"Trigger?" Su Yun asked as he pondered.
"Well, it could be a fall. It's normal for a patient with cerebral infarction to fall and injure themselves. Because of the gradual decline in physical fitness, a single trauma could lead to rhabdomyolysis. "Zheng Ren thought it through.
Seeing that his attendant was giving Christian a blood transfusion, he took out a few glasses of red, bloody drinks and asked, "Will he get better today?"
"He should be fine this time," one of the attendants replied with a bruised face. One of the attendants answered with a swollen face: "Lord Chris rarely acts up, he will get better after at most three treatments each time."
"It seems that he's an exception," Zheng Ren said with a slight smile.
"His condition isn't that serious," Su Yun said, "but the sulfide in the garlic will still act up."
"Yes," Zheng Ren said, "I hope he can get better quickly and provide the correct medical history. If there's no problem with the diagnosis, I think … "
"There's only a two to three out of a hundred thousand chance of rhabdomyolysis occurring with oral statin drugs. Boss, don't you think the probability is too low? "Su Yun asked.
"That's why I suspect that there's another factor that triggered this process."
"HMGCR antibody test, muscle biopsy, and muscle electrophysiology are enough to confirm rhabdomyolysis," Su Yun said.
"Yes, you're right," Zheng Ren said. "I forgot that the other side is said to have all kinds of medical equipment that's better than all the hospitals in the world. I hope Christian isn't lying about this. "
"Let's give it a try. We'll just have to wait anyway," Su Yun said as he began to communicate with the other side.
"Boss, this electronic medical record system is better than ours," Su Yun said after sending the consultation opinion.
"It's enough. There's no need to be so advanced," Zheng Ren said. "If it's confirmed rhabdomyolysis, the treatment will be simple."
"Prednisolone + methotrexate + immunoglobulin?" Su Yun asked.
"About half of the patients with rhabdomyolysis are cured with the conventional three-drug combination. Even immunoglobulin alone may be effective, but this patient's condition is too poor. I don't recommend conventional medication. "
"How are you going to use it?" Su Yun asked cautiously.
Conventional meant that a large number of clinical patients had used it, which meant that the risk was minimal.
"Considering this patient's heart dysfunction and history of thrombosis, I suggest choosing rituximab instead of immunoglobulin and combining it with 70 mg/d.
Prednisolone treatment at mg/d. "
"Rituximab injection? It is used to treat recurrent or drug-resistant follicular central lymphoma. There are reports that it can effectively control rhabdomyolysis, but do you think it's possible? "
"No problem, the patient's symptoms are completely consistent." Zheng Ren said, "It's not enough to just use medicine. Because of the hemiplegia after the stroke and the muscle weakness that cannot be relieved in the short term, the patient must also receive long-term physical rehabilitation treatment."
"Just wait." Su Yun placed his hands behind his head and leaned against the armchair. He said slowly, "HMGCR antibody test, muscle biopsy, and muscle electrophysiology test. Guess how long it will take for the results to come out?"
"If there's no delay on the other side, an hour is enough," Zheng Ren said. "I hope they'll seriously look at our consultation request and not throw it aside."
With that, he glanced at Christian.
After the blood was transfused again, the blisters on Christian's face and neck were much better. Although he was still a little dispirited, he looked much more normal. At the very least, a few of his fangs had retracted.
Zheng Ren thought about it and finally decided to wait for a while.
Time passed. About an hour later, Zheng Ren saw that Christian's wounds were healing quickly and he was much more energetic.
"Are you feeling better, Mr. Christian?" Zheng Ren stood up and sat in front of Christian, asking seriously.
"Damn it, did you hit me?" Christian said coldly.
His voice was very calm. There was no anger. He was just stating a fact.
"I'm glad that your consciousness has recovered under the stimulation of pain." Zheng Ren smiled and said, "When patients with porphyria have an acute attack, only 30% of them can accept the stimulation of pain."
"You're going to break my nose." Christian looked at Zheng Ren coldly.
Su Yun knew this kind of look very well. It meant that if it was not for the fact that he could not beat Zheng Ren, he would have gone up to beat him up long ago.
"It's mainly because the medical history is not detailed, which led to the doctor's misdiagnosis and misjudgment." Zheng Ren did not care about Christian's threat and said, "I'm not sure if the doctor over there will do the relevant examination, so I think it's better to get the most direct evidence from you."
"What evidence?"
"Has Ms. Vandy suffered any external injuries in the past few months?" Zheng Ren narrowed his eyes and stared closely into Christian's eyes.
"No."
"Mr. Christian, lying now will cost your dear Lady Fandi's life." Zheng Ren grinned slightly, very relaxed. "The diagnosis is clear. I firmly believe that it's rhabdomyolysis. However, there's a missing piece of the puzzle. "
"External injury history?" Christian's expression was a little strange.
"Yes," Zheng Ren said, "If we can get the exact medical history, we can at least give the medicine one to two hours in advance. And these one to two hours, for Madam Vandy, means whether or not she will be able to walk after the treatment, she will still have to lie in bed for the next few years or decades. "
"…" Christian was silent.
Zheng Ren stared into his eyes. From the change in his gaze, Zheng Ren had confirmed his guess.
However, it was not enough to rely on guesses.
The treatment plan he had given was already more extreme. Coupled with the lack of definite clinical evidence, using the wrong medicine was equivalent to killing someone.
"I …"
"Let me say it. You just need to nod or shake your head," Zheng Ren said softly. "This way, it might save more time."
Christian thought for a moment and nodded in agreement.
"The question might be a bit personal. Can your subordinates hear it?" Zheng Ren glanced at the two men with bruised noses and swollen faces.
Christian asked them to leave first.
"You really love Ms. Vandy, and she loves you too." Zheng Ren threw out a simple proposition.
Zheng Ren said it in English instead of Dutch.
Christian was a little surprised. Zheng Ren gave him the illusion that he was not a doctor but a damn priest, the kind who cultivated in both discipline and holiness.
However, he hesitated for a moment and nodded.
"Ms. Vandy had surgery for you 35 years ago." Zheng Ren saw Christian nod and continued to ask.
Su Yun was a little curious. What was the boss doing? He was serious, as if he was hosting a wedding.
Christian was silent for three seconds and nodded again.
"Ms. Vandy has a special hobby. For example, she obtains some kind of pleasure through suffocation." Zheng Ren suddenly raised his voice.
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