| abstract
| - Wander/Lust is case #7 in House M.D. - Critical Cases. Kaylee Wells, a "beautiful" 28 year old kindergarten teacher, is talking to a friend when she suddenly is doubled over with abdominal pain and her breathing is labored. She is rushed to the emergency room of Princeton-Plainsboro Teaching Hospital. Gregory House catches a glimpse of the patient and thinks he has seen her before, but can't remember where. As the ER doctors are having trouble providing Kaylee with a diagnosis, he takes the case. His team wonders why he's interested in a case with such prosaic systems until he reveals he's trying to find out where he saw her before. The team co-operate with their boss's behavior and do a blood analysis which shows thrombocytopenia - a low platelet count. After using 1 IV bag, 2 ward favors, $500 of the budget and using 7 body meds, they realize the normal white blood cell count rules out lymphoma. Imaging shows inflammation of the lining of the lungs - pleuritis. After using another ward favor, a tongue depressor and 8 digestive meds, they rule out sarcoidosis. They also notice that although the patient is very slender, she has an outstanding appetite. The symptoms point to lupus and the team uses 2 thermometers and 16 body meds. House breaks the news to the patient and while talking to her, he finally remembers where he saw her. Four years ago, she was a stripper going by the name "Krystal" at one of his favourite clubs, The Cherry Hole. She admits to it and tells House she quit stripping when she got married because it finally gave her the opportunity to go to school so she could teach. However, as they talk, she starts vomiting. House realizes the patient has nausea and since he was there and knew it wasn't self-induced, it rules out both lupus and bulimia. Kaylee takes a turn for the worse and goes code blue. She has to be defibrillated. House sends the team to do another environmental scan, where they find Kaylee's purse. They find a number of used tissues. Thirteen also finds a GPS which shows weekly visits to "The Eighth Veil" and realizes Kaylee has started stripping again. After using 3 syringes, spending $550 of the budget and using two more ward favors, they realize that her respiratory symptoms are due to a bout of influenza, and this is not the underlying disease. Another round of imaging shows a troubling large single mass in her abdomen. The team uses 4 digestive meds, 2 gauze and a ward favor and rule out myocarditis. The large mass and other symptoms point to stomach cancer. The team prepares 2 IV bags, 10 chemical meds and use 2 ward favors. Meanwhile, House sees the patient again to ask about her appetite. She tells him that it has increased during the last few weeks, although she has nausea in the morning, she is starving by lunchtime. House goes back to the rest of the team. He thinks Kaylee is pregnant, accounting for both her nausea and appetite. However, this doesn't explain the large mass or the low platelet count. When Thirteen finally tells House that she thinks Kaylee was hiding her pregnancy because she's returned to stripping, House gets an idea and tells them to invert Kaylee before doing more imaging. However, Kaylee takes another turn for the worse and goes code blue. She has to be defibrillated again. The blood analysis shows House was right - Kaylee is about 8 weeks pregnant. After using 3 tongue depressors and spending $600 of budget, the team rules out stomach cancer. After inverting Kaylee for as long as she can stand, a further round of imaging shows that there is only one pedicle leading to the Spleen. In addition, her arteries are twisted, not clenched. After using 2 more gauze, 1 ward favour and 12 head meds, the team can rule out coronary artery disease Kaylee is treated for wandering spleen with 12 body meds, $600 of the budget, 3 ward favors and 2 oxygen masks. The doctors come to the conclusion that she was born with a weak pedicle which gave way recently while she was stripping. It was mistaken for a stomach tumor on the scan. Kaylee admitted she had turned back to stripping because the school was short on supplies for her students and she needed extra money.
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