Posted by Lieutenant John McCandless (Head Nurse) in Primary Sickbay- Private Consultations

Posted by Captain Dira Myqian (Commanding Officer) in Primary Sickbay- Private Consultations

Posted by Lieutenant Solal Segal (Oncology and Immunology) in Primary Sickbay- Private Consultations
Posted by… suppressed (1) by the Post Ghost! 👻
<snip>

John nodded again feeling relieved, he was glad the Captain felt the same. He had found people were often on edge around him as a male nurse. The Captain however seemed much more open minded. He walked over to a table with a spare hypospray on it- modified slightly for the use of taking blood. He picked it up and walked over to the Captain.
“I’ll just take a few drops from your arm, fortunately we won’t need much for the tests Doctor Solal needs. I’m sorry if you’ve already been asked this, but what are your symptoms Captain?” He asked as he waited for the go ahead.

Lt John McCandless, Head Nurse

Dira simply nodded and moved her closest arm forward just slightly for easier access. “Um, fatigue, some brain fog, some aches in my body, especially in the areas I dislocated more recently. And then some unexplained dizziness the other day.” She gave John a knowing look. “Not exactly instantly identifiable in terms of causes, I know.”

Captain Myqian, CO

John listened intently as he bent down to Dira’s arm to take the blood for the tests. The symptoms were very vague and could point to any number of conditions. He shrugged as he placed the hypospray over a vein and pressed gently.
“Your symptoms, are your symptoms. You can’t help feeling the way you do. It is up to us to work out what the cause is. No matter how many tests we have to do. I once had a patient that took months for the Doctors to diagnose. Of course the patient was in ICU and couldn’t talk, but they did get there in the end.” He replied smiling hoping to reassure the Captain.

Myqian nodded. She knew he was trying to make her feel better and she was hopeful they would figure this out, but her underlying worries weighed on her so heavily.

“There, all done. I’ll run these now for you Captain. It shouldn’t be too long.” He added as he walked over and began to run the tests on the blood that Doctor Solal had requested.

Lt John McCandless, Head Nurse

The beauty of modern medicine was that the series of tests went from taking days to complete and analyze, to minutes.

John smiled to himself modern medicine was genuinely impressive. It always amazed him that a simple blood test used to take several days, sometimes weeks! Now, in a matter of mere minutes they came through.
“Amazing.” He said to himself as he waited. He couldn’t imagine having to wait days! He almost chuckled at the thought.

Out of the series of tests, everything was normal compared to Dira’s baseline except for:

• White Blood Cell count: slightly elevated
• Albumin: Slightly Low
• Total Protein: high globulin (resulting in an abnormal albumin/globulin (A/G) ratio)
• Liver Enzymes: Normal, except very tiny increase in ALT, but still within a normal range
• Thyroid- Low thyroxine (T4)
• C-reactive protein test- moderate elevation

While she waited, Dira just lay back on the bed and rested, feeling that fatigue creep in. She had forgotten to mention the difficulties sleeping to McCandless, but she knew she had to Solal. She inwardly sighed at the mental lapse, knowing that it was a small matter but at some point it would become a bigger deal.

Captain Myqian, CO

John frowned as the results came through. While he wasn’t a Doctor and so couldn’t put a diagnosis to the results, he could vaguely understand what they meant. For example, an abnormal a/g ratio could point to a kidney issue, infection, even some cancer. He also knew that an elevated CRP could indicate inflammation. Where, he had no idea. He’d leave the details to the Doctors. He forwarded the test results to Doctor Solal on a secure channel knowing he’d want them right away and then he paged him.
“Doctor Solal to exam room 7.” John then walked back over to the Captain.

He cleared his throat slightly.
“The results are back Captain. I’ve forwarded them to Doctor Solal on a secure channel and I’ve asked that he come to the exam room. He’ll be able to walk you through the next steps.” He explained and noted that the Captain appeared somewhat fatigued.
“Are you feeling okay Captain? Are you happy to continue? We can carry on another day if you’d prefer?” He asked with slight concern in his voice.

Lt John McCandless, Head Nurse

“I’m fine,” she said, pushing herself into a seated position. “We may not get as good an opportunity to do whatever testing needs to be done. I might get to set my schedule as needed, but rarely is my time my own,” Dira said. It was just the reality of being Captain. Even off-duty she was always on-call- it was a hazard of the job and one she had accepted by wearing that fourth pip.

John nodded, he respected Dira’s decision to continue with the tests. He could certainly appreciate how little time she had. The demands must be constant he thought as he waited for Doctor Solal to arrive.
“Very well Captain. I certainly appreciate your time is valuable.” He replied with a smile.

Solal entered the exam room, PaDD in hand. “Well, Captain, my test panels turned up something, at least.” He said. “I want to test for anti-TPO and anti-Tg antibodies. In short, I’m looking for a very old disease known as Hashimoto’s hypothyroidism. It’s an autoimmune disease, your body attacks the thyroid gland. Increased white blood count, low T4 are my primary indicators. Slightly low albumin, slightly high globulin were also found. These are common findings in autoimmune disorder.” He didn’t mention the slight increase in liver enzymes. It was within range, not worth mentioning. Not unless it trended upwards in a subsequent check.

~ Solal

At first Dira said nothing, but then she nodded. “Let’s keep going then,” she said softly. Myqian had a medical degree, but she residency had been in psychiatry. Still, she knew physiology enough to parse the potential problems they were facing.

Captain Myqian, CO

John raised an eyebrow. Hashimotos. Intriguing he thought as he listened to the next lot of required tests. John grabbed a second hypospray and walked over to Dira, ready to take more blood samples for the antibody tests.
“May I Captain?” He asked waited for permission to proceed.

Lt John McCandless, Head Nurse

Dira gestured with a flourish towards her arm. “By all means,” she said. At least she could sound neutral about the whole situation, even if inside, she was stressed. But answers were the goal, so she had to be open to the process.

Captain Myqian, CO