Chapter 40: Chapter 40: Don’t Hide Anything from the Doctor

The patient’s name was Liu Ping, a 31-year-old woman.

According to her medical records and her own account, Liu Ping had missed her period six months ago.

She thought she was pregnant.

Overjoyed, Liu Ping waited patiently for a while before going to the hospital for a check-up.

But at the hospital, both the urine and blood tests came back negative. Liu Ping was not pregnant.

If she wasn’t pregnant, a missed period meant she was sick.

Liu Ping started by visiting the obstetrics and gynecology department at her local county hospital.

The doctors ran some gynecological exams and prescribed a lot of medication, but her condition didn’t improve.

Later, someone told Liu Ping about an old traditional Chinese medicine doctor in a certain village, a master whose family had specialized in treating gynecological diseases for generations.

Many people had supposedly been cured there and had their wishes fulfilled.

Liu Ping went to see the old doctor and received a large amount of traditional Chinese medicine with unknown ingredients, which she took for over three consecutive months.

However, after several months of this herbal treatment, not only had her period not returned, but her complexion worsened, her skin quality declined, her energy levels dropped, and she had lost a noticeable amount of weight.

Sensing something was wrong, Liu Ping went to a Class A Grade 3 hospital in the city for another check-up.

After a series of detailed examinations, the gynecology specialist at the city hospital diagnosed her with secondary amenorrhea.

Having a normal menstrual cycle that later stops is called secondary amenorrhea.

The causes of secondary amenorrhea are numerous and complex.

Yan Feifan recalled that the establishment and maintenance of a normal menstrual cycle depended on an extremely complex neuroendocrine regulatory system.

Problems with any part of this system, from the hypothalamus, pituitary gland, and ovaries to the endometrium, could all lead to amenorrhea.

For some people, prolonged psychological stress, tension, anxiety, environmental changes, overexertion, or even emotional shifts could also cause amenorrhea.

Some people developed it while trying to lose weight.

Others developed it from long-term intense exercise, like dancing.

This might sound far-fetched, but they were real cases Yan Feifan had read about in medical journals and magazines.

For others still, amenorrhea was caused by long-term use of certain medications, such as some antipsychotics or antihypertensives.

The gynecologist at the Class A Grade 3 city hospital determined that the cause of Liu Ping’s secondary amenorrhea was liver cirrhosis.

Yan Feifan quickly filtered and analyzed the data from all the tests and lab work Liu Ping had undergone at that city hospital in his mind.

In all her examination and lab data, every indicator was normal except for her liver function transaminases… they were abnormal!

Her liver function transaminase data showed an ALT of 80 U/L and an AST of 78 U/L.

These numbers were clearly elevated.

Subsequent ultrasound and CT scans did indeed confirm that Liu Ping had liver cirrhosis.

The gynecology specialist gave her final diagnosis.

Long-term use of traditional Chinese medicine with unknown ingredients had led to liver damage, which in turn caused liver cirrhosis.

In patients with liver cirrhosis, many hormone levels change, especially a decreased ability to inactivate estrogen.

This would then trigger a series of secondary endocrine problems, resulting in amenorrhea.

Yan Feifan mentally reconstructed the patient’s entire clinical course, as well as the doctor’s diagnostic process.

Yan Feifan didn’t find any major flaws in the process. The doctor’s diagnosis was well-reasoned and evidence-based, seeming quite perfect.

But if the story had ended there, he wouldn’t be involved.

In the one or two months of follow-up treatment, Liu Ping’s symptoms did not improve in the slightest.

According to that doctor’s diagnosis, if the liver damage and cirrhosis were caused by taking large amounts of traditional Chinese medicine, then after stopping the medicine and undergoing one to two months of targeted treatment, Liu Ping’s condition should have shown significant improvement.

The problem was, Liu Ping’s condition seemed to have gotten even worse.

This made Liu Ping and her family lose faith in that doctor, and they decided to come to Binhai and pull some strings to find a better hospital and doctor.

’It wasn’t the traditional medicine that caused the cirrhosis!’ Yan Feifan deduced.

’But then, what was the real cause?’

According to her medical records, Liu Ping didn’t smoke or drink, and her blood tests showed she was not a patient with hepatitis B or C.

This ruled out the most common causes of liver cirrhosis in our country: viral hepatitis, alcoholic hepatitis, and cholestatic hepatitis.

’Could it be autoimmune liver disease?’

’Or cirrhosis caused by a parasite?’

’Could it be Budd-Chiari syndrome?’

…

As he drove, Wang Chuan had been secretly observing Yan Feifan.

He noticed that after looking at the numerous images sent to his phone, the young man’s eyes took on a distant, unfocused look.

Yet, his brow would occasionally furrow with small wrinkles.

Wang Chuan understood. The young man was deep in thought, clearly analyzing the patient file his sister had sent him.

This scene further solidified Wang Chuan’s confidence in Yan Feifan.

As a wily old fox who had seen it all, he could clearly tell that Yan Feifan had gotten into the car with a certain degree of unease.

After all, the trouble Yan Ziruo had caused was still unresolved, and Wang Chuan had been deliberately vague and confusing.

It would be impossible for Yan Feifan not to be nervous.

But this guy, upon seeing a complex case, would quickly become engrossed in his thoughts, forgetting everything else.

This showed that the kid truly, genuinely loved medicine.

There was no greater motivator for success and achieving world-shocking results than this kind of heartfelt passion.

’Talent, plus a passion that comes from the heart. Perhaps that’s the reason this kid has become so outstanding.’

Wang Chuan mused to himself and subconsciously slowed the car down a bit to avoid jostling Yan Feifan and breaking his concentration.

A short while later, Wang Chuan heard Yan Feifan’s voice.

“Sis, can you have that colleague of yours tell the patient to call me back now?”

“I have some questions for her.”

“What questions? Cirrhosis has a chance of developing into liver cancer, and liver cancer has a hereditary component.”

“In the family history report, the patient said her paternal aunt died at forty-five from a high fever.”

“That part made me a little suspicious, so I want to ask her about it over the phone.”

Yan Feifan hung up and noticed the car was driving on an overpass.

But the direction they were heading…

“Mr. Wang, are we leaving the city?”

Wang Chuan replied softly, “Our destination is Phoenix Tail Mountain in the southern suburbs. It’s about another hour’s drive.”

“Is that enough time for you to solve a difficult case?”

Yan Feifan said matter-of-factly, “The current clinical data isn’t enough for me to make an accurate diagnosis.”

“I hope the upcoming phone call will give me enough information…”

After waiting patiently for about ten minutes, Yan Feifan finally received a call from an unfamiliar out-of-province number.

“Mr. Yan, this is Liu Ping. What did you want to know?”

Recognizing the heavily accented and weak-sounding Mandarin, Yan Feifan spoke slowly, “Ms. Liu, I’d like to ask about the exact cause of your aunt’s death.”

“My aunt… she took her clothes off in the middle of winter, caught a bad cold, her fever hit forty degrees, and she died from it.”

Yan Feifan asked doubtfully, “With modern medicine being so advanced, even at forty degrees, that shouldn’t have been fatal, should it?”

“Doctor, we live in the countryside. It’s not very convenient to see a doctor.”

“Doctor, is my aunt’s death related to my illness?”

Yan Feifan said, a little disappointed, “If she really died because of a high fever and delayed treatment, then there’s no connection.”

“But if it was for some other reason…”

Yan Feifan’s tone grew heavier, and he paused deliberately.

He waited for only ten seconds before Liu Ping’s voice came through the phone again.

“Doctor, actually… well, the thing is, my aunt developed a mental illness before she died…”

Yan Feifan’s spirits lifted, and he cut in, “A mental illness?”

“What were her symptoms?”

“She slept a lot, shouted and screamed, um… she would also relieve herself anywhere, and she hated wearing clothes.”

“That’s what happened in the winter. We weren’t watching her for a moment, and she took off her clothes and caught a cold.”

Hearing this, Yan Feifan asked, “Before your aunt’s mental state became abnormal, did she experience a prolonged period of fatigue, loss of appetite, or jaundice—that is, yellowing of the eyes and skin?”

A moment later, Liu Ping’s weak voice came through the phone again. “Doctor, I’m not sure about the others, but I do know her face was very yellow.”

“Doctor, my aunt’s illness… it couldn’t be…”

At that moment, Yan Feifan knew what it was.

He organized his thoughts and said, “Ms. Liu, I highly suspect your aunt didn’t have a mental illness.”

“She had a liver disease called hepatolenticular degeneration.”

Yan Feifan explained, “Hepatolenticular degeneration is a rare inherited disorder caused by a defective gene that leads to impaired copper metabolism in the body.”

“It primarily affects liver and nervous system function.”

“Copper deposits in the liver lead to cirrhosis. Deposits in the lenticular nucleus of the brain cause brain dysfunction, resulting in psychiatric abnormalities, lethargy, and abnormal behavior.”

“Ms. Liu, it’s very likely you have this disease as well.”

Liu Ping’s anxious voice immediately came over the line. “Doctor, am I going to end up like my aunt?”

“No,” Yan Feifan reassured her.

“This is one of the few genetic diseases that can be treated. With systematic and proper copper chelation therapy, most patients can live and work like normal people.”

Yan Feifan advised, “Ms. Liu, don’t come to Binhai just yet. Go back to that Class A Grade 3 hospital in your hometown and get a serum copper and liver copper test. Also, have them check your eyes for K-F rings.”

Liu Ping’s panicked voice came through the phone again. “Doctor, Doctor, I don’t understand what you’re saying.”

Yan Feifan continued, “I’ll send you a text message. Just show it to the doctors, and they’ll understand.”

After a pause, Yan Feifan added a warning, “Ms. Liu, in the future when you see a doctor, don’t hide things from them.”

“Whatever there is, just say it…”

Source: Webnovel.com, updated by NovelKeep