Granting You A Second Life

The maître d' led Li Xiuying through the dining room. She felt her phone vibrate and saw it was a message from Ren Daiyu [Either I just saw you on the news or it was your doppelganger!]

Li Xiuying replied [Meeting at The Enchanted. Talk later]. She put her phone back in her bag.

Li Xiuying looked straight ahead and did not glance at the seated guests. She both did and didn't want people to remember her. On one hand, she wanted people to remember her in case anything went wrong. On the other hand, if things went fine she didn't want people to remember her and assume she had any sort of special relationship with the owner of The Enchanted. She was damned is she did and damned if she didn't. 

In all likelihood, nothing would happen to her today. Qilin wasn't the type to leave evidence and witnesses around. However, it was human nature to be cautious when entering a lion's personal den. 

The maître d' and Li Xiuying then walked into the back area where there was a set of stairs. She looked up at all the flights and frowned.

Maître d': "We will be there before you know it. The building at the back is actually connected to the restaurant but it is difficult to see from the front or side."

Li Xiuying: "Elevator?"

Maître d': "The boss wants to create obstacles for people who come in. It will tire out any assailants or at least slow them down."

Li Xiuying saw various cameras dotted around as she kept ascending.

The maître d' finally stopped on the 5th floor. He opened the door to the level and waited for Li Xiuying to pass through.

Li Xiuying looked down at the stairs in disgust. She couldn't even curse them otherwise she would be stuck in this building forever.

The maître d' lip twitched as he saw the scorn on Li Xiuying's face. 

Li Xiuying was greeted by 2 men in casual clothing on either side of the door. They turned and stared at her.

Maître d': "This is the boss's 7 pm."

The 2 guards returned to causal sitting on either side of the door. They may have appeared relaxed but Li Xiuing could tell they were poised to attack when required.

Maître d': "This way please."

Li Xiuying followed silently whilst scanning her surroundings, there were guards positioned every 10 meters. 

The maître d' eventually stopped at a door and knocked 5 times; leaving a gap of 3 seconds between each knock.

Qilin: "Come in."

The maître d' opened the door for Li Xiuying: "I will escort you out when you are finished."

Li Xiuying entered and the door was closed behind her. 

Li Xiuying expressionlessly looked at the 3 people in the room.

A distinguished grey-haired middle-aged man sat in the chair at the desk. Qilin was reclining on a sofa on the other side of the room with another man who looked to be in his early 20's sitting alongside him. 

Qilin: "Take a seat Dr Li." 

Li Xiuying went forward and sat in the seat in front of the desk.

Tu Zedong: "I am Qilin's father. You may address me as Elder Tu. This is my grandson Tu Nianzu. He is currently studying medicine at Northwest University and is here to observe this consultation." He was not giving Li Xiuying any choice. 

Li Xiuying looked indifferent: "Medical records."

Tu Nianzu walked over and pulled a chair to his grandfather's side. Tu Nianzu passed her 2 stacks of medical notes.

Li Xiuying slowly went over all the contents.

When Li Xiuying was done she asked for the images: " Doppler 1 ?"

Tu Nianzu stood and turned the desktop to face her: "All the images he's ever had."

Li Xiuying looked at the doppler ultrasound. The right carotid artery had moderate stenosis of 76%. 

Li Xiuying: "Why now?" The doppler image was dated 8 months ago. 

Elder Tu: "I'm assuming you're asking why I'm opting to have the surgery now? I was told I had a mini-stroke by my doctor."

Li Xiuying: "When did this happen?"

Elder Tu: "About 3 weeks ago."

Li Xiuying: "What symptoms did you experience that caused you to seek medical attention?"

Elder Tu: "I was out in the garden with Nianzu when suddenly I saw this black curtain descend over my vision. It all just went completely black before my eyes. I couldn't see anything and then after what felt like a lifetime everything returned to normal. Nianzu said it was only about 2 minutes, it certainly felt longer when your sight is stolen away."

Tu Nianzu chimed in: "Amoursis fugax."

Li Xiuying ignored him: "Any other symptoms?"

Elder Tu: "No, nothing else. I then went to see our private doctor and he ran some tests and said he suspected I had a mini-stroke. He prescribed me some medication and I was scheduled to have the operation to remove the blockage in my artery a week after the incident occurred. There were some inhouse issues that arose unexpectedly. My son suggested that it would be better to wait and he would find a skilled surgeon."

Li Xiuying nodded and looked at the history of the medication. Aspirin for 2 weeks followed by Plavix 2 75mg daily. Elder Tu was not currently taking any other medication. 

Li Xiuying: "Have you experienced the black curtain again? Or had any other symptoms since then? Numbness, tingling, altered sensation anywhere in your face or body?"

Elder Tu: "No, nothing since the black curtains."

Li Xiuying: "Any disturbances in your speech? Changes to your vision? Random headaches?"

Elder Tu was about to say that his wife had mentioned that he had slurred speech last Tuesday. 

Tu Nianzu frowned: "My grandfather has already made it clear he hasn't had any other symptoms."

Li Xiuying looked at Elder Tu, who looked like he was going to mention something. 

Elder Tu sat silently, he didn't want to embarrass Tu Nianzu. 

Li Xiuying: "Listening to your history you have had a transient ischemic stroke 3 which is often described as a mini-stroke. You may experience stroke-like symptoms that do not last for more than 24 hours. In your case, you saw a black curtain referred to as amaurosis fugax. A stroke or a mini-stroke is a clinical diagnosis and CT/MRI's may not always show any changes especially with ministrokes. The scan of your carotid arteries shows that your right carotid artery is significantly blocked. It is usually blocked up by a build-up of fatty material that grows over time. Parts of this plaque may break off and travel to the brain thus affecting the vessels in your brain and causing symptoms such as the ones you experienced."

Li Xiuying waited for Elder Tu to digest the information she had given.

Tu Nianzu: "How do you know that it was an embolus from the carotid plaque and not something caused by a faulty valve 4 ?"

Li Xiuying decided to respond to Tu Nianzu's question: "Elder Tu, the echo or scan they did to check your heart, were all normal. Additionally, the ECG tracing is normal." She clicked and brought up the echo images then ECG. She also explained the doppler image and CT images one at a time. 

Elder Tu: "I understand. My private doctor said that my ECG trace was normal and I don't have an irregular pulse." 

Tu Nianzu: "I've checked my grandfather's pulse. He doesn't have AF 5 ."

Li Xiuying: "You require an operation called a carotid endarterectomy. This is basically when an incision is made in the neck and then the wall of the carotid artery. I will remove the blockage within." She took a pen from her bag and drew a basic sketch on the back of a sheet of paper. 

Elder Tu: "Hmm."

Li Xiuying: "How is your pain tolerance?"

Elder Tu: "My pain threshold is quite high as you can imagine in my line of work."

Li Xiuying: "How would you feel about being awake in an operating theater?"

Elder Tu: "I think I would feel more reassured to know what was happening when a blade is at my neck."

Li Xiuying: "I suggest doing the operation with you mildly sedated. Some general anesthetic will be used to put you to sleep initially, then a nerve block around the area I will be operating. After that, we will keep you mildly sedated throughout the operation. We will be able to talk to you during the operation. This will help me to assess your neurological function."

Elder Tu: "My doctor didn't mention it was possible to have this procedure done while I was awake. He said I would have to be put to sleep."

Li Xiuying: "It is possible to do the procedure with the patient awake/slightly sedated or fully asleep. It is dependent on the surgeon's experience and training. It is the surgeon's choice and they take into account many factors such as the patient's pain tolerance and ability to remain calm during the procedure."