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 (1) by the Post Ghost! 👻

(snip)

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

“Does that happen often?” Drake asked. He had a few more tests he wanted to do, but if she was struggling, they could wait. “I’d like to get a scan of your heart, and test your bone marrow.” He waved over a nurse and said “Prep equipment for a bone marrow biopsy, and a chest CT.” Both procedures would’ve been strenuous many years prior, but had since been refined for ease with modern technology. “If you’re up for it, we’ll do them now.” He smiled. “Get it over with so to speak.”

-Lt Cmdr Drake Marshall, M.D.

Salin seemed to recover quickly and just gazed at Marshall. “The bone marrow biopsy… that’s where you go into my spine, correct?” she said, her hand clenching again and her heart rate rising slightly. On the surface she seemed calm, her face placid.

~Mischief Maker