The Enhanced Doctor-Chapter 446 Hit the target by a fluke

(Thanks to good friends EmptyLonelyCold671112, DSUK, and Perdu la vie for their monthly pass encouragement)

"How long has your father’s illness been diagnosed? Not three or four years, right?" Liu Banxia looked at the patient’s son.

The patient’s son nodded. "Just over a year. We’re truly sorry about today, for messing up the floor; we can contribute to the cleaning costs."

Liu Banxia waved his hand. "It’s not about that. I don’t think your father has Alzheimer’s."

DING! Task Announcement: A Strange Alzheimer’s Patient

Open Task: The host suspects numerous contradictions in the Alzheimer’s patient’s symptoms, suggesting a potential underlying illness that requires further diagnosis. Task rewards will be issued based on the diagnostic results.

"Doctor, really?"

The patient’s son was excited, his voice rising slightly.

It was no wonder he was excited. Alzheimer’s is considered a terminal illness, after all. Despite taking medication, it was having no effect whatsoever. Not only was it exhausting for the caregiver, but the old gentleman’s quality of life was also severely compromised. This time he had wandered off, and just now, he’d had an episode of urinary incontinence. If they hired a negligent caregiver, how much more suffering would his father endure for the rest of his life? What child wouldn’t be consumed with anxiety over this?

"The entire course of Alzheimer’s disease is relatively long," Liu Banxia said, frowning.

"Normally, it’s divided into three stages. The first stage typically lasts one to three years. Symptoms include forgetfulness, emotional instability, and impairment in problem-solving, analysis, and judgment, causing patients to get lost easily."

"Yes, yes, that’s exactly my father. When we noticed, we took him to the hospital for a checkup and a CT scan. They said there was some brain atrophy, which were early signs of dementia," the patient’s son said hurriedly.

Liu Banxia nodded. "The second stage lasts longer, varying from person to person, generally from two to ten years. During this stage, memory becomes significantly impaired, and previously forgotten events may constantly resurface."

"This often manifests as not recognizing people, because the memories that emerge are from their younger years. Emotional instability also increases, and symptoms of urinary incontinence may appear."

"When I first examined the old gentleman, I didn’t think too much of it. But what you just said made me reconsider. It’s been such a short time since the onset of the illness, yet his condition seems severe; he has already begun to experience urinary incontinence."

"But look at the old gentleman’s facial expression; he doesn’t seem bothered by the incontinence at all. I initially thought it was due to a good disposition, but that might not be the case."

"His symptoms, if judged according to the progression of Alzheimer’s, have already reached the severe third stage."

"At this stage, patients retain only fragments of memory. Therefore, they often don’t even register things like urinary or bowel incontinence."

"With so many conflicting symptoms, let’s do another brain CT scan to see if it’s caused by an organic brain lesion. If so, we might still be able to intervene in time."

"Doctor, is that really possible?" the patient’s son asked.

Liu Banxia nodded. "Whether it is or not, let’s do the scan first. I can only make a judgment based on my current medical knowledge; the actual situation will depend on what the images show."

"Look, we’ve been talking for so long, and the old gentleman isn’t paying any attention to what we’re saying. Let’s go get the scan; I’ll write up the order now."

"Alright, we’ll do a thorough check today," the patient’s son nodded firmly.

Even without a specific diagnosis yet, he felt a surge of excitement. This was hope, precious hope.

"Teacher Liu, can Alzheimer’s really be misdiagnosed?" Huang Bo asked curiously.

"It’s hard to say," Liu Banxia shook his head.

"The onset of this disease is very insidious; it doesn’t present any clear initial symptoms. By the time you notice it, it’s usually already in the later part of the first stage."

"Moreover, many factors can lead to this disease. It’s a neurodegenerative condition. Subtle brain damage or somatic lesions might not be detectable by instruments but can affect the cranial nerves."

"But the old gentleman’s symptoms today are highly contradictory, so further tests are necessary. We can’t overlook this just because it’s troublesome. We need to confirm it one way or another."

He was genuinely concerned about the old gentleman’s situation. After all, his earlier oversight had caused everyone a great deal of worry and effort for half a day. Seeing so many contradictory symptoms now, he couldn’t ignore them.

He didn’t order immediate emergency treatment for the old gentleman, as the situation wasn’t critical yet. After observing in the hall for a while, he headed to the CT room.

"Are you here about the recent contrast-enhanced CT? It shows a retroperitoneal tumor, likely malignant. The images aren’t very clear," said Wu Bo, the radiologist on duty.

"Another one diagnosed? Whose patient is it?" Liu Banxia asked.

"Wang Huan’s. I thought she had already consulted with you," Wu Bo said with a smile.

"I’m here about the next patient, the old gentleman diagnosed with Alzheimer’s. But I feel something isn’t right," Liu Banxia said, nodding. "His symptoms are too inconsistent, and the disease is progressing too quickly. Please take a good look at his scan later."

"Alright. Actually, I doubt you’d need me to look too closely; your judgment is quite accurate. How’s that young man with the tumor on his right hip?" Wu Bo asked.

"Wu Mingyu and Director Xu have scheduled surgery for a frozen section biopsy. If it’s malignant, they’ll replace the hip bone directly. If it’s benign, it’ll be much simpler," Liu Banxia said.

"But the young man has strong willpower. He was very anxious before we told him, but he became strong afterward. His parents have heart disease and high blood pressure, so he asked us to help keep it from them."

Wu Bo nodded. "Let’s hope it’s not too late; he’s so young."

Given Liu Banxia’s significant concern for the patient, Wu Bo took him to the CT monitoring room. This allowed them to view the images directly and avoid any delay.

The machine whirred, and images were gradually scanned out. Looking at the monitor, both Wu Bo and Liu Banxia frowned slightly, because the brain CT images revealed no apparent problems.

"President Liu, have you found anything?" Wu Bo asked.

Liu Banxia shook his head with a wry smile. "I haven’t found anything. I thought there might be a brain tumor pressing on some nerves, causing the current symptoms."

"I can’t see anything either. Unlike you, I can’t diagnose based on patient symptoms; I can only interpret the images," Wu Bo said.

"Thanks. I still need to think this over carefully," Liu Banxia said.

"The old gentleman’s illness is progressing too rapidly; I’ve never heard of Alzheimer’s progressing this fast. This is what’s been puzzling me; it’s just too unusual." 𝓯𝙧𝓮𝓮𝒘𝓮𝙗𝙣𝒐𝒗𝒆𝓵.𝓬𝓸𝒎

Regarding this matter, Wu Bo couldn’t offer any further opinion. As he said, he could only interpret the images.

"Doctor, how is my father?" the patient’s son asked anxiously, seeing Liu Banxia walk out with a serious expression.

"The current CT scan shows no apparent problems, but this contradicts the brain atrophy mentioned in your previous examinations," Liu Banxia said.

"So, I plan to perform a lumbar puncture next to test the cerebrospinal fluid. We need to check for an intracranial infection or a space-occupying lesion in the central nervous system."

"Although CT scans are very precise, the brain is exceedingly complex. Even a minuscule impact or pressure point can trigger associated symptoms."

"Doctor, is the lumbar puncture dangerous?" the patient’s son asked.

"There are certain risks, as it’s an invasive examination," Liu Banxia explained. "However, it’s a standard procedure these days. Considering your father’s current symptoms, it’s also the most effective diagnostic tool we can currently use."

"Okay, let’s do it then," the patient’s son nodded.

In truth, there wasn’t much to deliberate. He either had to accept continuing treatment for Alzheimer’s for his father, or opt for further examination to see if another illness was present. His father had been found by a police officer after wandering off and brought to this hospital, where he had received excellent care; they hadn’t treated him dismissively just because he was a lost old man. Though he didn’t understand medicine, he could comprehend what Liu Banxia had explained at the emergency center bedside. He also knew that a reputable hospital like this wouldn’t try to trick his father into unnecessary examinations with a string of excuses. Just look at the number of people waiting for tests here! What was there to gain by deceiving them? That sort of thing only happened in small, under-visited hospitals. This place was bustling with patients; they had no need for such tactics.

A lumbar puncture carries a certain level of risk, but it’s a relatively straightforward procedure, requiring only careful attention during execution.

Back in the emergency center, Liu Banxia had Miao Rui perform the lumbar puncture.

Miao Rui wasn’t hesitant; he had performed the procedure before. He was no longer the rookie he had been upon arrival; he had matured significantly.

With steady hands, he inserted the needle, withdrew the stylet, turned the needle hub, and cerebrospinal fluid began to flow out.

Once the sample was collected, Miao Rui reinserted the stylet, withdrew the puncture needle, and then applied sterile gauze to the site, securing it. He then carefully helped the old gentleman turn over to lie flat on the examination bed.

"He’ll need to lie flat for a while, for about six or seven hours," Liu Banxia instructed.

"Okay, I’ll stay here and watch over him," the patient’s son nodded.

"Qingfeng, is this a hospital? How did I end up in a hospital?" the old gentleman lying on the bed suddenly asked.

"Dad, you can recognize me?" the patient’s son exclaimed in surprise.

The old gentleman furrowed his brows. "Nonsense. Why does my back hurt so much? Have my fish been fed?"

"Doctor, Doctor! My father recognizes me! He even remembers that he kept fish! What’s happening?" the patient’s son turned to Liu Banxia, his eyes shining with excitement.

"It seems I stumbled upon the right answer by chance," Liu Banxia said with a wry smile. "Let me call for a consultation. Don’t worry, the old gentleman doesn’t have Alzheimer’s."

He hadn’t anticipated such a dramatic turn of events, but it was ultimately beneficial for the patient.