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Medical Consultations (Tag Solal)

Posted June 25, 2022, 12:27 p.m. by Lieutenant Junior Grade Solal Segal (Oncology and Immunology) (Lucas Foxley)

Posted by Lieutenant Alexis Bonner (Assistant Chief Medical Officer) in Medical Consultations (Tag Solal)

Posted by Lieutenant Junior Grade Solal Segal (Oncology and Immunology) in Medical Consultations (Tag Solal)

Posted by Lieutenant Alexis Bonner (Assistant Chief Medical Officer) in Medical Consultations (Tag Solal)
Posted by… suppressed (8) by the Post Ghost! 👻

It wasn’t that Alexis had forgotten about Gerald, but given current circumstances and the fact he was stable allowed her to focus else where. Gerald had been dealt a bad hand medically. He wasn’t born that way, Star Fleet made him that way. She was currently going through his current medical file. His immune suppressant medications were working much better now. His previous medication hadn’t been adjusted for his metabolism and so his body had burned through it. Things seemed to be stabilizing now, but there was still a lot of work to do. Alexis had a call in to Dr Asimina on the Saracen. She was a prosthetic expert, for ideas for replacements for his implants, but that wouldn’t solve the problem completely. Gerald’s immune system was still being pushed past safe limits. As she read and researched and contemplated and ran scenarios Alexis tapped a stylus rapidly against her hip. Then twisting her hair up into a bun and shoving two (or three) styluses through the bun she tapped her combadge. =/\=Lt Bonner to Lt Solal. Come to my office for a consultation at your earliest convivence.=/\=

Bonner, AMO

=^= One moment Lieutenant, and I’ll be right there. =^= His response to her was near instant. It took longer, however, for him to actually show up. Solal was in contact with a scientist aboard the Ark Angel and he’d been writing a letter when Bonner chose to ask for him. He took ‘at your earliest convenience’ to mean, ‘finish what you’re doing first’. And so, about twenty minutes later he arrived, wondering what exactly the consultation he had been called for was. “Lieutenant Bonner, you called for me?” He asked upon stepping through the door to her office.

~ Lt JG Solal, Immunology

“Please have a seat Lt.” Then Alexis passed Solal a PaDD. “This is Warrant Officer Gerald Hopkins, engineer.” She gave Solal a moment to skim the contents. “You can see from his file he’s undergone quite a bit. When he first boarded the Ogawa I adjusted is immunosuppressant because it wasn’t calibrated to his metabolism correctly. So naturally he was burning through it and in consequence he was having a great deal difficulty, and having to replace parts every few days. The length between cybernetic parts has increased, and we successfully replaced is old ocular pieces with newer models with great success. His immune system is still trying to reject the original ‘modifications’.” The way she said that last word left no doubt to her opinion of the so called doctors that had done this to him. “With your expertise in immunology, I wanted to bring you into his care team.”

Bonner, AMO

Solal took a seat and took a look at the PaDD as it was handed to him. “It’s impressive he’s alive,” he replied, after having skimmed the file. His accent was lightly French, influenced by his native language. From what it said, it made sense to Solal that he was having to replace parts so frequently. “Much like a transplanted organ, I doubt there’s any way to prevent rejection entirely, and it appears a great effort has been made to lessen the symptoms of rejection.” Her opinion on the modifications was quite clear to Solal. He couldn’t say she was wrong from a logical perspective either. The modifications had done their job sure, but it was a massive waste of resources trying to keep the rejection at bay. “What exactly are you hoping my expertise can do for him?”

~ Lt JG Solal, Immunology

“I am hoping your expertise can keep his immune system functioning. Due to the immunosuppressants not working, not being calibrated correctly for his body, his immune system has been working in over drive for far too long and it’s beginning to break down. He is doing better with the new regiment, but he also has a long way to go. Most of his implants, cybernetics, and prosthetics have to be replaced. It will take time and a huge toil on an already weakened body. I know there is no way to really stop his body from attempting to reject what is foreign, but can we give him a better quality of life than he has now?” Alexis had no delusions that Gerald would ever be totally healthy again. His body would always fight with what had been done to him - to enhance him in the name of protecting the Federation. Gerald had somehow beat the odds, when others involved in the ‘project’ had not. When Gerald had first come to her for his ‘check-in’ he had been content to continue on until his body simply failed. Alexis couldn’t accept that, when there were things they could do to improve his health. Alexis had seen a lot in her short years as a doctor, but the butchery that had been performed on Gerald went against everything they were taught and trained for at Star Fleet Medical.

Bonner, AMO

To Solal, the project seemed a fruitless endeavour. It was cold, his parents would tell him, but it was logical to him that the endpoint was inevitable. He may be able to slow the breakdown of this patient’s immune system, to ease the load on it, but he wasn’t sure it could be averted entirely. “The quality of life may be improved, though I cannot guarantee by how much.” He answered Bonner’s question at last.

~ Lt JG Solal, Doctor

Bonner nodded, “Quality of life is subjective and in the end is really a determination the patient will make. Right now he’s replacing parts every few days to at most 2 weeks, that should be lasting months. He has asked me for medical help, for our collective expertise, to help heal his body. The end result won’t change, but if he wants to prolong when it arrives, then it is my responsibility to do so. Any knowledge, skill, or theories you can provide are welcome.”

Bonner, AMO

Solal nodded. “With the time to review everything properly I should have a few ideas.” He was already considering the different immunosuppressants that existed, how exactly they worked, and how that might change the outcome. But he wasn’t prepared to make any official suggestions. “I’ll also need time to read up on the type of implants he has, and how they interact with the body and more specifically the immune system. How it rejects and attacks them.”

~ Lt JG Solal

Bonner nodded. She didn’t want a fast answer; she wanted an informed answer. Fast answers had put Gerald in this medical situation. “It’s all in his file. Also,” she tapped her screen and the PaDD beeped, “These are the new implants we are considering. I’ve contacted a prosthesis specialist for her insight, so that list most likely will change. I’m sure if you would like to speak with him or need to run any additional tests Warrant Officer Hopkins will make himself available. I appreciate your time, Dr. I won’t keep you longer.”

Bonner, AMO


It was a few months later before Solal had any new answers to report to Doctor Bonner. He’d been following medical studies in his field, he always did, and there had been a drug in its preliminary trials which was meant to limit the rejection of replacement organs in transplant patients. The drug had passed its preliminary trials but was still considered experimental. Solal thought it worth it to at least give Bonner the option.

Solal went to her office and rang the chime, PaDD in hand with studies ready to go. Zyeacronin had side effects, some were severe, but from what Solal understood this patient’s situation was dire, and he thought this had a real chance of working. Or at least helping.

~ Solal

“Come in.” Bonner sounded distracted, but that was nothing unusual for her. Her mind traveled at warp speed in infinite directions at once. She was examining test results and symptoms of a patient. She glanced up after a moment. “Dr. Solal what can I do for you?”

Bonner

“I might have something to help your patient with the implants,” Solal said as he went in and sat down. It was his version of being ‘excited’, he spoke a little faster and he didn’t seem quite as reserved as usual. He set his PaDD on the edge of her desk. “There’s a new medication, still experimental, but I think it has a good chance of lessening his symptoms.”

The studies on his PaDD showed a high rate of lessening rejections symptoms, with about 20% of cases showing some kind of side effect, 5% of which were severe. Patients so far had good outcomes but there was little or no data on long term outcomes.

~ Solal

Alexis sat up, her eyes widening slightly. This was good news. Her excitement was tempered by caution, but Gerald was running out of options. She took the PaDD and read silently for awhile. Most of the side-effects were mild - tiredness, dehydration, nausea, increased hair growth, hand trembling, and slight fever until the patient adjusted to the medication. Those could be annoying but usually resolved themselves. The trembling could be a major issue though for Gerald as he was an engineer.

There was of course the risk of major infection and the risk of death became high. But then Gerald was living against the clock right now. “The biggest concerns I see here is that it affects the way the body process glucose causing diabetes. An easy fix in our century but with his other problems, this may become a major issue. The other is the medication has an adverse interaction with levetiracetam. And he’s been taking that to help with the seizures he was getting due to the implants and rejection. So he may not need that anymore. It looks like it is certainly worth a try. Has this been used to assist with Cybernetic transplants or only biological tissue?”

Bonner

“Some cybernetic transplants, but nothing so extensive as your patient’s. It would be risky, but as I understand it, he doesn’t have the time to wait for a safer option.” Solal replied, “The diabetes can be managed. The interaction with levetiracetam poses an issue, he will have to discontinue it before starting zyeacronin, and that means risking seizures until the medication starts to make a difference. Its effects take a few weeks to build up and make a difference. It does suppress the immune system making infection more likely and more serious. But it is less risky in that aspect than other medications of its kind.” This was firmly in Solal’s area of specialty, he was sure he was correct in his risk assessment, but it was Bonner’s patient and Bonner and the patient’s choice.

~ Solal

Alexis nodded slowly, a stylus appearing in her hand, and she tapped it against her leg thoughtfully. “I can fix him with a monitor and an automatic pump of diastat for the seizures in the mean time. I will have him come in so we can go over the medication with him. This is your area of expertise though, so I would like you to monitor his case while he’s on the zyeacronin. It will take roughly 3 days for the levetiracetam to clear his system. How long would it be before you can get the zyeacronin?”

Bonner

Solal took his PaDD back, tapped a few things, then looked up. “A week, maybe a week and a half to get it on board. Since it’s experimental, I will have to get in contact with the doctor running its trials and get it from them. Then they’ll have to send it to us. The trials are on Earth. It would take longer but the doctor running it happens to be an old colleague of my parents.” He thought a moment then said, “You know the patient better, it is up to you whether to bring this information to him now or to wait until I am certain I can get my hands on the medication.”

~ Solal


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