noveltune Chapter 538 - 247: Lyme Disease, Making Plans
Chapter 538 - 247: Lyme Disease, Making Plans
"No, no, after you talked to him, his attitude has improved a lot. Now when I go to the bathroom or do other things, he doesn’t follow me anymore. Also, he’s cooperating more in his daughter’s treatment."
Dr. Shao Bing expressed his admiration and gratitude to Li Jingsheng when mentioning this matter.
"Not long after you left, the patient’s mother actively approached me and agreed to do the CSF test. Then I contacted someone I knew at Qiaobang Hospital. Since it was after hours, I waited a long time before they sent someone to do the lumbar puncture and then sent it for testing overnight. The results just came out, and as you expected, there was a major discovery."
Li Jingsheng was relieved to hear that the family agreed to the CSF test.
It seems that this difficult case can be figured out before tomorrow.
"What are the results? Send them to me to see."
"Sure! I’ve already sent it over. Eosinophils are greater than 5%, Cryptococcus, acid-fast bacillus, CSF bacterial smear culture are all negative. The possibility of acute meningitis is very high."
Dr. Shao Bing said excitedly.
"Let me look at the test results first, let’s chat on WeChat."
"Okay, okay! Thank you so much today, I’ll remember it for a lifetime."
Shao Bing said, his voice somewhat choked up.
It seemed his emotions were a bit out of control.
He quickly hung up the phone.
In recent days, first, the clinic was violently vandalized by family members, then he was forced to take the child everywhere for treatment.
He went to Qiaobang Hospital where he had worked before, only to witness the coldness of human society.
There was no progress in the child’s diagnosis either.
He expended money and effort, but the family was ungrateful, threatening him in various ways, and monitoring him twenty-four hours a day. The grievances and heartaches within, no one can truly understand.
At Dr. Shao Bing’s most desperate moment, Li Jingsheng, a doctor he had never met before, took a taxi in the middle of the night to help consult and achieved significant breakthroughs and progress. He even helped change the family’s attitude before leaving.
In Shao Bing’s mind, Li Jingsheng had long been considered a benefactor.
At this moment, with new breakthroughs and discoveries in the test results, he couldn’t help but be overwhelmed with joy and excitement.
It’s unimaginable how much grief and fear he must have suffered these days to make a nearly sixty-year-old man choke with emotion.
The family was exceedingly unreasonable.
Li Jingsheng carefully examined the CSF test results.
The tests from major hospitals are really detailed. Some results might have been repeated more than once.
From the test results, it supports the diagnosis of acute meningitis.
He pondered: bacterial meningitis? That can be directly ruled out.
Because the bacterial smear is negative, and bacterial meningitis usually has an acute onset with rapid progression. Severe meningeal irritation and lesions often occur within twenty-four hours, leading directly to mental confusion.
In earlier times when medical science wasn’t advanced, people might go mad in a day, and were thought to be possessed.
It could only be said that life wasn’t valued then.
With these difficult diseases, if they couldn’t be identified, they typically worsened with treatment, ending in death.
Viral meningitis? Protein is slightly elevated, sugar and chloride are normal, CSF bacterium is negative, seeming to align with the disease. But eosinophils are high, along with migratory erythema, and the patient had a bite a month ago.
Li Jingsheng believes it cannot be this disease.
Tuberculous meningitis has many similarities with this disease, but the elevated eosinophils can rule it out.
And the CSF didn’t show any purulent changes.
This further rules out tuberculous meningitis.
The remaining cryptococcal meningitis, the test results do not support.
That leaves only the last one, neuroborreliosis.
This is a rare infectious disease, usually occurring after a tick bite, leading to Lyme disease.
This disease was once prevalent in some remote areas.
For example, the region where Ou Qinglan’s hometown is located saw an outbreak in the fifties and sixties. Medicine was quite backward then and couldn’t identify it.
Until close to the eighties, around 1975, a superpower abroad first discovered the disease.
Later, as the technology spread, people began to know this disease, which is highly similar to meningitis, called Lyme disease.
With today’s level of medical technology, diagnosing this disease is easy; both serum and CSF tests can confirm it.
"I believe it’s possible it is Lyme disease!"
Li Jingsheng sent a message.
"Ah..."
Shao Bing seemed very surprised; he should be trying hard to diagnose which type of meningitis it is.
He didn’t expect Li Jingsheng to have a diagnostic conclusion so quickly.
And it’s a rare infectious disease.
"Let me explain my diagnostic approach and basis: the patient has migratory erythema, was bitten by a mosquito-like creature a month ago, developing a red bump. Then nausea, vomiting, neck stiffness, facial paralysis, delirium, lymphadenopathy, mild fever—these symptoms all align with this disease. The slow onset also matches."
Li Jingsheng laid out his diagnostic basis.
Actually, it is already quite sufficient.
"It seems to really be the disease you diagnosed, but it can be treated with ceftriaxone. Why didn’t I see any effect when I used it?"
Shao Bing’s reaction was swift.
His solid medical foundation was evident.
Once he heard of this disease, he immediately thought of the corresponding medication plan.
"There are three possibilities: first, you are using counterfeit or expired drugs."
Li Jingsheng began analyzing the reasons for him.
If unfamiliar, one generally wouldn’t dare say this, fearing a backlash.
They all run clinics, so naturally understand that when sourcing drugs, unreliable pharmaceutical companies might provide counterfeit ones.
For instance, Litong Pharmaceutical he cooperated with before sold many small factory imitations of big brands.
Some were about to expire as well.
Litong Pharmaceutical, at least, counts as an official pharmaceutical company; selling counterfeit drugs boldly hasn’t happened over there.
Whether Dr. Shao Bing’s drugs are counterfeit is unclear.
"Second, short treatment duration. You just used it once and changed medication the next day. In theory, when treating this disease with ceftriaxone, the second day should show some effect. But you likely panicked at the time, not noticing the changes in the patient."
Li Jingsheng provided the second possibility in his analysis.
This could indeed be possible.
"Third, the patient has a unique physique that poorly absorbs this drug."
This situation exists but is rare.
Major hospitals encountering such patients would usually try changing medication or combining medications.
Small clinics or hospitals facing this, whoever encounters it is truly unlucky.
Doctors can easily confuse themselves.
After Li Jingsheng analyzed three causes for him, Dr. Shao Bing didn’t reply, probably lost in thought.
About twenty minutes passed, and he had already fallen asleep.
A message came in from the other end, saying Dr. Shao had fainted during the conversation with you. I’m a former student of Dr. Shao and have already informed our superior about your diagnostic approach.
In a daze, Li Jingsheng received such a reply.
He felt a bit puzzled.
"Okay, I will visit Dr. Shao tomorrow. Thank you! If you really want to help Dr. Shao, push for the little girl’s diagnosis and treatment as soon as possible!"
After responding, Li Jingsheng didn’t dwell on it further.
He had to get some sleep quickly.
Tomorrow he’ll be on clinic duty at the hospital; it will be an incredibly busy day.
He also promised to perform that osteoblastoma removal surgery with Professor Wu at noon.
He’d be the chief surgeon at that time.
He definitely needed to be well-rested.
...
The next day, it’s not worth mentioning that Li Jingsheng went to work at the Second Hospital as usual.
Monday was approaching, and he needed to visit People’s Hospital to settle the operating room equipment issues.
It’s indeed been too busy lately.
But he enjoyed these busy and fulfilling days.
Every day, he rapidly advanced, with his skills improving quickly.
This busyness made a day blink past. He didn’t even have much time to meet with Ou Qinglan at noon, but he brought her into the operating room, progressing together.
She showed high talent in delicate surgeries like suturing and knotting.
Li Jingsheng thought that if she could solidify her fundamental skills, she could move towards minimally invasive and endoscopic surgery in the future.
Micro-surgery is gradually becoming the mainstream trend for future surgeries.
It was nothing unusual that both husband and wife worked in orthopedic surgery.
On the contrary, it was quite good.
They could look after each other.
Approaching the end of the day, Ruan Xiaoqin waited at the outpatient clinic with a beaming face.
"Dr. Li, that patient with the swollen thumb no longer demands to hit me and even apologized to me."
"That’s great! You fulfilled your responsibility, after all."
Li Jingsheng responded with a smile.
"Could you honor me with a meal? At work, I always ask for your help, and I truly feel bad about it. I’ve long wanted to treat you to a meal and toast to you."
Ruan Xiaoqin sincerely invited him.
"I really am not refusing you, someone offering a free meal makes me happy. Just that I truly have something today, maybe another day! I accept your goodwill."
Li Jingsheng was going to visit Dr. Shao Bing at Qiaobang Hospital after work today.
This Dr. Shao was quite pitiful, indeed a bit unlucky.
His clinic had been vandalized, he could ask about his future plans.
Li Jingsheng’s clinic now wanted to recruit talented individuals, but he wasn’t interested in ordinary doctors.
He had already recruited two very satisfactory nurses with high capability and expertise, each with their own strengths.
What he needed now was an outstanding doctor to oversee the clinic.
The requirements for this outstanding doctor were quite high, needing to be in the internal medicine field.
As every surgery at the clinic carried significant risk, the surgical aspect was barely even beginning.
So certainly, he had to lead personally.
It couldn’t be left to others.
In the internal medicine field, bringing Shao Bing on board would greatly benefit the clinic’s development. It would also free him up to do more things.
To achieve more significant breakthroughs in medical skills, he couldn’t have his time filled with numerous ordinary cases.
Moreover, now he worked at the Second Hospital three days a week.
In his absence for those three days, the clinic’s services dramatically declined, which wasn’t a good thing.
Balance needed to be maintained.
Besides, patients couldn’t wait with their illnesses.
He also wanted to continue observing Dr. Wang’s behavior.
If there were ethical issues, he might have to dismiss Dr. Wang.
The last incident left a negative impression on Li Jingsheng.
If Dr. Wang could genuinely change, Li Jingsheng could generously forgive him. But if not, then he could only dismiss.
He knew very well that Sunshine Clinic’s success was not due to excellent medical skills, good luck, or favorable relationships. The real core essence was one word: benevolence.
As the owner, he maintained a doctor’s benevolent and compassionate heart, enabling rapid growth after media coverage.
And gained the support and recognition of more and more people.
Those who follow the right path gain much support, while those who stray lose it.
This is the law of nature, the highest rule in the world.
After declining Ruan Xiaoqin’s dinner invitation, Li Jingsheng quickly attended to the remaining patients.
At that moment, his phone rang.
A look showed it was Director Hua calling.
Director Hua was the department head, reaching out certainly for a reason.
"Hello, Director Hua, what instructions do you have?"
Li Jingsheng respectfully said.
"After work, come to my office. I have something to discuss with you."
Director Hua hung up after speaking.
From the sound of it, there were probably others there with Director Hua.
After finishing with the last patient, he handed the remaining tasks to Dr. Chen and hastened to Director Hua’s office.
Once inside, goodness, several chief physicians from orthopedic surgery were there.
The pressure was palpable.