"Is the condition stimulated by estrogen during sex reassignment surgery?" Ringer felt a little bored and asked casually.
"Estrogen not only has the physiological effect of promoting and maintaining the female sexual organs and secondary sexual characteristics, but also has obvious effects on the endocrine, cardiovascular, metabolic systems, bone growth and maturation, skin, etc." Su Yun did not mind. Tell Ringer more about the effects of estrogen on the body after sex reassignment surgery.
Lin Ge was very straightforward in doing things, and Su Yun quite appreciated it, so he just treated it as a casual chat.
"Dr. Su, do you think heart failure is related to estrogen?" Ringer asked.
“Most of the estrogen drugs commonly used in clinical practice are synthetic derivatives with estradiol as the parent, such as estradiol benzoate, estradiol valerate, ethinyl estradiol, ethinyl estradiol, estrone, etc. These drugs have a considerable impact on the heart. The patient developed heart failure and continued failure, which is probably related to the injection of estrogen."
Alas, the price is quite high, Lin Ge thought.
However, as an individual human being, Ringer feels that others have no right to comment on how to choose his or her gender.
Think clearly for yourself and just be happy. Why do others make irresponsible remarks
It’s just that the cost is a bit high, with lifelong use of estrogen and so many side effects.
"Long-term use of large doses of estrogen may increase the risk of breast cancer, endometrial cancer, and cardiovascular and cerebrovascular diseases, as well as 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 a little sorry for this elderly patient.
She can bravely choose her own gender, and there seems to be a vampire who has always loved her, so her life is quite happy.
Just a few decades later, all kinds of diseases came to the door.
Whether it is heart failure or cerebral infarction, it is related to estrogen injection.
In Su Yun's view, this kind of case has no significance for consultation at all. Her body metabolized the drug and triggered a series of reactions, and now there should be no cure.
After 5 minutes, Zheng Ren took off his glasses.
"Boss, do you have any comments?" Su Yun asked.
"Yes." Zheng Ren said clearly: "Director Lin, please come back first."
"..." Lin Ge was stunned.
It’s just a case of a transgender person, why should he avoid speaking out
What does Boss Zheng mean...
Su Yun was also a little surprised and looked at Zheng Ren with countless questions in his eyes.
"Director Lin, I'm sorry, it involves confidentiality tasks." Zheng Ren said apologetically.
After reading the medical records, combined with the medical history stated by Su Yun, he discovered a small problem.
It's just that this involves a mission, so it's not something Lin Ge can listen to.
"Then I'll go back to bed first, you two are busy." Lin Ge didn't pay attention, stood up with a smile, and turned around to leave.
After working for a long time, as long as the word "task" is mentioned, any strange behavior is normal.
Don't pry or ask yourself, the farther away the better, this is Ringer's principle.
"Then I won't send you off." Zheng Ren stood up and said politely.
"You are busy here, go to bed early and take care of yourself." Lin Ge said, "I'm going back first. Don't think about things at home when you're on a mission. With Director Kong and me here, there shouldn't be any problems." "
"Thanks."
After sending Lin Ge away, Zheng Ren returned to Xiaoshi's classroom.
"Boss, what happened so mysteriously?" Su Yun asked.
"The patient had brown urine 4 days ago. Did you miss it on purpose?" Zheng Ren asked.
"Yes." Su Yun answered directly: "In the RV, you also saw that Christian probably drank whole blood and absorbed heme through his gastrointestinal tract."
"There is almost no research in this area." Zheng Ren pondered, "You cannot arbitrarily confuse tea-colored urine with drinking whole blood."
"It's just that taking estrogen for too long can cause cardiovascular and cerebrovascular diseases." Su Yundao said, "Tsk, boss, this is love."
Zheng Ren glanced at him, Su Yun's three views were wrong, could he have gone to this extent
Looking at any consultation case, it can all be related to love.
Zheng Ren didn't have any objections to sex reassignment surgery, but there were still some things about this case that he didn't understand.
"I have stopped taking estrogen for 2 years. It is said that there should be no persistent and progressive muscle weakness and chronic cerebral infarction." Zheng Rendao.
"35 years! You must not ignore this problem." Su Yundao said, "No matter what medicine is used for 35 years, the amount accumulated in the body will be huge!"
Zheng Ren pursed his lips. Although what Su Yun said made sense, he still felt that there was something wrong.
"There is nothing special in the laboratory tests. Except for the increase in serum phosphokinase to 20,793 u/l, no abnormalities were found in other indicators including inflammatory indicators such as erythrocyte sedimentation rate, C-reactive protein, etc." Su Yundao said, "And the increase in serum phosphokinase High, it just confirms..."
"No." Zheng Ren said, "High levels of estrogen accumulated 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?"
"It's meaningless." Su Yun waved his hand, "I think only one serum phosphokinase is increased, which has no clinical diagnostic significance."
"That's true." Zheng Ren was still thinking.
"I didn't do a thymus CT, but looking at the chest CT, it felt like there was nothing wrong with the thymus. It didn't look like myasthenia gravis." Su Yundao.
"Well, no." Zheng Ren was still thinking about a few suspicious indications, "I'll think about it again and I'll understand what's going on after seeing the patient."
Su Yun narrowed his eyes and stared at Zheng Ren.
"how?"
"What do you mean by looking at the patient and knowing what's going on?" Su Yun asked.
"Physical examination!" Zheng Ren said in a deep voice, "Don't you even want to do a physical examination?"
"Check, you have to knock the watermelon before you buy it, because others knock it too, right?" Su Yun said disdainfully.
"No." Zheng Ren replied firmly: "It's possible that the doctors in Massachusetts missed some special symptoms. I have to see the patient, conduct a physical examination and ask questions in person to find out the cause."
Su Yun didn't think Zheng Ren could 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 might be some problem between porphyria and estrogen?"
"No, if there is a problem, it won't last 35 years." Zheng Rendao: "There is a high probability that taking estrogen for a long time will lead to cardiovascular and cerebrovascular diseases. What we need to do now is to rule out small probability diseases."
…
…
at the same time.
In the old castle, which never sees the sun all year round, doctors and nurses in white uniforms are busy.
"The urine output has almost dried up in the past 24 hours. Ms. Fandi's condition is not optimistic. She may only have 48-72 hours to live." A doctor said.