At Yin Yue’s request, Yan Ziruo looked at her younger brother with a softened expression.

Yan Feifan replied without hesitation, “Send all the medical records over. I’ll take a look first.”

“If his condition is serious and complex, I’ll recommend a suitable specialist…”

After dinner, Yu Suye eagerly joined Yan Feifan. She peered at the tablet, looking at the test results, lab reports, imaging files, and treatment records that Yin Yue had sent.

The moment she saw the information on the tablet, she blurted out, “Oh, it really is kidney stones.”

The patient’s CT scan showed three stones of varying sizes in the upper part of his left ureter.

The largest one was 8 by 14 millimeters.

Additionally, the urinalysis showed occult blood at 3+.

Yan Feifan scrolled through the files on the tablet and said dismissively, “Use your head. Don’t jump to conclusions.”

“If the stones were causing the abdominal pain and hematuria, his symptoms should have significantly improved after three days of treatment to pass them.”

“They shouldn’t be getting worse, like they are now.”

Despite his tone, Yu Suye wasn’t the least bit upset.

She looped her arm through Yan Feifan’s and snuggled up against him.

Yan Feifan tried to pull away, but she held his arm tight, so he had no choice but to reluctantly put up with it.

Yu Suye tilted her head again, resting it on Yan Feifan’s shoulder.

“So, you’re saying the kidney stones are just a red herring, masking the true cause of the pain and hematuria.”

Following along as Yan Feifan scrolled, Yu Suye pieced together the history of Yin Yue’s husband’s illness and his course of treatment.

Patient: Yang Di, male, forty-three years old, producer at Binhai Satellite TV.

Three days ago, Yang Di woke up with a sudden aching pain in his lower back, which was concentrated in his lower abdomen and manifested as intermittent, colicky spasms.

Each episode of pain lasted for about ten minutes and was accompanied by nausea and vomiting.

Yang Di went to the nearby City’s Third People’s Hospital for an examination.

A urinary tract ultrasound revealed stones in his ureter, urinalysis indicated occult blood, and his blood test showed a white blood cell count of 14×10^9.

Yang Di was diagnosed with urinary stones and his condition improved after symptomatic treatment with ceftriaxone for the infection, an antispasmodic, and dezocine for the pain.

Two days ago, the abdominal pain returned, now lasting for about 30 minutes per episode, and he developed gross hematuria.

He underwent extracorporeal ultrasonic lithotripsy at the Third People’s Hospital.

A follow-up scan confirmed the stones had been fragmented.

According to Yin Yue, after two consecutive days of IV drips, Yang Di’s abdominal pain and hematuria didn’t improve; in fact, they seemed to be getting worse.

Yu Suye noted that the tests Yang Di had undergone were quite comprehensive.

However, aside from the ultrasound that found the stones, the elevated white blood cell count, the positive result for occult blood in his urine, and the presence of protein in his urine…

…his chest and abdominal CT scans, as well as his amylase, lipase, liver function, kidney function, electrolyte, cardiac enzyme, D-dimer, and EKG results, all showed no significant abnormalities.

Yu Suye mused, “Hematuria with colicky pain suggests urinary stones. Hematuria with a dull, heavy ache in the lower back suggests an infection. Asymptomatic gross hematuria suggests a tumor. Hematuria with irritative symptoms suggests a urinary tract infection.”

She continued her analysis, “Feifan, let’s say the pain is from the stones, but the hematuria is a symptom of a different, hidden disease.”

“In that case, the number of possible causes skyrockets.”

“Besides diseases of the urinary system, issues with adjacent organs, idiopathic hematuria, trauma, or exercise-induced hematuria…”

Yu Suye rattled off, “There are also hemorrhagic disorders, connective tissue diseases, endocrine disorders, infectious diseases, and so on.”

“Ruling those out one by one would be a huge pain.”

She noticed Yan Feifan’s fingers tapping lightly on the tablet; he too was lost in thought.

“Feifan, have you thought of something?”

Yu Suye quickly added, “I suggest we transfer him to the Affiliated Hospital for more thorough and comprehensive tests.”

Yan Feifan turned to look at her. “Did you notice any important tests missing from his workup?”

Yu Suye thought for a moment. “The City’s Third People’s Hospital is a decent, second-tier hospital, isn’t it?”

When Yan Feifan nodded, Yu Suye continued, trying to recall, “The chest and abdominal CTs, amylase, lipase, liver and kidney function panels, electrolytes, cardiac enzymes, D-dimer, EKG… they seem to have done basically everything they could.”

“Did I miss something?”

Yan Feifan just shook his head and flicked her on the forehead.

Yu Suye froze for a moment, then sat bolt upright. “Yan Feifan, how dare you—”

She cut herself off halfway through the sentence when she saw the nervous look on Yan Feifan’s face.

Yan Ziruo, sitting nearby, immediately shot a sharp glance their way.

Yu Suye quickly clapped a hand to her forehead, her expression instantly shifting to a pitiful one as her voice softened.

“How could you flick my forehead like that?”

“I’m not a little kid, you know. That hurt, and it’s so embarrassing…”

In truth, Yan Feifan regretted it the moment he did it.

For a second there, he had treated Yu Suye like one of his clueless students, like Tian Yu. It was pure habit.

Only after the flick did Yan Feifan remember that the woman beside him could transform from a kitten into a tiger in the blink of an eye.

Seeing Yu Suye revert to her theatrically cute kitten persona, Yan Feifan didn’t dare show his disdain. He just said seriously, “A toxicology screen!”

“Poisoning?”

It dawned on Su Ye. “Of course! Whenever we face a complex case that’s difficult to diagnose, we have to consider the possibility of poisoning!”

“Abdominal pain and hematuria can be caused by any number of toxic substances.”

Just then, Yan Ziruo, who had been sitting by and listening to her brother and Yu Suye’s discussion as if it were in another language, asked with a grave expression, “Feifan, Su Ye, how high is the possibility of poisoning?”

Yan Feifan answered honestly, “Sis, we can’t rule out the possibility.”

Yu Suye added as a reminder, “Feifan, you’re aware of the complicated relationship between Yin Yue and her husband.”

“If he really was poisoned, then who knows where this whole thing could lead.”

Yan Feifan said frankly, “Sis, don’t jump to conclusions. Poisoning can happen in all sorts of ways.”

“Besides, in Mr. Yang’s case, running a toxicology screen is just a routine procedure.”

Yan Ziruo sighed softly. “Feifan, it’s not that I’m making things complicated. The world itself is complicated.”

After a pause, she asked, “Feifan, what should we do now? Should we recommend a specialist for him?”

Yan Feifan thought for a moment. “Sis, first have him get a toxicology screen at the City’s Third Hospital.”

“If the screen comes back negative, have him transferred to the Affiliated Hospital immediately.”

Yan Ziruo picked up her phone, hesitated, then said, “Feifan, once I get her on the line, you talk to her, okay?”

Yan Feifan nodded.

Once the call connected, Yan Ziruo said, “I’ll let my brother talk to you,” then put the phone on speaker and held it up to Yan Feifan’s mouth.

“Yin Yue, it’s Yan Feifan.”

“Feifan, hello!”

After Yin Yue’s greeting, a weak male voice also came through the phone.

“Mr. Yan, hello!”

“This is Yang Di. I’ve heard a lot about you, not just from my wife, but from my colleagues as well.”

“Mr. Yan, what exactly is going on with me?”

“The pain is killing me.”

Yan Feifan stated frankly, “Based on the information I have, I can’t make an accurate diagnosis yet. But I can confirm that the primary cause isn’t the kidney stones.”

“Mr. Yang, are you still at the City’s Third Hospital?”

“Yes, I’m at the City’s Third Hospital.”

Yan Feifan replied, “Alright. Have your attending physician run a toxicology screen on you immediately.”

“If…”

“Mr. Yan…”

Yan Feifan was cut off by Yang Di’s urgent voice from the phone. “Are you saying I’ve been poisoned?”

Yan Feifan explained, “It’s just a routine test.”

“The City’s Third Hospital likely skipped it after diagnosing you with kidney stones.”

“Now that we need to do a comprehensive workup, this test is unavoidable.”

Source: Webnovel.com, updated by NovelKeep