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Main Sim - Primary Sickbay (Tag Marshall and Segal)

Posted March 24, 2023, 1 p.m. by Gamemaster Mischief Maker (co-Gamemaster) (Lindsay B)

Posted by Lieutenant Commander Drake Marshall (Surgical Chief/ Emergency Medicine) in Main Sim - Primary Sickbay (Tag Marshall and Segal)

Posted by Gamemaster Mischief Maker (co-Gamemaster) in Main Sim - Primary Sickbay (Tag Marshall and Segal)

Posted by Lieutenant Commander Drake Marshall (Surgical Chief/ Emergency Medicine) in Main Sim - Primary Sickbay (Tag Marshall and Segal)
Posted by… suppressed (6) by the Post Ghost! 👻
<snip>
“Ambassador, may I introduce the two doctors who will be leading our department’s efforts in your case?” he said. Indicating the human, he said “This is Dr. Drake Marshall, the senior-most doctor on the ship who’s not also an administrator,” a subtle dig at himself, then gesturing to the Vulcan, “And Dr. Solal Segal, who specializes in some of the more esoteric and difficult-to-diagnose ailments that can affect the body.”

Cmdr. Dr. Brad Walker
Chief of Staff

“Just ‘Doctor Solal’, please. Thank you.” The Vulcan swiftly corrected the Commander. Solal was half-Vulcan, hence having a surname, but preferred to be called by his first, which was more like a Vulcan name.

Brad acknowledged the preference with a nod of his head, internally reflecting that he hadn’t spent enough time with the half-Vulcan to know it in the first place. That was uncommon, and uncomfortable, but something he’d have to adjust to with the larger staff of the larger ship.

Salin beamed at the trio of doctors, her silver eyes lighting up. “I see. I am glad to meet you,” she said, pressing her hands together in of herself and bowing forward while carefully sweeping hands her hands outwards. Even seated on a biobed, the Ambassador moved ever so gracefully. “I appreciate any help you might be able to offer me. Do we have a plan for how we will proceed?” she asked, gazing at each in turn.

Zoi walked in and two security personnel took their place outside the med bay doors as was standard protocol for high priority guests. The ambassador certainly qualified. She smiled warmly and looked at those that had gathered. She had gotten the dossier of all of the Ambassador’s staff so she knew who all was supposed to be present. She went to Suén. “Good day. I am Lieutenant Commander Zoi Haven, Chief of Security. I want to go over security details and show you to the Ambassadors quarters to make sure we have all of her needs cared for.”

Haven, CoS

Drake cast a wary gaze at the Security officers. He didn’t like having guards in sickbay.

Momentarily distracted by the person approaching her aide, Mero simply smiled and returned her focus on the doctors.

~Mischief Maker

“I think, Ambassador, jumping straight to a plan is a mistake. Let’s get some vitals and some information and we’ll make a plan based on your current situation.” He pulled out a medical tricorder and started scanning. “So, how are you feeling today, Ambassador?”

-Lt Cmdr Drake Marshall, M.D.

As the exam begin, Brad quietly withdrew from the treatment area, heading to his office where he could monitor remotely without seeming to hover over his subordinates.

Mero startled as Marshall brandished the device, her mass of white hair floating about her head. “Oh! Umm, much the same,” she said clasping her hands together tightly. Even as he started scanning he could tell her heart rate increased rapidly.

Other than her heart rate, she was displaying signs of a headache in her right temple. There rest of her vitals were logged but would require comparison to her species’ baseline to know what was considered normal or not.

Salin turned to look at Su’en and gave him a strained smile. “You can go, I’ll be fine. And maybe you can bring a banana like you were mentioning?” she said more eagerly.

~Mischief Maker

“I would like to start with some of the things that brought you to us.” Solal started, keeping out of Marshall’s way as Marshall conducted the scans. “What were the symptoms that made you want to seek help here?”

~ Lt Solal, Immunology

Drake nodded approvingly of Solal’s questioning, while he pulled a PaDD out to compare the vitals displayed on his tricorder to species baseline. Unlike, it seemed to him, most people, Drake suspected strongly that she wasn’t being hypochondriacal when she complained of her various symptoms. Though it wouldn’t be beyond him to be after credit for uncovering a new disease and hopefully curing it.

-Lt Cmdr Drake Marshall, M.D.

Su’en pursed his lips. He was clearly not in favor of being dismissed by his charge, but also knew better than to argue with her when she was in treatment. “Of course, Ambassador. I’ll see Bananas sent right away.” At that he gave a rather long and pointed look at Marshall, expecting the doctor to do something regarding the banana situation but eventually let it drop with a heavy sigh.

Turning his attention back to Zoi he rolled a wrist, “Yes, right well let’s get on with it then, shall we?”

GM Wombat

Salin watched Su’en leave before returning her attention to her doctors. “Well, I do tend to be quite forgetful. Without Su’en I don’t know what I’d do somedays!”

“I’m also tired almost all the time. And I get these headaches quite frequently. Most of the time I can just work through them, but some days I feel driven to my bed. It does make it hard to work at times. And well…” The Ambassador dropped her head a little. “It’s odd, but my mouth hurts when I eat food that isn’t soft. That’s a new one, though. The rest I’ve had for awhile,” she said, looking back up and gazing at them rather expectantly.

~Mischief Maker

Solal would focus on one symptom at a time. Being tired all the time, anything could cause that. Dozens, hundreds even, of conditions. Focusing on that would be pointless. Headaches though… That could be narrowed down a little. The mouth pain was new, so the headaches probably weren’t caused by it. Was it tooth pain, perhaps? Jaw pain? Referred pain? Another symptom to chase down, after the headaches.

“The headaches. What part of the head do they occur in? The back, the sides, one side, the front…” He asked. Then his next question, “How painful are the headaches? On a scale from ‘It doesn’t really bother me’ to ‘I can’t do anything because of the pain’.” And one more question, “What kind of pain? Constant, throbbing, comes and goes…” With each question he gave a few example answers to give an idea of what kind of information he was looking for.

~ Solal

Salin lifted her fingertips to the temples. “Here, in the sides of my head. It comes on and can be mild if I have a quiet day but if I am busy just the moving about makes it worse. It is a throbbing pain, like I can feel my heart beat through my head. Sometimes it stays mild, but other days I don’t dare get out of bed or I can just barely function. Painkillers can help though, so I can work through most of them.”

~Mischief Maker

Cmdr. Dr. Brad Walker
Chief of Staff

When they compared her current scans with her baseline from the files they were given, they would notice a few differences:

-slightly elevated white blood cell count [treated with antibiotics and it went down for a brief time but seems to be up again]
-her metabolic rate was about 10% lower
-a small number of immature red blood cells

~Mischief Maker

Drake did a second, deeper scan. While those results were not necessarily cause for immediate alarm, he didn’t like the look of them. He narrowed his focus and swept slowly, still a general scan, but he paid particular attention to signs of anemia. Any number of infections could raise her white count and cause anemia, he just needed to find out if any of them existed, or if it was something else altogether.

-Lt Cmdr Drake Marshall, M.D.

OOC: Had to go hunting for this post/thread and will put it on the MOTD for reference, but this info will help (I think? Maybe?): https://www.star-fleet.com/core/stf3/ogawa/posts/195203/
IC:
Her iron levels and other vitamin levels were fine, and there was no obvious sign of infection.

Meanwhile, Ambassador Mero seemed to be practicing some deep breathing and at one point traced the tattoo on her forehead (a small circle with a dot in the center).

~Mischief Maker

The medical file stated the white count had gone down with antibiotics previously, further pointing Solal towards infection. Solal glanced at Marshall. There being no obvious sign of infection did not make sense. Another idea occured to him, autoimmune could mimic infection. The white blood cells being a result of the overactive immune system, the metabolic rate and small number of immature cells results of the immune system’s attack. The fatigue, memory recall problems, and headaches, would also be plausible in a number of immune disorders. That was within Solal’s specialty. It didn’t explain why the white count fell with antibiotic use, but it was worth investigating. “I would to run immune function tests. A CBC, metabolic panel, and autoantibody test.”

~ Lt Solal, Immunology

Salin’s silver eyes studied Solal for a moment. “You wish to look at my blood? I have no objections, so long as you take the necessary precautions,” the Ambassador said.

~Mischief Maker

Drake nodded to Solal and began conducting the blood draw, carefully sanitizing the area and drawing the necessary blood. When he was done, he said “Take a moment here, just let your body settle from the blood draw.”

-Lt Cmdr Drake Marshall, M.D.

She ran a hand over her airy mass of white hair. “I am fine, but I will heed your advice,” Ambassador Mero said. “What is it you are looking for?” she asked curiously of the two doctors. She did watch Marshall’s handling of her blood sample carefully, unsure whether these people understood the issue but also trying to trust them.

~Mischief Maker

“We’re examining you from the perspective of receiving a new patient. And from our initial exam, I think we’re both concerned about your white blood cell count, especially in the absence of apparent infectious symptoms. So we’re going to check for infection, autoimmune disorders, and anything else that might elevate your white count. It also never hurts to be thorough and make sure our scans didn’t miss anything.” Drake explained. Her ambassadorial status kept her from receiving the sarcasm to which he might’ve otherwise been inclined.”

-Lt Cmdr Drake Marshall, M.D.

The Ambassador eyed Marshall critically as if trying to decide if she should be worried.

The results of the blood screening were all normal except for the following:

CBC
-RBC (red blood cell) count: slightly lower than her baseline
-WBC (white blood cell) count: slightly elevated
-hemoglobin: very slightly lower
-hematocrit (fraction of blood made of RBCs): slightly lower
-Average RBC size: slightly smaller but on the borderline of normal

Metabolic panel
-Potassium- elevated

The autoantibody test came back normal.

Mero touched her breather for a moment as she seemed to hold her breath at the same time the monitors showed a momentary ventricular fibrillation. The heart palpitation lasted only about three seconds.

~Mischief Maker


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