The Surgeon’s Studio Chapter 352 - Beriberi Is Not A Disease

Chapter 352: Beriberi Is Not A Disease

“Have you checked her vitamin levels?” Zheng Ren asked.
“Vitamin?” Su Yun was stunned.
Their usual routine for emergency rescue in the ICU did not include vitamin tests unless the patient had a specific disease.
External injuries did not qualify as a specific disease.
“I’m thinking vitamin B1 deficiency,” Zheng Ren said, “Stop the patient’s sedatives.”
“…” Su Yun was still in a daze.
“I want to see if the patient presents symptoms of oculomotor nerve palsy during agitation.”
Paralysis of the extraocular muscle resulting from the oculomotor nerve palsy would lead to misalignment of eyes and a loss of pupillary light reflex.
Right before Su Yun was about to argue, he suddenly recalled the constant trembling of Yang Lili’s eyes while she was conscious. That was also why Su Yun felt as if she had seen a ghost.
He hummed softly for several minutes and lifted his head abruptly, his eyes brightened with realization, “Boss, I think you’re right.”
Chief Qian and the other consulting chiefs were baffled.
Were these two young lads joking?
The city council was still waiting for their morning report, yet they…
If it was not for the exceptional emergency rescue ability Zheng Ren demonstrated in the ICU prior to this, or the impeccable surgical skills he showed in the past emergency surgeries, he would be ridiculed and scoffed at.
Vitamin B1 deficiency?
What a joke.
“Little Zheng, Little Su, stop joking around,” Chief Qian said in a deep voice to indicate his dissatisfaction.
“We’re not joking, Chief Qian.” Su Yun chuckled.
Zheng Ren’s words unveiled the fog and the sky was clear now.
There were times that a seemingly unsolvable problem could be easily resolved with a simple push.
“How are the patient’s symptoms related to vitamin B1 deficiency!” The chief of the medical administration division roared, “Beriberi? What nonsense is this!”
“We all studied pathophysiology before, right?” Su Yun looked around with a sneer hanging on the corner of his mouth, “The common disease of vitamin B1 deficiency is called beriberi, nothing wrong about that.”
While he spoke, his smirk grew larger, attracting many pairs of glistening eyes from the ICU’s nurses.
“Vitamin B1, also known as thiamine is absorbed by the intestine and phosphorylated into thiamine diphosphate.
“Thiamine diphosphate is an important coenzyme in the decarboxylation of pyruvate and α-Ketoglutaric acid, as well as the coenzyme of erythrocyte transketolase.”
The people present were struck with a string of scientific jargon that appeared out of nowhere like lightning and thunder.
Chief Qian hummed softly. What Little Su just said made sense.
The chief of the medical administration division had an awkward expression because… he could not understand a thing.
His position was quite important, integrating each segment of the emergency rescue, ensuring the medical quality was up to standard, and handling medical disputes.
He had left clinical practice for a long time and lost touch with things like pathophysiology.
Su Yun could not be bothered about what they thought and continued saying, “Brain and cardiac tissues have a high metabolic rate. They require sufficient vitamin B in glycolysis to breakdown glucose into pyruvate, otherwise, the lack of thiamine diphosphate would prevent the keto acids from entering the tricarboxylic acid cycle.
“Accumulation of keto acids in the blood results in the dilation of surrounding arteries due to the decrease in peripheral resistance. The increased blood flow would then subsequently raise the cardiac output and cardiac workload.”
Hmm? Finally something about the right ventricle output and cardiac preload?
The chief of the medical administration division pretended to be in deep thought. He could not risk letting anyone discover that he could not understand.
Anyway… This rascal, could he just explain in simpler terms?
“Therefore, I…” Su Yun halted in midspeech, “My boss said that Yang Lili’s agitation and mental distress should be the complications from vitamin B1 deficiency.”
Su Yun glanced towards Zheng Ren after he finished speaking.
“Am I right, Boss?”
“That’s about it,” Zheng Ren said straightforwardly. He then continued, “I suggest giving her a shot of 100 mg of vitamin B1, but intramuscular injections tend to have a lower rate of absorption. We can try simultaneous injecting 20 mL of saline with 50 mg of vitamin B1 intravenously.”
“It should be fine to administer a higher dosage on the first day,” Zheng Ren said.
The department chiefs and the chief of the medical administration division stared at each other blankly. They could see the lost in each other’s eyes.
Even though not everybody agreed with what Zheng Ren and Su Yun said, they could not come up with a reasonable rebuttal.
They had explained their speculations clearly, with detailed elaborations on the biochemical processes.
Even when the people around could not follow, their reasoning sounded very professional.
What to do?
What else could they do?
“Let’s try that out since we have no other choices,” Chief Qian said.
He had known Su Yun for the longest time and knew him very well. Usually, if Su Yun had that obnoxious expression on his face, most likely he would be right.
They should not argue with him, even if they were a department chief. They might get a slap on the face even when they were backed with medical reasoning.
Moreover, a few milligrams of vitamin B1 would not cause any harm to Yang Lili’s condition.
“Stop the sedatives after half an hour,” Zheng Ren stood up and gave the last order.
“Sure, boss,” Su Yun noted down the doctor’s order.
Chief Qian got sentimental as he watched Zheng Ren leaving.
The young cub had matured into an adult.
Some older department chiefs might not even have the strong presence that Zheng Ren exuded.
Who dared to speak in such conclusively without knowing the guaranteed outcome of the medical treatment? If they just spoke without careful consideration, they would be given hell in the end.
Chief Qian only encountered a handful of professors from Imperial Capital and Sorcery Capital with said aura, but he had never seen one in… Sea City General Hospital.
After Su Yun conveyed the doctor’s order, the little nurse carried out the orders hurriedly. She gave an intravenous injection of vitamin B1 before injecting another dose intramuscularly.
Su Yun glanced at the time before sitting down beside Yang Lili’s bed, his eyes fixated on her.
Half an hour, the timing boss mentioned should not be a problem. If they stop the sedatives by then, it would take another 2 hours for Yang Lili’s body to metabolize the drug.
If the oculomotor nerve and cardiovascular symptoms were a result of vitamin B1 deficiency, the patient should be relieved of those symptoms then.
What an interesting diagnosis.
…
At the same time, the vertebral resection surgery was ongoing in the major general surgery operating room.
“Little Zhou, were the embolizations from yesterday done precisely?” Professor Tian from the orthopedics department asked while he made an incision.
Dr. Zhou said, “The embolization took longer than usual because we only have one interventional doctor. I can’t really tell if it was successful, but he performed embolizations on a patient with peritoneal hematoma after a pelvic fracture and it went really well.”
“Uhm, interventional doctors are quite rare. You’re lucky to have one.” Professor Tian started a blunt dissection to separate the muscles, carefully avoiding a location that was richer in capillaries.