949 A Doctor's Dilemma

pαndα`noνɐ1--сoМ

Seeing the serious look on the faces of these doctors, Landon found it funny.

Well, as doctors, it was their right to know these things.

"No. Gout doesn't aid or enhance enlargement of one's private genitals."

Landon flipped through the records and took his time to explain everything that he could.

The information made the doctors weak.

Such a thing existed?

This world was really strange.

In fact, Landon thought the strangest person was Andrew.

Even the late Nopline wasn't as big as he was.

In this era, where people struggled to survive all about the world, this guy was just chilling without any care.

Even nobles who had the money to sustain large quantities of food didn't allow themselves to get this big.

Everyone was fit with abs.

Even the grandfathers around were fit.

Talk less of the peasants who, even at their old age, still became fishers out in the sea, farmers working and carrying things over their shoulders and so on.

Their metabolism rates were high, leaving many hungry all the time.

Of course, things had changed within the Pyno continent, where peasants could now afford to eat more.

.

Previously, they were very much exploited and could spend 3 or 5 copper coins on a tiny loaf of bread.

Now, 3 cans of beans were sold for 2 copper coins.

There were Ramen noodles, Sardines, soups and so on.

Because of the Baymardian goods, other merchants had to stop exploitation and reasonably sell their goods.

Even those Black-bellied ones who used to sell 10 cups of rice for 50 copper coins have changed.

That was cups and not the actual bag of rice itself.

But now, with Baymardian small-sized boxes of rice to medium and even large bags of rice sold at moderate prices, they had to stop exploitation if they wanted to survive in the market.

And so, the peasants could now have their fill and could afford 3 Square meals, unlike previously when they would only eat once or sometimes skip days hungry, relying on just water.

Even the pleasant women who were deemed fat here could be seen as curvy or size 12's or 14 back on earth.

They weren't that big.

So seeing someone like Andrew was truly unusual.

It showed that he was spoiled with no discipline and had too much money.

How else could he afford such large quantities of food during all his meals?

Andrew's entire existence was a mystery to those who first laid their eyes on him.

.

Milla, who had been nothing down a few notes, tapped her pen on her face thoughtfully.

"Your majesty, now that we know what it is... is it curable?"

"Hmhm. It remains one of the most treatable forms of arthritis.

The aim of treatment here is to settle the symptoms of an acute attack.

Like I said, gout is a form of arthritis.

And arthritis has no cure.

However, we can prevent repeated attacks by some medications and therapy.

It's important to note that without any treatment, these episodes of gout would go away on their own."

"Then that's good. But why do I feel a 'but' coming along?"

Everyone looked at Landon curiously.

As doctors, they weren't that naive to believe that something this shocking could go away without any repercussions.

It wasn't the flu, alright?

Plus, the patient had a lot of complications.

Like high blood pressure, obesity and so on.

There was no way that the body wouldn't suffer.

Landon chuckled.

"You're right to be suspicious.

Since arthritis has no cure, the patient would undoubtedly have several episodes of Gout.

But, the more episodes came, the more it would develop into chronic gout with the destruction of joint surfaces... leading to joint deformity, Tophi, and kidney stones, to name a few.

It's no surprise that all this would potentially lead to kidney damage, hemolytic anemia and several other complicated illnesses.

Even though we can't cure it, we can do certain things to decrease the many episodes, keep the body healthy and suppress Gout.

Write that down."

.

Flip.

Everyone wrote and turned their little jotters, writing what they could.

"For starters, you already gave the patient Ibuprofen, which is an anti-inflammatory drug and pain reliever too.

So next, we will begin by placing the Patient under Uric Acid Lowering Therapy.

The drugs, diets, and treatment methods we use should suppress the gout attack, making the swells go away, returning his body to normal.

We have to have it done, as leaving those there could permanently disfigure his body and destroy his joint surfaces.

Weight loss is also a must for the patient.

And just for future cases, there's a reason why men are more likely to get it.

Estrogen protects women from high levels of Uric acid, making them less likely to get gout.

However, as women age and experience menopause, estrogen decreases.

Meanwhile, their chances for gout increases."

Good stuff.

Everyone wrote down a few key words and circled them.

After all, they didn't have time to write every sentence word for word.

They perked up their ears, clinging to Landon's every word.

Doctor Mason was pleased with the short lecture.

"Gout does seem to be treatable.

But, the Patient specifically said he didn't want to get treated.

And as per medical law, patients have the right to refuse medical treatments.

For example, a doctor can advise a patient and recommend a pain killer for a toothache.

And it's the patient's right to either follow through or take on the pain without taking the medication.

Even if one is plagued with an illness that needs a medical operation, they ache/she has the right to turn it down.

The right to refuse treatment goes hand in hand with the patient consent forms.

And the only times when a doctor can treat illness without the patient's consent... is if they had a brain injury, mental illness or are a considerable threat to the community by their refusal for treatment.

Accidentally stabbing someone in their sleep or doing anything else that endangers another person's life at risk.

In this case, the patient is sound of mind and can refuse treatment."

Everyone nodded in agreement.

It was true.

.

Landon stood up and placed his pen back in his pocket.

And everyone stood up and followed him too.

"Hmhm. Doctors Mason is correct.

In this case, the patient can turn down our suggestions.

There are four goals of all medical treatments that we doctors tackle.

Be either Prevent, Cure, manage or put the patient under palliative care (specialized medical care for serious illnesses)

We can only do our best to tell the patient all the side effects and dangers of gout, hoping that the patient chooses to undergo therapy and treatment.

But, if he still refuses and only wants to ease the pain, then Ibuprofen alone should do the trick.

Whatever happens to him in the near future would be caused by his own hands.

As one makes their bed, so shall they lie on it."