Doctor: It's reasonable to perform surgery on yourself.

Why is it not strict enough?

The only explanation is that the diagnostic process is not standard enough.

This cannot be blamed on other doctors. Agency syndrome itself is a very rare disease. There are only a few confirmed cases in China, and the behavior of Lu Ruping and Xiang Kai’s mother and son is too typical. The classic combination of a strong mother and an obedient son is very It’s hard not to let doctors rely on this.

"Have the test results come out?" Xu Qiu asked.

"It's out." Shi Lian quickly handed over the printed report.

Xu Qiu scanned it and found that except for low hemoglobin, other blood tests were normal.

Other examinations showed no obvious abnormalities.

This is reasonable... If a diagnosis could be made with just a few random tests, it wouldn't be necessary to go to 13 hospitals.

"By the way, the patient should be better now and ready for examination." Shi Lian reminded.

Reduced sensitivity?

Xu Qiu nodded, got up and rushed to the ward.

…

Routine physical examination.

The patient's face was pale, his hair was dry, his skin had poor elasticity, and he had a thin and transparent feeling.

"Stiff joints?" Xu Qiu tried to palpate.

Indeed, the patient's limb joints are restricted to varying degrees. Although the degree is not obvious, the range of motion has indeed become smaller.

And if you look closely, you can see that under some of the thin skin, the subcutaneous tissue has shrunk to a certain extent.

"It's getting worse again." Xu Qiu frowned when he saw the shrinkage.

During the examination at Union Medical College a few weeks ago, the only diagnosis was joint stiffness. The doctor at that time did not find atrophy of the subcutaneous tissue.

But now it appears!

The speed of the course of the disease has exceeded Xu Qiu's expectations.

Xu Qiu tried to lift Xiang Kai's calf.

As soon as it was lifted halfway, the popliteus muscle, flexor digitorum longus, tibialis posterior muscle, etc. deep in the posterior group of the calf began to twitch rapidly, the knee joint also flexed, and the entire calf rotated inwards.

"The twitching of muscle tissue is very likely to be accompanied by osteoporosis..." Xu Qiu made a judgment.

"pain!"

At this moment, Xiang Kai roared in pain again, and immediately retracted his calves and retracted into the quilt.

Lu Ruping's eyes suddenly showed a distressed look.

Xu Qiu's eyes changed.

pain?

It stands to reason that even if the pain is caused by muscle twitching or Xiang Kai's own sensitivity, it should appear the moment he lifts his lower limb.

However, Xiang Kai's pain reaction only appeared after the calf was internally rotated!

Although the time difference was less than one second, there was a moment's delay in a pain that should have occurred instantly. This was already very wrong.

"Have you ever injured your foot?" Xu Qiu immediately thought of a possibility.

Lu Ruping denied: "I shouldn't have been injured."

Xu Qiu nodded and asked Xiang Kai to stretch out his legs.

Although the other party was reluctant, he still cooperated and complied.

At this glance, Xu Qiu noticed something unusual.

The patient's ankle has an inward curvature. Although the angle is not large, it is real.

Xu Qiu looked at Lu Ruping and said, "Maybe not? If you think about it again, it doesn't matter if it's just a sprained foot."

Lu Ruping recalled it carefully, then suddenly her expression changed and she said: "He has participated in taekwondo and football training courses. Because he is young and does little exercise, he sprained his foot for the first time two months ago while playing football. Just rub it and it’ll be fine, so I won’t care.”

These words made Xu Qiu more convinced of the rationality of his doubts.

If it is really Munchausen Syndrome, is it possible to treat it as if it is a disease even if it is not a disease, and not go to the hospital for a few days if it is a sprained foot?

But she just rubbed it and stopped paying attention.

This is nothing like what someone with proxy syndrome should behave like.

It is not an exaggeration to say that children are left alone.

"It still hurts now, right?" Xu Qiu asked.

"Yes, a bit..." Xiang Kai finally spoke. He looked at Xu Qiu in surprise. This was the first time a doctor noticed the pain in his ankle after so many visits.

But Xiang Kai didn't pay much attention to it. He had mentioned this to other doctors before, but in the end it was classified as "body pain" and didn't pay much attention to it.

However, Xu Qiu was the first doctor to discover the pain in his ankle through physical examination and asked about the sprain he had sprained two months ago.

"Does this... have any impact?" Lu Ruping looked remorseful.

If the child's illness is related to the sprained foot, she may feel guilty for a long time.

However, I hope deep down in my heart that this is the final answer.

As long as I can keep my son from getting sick, it doesn't matter if I feel guilty.

"Not sure." Xu Qiu said frankly.

It was just discovered that the ankle was injured. How could it be so simple to overturn the diagnoses of thirteen hospitals based on this?

For a time, Xu Qiu also fell into a situation where he could not advance the diagnosis and treatment process.

The examination results showed no obvious abnormalities, and the physical examination did not reveal anything special.

"We can only use the stupidest method." Xu Qiu said helplessly.

He originally planned to use brute force to crack the problem and diagnose the disease directly from the front, relying on his familiarity and experience with rare diseases.

However, on the one hand, patients have no obvious symptoms, and on the other hand, there is no clear diagnostic process and diagnostic criteria for Munchausen syndrome, making it difficult to directly identify the disease.

"First rule out Munchausen syndrome by proxy." Xu Qiu said.

If even he can't rule it out, then he can only accept the diagnoses of thirteen other hospitals!

"How to rule it out?" Lu Ruping was pleasantly surprised.

After so many visits to the doctor, this was the first time she heard a doctor rule out Munchausen syndrome by proxy.

Because of this matter, her husband and parents-in-law almost broke up with her, and every time she went to a hospital, her family became more convinced that Lu Ruping had something wrong with her.

However, Xiang Kai said that he was really in pain and that his mother was not sick...

Because of this sentence, Lu Ruping went to many hospitals with her child despite the pressure from her family, and she became increasingly desperate.

It can be said that Xu Qiu is her last hope. If Xu Qiu is given this diagnosis, she may completely collapse!

She is not worried about being misunderstood or being regarded as a control freak. She is only worried that her son is really sick and cannot get timely treatment!

Thinking of this, Lu Ruping's eyes slowly turned red.

She wiped her tears and sobbed: "It doesn't matter if I am regarded as mentally ill, but if I am diagnosed and you treat me, you will ignore my son... If he is really not sick, how can he feel pain? I believe it He is really in pain. How can I rest assured if he is not cured?

"I accept taking medicine, but I'm afraid that no one will believe my son's pain anymore. They also think that I, the mother, have a mental problem. What should I do if his treatment is delayed?"

After hearing these words, everyone in the ward fell silent.

At this moment, they finally understood what Lu Ruping was thinking.

What she was afraid of was never that she would be misunderstood. What she was worried about from beginning to end was just what if her son was really sick and couldn't get treatment?

"If we want to rule out agent Munchausen syndrome, we first need your cooperation." After a long time, Xu Qiu stood up and said to Lu Ruping.

——

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