The Enhanced Doctor-Chapter 806: Vertigo or Syncope?

"President Liu, given the patient's current condition, these tests don't show much. All we can do for now is admit them and run a dynamic EEG to take a closer look."

Peng Bo said after examining.

"We've dealt with similar patients before, and often the first place we suspect is the head. If the dynamic EEG doesn't show anything, we'll look into other tests."

"It might also be narcolepsy, or an intracranial infection caused by another pathogen. If we hadn't done so many tests and the patient's vital signs weren't stable, we should actually be considering a lumbar puncture."

Liu Banxia nodded, "I've been hesitating about whether to proceed with it. Technically, it should be done, but a lumbar puncture is invasive, and the patient's vital signs are currently stable."

"Then let's follow your suggestion and observe first. If there are no symptoms after 24 hours of observation, we can perform the lumbar puncture. Meanwhile, if anything can be traced, the patient can take some rest now."

"President Liu, the echocardiogram seems to rule out cardiogenic vertigo. Could it be cervical vertebra issues instead?" Peng Bo asked.

"I doubt it, because when I examined her cervical vertebra manually, she didn't express any discomfort. Moreover, the joints in her cervical vertebra felt fine," Liu Banxia replied.

"Alright, let's stick with my suggestion and proceed with a dynamic EEG," Peng Bo decided.

Had it been someone else claiming nothing was wrong based on a manual cervical exam, Peng Bo would definitely have called for a cervical CT.

Though many cases of cardiogenic vertigo are misdiagnosed as cervical problems, it doesn't mean that none of the patients suffer from cerebral insufficiency caused by cervical issues.

Others might not detect it, but Liu Banxia can. His skills in orthopedic manipulation are strong; otherwise, would Director Xu from orthopedics favor him so much?

Also, people with cervical issues often experience neck pain. The patient doesn't, and with Liu Banxia's manual examination, it's ruled out.

"Doctor, what's wrong with Nana?"

Just as they stepped out, the boyfriend, holding the patient's hand by the bed, rushed over.

Leaving everything else aside, his boyfriend power is absolutely MAX. Among countless patients Liu Banxia has treated, this is the first time seeing a boyfriend so worried.

No wonder Xu Yino also looked a bit anxious. Any girl would probably like someone like this.

"Currently, we can rule out significant organic brain lesions and some heart-related diseases, but the patient's vertigo symptoms still need our attention," Liu Banxia said.

"Our current plan is to admit the patient and conduct a dynamic EEG for constant monitoring. If there's any variation, it will give us direction."

"Alright, let's get admitted. Should I go downstairs to handle the paperwork?" the patient's boyfriend asked.

"Yes, please. Take her to the neurology ward first. We'll also need to learn more about the patient's condition, see if we can identify any vertigo triggers,"

"Thank you, doctor. I'll go handle the paperwork now," the patient's boyfriend said, rushing back to the bedside.

"Nana, don't worry. We're here to get you treated. The doctors mentioned it's serious, and it really is. I'll stay with you in the hospital."

"It's not necessary. I'm feeling fine now. My head doesn't spin anymore, and my arm doesn't hurt," the patient said.

"Be good, listen. If anything happens to you, what am I supposed to do?" the patient's boyfriend said.

The patient thought for a moment and nodded.

"Alright, since you're stable now. Shen Lin, please help bring her to the ward, and we'll be there shortly," Liu Banxia called out.

"Okay," Shen Lin responded.

"Teacher Liu, are there any other conditions we should consider?" Xu Yino curiously asked.

"We can't speculate randomly now; all current tests are normal, so what's there to suspect?" Liu Banxia said with a wry smile.

"So we can only observe and gradually rule things out. Doctor Peng and I both lean towards a neurological issue, which is the hardest to examine."

"Currently, we can track it with EEG, and if it doesn't reveal any change, we'll have to consider a lumbar puncture. The indications are just not clear enough, not even a white blood cell count increase."

Xu Yino nodded, not unfamiliar with the topic, but she instinctively believed Liu Banxia could work miracles.

This time, Liu Banxia really couldn't perform a miracle. Some conditions require dynamic EEG and dynamic ECG, which are crucial diagnostic tools.

Internally, he still suspects a cardiogenic cause and considers additional monitoring.

He isn't rushing to the ward to inquire directly, preferring to let the patient rest and clear his own mind.

Before inquiring about this patient, Liu Banxia returned to the ICU to check on the patient with necrotizing fasciitis.

Currently, within the ICU, his condition is the lightest of all, yet also the most severe.

"The patient with liver damage just received a critical prognosis notice. There's a sign of bile enzyme separation, bilirubin has slightly increased, and transaminase has slightly decreased," Zhang Zhiyuan said.

"Do you estimate he can withstand it?" Liu Banxia asked.

"It's uncertain, just depends on the patient. Many times, our methods are merely auxiliary; the patient himself is the most crucial," Zhang Zhiyuan replied.

"Let's observe, a liver transplant is definitely off the table. Let's not even mention the donor; they can't afford the cost either. Keep persisting, tonight is critical." 𝑓𝘳𝑒𝑒𝓌𝘦𝘣𝘯ℴ𝑣𝘦𝑙.𝘤𝑜𝑚

"The current situation of the patient with necrotizing fasciitis looks fine, indicators are stable, and no new abnormalities have been found on the skin; you must have cleaned it very thoroughly."

"That's why I'm frustrated; the patients admitted in the last couple of days have all been quite challenging, either requiring manual labor or brainwork," Liu Banxia grumbled.

"Just admitted a patient with unexplained dizziness, not due to ear stones nor intracranial organic lesions. We'll investigate gradually. How's that girl's situation?"

"Currently seems fine as well; her spirits have improved significantly. Should we transfer her back now? I see no major issues; she'll be fine with more attention and rest in the ward."

"Let her stay one more night; only her father came over. There's also a friend, but they are not very convenient for care. Let her recover a bit more; if there's any situation, at least she can press the button herself," Liu Banxia said.

"Actually, recovery is adequate now; she can't do big movements, but small ones are fine. However, nursing care should be more attentive; her mother should be called over, or perhaps a professional caregiver could be arranged, for she will need service over the next few days," Zhang Zhiyuan added.

Liu Banxia nodded, needing to discuss this situation with the patient's father. After all, caregivers cost money, and the nature of the relationship between the patient and her friend isn't clear; taking care of someone is not easy.

After finishing in the ICU, he moved on to the ward.

The patient here had finished with the electrodes, and her boyfriend was sitting on the bed, holding her hand and whispering softly.

"Sit down."

Seeing the patient's boyfriend about to stand up, Liu Banxia gestured for him to remain seated.

"Her situation is special, so first admit her, then conduct a detailed diagnosis to avoid delaying the dynamic EEG test. What are the usual dizziness symptoms? Is it vertigo, where the world spins around, or sudden blackouts?"

"Uh... Doctor, is there a difference?" The patient hesitated before asking.

"Of course there's a difference. The spinning type can be classified as vertigo, which has an ongoing development process. Sudden blackouts resemble fainting, happening 'snap' just like that," Liu Banxia replied with a smile.

"Uh... seems, seems like it's just a moment of dizziness, and then I passed out. Used to wake up immediately, but this time, it's lasted longer," the patient recalled.

"I think I shouldn't have any major issues, just pay more attention in the future. I'm just like usual now, with no other unusual feelings."

"Nana, let's listen to the doctor, and follow what they recommend for the examination," the patient's boyfriend chimed in.

Liu Banxia felt a bit troubled, as this scenario leaned towards fainting. Nonetheless, he needed more precise differentiation based on the patient's current descriptions.

Because patients often have misconceptions; in reality, they may have been unconscious for seconds, but it may seem fast or slow to them subjectively.

"During previous fainting spells, did you experience any palpitations, increased heartbeat, or feelings of chest tightness and shortness of breath?" Liu Banxia continued to ask.

"Uh... Seems a bit anxious, like I couldn't catch my breath," the patient recalled.

Liu Banxia furrowed his brow, "Let's conduct a dynamic ECG; symptoms like yours seem related to heart or brain function issues."

"We've done an echocardiogram, and it generally suggests no heart organic lesions, but we must exclude other factors, in case there's something hidden we haven't detected."

"Go ahead, doctor, do I need to pay extra?" The patient's boyfriend asked.

"No, just deduct it from the hospital deposit; it's not much," Liu Banxia answered.

"Doctor, what about food and drink? Are there any requirements?" The patient's boyfriend further queried.

Liu Banxia shook his head, "Just maintain your usual lifestyle for now; there's no dietary requirement currently, as we're still in the observation phase."

"If you plan on staying overnight for bedside care, communicate with the other people in the ward, as it's a room full of female patients," Liu Banxia advised.

The patient's boyfriend nodded, this time less enthusiastic than about other matters.