Chapter 2369: 2374.2288 Avoidant-Restrictive Food Intake Disorder

2374.2288 Avoidant-Restrictive Food Intake Disorder

After a while, Su Yun returned having arranged the equipment needed for the surgery.

When he heard Zheng Ren mention the little girl's situation, he wasn't surprised; instead he gave a wry smile and said, "Boss, you're getting involved in too many things."

"I saw it, so I'll lend a hand." Zheng Ren asked in a low voice, "Right, I heard we have to go support the border every year; when are we going?"

"You definitely can't go this year; you have a Nobel Prize project, don't you know?" Su Yun glanced at Zheng Ren and dismissed the idea.

Zheng Ren nodded.

Many doctors in Di Du go to border regions every year to provide support for 1-3 months, raising the local medical standard.

Zheng Ren only knew about this; he didn't know the specific regulations or procedures. Suddenly remembering, he asked in passing.

This year it's definitely not possible; even if he wanted to go and made a request, Director Yan would reject it outright.

What a joke—with a Nobel Prize project ahead, everyone knows there's probably no chance within a year. But if you don't try, who could be willing?

At the very least, one should still show the proper attitude.

"Go take a look, Boss—what do you think is wrong with that little girl?"

"Her prominent feature is the presence of acute food refusal combined with long-term failure to gain weight; multiple diagnoses can explain this chronic and acute condition..."

"Can't you speak normally instead of like you're giving a pre-op briefing to a patient's family?" Su Yun said unhappily, "If things are fine, why can't you just speak normally?"

Zheng Ren was speechless—how could Su Yun have the nerve to say that!

"Her swallowing difficulty is behavioral. The characteristic features are sudden food refusal and weight loss after a traumatic choking episode. The two key psychiatric etiologies in the differential diagnosis are choking-specific phobia and anorexia nervosa."

"I think it's due to excessive psychological pressure; a child this age shouldn't be exposed to these things," Su Yun said.

"Hmm, I'm thinking the same."

"I haven't studied this area; do you have a solution?" Su Yun asked.

"She believes she cannot eat solid food because she fears choking and 'forgetting' how to chew and swallow."

Choking-specific phobia may cause patients to avoid any situation where choking might occur, including avoiding eating.

Because of the fear of death leading to this condition, I think we should first treat her great-grandfather's pneumothorax, then gradually soothe her; step by step, the little girl's avoidant-restrictive food intake disorder will improve.

"Come on, let's go take a look."

After work, most people from other teams had left the office, but the doctors in Zheng Ren's medical team were still working.

The boss is capable, so his subordinates are naturally busy.

Professor Rudolf Wagner now has almost no interest in anything; he has focused all his attention on the Nobel Prize.

With more than four months left, the professor, working without rest or food, organizes his materials and stays in contact with his beloved Xi Bao'er far away in Heidelberg, while his team there assists with various matters.

Gu Xiao Ran was working diligently, while Lin Yuan kept glancing over at this side.

"Work properly, go see a patient with an eating disorder—why are you joining in the fun?" Su Yun said.

Lin Yuan shrugged.

"Let's go." Zheng Ren said, stood up, and walked out of the office with Su Yun.

Lin Yuan watched their backs and sighed.

"Sister Lin, aren't you coming to take a look?" Gu Xiao Ran asked.

"No, I'm not going. I need to focus on work and get home early. I've been spending too little time at home lately, and my grandmother is already unhappy." Lin Yuan sighed, then after a moment of hesitation said.

"If I told my mom I work until after 10 p. m. every day, she'd surely come rushing over." Gu Xiao Ran chuckled, saying, "Better not to tell the family at all, to avoid worrying them."

"Sigh, you're lucky—your home is far away. If I don't go home, my mom would probably rush to the hospital the next day." Lin Yuan felt a bit envious of Gu Xiao Ran being away from home, recalling his own time far from his parents in the United States.

"Hehe." Gu Xiao Ran felt a little pleased, but seeing Lin Yuan's somewhat downcast expression, he changed the topic to comfort her: "Sister Lin, Boss Zheng said he'd let me perform a surgery in two days. After we finish work, could you explain the precautions for the surgery?"

"This week it seems a foreign expert team is coming to study; listening to my lecture wouldn't be useful—you'd be better off listening to Yun Ge'er's lecture and looking at the anatomy." Lin Yuan said.

"I've watched it twice, but I still don't feel confident." Gu Xiao Ran said, "If Boss Zheng lets me do a surgery and I mess it up, I'll never be able to do TIPS again."

"Surgery isn't that easy, and Boss Zheng isn't as strict as you imagine." Lin Yuan said.

The two worked while talking about TIPS surgery.

Gu Xiao Ran saw Professor Rudolf Wagner wholeheartedly organizing his materials, as if he hadn't heard a word he said, and felt a bit downhearted.

He knew the ranking of good and bad surgeries in the medical team; his probing was just to see if the professor would give him a couple of pointers.

It's really a shame—if only the foreign professor named Fugui'er could give him a lecture. Gu Xiao Ran pondered going to listen to Yun Ge'er's lecture, but he still felt afraid of performing surgery.

If Boss Zheng let him do a surgery and he couldn't do it well… thinking about it, his nose soured and tears almost fell.

……

……

"Boss, avoidant-restrictive food intake disorder doesn't seem to have any drug treatment, does it?" Su Yun asked on the way.

"Hmm, no. Even if there were, I wouldn't recommend taking it." Zheng Ren said, "We can resolve it more gently—avoid medication if possible."

Su Yun also knew this was the boss's habit; he is always cautious when it comes to mental illnesses.

Arriving at the Emergency Department, the two began reviewing the little girl's medical record.

In the physical examination, the patient's temperature was 37.2°C, respiratory rate 18 per minute, oxygen saturation in ambient air 97%; when she was supine, blood pressure was 107/70 mmHg, pulse 114 per minute; when standing, blood pressure was 95/72 mmHg, pulse 123 per minute.

The little girl weighed 26.5 kg, with a BMI of 12.5 kg/m². There was no oral bleeding point.

Hemoglobin level, hematocrit, platelet count, red cell indices, and kidney and liver function tests were all normal; blood glucose, calcium, magnesium, total protein, globulin, and TSH levels were also normal.

Potassium ions were slightly low, possibly related to the eating disorder; this was also diagnosed by Big Pig Trotter.

The ECG showed sinus tachycardia, heart rate 110 per minute, PR interval 116 ms, corrected QT interval 422 ms.

The examination revealed nothing noteworthy; the possibility of avoidant-restrictive food intake disorder is considered relatively high.