The Enhanced Doctor-Chapter 831: Symptoms Misdiagnosed

Rou is suffering from a very serious illness, and that's why Bao Chunlai and his wife are going through a tough time.

But what is the situation now? This young doctor actually laughed when he saw his daughter sleeping.

"Teacher Liu, have you found the direction for the diagnosis?" Xu Yino asked.

It was her question that turned the couple, who were on the verge of losing control, into well-behaved listeners.

"It proves that many times symptoms can be quite varied. Luckily, we came up for a closer look, otherwise, Rou would have suffered more," Liu Banxia said, not even noticing the reaction of the couple behind him.

"Look carefully, based on Rou's current condition, what symptoms do you see? Go through it from the beginning, such teaching opportunities are rare."

"Afraid of washing face and hair, anemia, mental disorders, multiple lung necrosis, ear canal infection, hmm..., and Rou's sleeping posture?" Liu Yiqing asked.

"Hmm..., not bad, so now, explain the possible causes for these symptoms," Liu Banxia nodded.

The two girls were a bit dumbfounded. What could be the possible causes? Haven't we discussed these already? But since Liu Banxia asked, they had to answer. Seeing his current demeanor, he must have discovered some problem.

"The reason for being afraid of washing face and hair is temporarily unknown, anemia may be caused by malnutrition due to mental disorders. Mental disorders are temporarily unknown, multiple lung necrosis is currently undergoing pathology," Xu Yino said, giving Liu Yiqing a look.

"The ear canal infection should have been caused by struggling too much while washing hair, and due to mental disorders, further treatment couldn't be done. Also, the rash on the scalp is the reason for not washing hair. The sleeping posture, hmm..., sleeping uncomfortably?" Liu Yiqing's final explanation was tentative.

Liu Banxia nodded, "It's the same as my initial consideration. Due to our limited thinking, it caused some degree of misleading."

"These symptoms currently present, if there is some degree of correlation between them, then can we, after comprehensive consideration, arrive at a rough inference of the illness?"

"Let's talk about these unexplained situations first. Chairman Bao, you and your wife listen along too, then you don't need to worry about Rou."

Bao Chunlai and his wife quickly nodded, unable to hide their excitement on their faces.

"Firstly, this schizophrenia, this accurate inference, it should have been provided when you were seeking medical advice in the United States, right?" Liu Banxia asked.

Bao Chunlai nodded again, "We were also diagnosed in the United States for over a month. The final result was idiopathic schizophrenia."

"So, sometimes, you don't necessarily have to think their medical skills are so good. Many times, they really might not care much about the patient," Liu Banxia said.

"In medical terms, we often label a disease with unknown cause as idiopathic. This represents something we cannot understand or figure out. So, I think Rou's schizophrenia should now be more accurately called 'mental disorder.'"

"Because she doesn't exhibit that many significant signs of schizophrenia, it could also be an error in translation between Western and Chinese medicine."

"As I mentioned earlier, we can categorize the symptoms of the mental disorder as one of the symptoms of a certain disease. What about the ear canal infection? Was it really only caused by water entering during a bath?"

"This conclusion was formed after we heard your description—misguidedly assuming it. Later information updated, she wasn't attending school locally, but abroad."

"Is there a possibility that there was already some degree of infection within the ear canal initially, which went unnoticed at the time? Then, subsequent water entry led us to mistakenly believe the infection was caused by water entry?"

"Okay, if that's the case, then we can link the ear canal infection as one of the symptoms, similar to multiple lung necrosis, adding up to three symptoms, right?"

"Teacher Liu, then why not wash hair or bathe?" Xu Yino was getting a little impatient.

"It's very simple. This is a natural protective instinct, similar to Rou's current sleeping posture," Liu Banxia said.

"Although Rou is slightly mentally disordered now, her body's instincts are still there. She knows washing and bathing might let water into her ear canal, making her ears more uncomfortable, so she resists heavily."

"Her unique sleeping posture is due to discomfort in her limbs. Covering her face while sleeping is an instinctive defense against someone washing her face or hair, or owing to discomfort caused by the ear canal infection."

"Also, because of not washing her hair later on, it led us to mistakenly believe the scalp rash was caused by it. What if these rashes are also one of the symptoms?"

"So next, can we summarize the symptoms? Neurological disorders affecting peripheral nerves, lower respiratory tract involvement, ear canal infection, anemia, possible joint involvement, rashes—what could it be?"

"GPA"

"Granulomatosis with Polyangiitis" 𝑓𝑟𝑒𝘦𝓌𝑒𝑏𝑛𝑜𝘷𝑒𝘭.𝒸𝘰𝑚

Xu Yino and Liu Yiqing exclaimed in unison, their tone filled with excitement.

Their volume was somewhat high, waking up Rou from her sleep. Instead of being confused from waking, there was a twisted expression on her face.

"It's alright; we know what illness you have. Today, we will confirm and start medication," Liu Banxia tried to make his face appear kinder.

However, Rou didn't show him any courtesy, swinging a pillow at him. It was only when Liu Yiqing hugged her that her emotions calmed a bit.

Liu Banxia rubbed his nose, feeling helpless. He is the hospital's most popular doctor among patients, so why didn't it work today?

"Dr. Liu, Dr. Liu, can Rou's illness be treated?"

Bao Chunlai grabbed Liu Banxia's arm, gripping it with such force that it hurt a little.

Liu Banxia nodded, "We have actually treated a similar case before, a young patient, who is normal now. The cause of this disease still has no clear pathway; it is an immune system disease."

"However, the reason it wasn't diagnosed initially is because the main symptom should be mucosal damage. Especially the nasal mucosa, but our Rou doesn't show such symptoms."

"The neurological symptoms affect mostly peripheral nerves, rarely impacting the cranial nerves. Rou's ear canal infection might be another external manifestation of an upper respiratory tract infection."

"Liu Yiqing, collect blood again for slide observation. If confirmed, use methylprednisolone pulse therapy, 1 gram daily, switching to oral on the fourth day. Then perform a kidney function test to check for renal involvement."

"Okay." Liu Yiqing nodded happily.

"Dr. Liu, isn't there a need for other tests? Just a blood draw?" Rou's mother asked worriedly.

Liu Banxia nodded, "Blood collection for slides, plus our lab's targeted pathological tests, will suffice. Just wait for the results; they'll be out soon."

Indeed, even with another blood draw, Rou didn't resist at all. However, she kept giving a guarded look towards Liu Banxia, making him feel quite helpless.

"Dr. Liu, can you tell me more about this vasculitis? Once treated, will it recur?" Bao Chunlai asked as he pulled Liu Banxia to sit on the couch.

"Chairman Bao, it's not a matter of recurrence or not, but the current medical means only allow control and relief," Liu Banxia thought for a moment before saying.

"In Rou's future life, she needs to avoid excessive fatigue, reduce stress, and boost her immune function. But as long as she is careful, she can maintain a normal life, usually without much impact on life expectancy."

"Judging from the current situation, Rou's disease hasn't progressed too rapidly. Otherwise, she might already be facing kidney failure now, and that kind of damage is irreversible."

"Perhaps it's because Rou's basic physical condition was relatively good, the symptoms developed but not too swiftly. It's not very apparent in her body. She can get treated in our hospital for a while, then go home to recuperate."

"What about the mental disorder? Can it be treated together?" Bao Chunlai asked.

"Theoretically, it can, but I cannot give you an accurate answer right now. After a period of medication, the corresponding examination should be possible." Liu Banxia said.

He couldn't confidently promise anything, given Rou's symptoms being a bit atypical. Even with ordinary patients, he wouldn't make such guarantees, let alone someone as unique as Rou.

For Bao Chunlai, this wasn't what he wanted to hear. He seeks a cure, not lingering risks.

"Chairman Bao, autoimmune diseases relate to the immune system. The most common symptoms are hives, mild in manifestation, while granulomatosis with polyangiitis is more severe," Liu Banxia continued.

"However, with future vigilance and prevention, under your conditions, Rou should have a good life, just requires more attention."

Bao Chunlai nodded, barely accepting Liu Banxia's comfort. Considering his daughter's current condition, returning to normalcy is already quite good.

The only uncertainty now is the mental state, which worries him the most.

His current thought differs slightly from before, feeling he's brought his daughter here too late. If they came a few months earlier, surely, the result would be different.

This illness has been lingering for nearly a year; any disease dragged on for so long, becomes significant.

Very regretful, greatly self-reproaching.

Beside him, Liu Banxia noticed his inner conflict, yet couldn't find a way to console further.