House M.D. Diagnostics Test Run - Take Two.

[Antihero]

And while you do that, maybe take a look at his legs as well for signs of infection or trauma or something? I mean, you're working his legs so it should be possible?

heart rate went up which means stroke volume went down. makes sense but i'm not smart enough to know what it means

[Antihero]

considering his platelets are low id be kinda surprised if there was a clot on the loose but... fuck i dont know.

[Antihero]

if there's a problem with the circulatory system
let's look at the heart

run an ekg

[Shadow Dancer]

MRI his brain again

I still want a clearer view of what's actually going on there. And I cannot really think of much else to do.
Are there chemical vasodilators he could be given to protect his toes?

[Antihero]

yes

[KuroiXHF]

Patient Event:
Raleo, your patient's circulation seems to have improved. The pain has come back and he has begun screaming.

MRI his brain again

The results are identical to the one that Antihero presented.

Procedure:

Run an angiogram to look for any obstruction in the blood vessels.

The results of the angiogram show restriction of the blood vessels.

if there's a problem with the circulatory system
let's look at the heart

run an ekg

The EKG show a slightly abnormally fast heartbeat

Do glucose tolerance test.

Type 1 diabetes. Prescribe insulin and adjust diet. Monitor patient for a while to adjust to insulin in combination with his exercise and diet.

*House steps in front of you.* "Didn't I say in the beginning that it wasn't diabetes?"

*Masquerade stands defiantly.* "All the symptoms fit."

"Did you not see the A1C? It's normal!"

"The A1C results only show throughout a three month period!"

"His blood glucose level when he showed up was fine!"

"And obviously it isn't anymore. He was fine up until his six hour car trip. He wasn't exercising and that drove his blood sugar. If it was inflammation, toxins or whatever else, we would have caught it. We've done every test under the sun. What he hasn't done was exercised. He has Diabetes Type 1."

"And you're an idiot, Dr. Masquerade. If he had diabetes, he would have known before now. Before he was ten."

"No. He was hiding it."

*House laughs.* "People lie. The numbers don't."

"Listen to me! Look at his diet. Grilled chicken, vegetables, no bread. His foods don't have any carbs in them. He exercises a lot. That's how he's able to keep his blood sugar down!"

"Fine. Run your damn test. Then when your results come back negative, I'll be right beside you to tell you you're fired."

*Masuerade shuddered then performed the test on Jimmy. House looked at the numbers. His jaw dropped.*

His blood glucose level is 750. That's more than five times the normal level. I guess you get to keep your job.

Final and correct diagnosis: Diabetes Type 1 by Dr. Masquerade

That's why you're my co-mod, Masquerade. lol

[Masquerade]

<3

[KuroiXHF]

Everyone, I won't be doing another test run since the game is about to run.

If the people want it after the game, I may make it a mish mash regular.

[FakeGod]

Wouldn't I have seen decreased glycogen storage in the liver through the liver biopsy?

[FakeGod]

I mean it's certainly unorthodox, but under EM you would be able to see that.

[KuroiXHF]

Wouldn't I have seen decreased glycogen storage in the liver through the liver biopsy?

I don't think that may have showed. Maybe yes and maybe no, but I was looking for more of cancerous or something that would show with the appearance of the liver, not necessarily with function. But more than that, keep in mind that he's only been feeling sick since his admittance. Not everything will show up.

Also, this is done to the capacity of someone who works on Google. I'm no doctor by any means.

[Antihero]

khan shouldve caught this w the pancreatic test and a1c would still be high

[Antihero]

yeah im googling the type 1 diabetics who can control their blood sugar wo insulin and w the exception of unverified homeopathic crap theyre all saying no

[KuroiXHF]

yeah im googling the type 1 diabetics who can control their blood sugar wo insulin and w the exception of unverified homeopathic crap theyre all saying no

Diabetes is a progressive disease and it can be unsymptomatic if managed correctly, even if the patient doesn't know he has it.

[FakeGod]

I kinda suspected that it would end like this.

Oh well, it was fun in the first half.

[KuroiXHF]

Sorry. I hoped it would have been funner. I was actually worried the game would be too easy, and it would have been too if House didn't say it wasn't diabetes.

[Antihero]

haha ignore me being a sore loser. thats how i am.

[Shadow Dancer]

MRI his brain again

The results are identical to the one that Antihero presented.

Meh... Can't you be a bit more specific? Which areas of his brain are damaged and how does the damage look like?

Procedure:

Run an angiogram to look for any obstruction in the blood vessels.

The results of the angiogram show restriction of the blood vessels.

What kind of restriction?! Clots? Vasospasm?

if there's a problem with the circulatory system
let's look at the heart

run an ekg

The EKG show a slightly abnormally fast heartbeat

Duh. All intervals are normal otherwise?

Do glucose tolerance test.

Type 1 diabetes. Prescribe insulin and adjust diet. Monitor patient for a while to adjust to insulin in combination with his exercise and diet.

*House steps in front of you.* "Didn't I say in the beginning that it wasn't diabetes?"

*Masquerade stands defiantly.* "All the symptoms fit."

"Did you not see the A1C? It's normal!"

"The A1C results only show throughout a three month period!"

"His blood glucose level when he showed up was fine!"

"And obviously it isn't anymore. He was fine up until his six hour car trip. He wasn't exercising and that drove his blood sugar. If it was inflammation, toxins or whatever else, we would have caught it. We've done every test under the sun. What he hasn't done was exercised. He has Diabetes Type 1."

"And you're an idiot, Dr. Masquerade. If he had diabetes, he would have known before now. Before he was ten."

"No. He was hiding it."

*House laughs.* "People lie. The numbers don't."

"Listen to me! Look at his diet. Grilled chicken, vegetables, no bread. His foods don't have any carbs in them. He exercises a lot. That's how he's able to keep his blood sugar down!"

"Fine. Run your damn test. Then when your results come back negative, I'll be right beside you to tell you you're fired."

*Masuerade shuddered then performed the test on Jimmy. House looked at the numbers. His jaw dropped.*

His blood glucose level is 750. That's more than five times the normal level. I guess you get to keep your job.

Final and correct diagnosis: Diabetes Type 1 by Dr. Masquerade

That's why you're my co-mod, Masquerade. lol

Very weird...
Would I be hated now for giving him IV glucose?

[Masquerade]

I still have books from my nursing education, and that's where I got my info. I'm p sure they are more accurate than anything randomly found on google..

[KuroiXHF]

Dude, giving a diabetic glucose (unless they're suffering from hypoglycemia) is probably the single worst thing you could do. When I read that, I was telling myself, "Yeah. This guy needs to pay." In that stage of the game, he was already with a very high blood sugar.

Althoguh the banana bag helped slightly, just nowhere near enough.

[KuroiXHF]

Also, a cortical atrophy if I remember correctly creates a lackluster metabolization in glucose and also diabetics are at risk of developing Alzheimers.

I'm sure if I needed to, I would look deeper and find the answer but I know diabetics suffer from restriction of blood vessels. It helps lead to a bunch of issues like glaucoma, kidney issues, etc.

And yes, EKG results were otherwise normal.

Also, Masquerade - Can I get your thought process on when you realized this patient had Diabetes 1?

[Masquerade]

The black feet.

[Masquerade]

The black feet was basically the last piece of the puzzle, in combination with everything else and the nature of this game I deduced (lol) it had to be type 1 diabetes.

[KuroiXHF]

Even though House said in the beginning of the game that it couldn't be? That scared off everyone else.

[Masquerade]

Well I sort of forgot about that but yeah earlier I dismissed diabetes a few times before because of that. But in the end it's House, you know? It's never what you think it is and everybody lies, even House