"Sex change surgery? Is the condition stimulated by estrogen?" Lin Ge felt a little bored, so he asked casually.
"Estrogen not only has the physiological effect of promoting and maintaining the female sex organs and secondary sexual characteristics, but it also has obvious effects on the endocrine, cardiovascular, metabolic system, bone growth and maturation, and skin." Su Yun did not mind telling Lin Ge in detail about the effects of estrogen on the body after sex reassignment surgery.
Lin Ge did things very straightforwardly, and Su Yun quite admired him, so he treated it as a casual chat.
"Doctor Su, do you think heart failure is related to estrogen?" Lin Ge asked.
"Most of the commonly used estrogen drugs in the clinic are synthetic derivatives with estradiol as the mother, such as estradiol benzoate, estradiol valerate, ethinylestradiol, estradiol, pregnanestrone, and so on. These drugs have a significant impact on the heart. The patient's heart failure and continued failure are probably related to the injection of estrogen. "
"Alas, the price is quite high," Lin Ge thought.
However, as an individual human, Lin Ge felt that others had no right to interfere with how he chose his own gender.
It was fine as long as he was happy. There was no need for others to criticize him.
It was just that the price was a little high. Using estrogen for the rest of her life had so many side effects.
"Long-term use of estrogen in large doses may increase the risk of breast cancer, endometrial cancer, cardiovascular and cerebrovascular diseases, and venous thrombosis."
Su Yun sighed. It seemed that he and Lin Ge had the same attitude when it came to patients choosing their own gender.
Su Yun also felt that it was a pity for this elderly patient.
She was brave enough to choose her own gender, and there seemed to be a vampire who loved her all the time. Her life was pretty good.
However, after a few decades, all kinds of illnesses came knocking on his door.
Whether it was heart failure or cerebral infarction, they were all related to the injection of estrogen.
In Su Yun's opinion, there was no point in consulting such a case. Her body had triggered a series of reactions due to the metabolism of the drug. She should be incurable now.
Five minutes later, he took off his glasses.
"Boss, do you have any objections?" Su Yun asked.
"Yes," Zheng Ren said very clearly. "Chief Lin, please go back first."
"…" Lin Ge was stunned.
It was just a case of a transsexual. Why did they avoid talking to him?
What did Boss Zheng mean?
Su Yun was also a little surprised. He looked at Zheng Ren with countless questions in his eyes.
"Chief Lin, I'm sorry. It involves a confidential mission," Zheng Ren said apologetically.
After reading the medical records and combining them with Su Yun's medical history, he found a small problem.
However, this involved a mission, so Lin Ge couldn't listen to it.
"Then I'm going back to sleep first. You two are busy." Lin Ge didn't care about that. He stood up smilingly and turned around to leave.
After working for a long time, as long as the word "mission" was mentioned, it was normal for people to behave strangely.
Lin Ge's principle was not to inquire or ask. The further the better, the better.
"Then I won't see you off," Zheng Ren stood up and said politely.
"You should go back to work first. Sleep early and take care of your health." Lin Ge said, "I'll go back first. Don't think about your family when you're out on a mission. With Director Kong and me around, there shouldn't be any problems. "
"Thanks."
After sending Lin Ge off, Zheng Ren returned to the demonstration room.
"Boss, what are you being so secretive about?" Su Yun asked.
"The patient had tea-colored urine four days ago. Did you deliberately miss it?" Zheng Ren asked.
"Yes," Su Yun replied directly. Su Yun replied directly, "In the limousine, you also saw that Christian drank all the blood and used his gastrointestinal tract to absorb the hemoglobin."
"There is almost no research in this area." Zheng Ren pondered. "You can't arbitrarily confuse tea-colored urine with drinking whole blood."
"It's just that he used estrogen for too long, causing cardiovascular and cerebrovascular diseases," Su Yun said. "Tsk tsk, boss, this is love."
Zheng Ren glanced at him. Su Yun's three views were wrong. Had it reached such an extent?
He could even talk about love when he looked at a consultation case.
Zheng Ren did not have any objections to sex reassignment surgery, but there were still some things he did not understand about this case.
"He's been off estrogen for two years. Logically speaking, there shouldn't be continuous progression of muscle weakness and chronic cerebral infarction," Zheng Ren said.
"Thirty-five years! You definitely can't ignore this problem, "Su Yun said." No matter what medicine is used, the accumulation in the body after 35 years is astronomical! "
Zheng Ren pursed his lips. Although Su Yun's words made sense, he still felt that there was a problem.
"There's nothing special about the test, other than the increase in serum phosphokinase to 20793.
Other indicators, including inflammation such as erythrocyte sedimentation rate, C-reactive protein, and so on, were not abnormal, "Su Yun said." And the increase in serum phosphokinase just happened to confirm … "
"That's not right," Zheng Ren said. "The accumulation of high estrogen in the body can indeed lead to the onset of cardiovascular and cerebrovascular diseases. But compared with previous medical records, don't you think this value is too high? "
"There's no point." Su Yun waved his hand. "I think there's only one increase in serum phosphokinase, which has no clinical significance."
"That's true." Zheng Ren was still thinking.
"I didn't do a thymus CT, but looking at the chest CT, I don't think there's anything wrong with the thymus. It doesn't seem like myasthenia gravis," Su Yun said.
"Yes, it's not." Zheng Ren was still thinking about a few suspicious indications. "Let me think about it again. I'll understand what's going on after seeing the patient."
Su Yun narrowed his eyes and stared at Zheng Ren.
"Why?"
"What do you mean I'll know what's going on after seeing the patient?" Su Yun asked.
"A physical examination!" Zheng Ren said in a low voice, "Don't you do a physical examination?"
"Pfft, you have to knock the watermelon before you buy it because other people knock it too. Is that it?" Su Yun said disdainfully.
"No," Zheng Ren answered with certainty. "It's possible that the doctors at Massachusetts General Hospital missed some special symptoms. I have to see the patient, do a physical examination, and ask questions to find the cause."
Su Yun did not think that Zheng Ren would get any answers by doing all this himself. The various examinations, physical examinations, and medical histories at Massachusetts General Hospital were already very detailed.
"Boss, do you think there's a problem between porphyria and estrogen?"
"It shouldn't be. If there's a problem, it won't last 35 years," Zheng Ren said. "There's a high probability that the use of estrogen for a long time will lead to cardiovascular and cerebrovascular diseases. What we need to do now is to eliminate the small probability of the disease. "
…
…
At the same time.
In an ancient castle that did not see the light of day all year round, doctors and nurses in white gowns were busy.
"Her urine output in the past 24 hours has almost dried up. Ms. Vandy's condition is not optimistic. She may only have 48 to 72 hours to live," a doctor said.
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