Rescued by the Billionaire (Billionaire Romance Novel) (11 page)

She was glad it was summer and Emma was out of school. If she had gotten sick during the school year, she would’ve already missed a couple of weeks. It made her realize she might miss school during the year, depending on the news she was about to receive. She envisioned going to school, meeting with all of Emma’s teachers and gathering her homework. The two of them would work tediously on her lessons to ensure she wouldn’t fall behind her peers. It, she thought, would be so time-consuming. How would I work then?
 

Suddenly, Kelly was pulled out of her thoughts when Dr. Hinton entered the room. He was a small
man, most likely working a few years past his retirement age. His thinning white hair and wrinkled skin gave him away. He loved children; his demeanor was always patient and kind.
 

“Ms. Hall?” Dr. Hinton extended his hand.
 

“Hi, Dr. Hinton.” Kelly reached out to return the handshake. “Wendy called and said you needed to go over Emma’s labs with me.” Her heart began to race again.
 

“Yes, that’s right.” He began to leaf through her chart until he found the blood test results. “Here we go.” He smiled at her, “I thought I’d misplaced her test results.”
 

He pulled up a stool and sat in front of Kelly, using his lap as a makeshift table. “According to her lab work, it appears her white blood cell count
is elevated as well as her CRP, or C-reactive protein. This tells us that inflammation is present. The rest of her labs checked out fine, indicating there is no virus, bacteria or fungi infection present within the blood.”
 

“That’s good, right?”
 

“Well so far, yes, but we did some additional testing. Now, I noticed in her patient history you marked a lot of ‘no’s’ regarding the family history section. With the symptoms Emma’s presenting and based on these lab results, I requested additional blood testing for genetic markers which might indicate other possibilities. She tested positive for HLA-B27; it’s a genetic marker that indicates juvenile ankylosing spondylitis.”
 

“I don’t understand? What does that mean?” Kelly was frightened at the words, although she
had no clue as to what they meant, but it sounded terrifying.
 

“Ankylosing spondylitis is a condition that affects children by presenting signs and symptoms of arthritis. Since Emma tested negative for any pathogenic organisms, it ruled out various types of infections. The only symptoms that seemed to fit were those of arthritis; mainly due to her chief complaint of swollen, stiff knees, ankles, toes, fingers, and back pain. Typically, those are all common ailments of those who have arthritis, which prompted me to request a variety of labs that would indicate arthritic diseases.”
 

“I still don’t understand. What’s causing the fever? I thought a temperature meant your body was fighting some sort of infection.”
 

“Not always. Fever can present during a sudden onset of symptoms, including those when the body’s autoimmune system is on the defense. It’s her body’s way of fighting itself. With the highly elevated levels of white blood cells and CRP, it makes perfect sense.”
 

“How do we fix it and why is she so weak and tired? Does arthritis cause that?”
 

“Ankylosing spondylitis, or AS, isn’t just arthritis. It can affect other organ systems such as her bowels, skin and eyes. Her lethargy and weakness are occurring because her body’s fighting off the disease. It's a hell of a battle for anyone to deal with, especially a little girl as small as her.”
 

“What do we do now?”
 

“Now, you’ve been giving her ibuprofen, correct?” he asked, looking through the chart.
 

“Yes. I’ve been giving it to her as directed on the label, according to her weight and age.”
 

“Good, the ibuprofen will help reduce the inflammation and ease the pain she’s experiencing, but due to the progressiveness it has taken on Emma, I think we need to ensure she’s physically active. Physical activity will help keep her joints mobile and decrease the stiffening.”
 

“But she’s been so tired and weak that she doesn’t want to get out of bed. I’ve been carrying her around the house because she doesn’t have the strength or energy to go about the day.”
 

“Stop, make her get up and walk; it’s good for her. You’re only helping the condition worsen its effects on her. I recommend physical therapy. Another thing you might want to try is hot and cold packs. This will also help ease the inflammation by relaxing the muscles and reducing joint pain.”
 

“So your answer is to force her to exercise, feed her a strong diet of ibuprofen and give her hot/cold packs?”
 

“Based on what you’ve told me, it seems her symptoms have become progressively worse since she came in last week. I’d like to prescribe a prescription-strength nonsteroidal anti-inflammatory drug, or NSAID, and a biologic DMARD.”
 

“A what?” Kelly asked. All of these words were beginning to make her head spin. How in the hell was she supposed to relay this information to everyone else? She wouldn’t be able to remember how to pronounce everything.
 

“DMARD stands for disease modifying anti-rheumatic drug. The biologic DMARDs contain a TNF-alpha factor which helps treat people with AS. Basically, it’s used to help slow, and sometimes halt, the progression of symptoms associated with the disease.” He began taking out his prescription pad. “She’ll take this once per week, but I must warn you it may take weeks or months until you see some improvement.”
 

“Weeks or months!?” Kelly was outraged.
 

“Yes, it may take that long. Of course, she may begin to see relief sooner and there may be some
complications with taking this type of drug. I’m going to prescribe methotrexate. Side effects can include a sore mouth and upset stomach. It’s critical if she begins to experience stomach or bowel problems, you report them immediately.”
 

“Why? What would that mean?”
 

“She is at risk of developing Crohn’s disease, and we would want to treat it right away. Another thing I want you to watch for is psoriasis, or dry, rough patches of skin. It usually appears on the elbows, shins and other parts of the body.”
 

“What if these medications don’t work?”
 

“If the NSAID and DMARD prescriptions don’t work, we’ll begin a more aggressive treatment, but I’d like to hold off on that until we see how she responds to these first.”
 

He tore the prescription from the tablet and handed it to Kelly. “I’ll ask Wendy print out some information about the disease and symptoms so you have a better understanding of it. The pharmacy will go over the medications when you order them and they’ll be able to address any questions or concerns. In the meantime, I’m also going to recommend you to a pediatric rheumatologist. His name is Dr. Robert Berringen.”
 

“Is she going to be okay?”
 

“The disease is completely manageable as long as you’re treating it. The most important thing is to get her in with Dr. Berringen so he can do additional testing and continue her treatment plan.”
 

Kelly left the doctor’s office speechless. When she reached her car, she began frantically reading the literature she’d received at her office visit, trying to make sense of everything. Motivated to become educated about Emma’s condition, she studied the information before her. It was all too much for her to take in.
 

She called Dawn on her way home and attempted to articulate everything the doctor had told her about Emma’s disease.
 

“I don’t understand. So it’s genetic? Has anyone in your family ever had it?” Dawn asked.
 

“No. I’ve never even heard of anything like this.”
 

“You know what that means? Adam must’ve been a carrier for the gene. I wonder if he even knows it.”
 

“That’s a good point! I never thought about Adam, but it’s easy to do when you’re the only parent raising a child; sometimes you forget about the loser who gave her to you.”
 

“I know I’d like to forget about him. I’m so glad you don’t deal with him anymore. Could you imagine dealing with him and trying to take care of Emma right now? I’m pretty sure you’d end up in a ward somewhere.”
 

“For sure. I’m on the service road now and I should be home in a few minutes. When I get there, I don’t want us to talk about Emma’s condition in front of her. I’ll explain it to her later, but I don’t want her to hear any negativity.”
 

“Mums the word.”
 

When Kelly came home, Emma was sitting in Kelly’s bed, coloring a picture.
 

“Look, momma,” she said as she held up the picture. “I colored this just for you.”
 

“Oh, thank you!” Kelly said as she took the picture from her daughter. “It’s beautiful.”
 

“What did the doctor say, momma?”
 

Kelly and Dawn sat on the bed with her. “I talked to him and he gave me a good explanation of your symptoms. You have inflammation in your body, which is what’s causing all the swelling. Dr. Hinton said you need to see a specialist, but in the
meantime, he prescribed you some medicine that will help you feel better.”
 

“I don’t have to take a shot, do I?”
 

“Oh no, honey. It’s nothing like that.”
 

“Yeah, your mom’s right. You just need to take some medicine that will make you feel better.”
 

“Oh good. More medicine,” Emma said as she rolled her eyes.
 

“Emma Buggy, don’t think of it as more medicine. You only need to take a particular medicine once a week and another one when you need it for swelling.”
 

“Momma, what’s a specialist?”
 

“It’s a doctor who only works with certain people.”
 

“What do I have?”
 

“I don’t remember how it’s pronounced, but it’s called ‘A-S’ for short. Ankle-something is all I know,” Kelly laughed, trying to make light of the long name she couldn’t remember.
 

“Oh. Will the kids at school know that I have AS when I go back?”
 

“No. They won’t know anything. You’ll take your medicine at home, okay?”
 

Emma nodded. “Aunt Dawn and I will be right back. Why don’t you color me another beautiful picture? Okay?”
 

“Ok, momma.”
 

Kelly motioned for Dawn to follow her into the living room. “I need to get these prescriptions filled, can you keep an eye on her while I run to the pharmacy?”
 

“Sure, no problem. Do you want me to get dinner started for you? Did you set anything out?”
 

“Oh, crap! No, I completely forgot this morning. I’ll pick something up. Do you want to eat with us?”
 

“No, it’s okay. Derek’s grilling chicken breasts for us tonight. I’m sure he’ll start dinner as soon as I get home.”
 

“Okay, I won’t be long. See you in a bit.”
 

Kelly handed the prescriptions to the pharmacist who looked them over.
 

“I’m sorry. We can fill her prescription strength NSAID, but we don’t fill DMARDs.”
 

“You don’t fill them? Where am I supposed to go? Who does them?” Kelly questioned, trying to figure things out.
 

“Well, most patients who take them have to do mail order pharmacies; most insurance companies require it.”
 

“Mail order? You mean my daughter has to wait for her prescription to come in the mail?”
 

“Again, I’m sorry. That’s just the way it is. If you’d like, we can fill this portion of the prescription and fax a copy of this over to the mail
order company, and they can fill the DMARD portion.”
 

Kelly was at least glad the pharmacist was willing to help her. “Okay, that’d be great. Do you know how long until they typically send it out?”
 

“I don’t know.”
 

Kelly nodded. “Okay. How long for this one to be ready?”
 

“Oh, say about 30 minutes. We can page you when it’s ready if you’re going to wait for it.”
 

“Yes, please. Page me when it’s ready.”
 

After the prescription had been filled, Kelly inquired as to which mail order pharmacy they faxed the DMARD drug to.
 

“We ran your insurance, and it appears MaxCare is covered under your insurance, so we sent it there. They should contact you soon to obtain all of your information.”
 

“Thank you,” Kelly said as she paid for her daughter’s medicine and headed home.