(Thanks to xmd11 for the support with the November tickets)
"What are you all following for?" Hearing the footsteps behind him, Liu Banxia asked with a smile.
"There must be good news; we can’t miss it," Xu Yino quickly responded.
The rest nodded in agreent. That was exactly it.
"Then let’s walk over slowly; we don’t want to scare anyone," Liu Banxia said seriously.
The interns collectively rolled their eyes.
You ran all this way and scared people already. And now you’re telling us not to? Are you blaming us?
"Let ask you a small question: why would the patient test positive for a copper allergy, yet we haven’t found any copper, and she’s still having a severe allergic reaction? What’s going on?" Liu Banxia asked, feigning seriousness.
The interns truly didn’t know what to say, but their hearts began to fill with anticipation.
This matter had been troubling Liu Banxia for the entire day. Could his playful deanor now signify that he had genuinely found the invisible copper?
"Doctor, did you find anything?" Seeing Liu Banxia and his group co in, the patient’s husband quickly asked.
"Try to recall carefully, has she suffered any external injuries in the past? Or perhaps been accidentally punctured by sothing?" Liu Banxia asked.
The patient’s husband shook his head. "She’s had injuries, yes, but they were mostly just scrapes or bumps. A puncture wound? Perhaps? Yes, I think so?"
"Here’s the situation. There’s an inconsistency in our current test results. Your wife tested positive for a copper allergy, but she hasn’t had any contact with copper, yet she’s experiencing continuous allergic reactions," Liu Banxia said after so thought.
"So I’m wondering if there’s a possibility that during an accidental injury in the past, the wound wasn’t cleaned thoroughly, resulting in copper being left inside?"
"If that’s the case, it would explain why we can’t find any copper, yet she’s still having an allergic reaction. To verify this, we need to perform an examination on the patient."
"Doctor, wh-what kind of examination are we talking about here?" the patient’s husband asked hesitantly.
"An X-ray. It’s the quickest, most convenient, and not very expensive. We’ve already done a chest CT, so we’ll start imaging from the abdominal cavity, then the pelvic cavity, legs, and arms," Liu Banxia said.
"The advantage of an X-ray is that if we’re lucky, we can get the images quickly. However, the radiation dose from an X-ray is relatively high and can harm the patient’s body. We could also do a CT scan, which is safer. If we choose X-rays, we can’t do them all at once; it would need to be done over a period. CT scans involve less radiation, and we might be able to save so ti with that approach."
"Is there no other way?" asked the patient’s husband.
Liu Banxia scratched his head. "This is indeed sothing we need to consider carefully. I just ca up with this possibility and got a bit excited."
"What if we borrow a tal detector from the train station and try that first? I just don’t know the principle behind those things. It’s possible that your wife only has a small piece of copper wire or sothing similar in her body, or if it’s an old childhood injury, it might have beco encapsulated by tissue over ti and might not be detectable."
This was the first ti he had encountered such a situation, and it was proving sowhat difficult to handle.
He was inspired by that little blade of grass; foreign objects could indeed unknowingly get into the body.
However, whether it’s an X-ray or a CT scan, both involve a certain degree of radiation. Such examinations would also be very taxing on the patient’s body.
If the radiation further weakens the patient’s immune system, could it trigger another allergic reaction?
At this mont, Xu Yino, standing beside him, tapped twice on his back.
"Teacher Liu, maybe you guys could discuss this outside? We can stay here with the patient and help her rember," Xu Yino suggested.
Liu Banxia glanced at her, nodded his head, then led the patient’s husband and Su Wenhao outside.
"Please don’t worry. We will definitely devise a thod that is most effective and causes the least harm to the patient," Liu Banxia said after they went outside.
"I’ll check with the police station later to see how sensitive their handheld tal detectors are. Perhaps we can use that little gadget to determine the location, and then we can perform a targeted X-ray or CT scan for precise localization."
The patient’s husband asked, "Sigh... this is so worrying. If we do the tests, it’s bad for her body. If we don’t, we’ll never know what the problem is. Doctor, how likely do you think it is that there’s copper in her body?"
"If it’s not because of this, then it could only be that the patient has other allergens or so other autoimmune disease," Liu Banxia said after so thought.
"However, based on the current situation, it appears to be a normal allergic reaction, and all these items in the hospital room are also on the allergen screening list."
"Teacher Liu, a bedside ultrasound will do!" Xu Yino walked out, beaming.
"Did the patient recall an injury?" Liu Banxia asked, surprised.
Xu Yino shook her head and glanced at the patient’s husband. "The patient said she had an IUD inserted. That’s the only thing external to her body she could think of."
"An IUD, an IUD? Yes, yes, that’s it, that’s it! Many IUDs are copper-bearing!" Liu Banxia muttered to himself before exclaiming with great joy.
This was the missing copper; it had been in the patient’s body all along.
DING! Mission: The Missing Copper - Completed.
Received 100 Experience Points, 100 Diagnostic Skill Proficiency Points, 3 Glory Points.
The patient’s husband sighed.
"It’s my fault. If it’s because of this, it’s all my fault." Seeing Liu Banxia look over, the patient’s husband squatted on the ground.
"Sir, what’s wrong?" Liu Banxia also squatted down beside him.
"I used to really want a boy, but we ended up having two daughters in a row. My job got ssed up, and we had to pay fines. Back then, I was obsessed, still wanting to try for a son," the patient’s husband said.
"I didn’t even know she had an IUD inserted. It’s been so many years. If she had told earlier, we could have taken it out, and she wouldn’t have had to suffer like this. It’s my fault."
As the patient’s husband spoke, his eyes reddened.
Liu Banxia patted his shoulder. "These are things of the past; let’s not dwell on them for now. I’ll find a gynecologist right away. We’ll remove it directly and see what the situation is."
"You have two children in your family; that’s a blessing. You can’t always look at the past; you have to look towards the future too. Go in and keep your wife company for a while. She’s probably feeling lonely right now and needs soone with her."
The patient’s husband nodded, wiped his tears, and went inside.
"Little Xu, you did very well. Tell , how did you figure it out?" Liu Banxia looked at Xu Yino.
"I just saw that the patient’s wife seed to have sothing she wanted to say but was hesitant. So I thought I’d give it a try," Xu Yino said, looking pleased with herself.
"Teacher Liu, are you saying it’s really the IUD causing this? Wouldn’t that an many people could potentially develop a copper allergy? Could it be very dangerous?"
"Not necessarily, and the use of IUDs is less common now," Liu Banxia shook his head.
"The reason this has beco such a big ordeal is also due to my lack of experience. Otherwise, I should have asked about it when the copper allergy was first detected. It’s just that this kind of thing is too rarely encountered in our daily work."
"Since you’re the one who discovered it, the patient is your responsibility now. Call a gynecologist over and book an operating room. Hopefully, this is indeed the cause of the allergic reaction, and she’ll be fine after this."
Xu Yino nodded happily and quickly began making the arrangents.
This was the most gratifying part of the diagnostic process; that feeling of sudden clarity was truly wonderful.
"Looks like it’s resolved? Tell , what was the allergy?" As Liu Banxia and the others returned to the ergency hall, Xu Hui asked impatiently.
"The patient had an IUD inserted many years ago," Liu Banxia explained.
"Damn it! How did I not think of that?" Xu Hui imdiately cursed.
The interns all looked at him with amusent; his reaction seed quite similar to Teacher Liu’s earlier one.
"Sigh, it’s a lesson learned from inexperience. Only the patient knew about this. Even when she told Xu Yino, she didn’t know the IUD contained copper," Liu Banxia patted his shoulder.
"Didn’t we ntion during our chat, about them wanting a boy and all? Actually, it’s not so bad; they have two daughters at ho. That’s why the patient secretly got the IUD."
"After all these years, she herself hadn’t given it much thought. Fortunately, she rembered. Otherwise, I wouldn’t have known how to proceed with the examination. Too many tests, and the patient wouldn’t be able to endure it."
Xu Hui nodded. "It’s true that people used to get IUDs more often; it’s less common now. A major oversight, a major oversight. I should have thought of it much earlier."
"nding the fold after the sheep is lost isn’t too late. How about adding a chicken leg for us?" Liu Banxia said, seemingly casually.
"If we’re adding, it should be for them. What does it have to do with you? Add chicken legs? We absolutely must add them," Xu Hui said.
This patient’s situation was resolved, and a heavy stone was lifted from his heart. This was truly sothing to be happy about.
"Sigh... I was extorted quite a bit by them in the OR. When I ca back, I originally wanted to cadge one, but didn’t manage to," Liu Banxia said with a sigh.
"Well, look at you, always on guard," Xu Hui said, pleased with himself.
"How did you think of copper being inside the body? I didn’t even think of that. Actually, I had already started to consider new allergens; otherwise, I really would have been out of options."
"It was probably the inspiration from that little blade of grass. Who would have thought there could be a blade of grass in the lungs? So, it’s also possible for there to be copper in the body," Liu Banxia said.
"Sotis it’s not necessarily about the quantity. Even a tiny amount, if the patient’s immunity is low, can trigger a reaction."
"We often encounter this during debrident. Small wooden splinters, tiny grains of sand – these are all caused by incomplete debrident after an injury. Then it leads to suppuration, and we can only incise, drain, and debride."
Xu Hui nodded; indeed, that was the case.
No matter what, this patient should be fine now.
Once the allergen is removed, the next step is antiviral treatnt. It’s just a matter of ti before she can be discharged smoothly from the hospital.
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