Chapter 1817: with translation of chapter title

Old Luan, your physique has recovered very quickly." Su Yun sat down, laughing and chatting with Luan Yingjie.

Yun Ge'er, look what you're saying." Luan Yingjie sat down, chuckling and said: "Isn't this the ketogenic diet you told me to follow?"

How's the effect?" Su Yun asked casually.

The effect is not bad, the belly has gone down, blood sugar is under control. But now I truly feel this saying—meat is just a garnish of life, carbs are eternal happiness." Luan Boss said somewhat emotionally.

Hahaha, whatever you lack you crave—when you're allowed to eat freely, do you eat rice and drink well water every day?" Su Yun laughed: "Stop small talk, let's get to the point."

My father is 72 years old; half a year ago he began experiencing intermittent dizziness. Strangely, he only gets dizzy when eating, especially when he eats a lot of rice or steamed buns, solid food, which is the worst." Luan Yingjie said, "At first I didn't pay attention, thinking I was busy with work, never home, the old man missed me and pretended to be sick to get me to come back."

Later I went home to keep him company for a few meals; it didn't look like he was faking. But normally he's fine—don't let his age of 72 fool you, he rides his bike every day, roaming all over the city, his health is good. Yet the problem of getting dizzy as soon as he eats hasn't improved, and he's become terribly thin.

Zheng Ren listened to Luan Yingjie describe the condition while flipping through the medical records and test sheets.

He's been to the hospital for checkups several times, everything was normal, even the doctors were stumped.

No other medical history?" Zheng Ren asked, "Hypertension, Coronary Heart Disease, diabetes—any of those? Does he take medicine daily?"

He has none, his body is great, but lately nothing he eats tastes good." Luan Yingjie said.

Zheng Ren flipped through various test sheets.

The tests from half a year ago, just as Luan Yingjie said, showed no problems. Blood work was fairly comprehensive—liver and kidney function, electrolytes, blood sugar, tumor markers, trace elements, uric acid, etc. —all routine checks were present.

In terms of imaging, the head CT showed a slight atherosclerotic shadow, absolutely no problem, and no tumor.

The basilar and neck vascular Doppler ultrasound showed normal blood supply, not due to insufficient cerebral blood flow.

Cardiac-wise, the echocardiogram and ECG were fine, related blood tests such as D-dimer were done later, and there was even a coronary angiogram image.

No issues at all; for a 72-year-old, his health is considered good.

Just as Luan Yingjie said, there are no problems.

The lung CT also showed no tumor, not even tracheitis, bronchitis, or emphysema.

Lung markings were clear, and lung function was obviously good at a glance.

The abdominal CT was fine, the colonoscopy showed no problems, just that a gastroscopy wasn't done.

Why wasn't a gastroscopy done?" Zheng Ren asked.

He underwent it once; as soon as the scope passed the pharynx, he couldn't tolerate it. Later the doctor suggested trying again, but my father said he wouldn't do anything, claiming that doing it once was equivalent to dying once." Luan Yingjie said anxiously.

Had this happened before? I mean before the onset half a year ago." Zheng Ren asked.

No, never before—no one in my family has ever experienced this.

How is the old man now?" Zheng Ren continued looking at the sheet, asking.

Because eating makes him uncomfortable, he started eating less, mainly liquid foods. But although his food intake decreased, he says the feeling of swallowing difficulty has worsened.

Zheng Ren set the test sheet aside, holding the film up to the light.

While everyone else was noisily eating hot pot, he sat alone looking at the film, but Zheng Ren felt nothing—seemingly this was normal.

Strange." Su Yun muttered while looking at the lung CT.

Hmm, it's very strange." Zheng Ren said: "All test indicators show no problems."

Blood system disease?

Not likely." Zheng Ren said: "Whether it's a blood system disease or an endocrine system disease, there should be symptoms even when not eating; it definitely wouldn't occur only when eating."

Su Yun nodded and continued viewing the film.

Zheng Ren suddenly remembered something and began searching for the film.

Zheng Lao Ban, what are you looking for?" Luan Yingjie asked.

Was an upper GI barium study done?" Zheng Ren asked.

Yes, we did it, and it was fine." Luan Yingjie began searching for the film, flipping through for a while, then said embarrassedly: "Maybe it's still in the car; I'll go get it."

After saying that, he stood up, bowed politely, then turned and left.

Zheng Lao Ban, it's probably a psychiatric disorder." Lao He turned and said his opinion: "I once encountered a patient from a psychiatric hospital who came to our 912 for gastric cancer surgery. When I anesthetized him, he talked to me for half a day.

Story?

Ah, just a tragic life story—being deceived, involved in MLM, later arrested, etc." Lao He said: "It sounded just like the real thing; he claimed to be a jinxed lone star.

What was the outcome?

His parents, wife, and children were waiting outside the operating room—what a waste, I still felt awful for the duration of the surgery." Lao He said: "Later I asked, and he said he had a performative personality; if he didn't put himself into the role, he felt terrible all over.

The possibility of a psychiatric disorder exists, but it shouldn't be diagnosed lightly." Zheng Ren said.

We've already been thorough; all test indicators are normal—what are you saying we should diagnose?" Su Yun said.

Let me think again." Zheng Ren held the test sheet, leaning back on the sofa, his fingers lightly tapping the armrest.

Su Yun felt this guy was becoming more and more like Director Pan.

Once we get the upper GI barium study images, we'll be able to diagnose." Su Yun said bluntly: "At 72, he doesn't even have mild valve regurgitation—his health is too good. The ECG is also fine; we're not considering cardiac disease.

What do you think it is?

Achalasia of the cardia—this is a strong possibility." Su Yun said.

Achalasia of the cardia is a esophageal functional disorder caused by neuromuscular dysfunction of the esophageal cardia, leading to incomplete relaxation of the lower esophageal sphincter, preventing smooth passage of food, causing it to stagnate, which gradually reduces esophageal tension and peristalsis and leads to esophageal dilation.

However, typically the chief complaint of this disease is not dizziness, but dysphagia, food regurgitation, and weight loss.

Zheng Ren carefully searched various cases of cardia achalasia, and indeed there are instances where malnutrition caused dizziness and other symptoms. But to say dizziness upon eating…

This is too strange; Su Yun was just guessing. Zheng Ren considered that it might be due to an endocrine system tumor.

Soon, Luan Yingjie brought up the films, this time also bringing a PET-CT.

Too many tests were done, we missed two items—sorry, Zheng Lao Ban, sorry, Yun Ge'er." Luan Yingjie repeatedly bowed in apology.