling today?" asked Liu Banxia.

Tang Feifei nodded with a smile. "There are still some minor symptoms, but my mood is great. Is the biopsy scheduled for today?"

Liu Banxia nodded. "It’s simple. We’ll take a tiny piece of tissue for examination. Then we can confirm whether it’s Hashimoto’s thyroiditis. This is the only standard for diagnosis."

"Keep this positive attitude, wait for the symptoms to disappear, and then you can be discharged. Pay attention to your diet and have a thyroid function monitoring test every once in a while to adjust your medication dose."

Tang Feifei nodded. Though it sounded quite tough, she chose not to dwell on it right now.

Last night, she had also been looking up information online, which scared her badly. Now, she felt grateful for the bedwetting; otherwise, why would she have thought of coming to the hospital for a check-up?

"Keep up this good mood; it works better than medicine. I’m not joking, this is a fact," Liu Banxia said.

Tang Feifei nodded resolutely. Now, whatever Liu Banxia told her, she would believe. Even if he told her to walk around the hospital without covering her face, as long as it could speed up her recovery, she would do it.

This was blind faith, really, because she felt that Liu Banxia was very capable.

Coming down from the upper floor, Liu Banxia also gave the interns some encouragement. Now he had to do it every day. Otherwise, they wouldn’t stay motivated.

"President Liu, there are too many patients in the Department of Internal Medicine. Can you please take a few for me?" Xu Hui shouted.

"Okay," Liu Banxia replied.

In the future, this would likely be his routine work. He might as well start getting used to it now. He had never properly worked in Cardiac Surgery before, but he had sutured a heart in the past.

Sitting in the temporary consultation room, he glanced at the patient’s information: a 27-year-old woman with abdominal pain, nausea, and dizziness.

"When did these symptoms start?" Liu Banxia asked.

"I had a bit of a stomach ache yesterday, but it wasn’t severe. This morning, after I got up, I felt nauseous, and I didn’t eat breakfast. I felt worse when I got to work, and I was also experiencing dizziness," the patient explained.

"Lie down, please. I’ll give you a physical examination," Liu Banxia said.

He first conducted a digital examination. The abdomen was soft, with no evidence of rebound tenderness. After auscultation, the patient’s bowel sounds were also normal, which made Liu Banxia frown.

It seemed like there was no problem with the patient’s abdomen, ruling out appendicitis or gallbladder issues.

"Do you have any other symptoms? How has your diet been in the past few days? Any symptoms of diarrhea?" Liu Banxia asked.

The patient shook her head. "Everything was fine. Just yesterday, I had a little bit of a stomach ache. I didn’t pay much attention to it, and then it worsened today with the nausea. Doctor, could I be pregnant? Isn’t this how pregnancy feels?"

"When was your last menstrual period?" Liu Banxia asked.

"About half a month ago," the patient quickly replied.

"Then it’s not morning sickness," Liu Banxia explained. "Morning sickness generally occurs about six weeks after a missed period. Even if it happens earlier, it wouldn’t occur this early."

"The physical and digital examinations of your abdomen showed no problems. Now, since you’re feeling nauseous and dizzy, I also want to check your lung and heart sounds. Do you have a history of hypertension?"

The patient shook her head.

"Liu Yiqing, draw the curtain, please. I need to auscultate the patient’s heart and lungs," Liu Banxia instructed.

Liu Yiqing quickly pulled the curtain. This was special consideration when examining female patients. If the patient were male, they would just lift their shirt for auscultation.

After auscultating for a while, Liu Banxia frowned and listened carefully to the left sternal border, at the second intercostal space.

"Liu Yiqing, you listen too," Liu Banxia said.

Liu Yiqing looked nervous as she took out her stethoscope and carefully auscultated the patient.

"Tell me what you found," Liu Banxia said after Liu Yiqing finished.

"I heard a somewhat rough systolic murmur, and I couldn’t detect the second pulmonary sound. Could it be pulmonary valve stenosis?" Liu Yiqing speculated.

Liu Banxia nodded. "Pretty much. Next, let’s get an ECG for the patient, and then call a cardiac surgeon."

"Doctor, are you saying I have heart disease? But shouldn’t heart disease cause chest pain?" the patient asked incredulously.

Even someone without medical knowledge would know that an ECG and a referral to a cardiac surgeon suggested a heart-related issue.

"Symptoms can sometimes differ between men and women. In female patients, it can sometimes present like a stomach issue. We may also need to perform an echocardiogram to examine the exact condition of your heart."

"Doctor, am I going to die?" asked the patient, becoming increasingly anxious.

"Don’t worry," Liu Banxia said. "Based on your current situation, it doesn’t seem too serious. However, surgical intervention might be needed, but it’s a routine procedure."

"Basically, a blood vessel connected to your heart has narrowed. The heart is the body’s engine, and now there’s a small problem with your blood flow."

"We just need to correct the narrowed part with a minimally invasive surgery. The cardiac surgeon is here. She’s the expert. Let her assess if you’ve reached the stage where surgical intervention is needed."

"Pulmonary artery stenosis?" Wu Xiaoyue, who had rushed over, asked.

Liu Banxia nodded. "Abdominal pain, nausea, dizziness, and a heart murmur on auscultation. I think an ECG will clarify the specifics."

"Your auscultation skills are pretty good. Let’s proceed with the ECG then," Wu Xiaoyue said.

Without needing further instruction from Liu Banxia, Liu Yiqing began to prepare.

"Right axis deviation, tall peaked P-waves, right ventricular hypertrophy. This needs surgical intervention. Shall we admit her directly to our Cardiac Surgery Department? I’ll explain the details to the patient," Wu Xiaoyue asked after looking at the ECG results.

DING! Consultation completed.

Earned 100 Experience Points and 30 Skill Proficiency Points for Diagnosis.

Liu Banxia turned to the patient. "Don’t worry. Even though it’s surgery, it’s a routine one. These specialists will evaluate your heart condition and carry out detailed pre-operative checks."

The patient nodded. Although Liu Banxia’s words were comforting, she was still afraid. After all, this was heart disease, not something minor.

"Teacher Liu, should we call in the next patient?" Liu Yiqing asked after the patient was led away.

Liu Banxia chuckled and nodded. "Feeling that the internal medicine department lacks excitement? Not as thrilling as assisting in emergency treatment in general surgery?"

Liu Yiqing paused, then smiled shyly.

"Don’t worry, I’m planning for you all to intern in the ICU for about twenty days. That’ll let your passion bloom indefinitely," Liu Banxia said with a grin.

Hearing this, Liu Yiqing’s expression immediately turned sour. The ICU... that was also a place she dreaded. Facing so many critically ill patients every day would be an immense strain on her nerves.

But there was no way around it. Since the wicked Liu had said so, it was bound to happen.

The next patient was brought in. Liu Banxia looked at the information: 47 years old, self-reported flu.

"How many days? Do you have a fever or cough?" Liu Banxia asked.

"It’s been three days today. Despite taking Contac, I still have a high fever. My temperature at home was 38.7 degrees Celsius. I cough occasionally, and breathing is a bit difficult," the patient replied.

"Liu Yiqing, take his blood pressure and temperature. I’ll auscultate your lungs. Do you have any underlying conditions like hypertension or diabetes?" Liu Banxia asked.

The patient shook his head. "I exercise daily and go for a run every morning. It’s just that this flu seems quite severe. Man, this fever is really hitting me hard."

"Teacher Liu, temperature is 38.9 degrees Celsius, blood pressure is 100/55," Liu Yiqing reported, having finished taking the measurements.

Liu Banxia carefully auscultated the patient’s lungs. The sounds on the left side were acceptable, but the right side was much worse.

"Let’s get a blood sample and a chest X-ray," Liu Banxia said.

"There seems to be some inflammation in your lungs, but we need to see the specifics. Your blood pressure is a bit low. How does it compare to your usual levels?"

The patient shook his head. "I’ve never measured it before, but I don’t feel dizzy or anything like that. It’s just the fever making me uncomfortable, and it’s hard to breathe."

"This might be related to your regular exercise; athletes generally have lower blood pressure. It could also be affected by your current illness. Let’s do the lab tests first," Liu Banxia said.

The patient nodded, understanding this was the hospital’s procedure.

Liu Banxia saw a few more patients, all presenting with self-reported cold symptoms. There was no other way but to follow a similar procedure as with the previous patient: physical examination, blood tests, and X-rays.

Liu Banxia stretched. He was mostly triaging patients; Xu Hui was handling the bulk of the consultations.

Just then, the flu patient with low blood pressure returned with his X-ray films. "Doctor, the doctor over there said the lung inflammation seems quite serious."

Liu Banxia took the films, clipped them onto the light box, and frowned upon seeing them clearly. A thought stirred in his mind. "This is indeed quite severe. No wonder your temperature is so high. Have you sweated at all after running around for these tests?"

The patient shook his head. "I even drank two bottles of water while waiting for the X-ray results. Can I get an IV drip now?"

DING! Task announced: Unusual Flu Patient.

Open-ended task: According to the patient’s X-ray results, the host needs to determine if the patient’s high fever is influenced by an underlying condition, requiring further diagnosis. Task rewards will be issued based on the diagnostic results.

Liu Banxia stared at the films again, examining them carefully. "Look at your X-ray. Your left lung also has a bit of inflammation, though it’s not very severe. However, the inflammation in your right lung is quite extensive. You should get a CT scan of your lungs."

"Doctor, can’t you give me an IV drip to reduce the fever now?" the patient asked.

"The inflammation in your right lung is too severe. Trust me, a CT scan will give us a more accurate picture," Liu Banxia said.

The patient hesitated but eventually nodded.

He had come to the hospital hoping for some medication for his flu and fever, not expecting such a hassle.