The World Keeps Spinning - Chapter 3
Title: The World Keeps Spinning
Rating: T (at the moment)
Pairing: Huddy
Summary: Cuddy just wants his sperm, really. House likes the sex, but likes Lisa even more. Now he's going to be a father, whether he likes it or not! AU
Chapter 1: http://tabbysnape.livejournal.com/1611.html
Chapter 2: http://tabbysnape.livejournal.com/1854.html
Disclaimer: I own a wonderful box set of House DVDs. I don't own House. Bugger.
Authors note: I've never been to America or to rehab, so I'm probably going to make a lot of mistakes. I'm a pharmacy student, so I do know a bit about drugs, but I don't know the American brand names, and which drugs are available without a prescription over there, etc. If I get something wrong, please let me know so I can fix it! Thanks :)
Also, this is set in an AU starting season 2, so ignore everything after.
Chapter 3
"Hey Cuddy!" Called House from across the clinic, "I'm gonna take some time off."
"Dream on, House! You've already used up about five years of vacation leave, ten years of pretend-to-be-sick leave and you're way over-quota for 'hangover' leave."
The patients in the waiting room watched raptly. It wasn't as if they had much else to do, after all.
"How about 'voluntary rehab' leave? I seem to recall having a bit of that left."
Cuddy couldn't keep the grin from her face.
"Take as long as you need."
House would have preferred to simply detox in his apartment, but Cuddy organised him a bed in the PPTH Rehab Wing. He had stayed there once before, after the infarction. The staff there were used to dealing with a variety of patients; mainly people who weren't sick enough to justify a continued hospital stay, but needed further supervised therapy before they would be well enough to function fully at home. They were also quite used to coping with drug addicts.
"I'm really glad you're doing this." Wilson said as he carried House's sports bag inside from the car.
"Yippee." replied House in a monotone.
He was frantically trying to think of ways to get out of this. It wasn't that he was nervous, he told himself; no - he was terrified! He'd actually puked twice before Wilson had picked him up, and it was only 10 am. He'd taken his 'wake-up' vicodin as usual, so he couldn't even blame it on withdrawals. It was the thought of publicly admitting that his life was screwed up that he was uncomfortable with, because that was essentially what he would be doing. In a couple of hours the fact that Greg House was in rehab would be the hottest piece of gossip in the hospital. It might have been overshadowed by Cuddy's illegitimate baby, but that one wasn't public yet. The withdrawals weren't going to be a picnic either, nor the thought of reduced pain control. He pushed these thoughts from his head. Of course it was going to be unpleasant, but it was the right thing to do. He'd seen enough clinic patients to know that drug addicts weren't good parents.
They entered through the front doors , and House had an unpleasant feeling that this was really a prison or a concentration camp. He had to remind himself not to run (yet). After all, he could sign out AMA if need be.
"This looks nice." said Wilson as he dropped the sports bag onto one of the chairs by the front desk. House decided that a comment that inane wasn't even worth a sarcastic reply.
They were a few minutes early for House's initial appointment with Dr Nguyen ("Nice one, Wilson."), but a nurse set House up with a huge pile of paperwork to fill out.
"OK Mommy, you can leave now. I don't need a babysitter."
"No way! Knowing you, you'll drive the doctor to a nervous breakdown and convince the nurses to give you morphine. You need supervision."
"Hmph. Well, if you're staying, the least you can do is fill out some forms."
Wilson rolled his eyes, but dutifully took a form. House passed the rest over to Wilson too.
"How many vicodin do you take?" asked Wilson after a minute.
"Hey, give me that one!" House said, snatching the form back from Wilson.
At last, Dr Nguyen called House to his office. Wilson trailed behind like a sad duckling.
"Morning Greg. I hope you haven't forgotten the tenner you owe me."
"Nguyen, you're looking old.... and pregnant."
Dr Nguyen may have taken offense to being told he looked pregnant, as he was, in fact, male.
“Long time since college, Greg! I hear you’ve grown a third leg.”
House whacked him in the shins with his ‘third leg’, but otherwise ignored the comment.
“Nguyen, what the hell did you do to deserve this crap job?”
Dr Nguyen bent over to rub his leg, but answered nonetheless, “It must be the bad karma from puking on your side of the dorm and nicking your tennis racquet.”
“So that’s where my racquet went!”
“Are you going to introduce me to your friend?”
“eh, Nguyen, this is my babysitter, Dr Jimmy Wilson. Wilson, this is my old roommate and the thief of my prized tennis racquet, Dr Thanh Nguyen.”
They sat in Nguyen’s office, and House put his feet on the desk.
“So, what brings you here today?”
“You aren’t a very good doctor if you haven’t even read the referral letter.”
Dr Nguyen snorted. “This is where bad doctors go to die. I hope you weren’t expecting a good one. Now I have, in fact, read your referral. Dr Cuddy is hoping you can get your Vicodin addiction under control and convert to other forms of pain management.”
“Then why did you bother asking?”
“I want to know what you think the problem is. Dr Cuddy’s opinion isn’t nearly as relevant as yours.”
House sighed. “I don’t want to be an addict anymore.”
“Good for you. Could you please tell me about what you’re addicted to?”
“ Drugs.”
“He takes Vicodin ES, at least 10 per day,” Wilson interrupted.
“Excuse me, Dr Wilson, but I’d prefer to hear it from Greg.”
“I take Vicodin ES, at least 8 per day, sometimes up to 14. Supplemented with whatever other painkillers I can get my hands on. “
“Now, I understand the Vicodin is what you’ve been prescribed for chronic pain following an infarction and muscle debridement . Is the chronic pain still an issue?”
“Yes.”
“Improving, worsening or consistent?”
“I don’t think it’s worsening, I think I’m just more tolerant to the drugs.”
“What else have you tried for pain control?”
“I started adding in diclofenac a few years ago, with some omeprazole to stop it eating my stomach lining. It doesn’t do a lot for the leg, but my shoulder sometimes plays up because of the cane. Heat packs can take the edge off a bit. I’ve got some lidocaine patches; they’re OK except that they give me a rash. Marijuana helps, but I can’t use that on weekdays because Cuddy can smell it on me. You should have heard her last time! I thought she was going to explode!”
“Go on..”
“hmph. I’ve been on St John’s Wort for a while now. Studies show that tricyclic antidepressants can help with neuropathic pain.”
“I’ve heard of those studies too, but St John’s Wort isn’t a tricyclic. I don’t understand why you would have picked it instead of amitriptyline.”
“Can you imagine what Jimmy would have done if I asked him for an antidepressant script? God, he’s worse than my mother.”
Wilson looked hurt. “House, I wouldn’t have over-reacted! I can’t believe you didn’t tell me!”
Dr Nguyen ignored Wilson, “Do you want to see if you can get a better response from amitriptyline?”
House just shrugged.
“What else do you use?”
House shrugged again, and looked almost apologetically towards Wilson. “I’ve got a bit of an emergency stash for breakthrough pain.”
“Go on...”
“... morphine, oxycontin, ... heroin.. “
Wilson looked scandalised. “House!”
Dr Nguyen, to his credit, kept a straight face.
“How well do you think the pain is managed with the opiates?”
“They work best, but the pain is only partially responsive to anything I’ve tried.”
“OK. I’m a little concerned about whether your pain management program will be effective enough without opiates. What treatment plan would you suggest?”
“Do you always ask the patient to do your job for you?”
“Only when my patient is Greg House.”
House snorted. “I wanna start on gabapentin 300mg and amitriptyline 50mg along with the diclofenac and some topical anesthetic. And a shot of naloxone to speed up the withdrawals so I can get out of here stat.”
“You know speeding up the withdrawals will make it more unpleasant.”
“I’m not an idiot. And plus, the amitriptyline and gabapentin will probably send me to sleep for a week.”
“OK. What if that’s not enough pain relief? You'll be way more likely to relapse if your pain isn’t controlled.”
House shrugged.
“How about we titrate in a low dose of methadone if we need to?”
House had to agree that was a good solution.
“I also noticed from your file that you gave up on physical therapy pretty quickly.”
“I gave it longer than it deserved.”
“I’d like you to have another go at it. Maybe we’ll be able to lessen the limp and help your shoulder.”
“No way! You can’t make me!”
“Greg!” warned Wilson, “Don’t make me tell Cuddy on you!”
House sulked and poked his tongue out, “Whatever.”
"Lets get you settled into a room."
House felt his anxiety returning, and had to remind himself why he was doing this.
Authors note:
In case you were wondering - St John's wort is a natural health product that is often used for depression. The exact mode of action isn't well understood, it interacts with quite a number of drugs, and as far as I could tell it has no documented effect on chronic pain. House picked it because you don't need a prescription.
Diclofenac is an anti-inflamatory medication that is available without a prescription where I live (though I'm not sure about America - I'm just assuming). It's basically a bit stronger than ibuprofen. The main side effect with long term use is stomach ulcers, hence the omeprazole, which prevents/treats ulcers by reducing stomach acid secretion. I have heard it is available without a prescription in America.
I just like the idea that House would be self medicating without Wilson knowing! :)
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