Chapter 7 Choosing Between Two Treatment Methods
When we got back to the health center, it was still more than an hour before 2 p.m.
With nowhere to stay in the main building, Lin Xili strolled back to the old building that specialized in treating hyperthyroidism.
There is a huge longan tree in front of the building, with lush branches and leaves. It is very thoughtful to build a low brick wall around the shady area cast by the branches, so as to increase the space for patients to sit and wait.
In the middle of the room were several stone tables, each with four stone benches. There were already more than a dozen people sitting there, the same patients who had lined up for treatment that morning.
Unlike in the morning, most of them were accompanied by family members.
They chatted warmly in the local dialect, sharing their illnesses, family matters, and news from the town, creating a familiar and homely atmosphere.
Lin Xili stood there alone, looking somewhat out of place.
She couldn't understand a word of their conversation, and the noisy, lively sounds only made her feel more lonely.
She silently sat down on a stone bench at the very edge, took out her phone, and pretended to be browsing the news, trying to isolate herself from her surroundings.
Cell phone signal isn't very good here, and web pages load slowly.
She absentmindedly swiped through the screen. Unlike hospitals in Hong Kong, where test reports could be viewed directly on a mobile app, this place was different.
Here, the reports are printed out by the attending physicians, and patients cannot know the results in advance; they can only passively wait for the doctor's verdict.
This uncertainty made her feel somewhat irritable and uneasy.
At that moment, a young couple sat down on the stone bricks of the stone bench next to her.
“We’ve been seeing doctors and taking medicine at the city hospital for two years, but we still haven’t gotten better. How can we expect to get better at this rural clinic?” The girl leaned on the boy’s shoulder and sighed.
"Baby, don't worry, it will be alright. My cousin got better here last year, it was Dr. Huo. She has a daughter now and is doing very well," the boy comforted her.
They were communicating in Mandarin, which Lin Xili could hear clearly. She couldn't help but look up at the couple.
If she had seen such a lovey-dovey couple in public before, she would have found it all trivial, but now, her eyes were filled with envy.
Looking around at the other patients, their relatives, lovers, and boyfriends didn't seem to mind at all, and they accompanied them to the consultation.
She was diagnosed with hyperthyroidism simply because she needed to take medication to manage it, and during that time she couldn't get pregnant. It was as if she had broken a law of nature; she was jilted and accused by her family of disgracing the Lin family.
She lowered her head again and continued scrolling through her phone, trying to suppress the bitterness in her heart.
At exactly 2 p.m., a commotion was heard from the old building.
The patients started to get up and lined up on the first-floor stairwell, waiting to go upstairs to get their results.
The group didn't move very fast, since everyone had to stay with the doctor for a while to ask questions, get explanations, and get prescriptions.
Lin Xili didn't want to squeeze in with the crowd, nor did she want to experience the tense atmosphere in the cramped consultation room.
She decided to wait until everyone else had finished watching before going last.
Anyway, she has plenty of time.
She knew that patients were used to coming to the doctor in the morning, since it involved blood tests. After the tests, they could get the results and medication in the afternoon and then go home.
She continued to sit under the longan tree, watching the people in line go upstairs one by one, and then come down one by one, leaving with their waiting families.
Finally, it was her turn to be the last one.
She stood up, straightened the slightly wrinkled hem of her clothes, and slowly walked up to the second floor.
Huo Nanchen was the only one left in the consultation room. He was looking down and organizing the medical records. Dr. Zhang was not there.
Hearing footsteps, he looked up and saw it was her. He reached out and accurately pulled out hers from a stack of reports.
"sit."
Lin Xili sat down opposite him, her gaze falling on the thick stack of reports, a slight tension tightening in her heart.
Huo Nanchen flipped through her report, his fingertip tracing several key figures:
"The thyroid hormone levels are still very high, with FT3 and FT4 both exceeding the normal range by a large margin, and TSH is suppressed to a very low level. This is a typical case of hyperthyroidism."
He turned to the next few pages, "However, heart function is normal, liver function is normal, and blood routine is normal."
"What treatment plan do you have in mind next?" Huo Nanchen put down the report and looked at her, asking, "Should we continue with medication, or consider iodine-131?"
Lin Xili naturally knew what iodine-131 was; it was a radioactive substance, which, to put it bluntly, was chemotherapy.
Radioactive materials will always emit radiation, which may harm other organs in the human body.
"How long will the medication treatment take?" she asked cautiously.
"Western medicine, such as the methimazole you are taking now, can only control the symptoms and inhibit the synthesis of thyroid hormones, but it cannot cure the root cause of the disease."
"Most patients relapse after stopping medication. Otherwise, so many people wouldn't have taken the medication for eight or ten years and still have fluctuating test results, making it impossible to completely stop taking the medication."
This statement is similar to what Lin Xili learned in Xiangjiang City.
Taking medication for a long time and undergoing repeated examinations is indeed a torturous process.
"What about Iodine-131?" she pressed.
"Iodine-131 treatment, from medication to normal functional recovery, normally takes three to six months. It only requires one oral dose of medication containing radioactive iodine, but in rare cases, a second dose of iodine may be necessary!"
Lin Xili asked, "What is the chance of a cure?"
"The cure rate is around 98%. 2% will develop permanent hypothyroidism."
What is hypothyroidism?
"Hypothyroidism, the opposite of hyperthyroidism, is caused by insufficient secretion of thyroid hormones, leading to a slowed metabolism. Symptoms include feeling cold, fatigue, weight gain, and memory loss."
He paused, then added, "If you develop hypothyroidism, you'll need to take thyroid hormone tablets, such as levothyroxine, for life to supplement the hormone your body lacks. However, levothyroxine is a hormone replacement therapy, and its side effects are far fewer and more stable than the methimazole you're currently taking."
Lifelong medication?
How can a disease that requires long-term control and may recur become a disease that requires lifelong medication?
This doesn't sound like a good option.
She looked at him, "Then...can you guarantee that if I drink that medicine, I won't develop hypothyroidism?"
She thought she was crazy for asking such an unprofessional question.
Huo Nanchen gave her a deep look upon hearing this.
He should have felt that, given her apparent rationality, she shouldn't have asked such a question demanding assurances.
"There is no 100% guarantee in medicine."
"However, to date, not a single patient who has received a dose of medication prepared by me has developed permanent hypothyroidism."
Lin Xili was stunned.
Not a single case?
If this data is accurate, it's practically a miracle.
She looked into his dark eyes, which held no boasting or exaggeration, only a calm statement based on facts.
This made her doubts begin to waver.
"Do I need to be hospitalized?" she asked, changing the subject.
"No need. You can leave after taking the medicine, just pay attention to some protective and isolation measures."
“You can go back and think it over. After all, if you decide to get iodine-131, you need to stop taking methimazole and strictly avoid iodine, especially seafood.”
"After stopping medication and abstaining from iodine for a month, come back to have your thyroid iodine uptake rate tested. Only then can I accurately calculate the dosage of iodine-131 you need to take based on the results to determine if you can be treated with iodine-131."
Lin Xili looked at the young doctor in front of her, who exuded amazing confidence, and then remembered that the doctor in Hong Kong had only prescribed medication.
The clinic didn't mention any treatment methods for iodine-131, but instead, in this remote clinic, they mentioned two treatment options.
Is it better to choose a long and arduous course of medication, or a single high-risk, high-reward radiation therapy?
She was unsure what to choose. "I'll go back and think about it."
Huo Nanchen nodded, handed her the stack of reports, and indicated that she could go back first.
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