RP LOG with geniuscowboy | Underlying causes
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Bella couldn't believe how long this day felt and it wasn't even lunch time. She was at the nurses' station in the Oncology ward in her scrubs following two small surgeries early that morning for biopsies, but the way she had been feeling only succeeded in making the day feel like it was dragging. When she woke up, Aaron had been sitting on her sofa huddled up under a blanket still looking like death warmed up, though apparently the puking had eased off. It was still early at that point, and after making him promise to call her later with a gut update, she left for work. She just had to wonder if what he had was somehow catching because her own stomach had been churning uncomfortably since she woke up. It didn't feel like it was going to let up anytime soon, either, but she palmed it off to not getting enough sleep after letting her mind go into overdrive following the mess with Rick the evening before.
In all honesty, she hadn't expected him to be able to perform. He had put a lot more expectations on himself than she did. In fact, she put none him. She followed his lead, even if she did instigate the encounter with the kiss. She was still his doctor, and she knew him inside and out physically. It would have probably been close to a miracle if he was able to perform from start to finish. But he couldn't even get aroused, and like any male in their sexual prime, it had extremely pissed him off even though he had been warned about it, and that was the reason he and Bella had even slept together in the start. It was just easy to get caught up in the moment, and she would be lying if she didn't admit to wanting it too. There was just no pressure. It had just been a disaster, and after waiting until Chris and Serena were about due home, she left with Rick disappearing into his room saying he was tired. It definitely hadn't been the sweetest of goodbyes, to say the least. In fact, he could be a right moody shit when he put his mind to it. Not that she could blame him at all.
She was just trying to figure out the best course of action to take, and of course, she still had other patients that needed to be her priority for the moment. She sipped from her bottle of water in an effort to calm her upset stomach as she wrote her progress notes on the patients she had just seen in Recovery. Lost in her own little world for the moment as she relayed her treatment plan out onto the sheets of paper, she nearly jumped out of her skin when someone came up beside her and asked her for a word. Glancing up, she found Chris standing there expectantly and she let out a sigh of exasperation. "Hell, you've got to quit sneaking up on people like that. It's not healthy and Cardio is too far away for my comfort to be having random heart attacks." She closed the patient file over and rested her weight against the counter. It would surely help if she could stop feeling so tired. "I expected to hear from you, but an advanced phone call would have been nice. I do have other patients, you know." She listened as the words came out sounding 100% bitchy and she really had no idea where that came from. It wasn't Chris' fault, it wasn't even Rick's fault, yet she had the urge to bite his head off.
"Never underestimate the Dr C Defib Skills," Chris replied with a smirk. The tetchiness wasn't lost on him, but he didn't mind if she wanted to bitch him out. He could cop it. All he wanted was answers, and he was willing to wait for them if she was busy with her patient load. "He wouldn't let me call you. He thinks I'm coming to have lunch with Serena, and technically I am. If I can get to MT1 when she has a break. I need to talk to you first, though. Have you got time? I can wait? I can wait as long as it takes. To be honest, I seem to be suddenly having the worst week of my life, and sitting in a hospital waiting to talk to a doctor feels like paradise right now."
With another sigh, Bella piled the medical records up and placed them over the counter on the desk. She picked up the bed list to check if there was an exam room free and then she nodded her head in the direction of Room Four. "I've got a bit of time now. It's a good thing you didn't get me on a bad day or you could be waiting a very long time, Dr Deleo," she told him and made her way over to the exam room. Once he had followed her in, she closed the door and then perched against the edge of the exam bed. "So, shoot. What do you need to talk about?"
Chris went over to the sink and pulled himself up to sit on the counter beside it. "Rick told me what went down last night... or rather what didn't even come up. I'm not here to be all pain in the ass about that, even if I want to know why it happened when it was only supposed to be a once off. I want to know why you came on heavy about more tests out of the blue. He thinks the whole ED thing means something is wrong, and come on, Bella. You know it's the chemo, you warned him it would be the chemo. What are you seriously playing at putting the wind up him? Do I have to be the asshole here and threaten to get him a different doctor? I'm not going to let you fuck him around."
Bella listened, watching him blandly. "Thank you for even assuming I would. If you have no confidence in me as his oncologist, please, feel free to seek his treatment elsewhere," she challenged and held his gaze. "Just to clarify the situation here so you are not running off half-cocked with a lack of information, I did not 'come on all heavy'," she began, making quotation marks with her fingers. "I told him I wanted to do more tests over the next few days prior to his next chemo dose. Apparently there are some pluses to fucking your doctor, because when we were getting intimate, I felt some swelling around his thigh and groin. I didn't alert him to the fact because he was already aggravated about the ED. I was going to talk to him about it when he calmed down, but he didn't and went to bed pissed off at the situation. I still plan on talking to him about it and I was going to call him this morning."
"Swelling?" Chris shrugged a little in confusion. "So, there was swelling. What do you think that means? I thought you might be thinking he had a UTI or something. That he would need some ABs if he did to keep that other kidney functioning properly. I dunno. A lot of thoughts when through my head. But you know Rick. He was still pissed off this morning, and he was confused. He didn't exactly have all the information either to give me a clear picture. I'm just worried about him alright? I apologise for the, er, threat. I don't want another doctor. I know you're the best Miami has."
"Thank you," Bella murmured in response. "And I assure you, his health is just as important as any of my other patients. There is just something there beyond the clinical care. Chris, a UTI doesn't cause swelling and if that was what I suspected, I would have gotten him to pee in a bottle and the results would have been back this morning. I need more than pee. I want blood, I want swabs, and I want another CT. Swelling in the extremeties could be an early sign of kidney failure, Chris. But in cancer patients, swelling of the lymph nodes could indicate more metastasis. It could just be another chemo symptom, and that is the most likely scenario, but I want to be safe rather than sorry."
Chris frowned, glancing away at the floor as he tried to work it all out in his mind. "Was it a lot of swelling? What do you personally feel like it might be? Just if you had to make a guess? You think it's gone to his other kidney?"
"I don't make guesses, Chris. I work with hard clinical evidence. All I know is this is a new symptom that wasn't there when I slept with him before and it wasn't there when I examined prior to the chemo. It was enough for me to notice on touch. I did say that if something like this happened, I would need to take more tests. It was just bad timing that it happened to coincide with him realising that the chemo has, in fact, affected his erectile functioning. Not his libido, however. It could just be a matter of his body is still weak, but there was no reasoning with him last night. He had to get pissed off about it so he could go away and process it. Last night, he didn't want me to be his doctor, plain and simple." Bella really wished her stomach didn't choose that time to start rebelling again. A strong wave of nausea hit her and she felt her skin break out into a sweat in response. She let out a heavy breath to try and quell it, rubbing a hand over her face. She needed another drink, but when she pushed away from the bed to head to the cooler in the corner of the room, a horrible dizziness overcame her and she stumbled as she grabbed for the edge of the bed to remain upright.
Chris shot off the counter and was by her side, catching her arm to hold her up the minute he saw her pale and get restless. "Hey... whoa... you alright there, Dr W? You look terrible," he told her in concern and led her over to one of the chairs. "Here, sit. I'll get you some water." There was a dispenser of sick bags on the wall, so he snatched one of those out to hand to her before getting her a drink. He crouched down in front of her, waiting to see if she was okay. "Do you make a habit of nearly passing out in consult, or has this come on just now?"
"Probably low blood sugar. I skipped breakfast--" was all Bella got out before she was throwing up into the bag. She was still feeling dizzy, so she tried to lean right forward to stop it. She realised she probably should be embarrassed at this, in front of Chris of all people, but there was no escaping the fact that at that moment, she just felt plain sick. She couldn't put up a facade if she wanted to. "It'll pass. I haven't been feeling great for most of the morning."
Chris wasn't sure how convinced he was supposed to be, and even though he was a doctor on leave, it wasn't like he ever stopped being a doctor. It was a foreign exam room, but he still located a thermometer and the sphyg so he could check her blood pressure, unhooking her own stethoscope from around her neck so he could borrow it. "Did you skip breakfast because you were feeling sick?" he asked and placed the thermometer in her ear to check her temperature and then moved on to check her blood pressure. He frowned a little, watching her bend forward as he unhooked the cuff from around her arm. "You're afebrile but your blood pressure is a little low. Is this the first vomit?"
Bella might have laughed if she didn't feel so crap. In the blink of an eye, they had completely switched positions and while her hackles were up that another doctor was trying to diagnose her, any protests would probably just kick the stubborn Deleo genes in more. "Yes, and no. I'm just feeling a bit off-colour and I don't need diagnosing, doctor," she told him pointedly and took her stethoscope back. "Now you're just going to stand there and give me a look I know all too well, because I give it to people too. I'll make you a deal. You get your brother in here for those tests tomorrow, and if I don't start to feel any better, I'll go home and lie down. Even if I can't be here, I still want someone doing that path. I'm going to write up orders for a full blood count. I also want nasal and oral swabs, and I want urine. Once that's all done, I want full body CT. Expect to be at the hospital for a few hours, not that you need me to tell you that. Results should be back in a couple of days, assuming the CT doesn't show anything. In the meantime, even if it will piss him off, I want you to monitor his temp and blood pressure overnight. If this is an infection, he'll spike a temp and if he does, straight to the ER. Got it?" She stood up, still feeling a little shaky and weak. She was probably just coming down with something, and going home to bed was sounding really appealling all of a sudden. "Don't tell him I'm sick," she added.
"Oh, come on! You can't ask that of me. If you aren't here when you want to bring him in and start stabbing more shit into him, he's going to want to know where you are. He really cares about you. Don't be a bitch and tell me to not mention this to him," Chris complained, but he was staying close to her in case she ended up still passing out on him. "I'll get him in, and you can do all the tests you want, or have your off-sider do them, but he deserves to know you're not feeling well, even if it's just something in passing."
"If it's not something in passing you can say something, but I'm okay. I'm starting to feel better already. What would you do if Serena told you she was feeling sick, huh?" Bella asked, turning it back on him a little. She got rid of the bag and started scrubbing her hands in the sink. Thank god she only had the next few hours to catch up on backlogged paperwork.
Chris tilted his head a little. The only time he had seen Serena feeling crap was when she was hungover, or with that morning after pill. "I'd take her home, make sure she was comfortable, take care of her, just be there for her... oh." He shot her a guilty look. "Okay. I won't say. Or I'll try not to. That's all I can promise. That, and having him here first thing tomorrow for tests, and monitoring his obs overnight. You know, if you just let him in a little more, he'd take care of you too. Not that I have seen it in action, but I just know he would."
Bella kept her head lowered as she finished washing her hands and took some towels from the dispenser to dry them. "He needs to focus on himself right now," she replied but was saved by the bell from saying anything further when her pager started to go off. She unclipped it from her pocket and held it up. "One of my patients is in the ER. I have to go. Let me know if there are any changes in his condition, no matter how small it seems."
"Wait, Bella. He said it hurts to pee," Chris quickly added as she headed for the door of the exam room. He meant to say it earlier, but he got distracted when she nearly fainted.
Bella stopped and pressed her lips together in thought. "Cease his painkillers for the night. See if there is any increase in the pain, or any blood in the urine. Sometimes a kidney can try to work in overdrive if it's filtering strong pain meds. Keep him drinking to flush through his system and get him on some IV fluids again if he doesn't feel like much water. That will help any UTI if it's there, too, even if it will all make him pee a lot. If you think there is anything to worry about in the morning, I'll monitor is input and output tomorrow. The more information I have to work with, the better the picture I'll get as to what is going on. We rule all that out and we can hone it down to just chemo reactions. He's due is second dose the day after tomorrow anyway. I might even keep him in overnight." She pointed as her pager buzzed again. "Call me if there are any changes," she reminded him and had to leave.
She just wished he hadn't added that other piece of information. She was already worried and the two symptoms together were pointing to something she really had hoped she could have prevented. There was just no sense ringing warning bells until she had the evidence she needed, and in the meantime... it wouldn't hurt to try and pray for the best. No matter how much she tried to deny it, she didn't want to lose Rick before she even let herself know she truly wanted him.
Word Count | 2,988
Bella couldn't believe how long this day felt and it wasn't even lunch time. She was at the nurses' station in the Oncology ward in her scrubs following two small surgeries early that morning for biopsies, but the way she had been feeling only succeeded in making the day feel like it was dragging. When she woke up, Aaron had been sitting on her sofa huddled up under a blanket still looking like death warmed up, though apparently the puking had eased off. It was still early at that point, and after making him promise to call her later with a gut update, she left for work. She just had to wonder if what he had was somehow catching because her own stomach had been churning uncomfortably since she woke up. It didn't feel like it was going to let up anytime soon, either, but she palmed it off to not getting enough sleep after letting her mind go into overdrive following the mess with Rick the evening before.
In all honesty, she hadn't expected him to be able to perform. He had put a lot more expectations on himself than she did. In fact, she put none him. She followed his lead, even if she did instigate the encounter with the kiss. She was still his doctor, and she knew him inside and out physically. It would have probably been close to a miracle if he was able to perform from start to finish. But he couldn't even get aroused, and like any male in their sexual prime, it had extremely pissed him off even though he had been warned about it, and that was the reason he and Bella had even slept together in the start. It was just easy to get caught up in the moment, and she would be lying if she didn't admit to wanting it too. There was just no pressure. It had just been a disaster, and after waiting until Chris and Serena were about due home, she left with Rick disappearing into his room saying he was tired. It definitely hadn't been the sweetest of goodbyes, to say the least. In fact, he could be a right moody shit when he put his mind to it. Not that she could blame him at all.
She was just trying to figure out the best course of action to take, and of course, she still had other patients that needed to be her priority for the moment. She sipped from her bottle of water in an effort to calm her upset stomach as she wrote her progress notes on the patients she had just seen in Recovery. Lost in her own little world for the moment as she relayed her treatment plan out onto the sheets of paper, she nearly jumped out of her skin when someone came up beside her and asked her for a word. Glancing up, she found Chris standing there expectantly and she let out a sigh of exasperation. "Hell, you've got to quit sneaking up on people like that. It's not healthy and Cardio is too far away for my comfort to be having random heart attacks." She closed the patient file over and rested her weight against the counter. It would surely help if she could stop feeling so tired. "I expected to hear from you, but an advanced phone call would have been nice. I do have other patients, you know." She listened as the words came out sounding 100% bitchy and she really had no idea where that came from. It wasn't Chris' fault, it wasn't even Rick's fault, yet she had the urge to bite his head off.
"Never underestimate the Dr C Defib Skills," Chris replied with a smirk. The tetchiness wasn't lost on him, but he didn't mind if she wanted to bitch him out. He could cop it. All he wanted was answers, and he was willing to wait for them if she was busy with her patient load. "He wouldn't let me call you. He thinks I'm coming to have lunch with Serena, and technically I am. If I can get to MT1 when she has a break. I need to talk to you first, though. Have you got time? I can wait? I can wait as long as it takes. To be honest, I seem to be suddenly having the worst week of my life, and sitting in a hospital waiting to talk to a doctor feels like paradise right now."
With another sigh, Bella piled the medical records up and placed them over the counter on the desk. She picked up the bed list to check if there was an exam room free and then she nodded her head in the direction of Room Four. "I've got a bit of time now. It's a good thing you didn't get me on a bad day or you could be waiting a very long time, Dr Deleo," she told him and made her way over to the exam room. Once he had followed her in, she closed the door and then perched against the edge of the exam bed. "So, shoot. What do you need to talk about?"
Chris went over to the sink and pulled himself up to sit on the counter beside it. "Rick told me what went down last night... or rather what didn't even come up. I'm not here to be all pain in the ass about that, even if I want to know why it happened when it was only supposed to be a once off. I want to know why you came on heavy about more tests out of the blue. He thinks the whole ED thing means something is wrong, and come on, Bella. You know it's the chemo, you warned him it would be the chemo. What are you seriously playing at putting the wind up him? Do I have to be the asshole here and threaten to get him a different doctor? I'm not going to let you fuck him around."
Bella listened, watching him blandly. "Thank you for even assuming I would. If you have no confidence in me as his oncologist, please, feel free to seek his treatment elsewhere," she challenged and held his gaze. "Just to clarify the situation here so you are not running off half-cocked with a lack of information, I did not 'come on all heavy'," she began, making quotation marks with her fingers. "I told him I wanted to do more tests over the next few days prior to his next chemo dose. Apparently there are some pluses to fucking your doctor, because when we were getting intimate, I felt some swelling around his thigh and groin. I didn't alert him to the fact because he was already aggravated about the ED. I was going to talk to him about it when he calmed down, but he didn't and went to bed pissed off at the situation. I still plan on talking to him about it and I was going to call him this morning."
"Swelling?" Chris shrugged a little in confusion. "So, there was swelling. What do you think that means? I thought you might be thinking he had a UTI or something. That he would need some ABs if he did to keep that other kidney functioning properly. I dunno. A lot of thoughts when through my head. But you know Rick. He was still pissed off this morning, and he was confused. He didn't exactly have all the information either to give me a clear picture. I'm just worried about him alright? I apologise for the, er, threat. I don't want another doctor. I know you're the best Miami has."
"Thank you," Bella murmured in response. "And I assure you, his health is just as important as any of my other patients. There is just something there beyond the clinical care. Chris, a UTI doesn't cause swelling and if that was what I suspected, I would have gotten him to pee in a bottle and the results would have been back this morning. I need more than pee. I want blood, I want swabs, and I want another CT. Swelling in the extremeties could be an early sign of kidney failure, Chris. But in cancer patients, swelling of the lymph nodes could indicate more metastasis. It could just be another chemo symptom, and that is the most likely scenario, but I want to be safe rather than sorry."
Chris frowned, glancing away at the floor as he tried to work it all out in his mind. "Was it a lot of swelling? What do you personally feel like it might be? Just if you had to make a guess? You think it's gone to his other kidney?"
"I don't make guesses, Chris. I work with hard clinical evidence. All I know is this is a new symptom that wasn't there when I slept with him before and it wasn't there when I examined prior to the chemo. It was enough for me to notice on touch. I did say that if something like this happened, I would need to take more tests. It was just bad timing that it happened to coincide with him realising that the chemo has, in fact, affected his erectile functioning. Not his libido, however. It could just be a matter of his body is still weak, but there was no reasoning with him last night. He had to get pissed off about it so he could go away and process it. Last night, he didn't want me to be his doctor, plain and simple." Bella really wished her stomach didn't choose that time to start rebelling again. A strong wave of nausea hit her and she felt her skin break out into a sweat in response. She let out a heavy breath to try and quell it, rubbing a hand over her face. She needed another drink, but when she pushed away from the bed to head to the cooler in the corner of the room, a horrible dizziness overcame her and she stumbled as she grabbed for the edge of the bed to remain upright.
Chris shot off the counter and was by her side, catching her arm to hold her up the minute he saw her pale and get restless. "Hey... whoa... you alright there, Dr W? You look terrible," he told her in concern and led her over to one of the chairs. "Here, sit. I'll get you some water." There was a dispenser of sick bags on the wall, so he snatched one of those out to hand to her before getting her a drink. He crouched down in front of her, waiting to see if she was okay. "Do you make a habit of nearly passing out in consult, or has this come on just now?"
"Probably low blood sugar. I skipped breakfast--" was all Bella got out before she was throwing up into the bag. She was still feeling dizzy, so she tried to lean right forward to stop it. She realised she probably should be embarrassed at this, in front of Chris of all people, but there was no escaping the fact that at that moment, she just felt plain sick. She couldn't put up a facade if she wanted to. "It'll pass. I haven't been feeling great for most of the morning."
Chris wasn't sure how convinced he was supposed to be, and even though he was a doctor on leave, it wasn't like he ever stopped being a doctor. It was a foreign exam room, but he still located a thermometer and the sphyg so he could check her blood pressure, unhooking her own stethoscope from around her neck so he could borrow it. "Did you skip breakfast because you were feeling sick?" he asked and placed the thermometer in her ear to check her temperature and then moved on to check her blood pressure. He frowned a little, watching her bend forward as he unhooked the cuff from around her arm. "You're afebrile but your blood pressure is a little low. Is this the first vomit?"
Bella might have laughed if she didn't feel so crap. In the blink of an eye, they had completely switched positions and while her hackles were up that another doctor was trying to diagnose her, any protests would probably just kick the stubborn Deleo genes in more. "Yes, and no. I'm just feeling a bit off-colour and I don't need diagnosing, doctor," she told him pointedly and took her stethoscope back. "Now you're just going to stand there and give me a look I know all too well, because I give it to people too. I'll make you a deal. You get your brother in here for those tests tomorrow, and if I don't start to feel any better, I'll go home and lie down. Even if I can't be here, I still want someone doing that path. I'm going to write up orders for a full blood count. I also want nasal and oral swabs, and I want urine. Once that's all done, I want full body CT. Expect to be at the hospital for a few hours, not that you need me to tell you that. Results should be back in a couple of days, assuming the CT doesn't show anything. In the meantime, even if it will piss him off, I want you to monitor his temp and blood pressure overnight. If this is an infection, he'll spike a temp and if he does, straight to the ER. Got it?" She stood up, still feeling a little shaky and weak. She was probably just coming down with something, and going home to bed was sounding really appealling all of a sudden. "Don't tell him I'm sick," she added.
"Oh, come on! You can't ask that of me. If you aren't here when you want to bring him in and start stabbing more shit into him, he's going to want to know where you are. He really cares about you. Don't be a bitch and tell me to not mention this to him," Chris complained, but he was staying close to her in case she ended up still passing out on him. "I'll get him in, and you can do all the tests you want, or have your off-sider do them, but he deserves to know you're not feeling well, even if it's just something in passing."
"If it's not something in passing you can say something, but I'm okay. I'm starting to feel better already. What would you do if Serena told you she was feeling sick, huh?" Bella asked, turning it back on him a little. She got rid of the bag and started scrubbing her hands in the sink. Thank god she only had the next few hours to catch up on backlogged paperwork.
Chris tilted his head a little. The only time he had seen Serena feeling crap was when she was hungover, or with that morning after pill. "I'd take her home, make sure she was comfortable, take care of her, just be there for her... oh." He shot her a guilty look. "Okay. I won't say. Or I'll try not to. That's all I can promise. That, and having him here first thing tomorrow for tests, and monitoring his obs overnight. You know, if you just let him in a little more, he'd take care of you too. Not that I have seen it in action, but I just know he would."
Bella kept her head lowered as she finished washing her hands and took some towels from the dispenser to dry them. "He needs to focus on himself right now," she replied but was saved by the bell from saying anything further when her pager started to go off. She unclipped it from her pocket and held it up. "One of my patients is in the ER. I have to go. Let me know if there are any changes in his condition, no matter how small it seems."
"Wait, Bella. He said it hurts to pee," Chris quickly added as she headed for the door of the exam room. He meant to say it earlier, but he got distracted when she nearly fainted.
Bella stopped and pressed her lips together in thought. "Cease his painkillers for the night. See if there is any increase in the pain, or any blood in the urine. Sometimes a kidney can try to work in overdrive if it's filtering strong pain meds. Keep him drinking to flush through his system and get him on some IV fluids again if he doesn't feel like much water. That will help any UTI if it's there, too, even if it will all make him pee a lot. If you think there is anything to worry about in the morning, I'll monitor is input and output tomorrow. The more information I have to work with, the better the picture I'll get as to what is going on. We rule all that out and we can hone it down to just chemo reactions. He's due is second dose the day after tomorrow anyway. I might even keep him in overnight." She pointed as her pager buzzed again. "Call me if there are any changes," she reminded him and had to leave.
She just wished he hadn't added that other piece of information. She was already worried and the two symptoms together were pointing to something she really had hoped she could have prevented. There was just no sense ringing warning bells until she had the evidence she needed, and in the meantime... it wouldn't hurt to try and pray for the best. No matter how much she tried to deny it, she didn't want to lose Rick before she even let herself know she truly wanted him.
Word Count | 2,988