Chapter 817 - 382: Eight Years of Persistent Fever, the Hidden Tumor (Part 2)

Chapter 817: Chapter 382: Eight Years of Persistent Fever, the Hidden Tumor (Part 2)

She has had this illness for eight years, and it’s only now that her condition has worsened that she’s seeking hospital treatment.

Seeing her weak and feeble, if it’s a serious illness, it must already be quite advanced.

"Blood pressure is 107 over 76 mmHg, heart rate is 86 beats per minute."

Han Siying is now quite efficient at taking the patient’s blood pressure and other vitals.

"Lie down for a bit, let me examine you. Your illness might be tricky. If it can’t be treated here, you might need to go to a larger hospital for further tests. What we’ve found so far is that your anemia is very severe."

She’s not only thin; the signs of anemia are also quite apparent.

It’s baffling that the community health station in the south of the city just did a basic blood test and nothing else.

Li Jingsheng thought to himself, could the health station be treating this patient as if she just had a cold?

It’s certainly possible.

He examined the patient—no obvious thyroid swelling, neck is soft, chest is not tender.

Listening to the heart and lung sounds, they also seem normal.

During abdominal pressing, the abdomen is soft and flat.

No obvious signs of ascites were observed.

Both lower limbs also show no edema.

"This shouldn’t be possible!"

Li Jingsheng checked the patient’s armpit lymph nodes again, but found no significant enlargement.

Then why does the patient have symptoms like low fever, weight loss, and anemia?

And it’s not just for a day or two; it’s persisted for more than eight years.

This low fever is truly frightening—an eight-year fever.

Normally, even half a day is unbearable. I really admire this lady for enduring it for over eight years; if she weren’t seriously ill now and unable to work normally, she might still be enduring it.

Based on his diagnostic experience, such patients are likely to have tumors in their bodies.

Whenever a tumor is present, with his experience, it can usually be detected during a physical examination.

But the chest, abdomen, neck, and underarm areas are all normal, so where is this tumor growing?

Or perhaps it’s not a tumor but another chronic disease.

So what disease could it be?

He quickly thought about diseases with similar symptoms.

After careful thought, he still believes the possibility of a tumor is the greatest.

There remains a possibility of a blood disorder, but many blood disorders are quite aggressive and cause multiple symptoms in the body. Left untreated for so long, they can easily lead to severe complications.

But since this patient hasn’t shown those, it suggests the likelihood of a blood disorder is small.

He’s still focused on the tumor as the primary concern.

The patient’s neutrophils are only 0.8, below normal levels.

This is actually a good diagnostic direction.

For her situation, a routine fecal and urine analysis would be better.

These two tests don’t cost much, so why have they not been done?

"Were you hospitalized at the health station or not?"

"I have children at home to care for, my husband is very busy at work and doesn’t have time to care for the family, so I didn’t get hospitalized. They agreed I could come in daily for an infusion."

She looked petite and thin, yet she carries the burden of taking care of the family.

It’s really not easy.

"Did the health station require you to do routine fecal and urine analyses?"

"The doctor suggested I get these two tested and take a couple of X-rays, but I was worried about the cost, so I didn’t agree."

So that’s how it is.

No wonder no fecal or urine analyses were done.

Even for the blood test, it was probably only done at the doctor’s insistence.

In facing such patients, doctors actually feel quite helpless.

If they insist on doing all the tests before treatment, she might just run away.

Health stations and clinics admit patients in a fundamentally different way than larger hospitals.

When treating low-income patients, there’s no way to ask too much.

If, like a large hospital, you walk in and have all the necessary tests done right away, as soon as the doctor fills out the test application, the patient might simply run away.

When Li Jingsheng treats patients, he sometimes avoids X-rays for financially disadvantaged patients whenever possible.

Unless it’s for injuries like fractures where an X-ray is a must.

Without an X-ray, it’s hard to clearly check. If the patient makes false claims, he’ll be in big trouble.

Some patients won’t talk about reasoning at all.

Of course, the vast majority of patients and their families are kind-hearted.

It’s harsh to say, but even if one hundred patients and their families are kind, if just one wants to maliciously extort the doctor, every doctor will be strict with all one hundred patients.

The current dire medical environment is stirred by that small group of patients.

Frequent complaints and lawsuits against doctors make no doctor dare to risk their future and career.

Don’t be misled by Li Jingsheng’s ability to perform surgeries now; it’s only because he has the qualification to participate in surgeries.

To truly lead a surgery team and have your own medical group, you’d need to be at least an Associate Chief Physician.

Pursuing this rank is unexpectedly difficult.

At some regional tertiary hospitals, advancing to Associate Chief Physician is much easier, but carries less prestige.

Ideal medical students don’t even consider entering these hospitals after graduation.

They all fight to get into the big hospitals.

Especially the provincial top-tier hospitals, which are the dream places for countless medical students.

Once in, however, advancing to Associate Chief Physician is hell-level challenging. Many PhD students even doubt their life choices.

As for Master’s students, unless they are exceptionally capable, their stories are filled with tears.

Graduates from prestigious universities like 985 and 211 Institutes have incredible credentials. They made it through the intense competition, emerging victoriously.

As a Master’s graduate from a non-elite school, Li Jingsheng’s competitiveness is weaker.

He doesn’t even have the qualifications to vie for those positions.

In the early days of his career, he cried buckets of tears.

Given the arduous and costly career advancement path for doctors, which doctor is willing to gamble their future and career?

Is it really worth it to save a stranger?

In fact, there are plenty of ’naive’ doctors like that.

Call it respect for life or sympathy for patients, doctors who ignore dying patients are ultimately a minority.

"Your illness probably isn’t a minor issue, the necessary tests still need to be done."

"Dr. Li, I honestly understand the reasoning. It’s just that our financial situation is truly poor. My husband earns about 4,000 a month, and after social security and such, there’s only over 3,000 left. My income is even less, only 1,800, and we have two kids at home. Seven years ago, my father-in-law developed liver cirrhosis, and after spending a lot on treatment, it was diagnosed as liver cancer.

In the end, he couldn’t be cured, and he drained all our savings.

My mother-in-law passed away last year, treatment cost nearly 30,000, and funeral expenses including buying a burial plot took another big amount. We still haven’t cleared the debts.

They say your medical skills are outstanding, could you prescribe some medicine without those tests?

Rest assured, even if it doesn’t work, I won’t blame you."

She nearly begged in her tone.

"Your situation at home is indeed tough."

Li Jingsheng felt deep sympathy for this patient, and admired her for silently and selflessly contributing to her family.

Despite being unwell herself, she allowed her father-in-law and mother-in-law to receive their treatments.

Such a filial daughter-in-law is rare even with a lantern search.

Given that the patient has no abnormalities in her chest, abdomen, or armpits, and no leg edema, where could her tumor be?

Based on her blood test results and symptoms, Li Jingsheng still tends to believe that her illness is tumor-related.

Her legs do not show hematomas, and her skin and sclera are not yellowed, indicating a smaller likelihood of liver or kidney issues.

Her heart and lung sounds are normal, suggesting her heart and lungs should be healthy.

...

He began relying on his extraordinary experience to analyze her disease.

Eliminating all the unlikely possibilities.

Moreover, having had this disease for over eight years without pain is a positive sign.

If it were a malignant tumor, it would surely be accompanied by cancer pain.

And in advanced stages, cancer pain can be quite severe.

"Have you felt any pain lately?"

"No, it’s just... there’s an area that feels a bit uncomfortable."

Her gaze was somewhat evasive, showing embarrassment on her face.

"There’s no shame in discussing symptoms with a doctor. Saying what feels uncomfortable can greatly assist my diagnosis."

Li Jingsheng said with a serious expression.

It’s not just female patients; male patients sometimes hesitate when discussing problematic areas.

Everyone has their own dignity.

Some ailments make people feel shy about speaking up.

"It’s the inner thigh area that feels a bit uncomfortable, especially noticeable while walking."

She finally mustered the courage to say it.

Upon hearing this, Li Jingsheng’s eyes brightened, realizing he had overlooked an important part of the physical examination.