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Episode 12: Sports MedicineAired 2/22/05 A baseball player named Hank Wiggen shoots an anti-drug commercial but it’s not going well. The director tries to provide some help, but Hank doesn’t grasp what to do until his wife, Lola, advises him to just tell his own story. Hank got mixed up in drugs and only quit because he was going to die. Now he’s clean and getting ready to pitch on Opening Day. On the next take, Hank throws a pitch and his upper arm breaks. His comeback is over. At the hospital, Wilson tells House that he thinks Hank has osteopenia but that his bones are too thin to be fixed. Since Hank is young, House feels that cancer is the cause and Wilson hasn’t found the cancer yet. The rest of the staff agrees that it must be cancer. Looking at Hank’s baseball card, House notices that Hank put on 25 pounds after spending the previous season in a Japanese league. The doctors suspect steroids, which would explain the kidney problems and bone loss. Chase wants a urine sample but Hank isn’t willing. Chase just takes some from Hank’s catheter bag. Cameron and Foreman report to House that tests showed there are no steroids, but that that Hank has elevated levels of Beta 2 proteins. He could have either amyloidosis or lymphoma. House still believes that steroids have come into play. Foreman admits that the FAT PAD biopsy and abdominal CT scan were negative for cancers, but Cameron points out that Hank also tested negative for steroids. House knows that today’s steroids can be hidden from tests, but one thing can’t be hidden. House goes into Hank’s room and pulls back the bed sheet. Hank suffers from hypogonadism, which is shrunken testicles. House has them start Hank on Lupron. Hank’s wife Lola is outraged. If Hank isn’t on steroids, Lupron will cause severe respiratory problems. Sure enough, Hank begins to gasp for air. House and staff try to figure out what’s killing Hank. He isn’t producing enough testosterone which is causing the hypogonadism. Chase suggests that it could be Addison’s disease, which is treated with steroids. But Foreman mentions that Addison’s would cause him to retain fluid, and that would overwork Hank’s strained kidneys. What exactly is creating the kidney problems? House suggests past steroid use. House drops in on Hank and Lola to explain the situation. He can keep denying steroid use, but that may be the trigger to all his health problems and it is treatable. If there is no steroid use, then the doctors are at a loss on what is causing the liver to malfunction. He could die. Lola is adamant that her husband is telling the truth, but Hank finally opens up. He admits that five years ago, a pitching coach gave him something that made him gain twelve pounds of muscle in a month. Hank has no idea what it was. House presses Cuddy to put Hank on the transplant list, but she won’t budge. She wants evidence of Addison’s disease or anything else life-threatening. Lola tells House she wants to donate one of her own kidneys, and he is skeptical that she’ll be a donor match. After some time, House gets back the lab results. Although Lola is a match, she’s pregnant and cannot donate in her current condition. The next day, Foreman tells Hank that he’s healthy enough for the transplant. Hank forbids his wife to get an abortion in order to undergo the surgery. House thinks he’s being ridiculous, but Cameron isn’t so sure. They haven’t even narrowed the diagnosis to Addison’s disease yet. Hank’s heart starts racing. His T-waves have peaked and his potassium is up. Chase and Foreman give him insulin sub q, D-50 glucose and kayexolate to treat hyperkalemia and get the potassium out. They think this will rule out both Addison’s and steroids. House and Cameron arrive to find Hank’s heart rate dropping precipitously. They have no idea what’s afflicting Hank and they can’t stabilize his heart rate. That night, House observes Hank and notices he is hallucinating. Wilson wonders whether it is digitalis, which would explain the heart rate fluctuation and this new symptom, but not the earlier ones. Hank is not even on digitalis. House pays a visit to Warner, the scout that discovered Hank and was on the set of the commercial. Warner tells House that he has a heart condition and treats it with digitalis. However, he can’t find the bottle. House thinks Hank stole the pills and tried to kill himself with the drug. Back at the hospital, House lays it out for Hank. He knows what he did and he’s scheduling the transplant. Hank wants Lola to have the baby. Making his point, he spills some of his urine bag on House’s pants. House will begin treating for Addison’s disease, which will ruin the patient’s kidneys. House runs into Lola in the hallway and tells her about Hank. When he says she should keep her baby, Lola hugs him. House wonders why she didn’t smell the urine that Hank splashed on him. House tracks down his group. They eliminated environmental causes
because they thought Lola was healthy. She hasn’t been able
to smell anything for six months. The group should now consider
this couple as a single patient. Their symptoms point to cadmium
poisoning. Chase visits Hank to get another urine sample and asks
what they should be looking for this time. Hank admits he’s
still using marijuana from the dealer he and Lola shared in Japan.
She quit but he didn’t. Chase points out that if there’s
cadmium in the soil, the marijuana can cause all of these symptoms.
Chase puts Hank on treatment for cadmium poisoning. However, House
writes on the medical report that it is Addison’s disease so
that Hank can avoid a drug ban from Major League Baseball. - From Fox.com |