The Enhanced Doctor-Chapter 499 Contraceptive pills are the chief culprit
"Doctor, please don’t scare me." The young man gripped Liu Banxia’s arm, speaking in a rather anxious tone.
"I’m not scaring you. If my judgment is accurate, she currently has no effective treatment available in our country," Liu Banxia responded seriously.
"It’s a rare disease characterized by subcutaneous capillary dilation and swelling of the mucous membranes. This swelling is non-pitting and recurrent. It typically affects areas with loose tissue, such as the face, tongue, throat, hands, and feet, and can occasionally occur in the gastrointestinal tract."
"The patient’s current symptoms all align with this. It started in her foot and then resolved on its own. However, due to disrupted estrogen levels, a large-scale outbreak occurred—first in her head, then in her gastrointestinal tract."
Xu Hui racked his brain, trying to identify the disease. It seemed somewhat familiar, yet elusive.
"Ah... I remember! Isn’t it Hereditary Angioedema? Should we test her serum C1 esterase inhibitor levels? No, she’s in an acute phase now, so we should also check C2 and C4, shouldn’t we?" Xu Yino asked, somewhat excited.
Liu Banxia nodded. "If you know, then go draw blood for the tests."
Xu Yino scampered off.
"Doctor, then... then... is Xiao Yu not going to live much longer?" Tears welled up in the young man’s eyes.
Liu Banxia flicked his forehead. "If she weren’t going to live long, would I be wasting my breath here? Forgotten what I just said? This is a recurrent disease."
"Although there’s no cure, she will return to normal once her body self-regulates. The current treatment in our country involves plasma exchange."
"However, I don’t recommend it for her, not just because of the cost. Plasma exchange also carries certain risks."
"Moreover, the disease typically peaks 12 to 18 hours after being triggered. We’ve already protected her airway. For the severe abdominal pain, simple analgesics will suffice."
"Stop worrying unnecessarily. In the future, don’t let her take contraceptive medications. Taking too many can cause estrogen imbalances, leading to her current condition."
"Then... then should I go tell her parents now?" the young man asked, conflicted.
"You... It’s better if I tell them. It might soften the blow a bit," Liu Banxia said.
The young man was, in a way, partly responsible for the girl’s current condition. If her father found out, he might get ideas and could even beat him up.
Upon arriving at the ward upstairs, the patient’s parents were sitting by her bedside, each holding one of her hands.
Their daughter was in this state, possibly facing a life-threatening situation. What parent could remain calm?
"Based on our latest test results, we’ve deduced that your child likely has Hereditary Angioedema, which can manifest after exposure to certain triggers," Liu Banxia said.
Seeing the patient’s father about to speak, Liu Banxia gestured with his hand. "Please, let me explain first. Currently, your child doesn’t need any other medications or treatments. Giving her some pain relief medication should help her improve over the next few hours."
"Really?" The patient’s father couldn’t resist asking.
Liu Banxia nodded. "Yes, it’s a hereditary disease, a congenital defect. However, with precautions in daily life, it won’t cause much trouble."
"She needs to strengthen her immunity, consume more vegetables, and exercise more. Try to avoid injuries. If she does get hurt, immediate wound debridement is necessary."
"Keep some iodophor solution at home for minor wounds; larger ones will require hospital debridement. Also, be careful about bumps and bruises. If you notice swelling anywhere on her body—whether it’s her head, hands, feet, or one side of a limb—you must pay close attention."
"It’s best to go to the nearest hospital. Explain her condition clearly to the attending physician. If her head starts to swell as it did today, you’ll need to proactively arrange for airway protection or plasma exchange."
"This disease commonly occurs during puberty, and its impact tends to lessen with age. As long as she’s careful, it shouldn’t affect her future life."
"Oh? Yes, when Xiao Yu was little, her wounds would swell up quite a bit," the patient’s mother chimed in.
"We’re currently conducting the final confirmatory tests. Even if it’s confirmed, don’t worry too much. As long as we are careful and can prevent the risk of suffocation from laryngeal edema, that’s already a great success."
The couple was a bit overwhelmed by the amount of information Liu Banxia provided. But they were also very happy now. Their daughter was going to be okay—that was what they could be sure of at this moment.
As Liu Banxia went out, the young man looked at him gratefully. Liu Banxia responded with a nod and a smile.
The young couple seemed to have a good relationship. Whatever the reason for this incident, they just needed to avoid it in the future.
"Banxia, we should get you an MRI. I really want to see how your brain is wired," Xu Hui remarked with feeling.
Liu Banxia rolled his eyes. "It was from a book I casually flipped through when we diagnosed that case of acute intermittent porphyria. The interns were discussing it back then too."
"I just didn’t pay close attention. Who would’ve thought we’d actually encounter a patient like this? If I’d remembered earlier, I might have opted for plasma exchange."
"This disease is highly misleading. It’s natural to associate it with allergic symptoms, and once it manifests, it makes it difficult for the patient to describe what’s happening."
"Our case is even more unique. Who would’ve thought it was triggered by birth control pills? Kids these days lack common sense about this. It says ’emergency,’ but they still take it like a regular medication."
"Access is easier now, but the dissemination of related knowledge hasn’t kept up. Using condoms is much better—safe and reliable. After all, every medicine has its side effects."
Xu Hui looked at him, somewhat helpless. This really wasn’t something doctors could control.
They’re readily available in every pharmacy and adult store. And pharmacies are everywhere these days. Buying medicine? It’s just too easy. Otherwise, we wouldn’t have such rampant antibiotic overuse.
Liu Banxia was in a genuinely good mood now. The most severe symptom of this disease is laryngeal edema. It could be said that once her airway was protected, the girl was essentially saved.
It’s just that he didn’t know it at the time, so he’d been worried sick.
What truly pleased him wasn’t just that, but diagnosing this disease as it progressed. This illness is incredibly deceptive; many people only receive a definitive diagnosis after many years.
Just as he’d said, its onset resembles an allergic reaction. If an episode isn’t severe—unlike this patient’s case today—and only involves limb swelling, it might resolve on its own after some time or with an IV drip.
What would happen then? Both doctors and patients would likely assume it was an allergic reaction.
Only in cases like this girl’s, where symptoms triggered by endogenous factors are so severe, would it be different.
That’s the frightening thing about rare diseases: they can be overlooked not only by patients but also by doctors.
"Teacher Liu, we can confirm the diagnosis now."
Liu Banxia was drinking water infused with goji berries and astragalus root when Xu Yino came running in excitedly.
DING!
Task: Girl with Swollen Head completed.
Reward: 300 Experience Points, 200 Diagnostics Skill Proficiency Points.
Liu Banxia stretched languidly. "From now on, if we encounter such patients, we’ll at least consider this possibility. But even if we do, it doesn’t help much since there’s currently no medication to treat it."
"Some treatments exist abroad, but they haven’t been introduced here yet. Hopefully, some will be in the future. But there’s no need to be overly concerned; it’s a rare disease, after all."
"This incident also reminds us that one’s own immunity is crucial. You all must maintain a proper diet and get appropriate exercise."
"Teacher Liu, are you going to treat us to extra dishes?" Xu Yino asked with a grin.
"All you know is how to tease me! Even a landlord doesn’t have endless surplus grain!" Liu Banxia shot her a look.
Just then, the young man’s parents arrived. A nurse informed them, and they headed straight for the ward.
"It seems I’ll need to put more effort into studying rare diseases in the future, or you’ll leave me too far behind," Xu Hui chimed in again, approaching him.
"No, no, please don’t," Liu Banxia said. "You should just continue forging ahead on the conventional path."
"I only saw it when I was casually flipping through some books. We haven’t encountered a case like this at our Second Affiliated Hospital in all these years, have we? Hmm... then again, perhaps we have, and it just slipped through the cracks." 𝕗𝚛𝚎𝚎𝐰𝗲𝗯𝗻𝚘𝚟𝚎𝗹.𝕔𝐨𝕞
"That’s why I admire you. You remembered it just from a glance," Xu Hui said.
"Otherwise, we might have had to wait for the patient to recover and still wouldn’t have been able to make an accurate diagnosis. Even if we gave preventive advice, there would always be some regret."
"I’ll take that as a compliment from you, and I accept it wholeheartedly," Liu Banxia said with a grin.
Xu Hui rolled his eyes at him. Although he admired him, he couldn’t stand his smugness.
Liu Banxia felt a wave of emotion. He really had to thank the system.
With the Dream Space, he had more opportunities for hands-on practice. His improved mental state allowed him to make better use of fragmented moments.
If it were his old self, he would surely have forgotten it after flipping through the book, treating it as mere trivia at best. Even if he encountered such a patient, he wouldn’t have expected himself to recall it.
The system’s enhancement was comprehensive. Compared to his past self, he was now stronger by leaps and bounds.
Even if he hadn’t reached the heavens yet, he was at least in the process of soaring. And his past self? He wasn’t even on solid ground; he was in a pit, at the very bottom layer.
That was the power of Diagnostics; it allowed him to connect many disparate pieces of information to diagnose illnesses.
After these satisfying thoughts, he began to exercise his "authority" as chief resident, taking charge of supervision.
Use it or lose it, as they say. Besides, these interns needed more opportunities to practice.
