[Diary] Afternoon Outpatient Clinic, Giving Myself a Little Break ~Aobura Literature Club~

A busy afternoon outpatient clinic
The charts are piling up

The next patient... this might take a while
I sigh while reading the filled-out sheet

The case is a woman in her 70s
She was instructed by the urology department to come here because it is thought to be polyuria, not frequent urination

"It's been going on for half a year. The doctor told me to keep a record and to show this..."

The times and volumes of urination for the past two weeks are written densely in a small notebook
That's amazing. I don't think I could do that much
She must be a very diligent person

"This is important information. Thank you."
The urine volume is roughly 2500ml to 3500ml per day
Polyuria is defined as 3000ml or more, so it is indeed polyuria
Moreover, it is high at night; two-thirds is nocturnal

Imagining her going to the bathroom every hour or two, measuring the urine volume, and writing it in the notebook makes me feel sorry for her

"It must be tough to have so much urine at night."
"The thing is, I can't sleep..."
"With this much output, don't you lose weight? Are you thirsty and drinking a lot of water...?"
(I suspect diabetes)

"That... is not the case."
The urinalysis seems to be negative for both sugar and protein
(I guess diabetes is unlikely)

I must perform a differential diagnosis for polyuria and nocturnal polyuria

The receptionist drops off a stack of charts for several new patients
I want to think slowly, but it only happens at times like this...

"Are you taking any medication that might cause urination?"
"I have swelling, but I'm not taking any."
"...I see... I wonder what it could be..."

This kind of exchange continues for a while

The nurse next to me starts getting restless
I know, I know, I'll speed things up

"For now, let's run some blood tests."

Furthermore, the receptionist says,
"A representative from XX Pharmaceutical wants to meet regarding the upcoming lecture... Should we decline for today?"
"Yeah, decline... no, let's meet for just a little bit."

No, no, it's not a lecture on heart failure right now...

Diseases that cause frequent urination, necessary test items...
Several things line up in my head, but nothing feels quite right
There is a mountain of charts next to me
My thinking is shallow. I'm getting tired

I want to give myself a break

At times like this, I should ask that guy to appear
Yes, it's time for ChatGPT

I immediately open my smartphone and throw the query in
The differential diagnoses are instantly and neatly lined up. As expected
"Ah, that's it," and things I had missed also come up

I place the test orders right away

The results are in
Everything is mostly okay, but only the calcium is high at 11.4

(Is this it? Yeah, it's probably this)

"Your calcium is high."
"I'm taking medicine for it. I got it from the orthopedic surgeon."
(I knew it)
"I see. Is it medicine for osteoporosis?"
"Yes. It's been over a year now, I think..."

It seems the vitamin D3 preparation prescribed for osteoporosis is inducing hypercalcemia
Frequent urination, especially nocturnal enuresis, is one of the symptoms of hypercalcemia; it's one of those things you encounter when you've forgotten about it

"Is it a side effect of the medicine?"
"I don't know yet, but please consult with your orthopedic surgeon. If it doesn't get better, please come back, and we'll look for the cause together."

She left quickly. I wonder if she was satisfied

"Even though we finally figured it out, she was quite indifferent, wasn't she?"
"Well, I'm not doing this to be thanked."
I lean back in my chair, clasp my hands behind my head, and sigh

"If you sigh, your happiness will escape."
"I wonder if happiness is contained within a sigh. If it could infect someone else, that would be fine, though."
I said something random like that, but
When I noticed, the nurse was gone

I open the chart for the next patient...

Since then, that patient has not come to the clinic again

I have participated in this prompt.
I look forward to working with you.

I hope you can get a sense of the daily life in a medical setting.

Medicine is also in the age of AI.

The magazine I subscribe to also has an AI special feature, which I am reading now.