"President Liu, not spending your day in the operating room today?" Peng Bo, the attending neurologist called for a consult, joked.
"If I stay in the operating room any longer, I’ll be out of breath. Her electromyography was just completed; she has a severe B12 deficiency," Liu Banxia said, handing over the electromyography report.
At first, Peng Bo didn’t pay much attention. However, after reading the electromyography report, his eyebrows furrowed. The report indicated peripheral neurogenic damage, representing a lesion in the patient’s spinal cord.
Combined with Liu Banxia’s ntion of B12 deficiency, he also thought of a possible diagnosis.
"If it is, this would likely be the first case in Binhai City. However, a spinal cord MRI is still necessary. Have you contacted the patient’s family? What was her reason for seeking treatnt?" Peng Bo asked.
"She ca in for diarrhea and fell after reaching the waiting hall," Liu Banxia said.
"Based on the intelligence our interns gathered, the patient has been frequently partying with friends during this sumr vacation. That’s probably the long and short of it."
At this mont, Liu Banxia felt soone tugging at his sleeve. Turning around, he saw Qing Kewa. Behind her, Liang Xiaolin and the others were also looking their way.
"Xu Yino, take the patient to an internal dicine consultation room. I need to talk with her," Liu Banxia instructed.
Xu Yino nodded obediently and, regardless of what the patient might think, quickly wheeled her into the room.
"To avoid making the patient nervous, it’s better if you go in and talk to her," Wang Huan said.
Liu Banxia nodded, walked into the consultation room, and sat directly across from the patient.
"Doctor, what’s going on?" The patient had clearly sensed sothing was amiss.
"Tell the truth, have you been habitually inhaling nitrous oxide? This will help with your diagnosis," Liu Banxia asked directly.
The young woman flinched, her gaze flickering away. Although she hadn’t answered, Liu Banxia was quite certain.
"Nitrous oxide... in recent years, many young people in our country have started using it. While it doesn’t have the sa strong addictive properties as other drugs, it can still endanger the user’s life," Liu Banxia explained.
"Currently, you’re suffering from severe anemia and peripheral nerve damage. If this progresses, it could lead to permanent spinal cord injury, resulting in quadriplegia, incontinence, and ultimately, it could be life-threatening.
"Moreover, once the spinal cord injury reaches a certain level, it becos irreversible. This ans there’s a high probability you’ll spend the rest of your life in a wheelchair, requiring a full-ti caregiver.
"Unlike vitamin B12 deficiency caused by other diseases, the effects of nitrous oxide can persist for up to two months. Moreover, this sudden, rapid depletion of vitamin B12 will also cause your body to react abnormally.
"We still don’t know the extent of the damage nitrous oxide has caused to you and your spinal cord. The next step is a spinal cord MRI.
"You might think I’m fearmongering to scare you. But the reflexes in your feet and hands are already much weaker, and your feet are numb. You can look it up online yourself to see if what I’m saying is true or false."
"Doctor, don’t they say that only happens to people who inhale hundreds of canisters at a ti?" the patient asked guiltily.
"Have you forgotten what I just said? The effects can last for two months. Besides, everyone’s body is different, and tolerance to this substance varies," Liu Banxia said.
"You’re an adult now, so we can choose to keep this from your parents. However, you must take responsibility for your own life, and you need to be hospitalized for treatnt now.
"Also, your friends, the ones you often hang out with—it would be best to advise them to get checked at a hospital too. It doesn’t have to be our hospital; any hospital will do. They should go to the Neurology Departnt.
"If they feel any numbness in their limbs, or if their hands and feet are less agile, they should definitely get an examination. That’s all I can say. Your body and your life are your own; the choice is yours."
Young people tend to be rebellious, and she had already undergone nurous examinations at the hospital today. If her legs hadn’t felt so weak, she would have certainly left right after her IV drip finished. But Liu Banxia’s words had genuinely frightened her. She felt it most clearly today: her feet were incredibly numb.
The following steps were straightforward: an MRI scan, and then Peng Bo admitted her directly to the neurology inpatient ward. They were better equipped to treat this condition; the current Ergency Departnt wasn’t up to par yet.
"Dr. Liu, what exactly is this illness?" Liu Yiqing asked after everything was settled.
"It’s the infamous nitrous oxide, dinitrogen monoxide. Because it’s widely used, it’s very easy to obtain outside," Liu Banxia said.
"It used to be very popular in European and Arican countries, and now it has spread to our country. Young people don’t know any better, and once they get into it, they’re done for. I’m warning all of you: no matter how tired you are, you must not touch this kind of thing. I don’t care if you pick up smoking or drinking, but these things are absolutely off-limits."
"Nitrous oxide? We have that in Binhai City too?" Liang Xiaolin asked in surprise.
"Of course, we do. It’s just not very widespread at the mont," Liu Banxia said.
"It’s just that there isn’t a clear classification for it yet, so the controls aren’t that strict. Or perhaps it hasn’t drawn enough attention."
"And looking at her, she’s clearly been inhaling it for so ti. I just don’t know how many of her friends are involved. We might see a batch of these cases erge this sumr."
"Dr. Liu, I’ve tried it before too. Does that count as a mistake? It was two years ago," Qing Kewa asked, raising her hand timidly.
Liu Banxia glanced at her and shook his head helplessly. "You don’t count. You folks over there have always played pretty wild. How could I have managed you back then? Just don’t touch this ssy stuff from now on."
Qing Kewa nodded happily; she hadn’t made a mistake and wouldn’t in the future.
"Wang Chao, you and Brother Wang go eat first. I’ll stay here and supervise them," Liu Banxia continued.
Wang Chao nodded. He knew that Su Wenhao, though his intern, was now generally following Liu Banxia. He didn’t mind; Liu Banxia could give them more hands-on opportunities, sothing he himself lacked the courage for.
"Dr. Liu, when did you realize sothing was wrong? Hmm... that it might be related to nitrous oxide?" Liu Yiqing asked curiously.
"It was also the discovery of the severe B12 deficiency. I’d seen reports in so journals, but I just thought this kind of thing was still far removed from us," Liu Banxia said casually.
"Anyway, it’s best to avoid bad habits altogether. Especially for us in the dical field. I rarely even drink alcohol. Only when I truly have nothing to worry about, I might have so beer at most."
"Teacher Liu, are we drinking tomorrow then?" Xu Yino asked.
"If you want to drink, then drink. But don’t expect to arrange a huge banquet. This is coming out of my own pocket, a reward for your performance during this period," Liu Banxia said with a smile.
"Actually, this is the first ti I’m eating at such a nice hotel. It’s only because I know Qiaoqiao that I can get so sort of discount. I’ll formally introduce you all then. Liang Xiaolin and Qing Kewa get along quite well with her."
"Brother Liu, so you an you’re going to stand my dad up again?" Qiu Mingyuan, who had been listening nearby for a while, said helplessly.
"Ming Yuan, do you think this is my fault? How about this: I have to go to Qiaoqiao’s place today anyway, so I’ll try to go earlier. Then tonight, I’ll go to your place for so late-night supper, okay? Anyway, your dad can’t drink alcohol now," Liu Banxia said.
"Haha, that works! Then my task is complete. Otherwise, my dad asks every day," Qiu Mingyuan said gleefully.
"Dr. Liu, can you take and Linlin?" Qing Kewa raised her hand again.
"Sure, sure. You know Old Qiu anyway," Liu Banxia readily agreed.
"Oh, right, Xu Yino, rember later to call those two from Internal dicine—Cao Peng and Zhou Shangkai, right? Call them too. I’ve been so busy with you all that I forgot about them."
"Okay, leave it to !" Xu Yino nodded cheerfully.
While they were chatting, Liu Banxia received a text ssage from Peng Bo. It was confird: the spinal cord MRI had already revealed the characteristic V-shaped lesion.
This essentially confird the three key elents for diagnosing the sequelae of nitrous oxide inhalation: B12 deficiency, distal limb paresthesia, and the characteristic V-shaped lesion in the spinal cord.
DING! Daily Task Completed (6/20)
Task: Patient with weak legs and trembling hands - Completed
Obtained: Experience Value 300 points, Diagnostic Skill Proficiency 200 points, Glory Points 2
Although the task was considered complete, the excess experience points were also consud. For him right now, experience was truly precious. The wonderful ti of leveling up with each surgery was probably gone for good.
He showed the ssage on his phone screen to the group. This served as the official confirmation of the diagnosis.
"Sigh... who knows how many more people like this there will be," Liang Xiaolin sighed.
"That’s why I said, what shouldn’t be touched, absolutely must not be touched. Just you watch, she’s probably a relatively mild case. There are definitely more severe ones out there," Liu Banxia said.
"She was more obviously affected because her constitution was already relatively poor, and she happened to have diarrhea this ti. If it were a normal person, would they even pay attention if they felt numbness in their hands and feet initially?"
"Sotis, you all need to do so public awareness work too. So people are rely curious, but this kind of curiosity is very dangerous. Like this patient just now, she also knew inhaling this stuff wasn’t good, but she still did it."
"The harm from excessive inhalation of these substances is actually greater than that of many controlled narcotics. Just wait and see; major hospitals will start seeing such patients one after another."
He wasn’t just talking nonsense. Considering the situation today, there were likely quite a few people involved with this. So might have already sought dical attention but hadn’t been diagnosed with the specific problem. If he hadn’t read similar reports himself, it would have been difficult to consider this possibility. After all, simple myelopathy and lesions caused by nitrous oxide inhalation still have so differences.
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