Free Web NovelChapter 1118: Chapter 1118: Incurable PANDAS
(Thanks to Sterling and fwxiaoyang for the monthly ticket encouragement)
"Dalei, let me introduce you, this is Director Liu, he’s very capable."
Just before one o’clock in the afternoon, Bao Chunlai led a family of three to the emergency center.
"Director Liu, we’re sorry to trouble you. We really don’t know what to do. We even took the child to the United States, and there was no solution there either," Wulei said.
"Since it was Chairman Bao who introduced you, I won’t hide anything from you. Before you came, I also consulted with pediatric experts about the child’s condition. The situation is really not very optimistic," Liu Banxia said.
"Let’s sit in my office first, we can talk and then see how things are. Chairman Bao, if you have nothing else to do, you can go upstairs and stay with Rou for a while; you can leave it to me."
"Alright, I also brought Rou her toiletries and pajamas, sorry to bother you for two days," Bao Chunlai said.
"It’s nothing, she’ll have company with Qiaoqiao," Liu Banxia said casually, then led Wulei’s family of three into the office.
He noticed Xu Yino peeking in their direction and gestured for her to come over.
"Teacher Liu, is there something you need?" Xu Yino hurried over.
"Since you came so urgently, you must not have eaten. Go to the cafeteria and arrange for Manager Zhou to make three meals, one with extra care for the child," Liu Banxia said.
"Director Liu, it’s no problem, we can eat later," Wulei hastily said.
"No need for formalities with me. Our meals here are really good, even Old Bao likes them," Liu Banxia waved his hand.
"Sister-in-law, why don’t you take the child outside for a rest? Children today are very clever. Or you can go with Xu Yino for a walk in the cafeteria and see what you’d like to eat."
"Alright, Director Liu, you go ahead and talk," Wulei’s wife quickly said.
In fact, in the past two years seeking medical help for their child, they had heard too many disappointing words. Now Liu Banxia’s words and attitude also showed they still had no hope.
"Director Liu, go ahead,"
Once his wife and child went out, Wulei spoke up.
"Chairman Bao has explained the basic situation, but when exactly did the symptoms start?" Liu Banxia asked.
"Two years ago, when he was six," Wulei said.
"We didn’t pay much attention at the time, no one thought it would be this illness. It just started with a fever, then when treated at the hospital, the child suddenly started twitching, and his toys had to be arranged perfectly."
"Even at that time, we didn’t think much of it. We thought it was just a common cold or pneumonia, and we even praised the child for being orderly in everything."
"Even with the twitching, we assumed it was due to the fever. Later the doctor mentioned streptococcal infection and, combined with the child’s symptoms, said it might be PANDAS."
"And that was it, we went to all the renowned children’s hospitals in the country and consulted foreign experts. These two years, we did nothing but take the child for treatments."
"In the United States, Professor Clark is considered an authority on this. But even with the medication he prescribed, it only manages to control the symptoms."
"We’re scared the child will get infected again, which would trigger the symptoms. Without infection, the condition is controlled; even though there are compulsive symptoms, the twitching is not very evident."
"But it can’t go on like this. Chairman Bao suggested if all else fails, we should come to you. Your medical skills are high, maybe you could think of a different solution."
Liu Banxia nodded, "I paid attention to the child’s behavior just now. Is her compulsive behavior quite severe currently? From the time I saw her until when her mother took her out, she blinked three rounds of her eyes, each time twice."
Wulei gave a bitter laugh, "This is a new symptom in the past six months, didn’t expect you to notice it. In the past, everything had to be arranged neatly, no grains of rice could be left in the bowl, and even spilled food had to be eaten."
"Obsessive-compulsive disorder is a tricky condition, constantly bringing up new issues. I don’t know if in another year or so, there will be more symptoms."
"She should be in elementary school now, right? When we came back, we did send her to school. Kids don’t know much, seeing his peculiar behavior they get curious, which makes him more anxious and thus worsens the compulsive symptoms."
"I don’t know if the doctor explained to you in detail about the possible future scenarios, that long-term use of antibiotics could disrupt the child’s gut microbiota," Liu Banxia said.
"If this condition really flares up, it would be even more terrifying than PANDAS. Because the child is young and has weak immunity, it can directly threaten life."
Wulei nodded, "Professor Clark mentioned it too, but he said the medication he prescribes is currently the mildest. It’s experimental, supposedly with no side effects, very gentle."
Liu Banxia frowned slightly, then quickly relaxed.
With experimental drugs, no one can guarantee there are no side effects. Because it’s still experimental, even if it’s reached clinical trials, there are definitely some side effects that haven’t manifested yet.
However, he understood Wulei’s situation. No one wants to randomly drug their child. But when there’s no other way, PANDAS is really not an ordinary condition.
To control the disease, while also preventing gut flora imbalance, it’s hard to achieve both perfectly.
"Dr. Liu, do you mean to let PANDAS go unchecked?" Wulei asked.
"Regarding the same disease, every doctor will have different opinions." Liu Banxia considered for a moment.
"From the information relayed by Chairman Bao, it shows that the child’s gut flora is already at an imbalanced stage. There will be habitual abdominal pain recently, including this morning."
"This is a dangerous signal and must be taken seriously. I’ve talked a lot with Chairman Bao before, and he is actually worried about this aspect, which is why he brought you here to see me."
"My personal opinion is to temporarily stop all antibiotics for now, to let the child’s gut flora recover. If it’s truly imbalanced, even if we have a fecal transplant program here, we can’t guarantee with absolute certainty that the child will pull through."
"Moreover, for children, their immune system is inherently weak. As I just observed, perhaps due to the impact of the condition, the child is emotionally down, typically eats poorly, and is a bit too thin."
"But if that’s the case, if no medication is used, isn’t there a risk of life-threatening complications if PANDAS worsens?" Wulei asked worriedly.
"This is the dilemma of this disease; my view is to treat symptomatically first," Liu Banxia said.
"Deterioration takes time, but I don’t think the child’s gut issues can wait any longer. We can conduct a stool test later to examine the gut flora condition."
"Actually, it’s known even without testing that long-term use of antibiotics, even pediatric versions with low doses, has a significant impact on the gut."
"Another point to consider is that the gut flora of children differs significantly from that of adults."
"With life experiences, an adult’s gut flora becomes more complex. If a child develops related gut diseases, I wouldn’t dare to casually prescribe a fecal transplant."
"Because our donor feces are sourced from adults, giving them to a child rashly may only worsen the situation."
"So I’m very concerned about this aspect; I don’t want to remove the entire colon from a child at such a young age. It’s painful enough for adults, let alone for a child."
"However, these decisions are ultimately up to you, I can only offer a rough reference. There isn’t really a standard to determine the best action."
Just as Liu Banxia finished speaking, Xu Yino and the others returned, carrying boxed meals.
"Regardless of anything, let’s eat first, we can slowly discuss the issues. If you can’t hold on, it’ll be even worse for the child," Liu Banxia said.
Wulei nodded and took the boxed meal.
The situation Liu Banxia described had been mentioned by other doctors as well. This is the most difficult and troublesome aspect of PANDAS; even if the child’s future lifestyle is affected, preserving their life is what matters most.
Yet reality rarely gives such an easy choice.
Not taking medicine could lead to serious, life-threatening complications from worsening PANDAS, while taking medicine harms the child’s gut.
No one had explained it as thoroughly as Liu Banxia did; he had thought at worst the child would just develop habitual colitis, frequently having diarrhea or such.
When the child ate, Liu Banxia paid special attention.
While other kids might feel scared when coming to the hospital, this little guy didn’t.
Although a picky eater, he ate earnestly, making Liu Banxia feel a pang of empathy.
As a new father himself, he couldn’t imagine how he’d cope if his own child faced such a situation.
Children are the apple of their parents’ eyes, and this illness is like stabbing a knife into their hearts.
Standing next to him, Xu Yino’s mood wasn’t great either; she regretted following out of curiosity.
Seeing the child’s condition and the worry on the parents’ faces saddened her too.
Even as the child ate, his arms occasionally twitched, clearly an effect of the illness.
"Mom, my stomach hurts."
At this moment, the little one put down the spoon, frowned, and covered his stomach with his hand.
Wulei looked at Liu Banxia.
"Shall we conduct an examination of the gut first, take an X-ray, and then do a stool test?" Liu Banxia suggested.
They were just discussing the child’s gut issues, and unexpectedly, the little one showed symptoms again.
This indicates the child’s gut health is on the brink of collapse; any misstep could lead to severe consequences.
