Title: Never Give Up
Chapter 2 – Reshaping the Future
A/N: Hey thanks everyone! I know a few had suggested some temporary memory loss but I already did a story with that so I'm so glad you all liked the kidney donation idea AND because so many of you liked it I was inspired to add some more. It's going to be another angsty roller-coaster ride (which we all love best for our boys hehe) so please enjoy and thanks so much!
'Why do you take such chances Matt?'
'Hermann has a family…I couldn't let them lose their father.'
'If you had a family would you take less chances?'
'I…'
'That's just it Matt…it's inbred into you, you wouldn't. I just don't that to be what finally takes you for good. I couldn't bear it.'
Casey's watery eyes gently flutter as he slowly opens them; Hallie's image fading from his view, the memory from the past being tucked away for another time. His memory flashes back to yesterday…coming to in the ER surgical room, being told about his head injury…coming out of surgery – the drainage of the excess blood and fluid was a success. But then…'He's crashing!' his world started to darken once more…and when he awoke the second time he was told that he had lost his right kidney – damaged…shattered beyond repair in the injury. 'We nearly lost the left one but Mr. Severide donated one of his. He saved your life…saved your life…saved…'
Casey tries to prop himself up on his elbows, but the sudden movement forces the tubing to kink and the monitors to scream, Casey slumping down with a heavy sigh as Severide struggles to awaken and the nurse comes rushing into his room.
"I just…tried to sit up," Casey states in his defense as Severide looks at him in concern.
"Please use this device from now on," the nurse reminds him as she hands him the small device. "The doctor will be in to see you both shortly."
"Thanks," Casey mutters as he watches her check his fluid levels and catheter bag and then leave. "It's um…the bag is empty."
"Your body needs time to adjust."
"Right," Casey replies with a heavy sigh as he looks down at the bag and then back up at Severide. "So uh…how long do you think we have to stay here?"
"For you Mr. Casey four to five days. For you Mr. Severide, about two to three days depending on how your recovery goes. Good morning. I'm Doctor Kyle Tennyson," he tells them. "I know you both must have a lot of questions after all that, so I'll talk to and examine each of you individually."
"When can we get back to work?" Casey asks in haste as the older man looks down with a small frown.
"You just came through a very traumatic situation Mr. Casey and…"
"Please call me Matt."
"Okay Matt. Things will return to normal…but not right away. How are you feeling this morning?"
"Anxious. I uh…" Casey pauses as he looks over at Severide and then back up at the doctor. "I've had minor surgeries before but um…I just want to go home and try to forget…"
"Hey hold on a sec," Dr. Tennyson's hand rests on Casey's shoulder as he gently pushes him back down to his bed, Severide looking at Casey in wonder. "You just need to take it easy Matt. I know this is going to be very new and frustrating for you, especially when I outline the recovery process but…"
"Process?" Casey asks weakly. "You mean it's longer than a few days?"
"I take it you and Mr. Severide are friends?"
"Yes but…"
"Close friends?"
"Yes but…" Casey tries once more as his anxiety starts to gain momentum. "I thanked him."
Dr. Tennyson offers him a small smile as he looks over at Severide and then back to Casey. "It's best if I talk to each of you indiv…"
"You can tell us at the same time. It's bad right? I can't ever go back to work?"
"Hold on a second here. I can see you two are not used to waiting for answers. Matt, your body will have the most work as you received the new organ. We need to keep a close eye on your recovery just to make sure there are no complications and that your body starts to produce urine normally. There will be some soreness and incision around the wound. This is just standard but I do recommend that later on today, the two of you get up and walk…if you can. It'll help with the healing and recovery process and it's also beneficial for your mental wellbeing. The blood types between yourself and Mr. Severide were a match and the transplant itself was successful but we are going to keep you in the hospital for at least four days to start to make sure your immune system doesn't attack the new organ."
"Attack?" Casey asks with a small swallow.
"That is not uncommon unfortunately. But I am going to start you on a prescription of new medications that will include immunosuppressant's that will help the immune system to cooperate. There will be a combination of CellCept, Cyclosporine, Sirolimus, Prograf…other good stuff. I'll check with your current doctor to make sure you're not allergic to any of these," Dr. Tennyson pauses and offers Casey a small smile. "They will help your recovery and organ acceptance."
"And um…how long do I have to take those?"
"The rest of your life," Dr. Tennyson replies matter-of-factly as Casey looks up in shock; Severide's eyes widening at the same time.
"The rest…of my Life?" Casey manages weakly.
"What?" Severide asks just as weakly as Casey looks over with an almost panicked expression that forces his concern to surge. "Is that normal?"
"For any kidney transplant recipient? Yes. We don't want any infections or complications to arise at any time after this going forward and this will…"
"But you mean in the few days while I'm in the hospital, right?" Casey tries in shock.
"No. I literally mean the rest of your life. I am going to put together a schedule of when to take them and in that schedule it'll outline the dosage and how to take them. It'll also tell you what each drug does to help you with your recovery and lifelong acceptance of the new organ. My team is going to get started on this this morning and we'll monitor side effects to make sure when you leave you have everything to start your at home recovery and then…get on with your life."
"But…I have to now take medication for the rest of my life?" Casey asks as his brain fights the urge of his eyes wanting to well.
"You could stop that is your choice of course. But I will warn you in no uncertain terms that if you were to stop there could be a good chance that the body would start to work at rejecting the organ. That threat will never go away as long as you have a different organ in your body. I know this can seem overwhelming but trust me its standard and once you settle back into your regular, daily routine this will all be…just one more thing you do like brushing your teeth after breakfast."
Casey's mind starts to spin as he looks at the doctor and then looks away…his head lightly shaking as he tries to process all that the doctor's just told him. "The rest of my life…" he utters in a half whisper.
"I know it seems daunting right now. But you've just put a foreign object into your body. We did the best we could to make sure it was as close a match to your own as possible but your body will still need help with the acceptance."
"And if I um…" Casey starts and then tries to swallow.
"Didn't want to have it?" Dr. Tennyson asks directly as Casey tries to shake his head no. "It's okay. It's post-surgery remorse. Simple truth, Mr. Severide really did save your life. Your body was failing and your friend saved your life. This all seems a little overwhelming to take in and when I outline your recovery process for the next few months you'll…"
"Months? I'm stuck here for months?" Casey asks as his stomach starts to lurch and his head swim with dizzying pain. "I uh…."
"No not…Matt?" Dr. Tennyson states as he quickly leans in and touches Casey's face, glancing up to see his monitors starting to scream.
"What's going on?" Severide asks in haste as he slowly tries to get out of his own bed, always mindful of the catheter attached.
Casey's body starts to buckle as he tosses his head forward and throws up water bile.
"Matt!"
"It's okay…" Dr. Tennyson tries to assure a panicked Severide as two nurses rush in to help. "Deep breath Matt…" Dr. Tennyson instructs as Casey's breathing starts to slow and his lungs ease in their heaving. "He'll be okay…just take a deep breath Matt."
A few anxious moments pass before Casey's body starts to return to normal, his flushed face being offered some relief from a cold cloth from the nurse. "That's it Matt…deep breath…it's going to be okay," Dr. Tennyson continues to try to calm Casey down; Severide watching in utter anxiety. "Better now?"
"Please doc…just tell me how long…get all the bad news over with," Casey begs in haste as Dr. Tennyson's face gently softens.
"Matt, if you could give up a few months for the rest of your life would you?" Dr. Tennyson asks directly as Casey looks down with a sheepish expression.
"Just…tell me," he mutters under his breath.
"I know you are used to a very busy, hectic and fast paced profession. But when you leave and are ready to return to work in a few weeks, I'll send through a modified work schedule to Chief Boden and you two will work together to make this right for you."
"Modified? I can't…doc I can't do modified," Casey insists stubbornly.
"You will," Dr. Tennyson offers Casey as warm smile.
"How um…how modified? A few weeks and then…"
"A bit more than that. Matt you've just undergone major surgery. Despite the fact there was very little blood loss and the surgery was a success it was a major operation. Losing organs and having a new one put in isn't like setting a broken leg or even draining the fluid from your brain. Your body has to get used to this and it will take time. Now for at least six to eight weeks after you leave here it's important that you do not lift any heavy objects or do strenuous physical work. It's important that you don't lift anything heavier than 20 pounds for two to three months and then nothing heavier than 40 for about four to six after your surgery. So if you want to start your countdown….start from today."
"This isn't…happening…" Casey gently gasps, "nothing over 40 pounds for half a year? Doc I'm a firefighter!" Casey hisses as he looks over at Severide. "And how long for him?"
"It's considerably lesser time that…"
"So he gets to return to life normally in a few weeks and I have to…" Casey tosses out bitterly as Severide frowns.
"It's only six months."
"Six…months…no doc I…I can't…" Casey shakes his head as his stomach continues to tighten with anxiety.
"I'm sorry Matt, I'm not going to lie to you. If you had an office job it would be a bit different but you have a very physically demanding, strenuous job that requires a lot of wear and tear on your body. You take it for granted when it was working properly. Now these are just the general guidelines and I have a duty to give them all to you no matter how hard it seems to be for you to hear and digest. This all depends on how well you take care of yourself and how fast your recovery is. It's different for each patient."
"Any other bad news?" Casey asks sourly.
"I'm not one to sugar coat things Matt. There will be some driving restrictions. Avoiding rough, contact sports and a few other things. Exercise, however, is encouraged and I have a team of transplant experts that are available any time to answer any questions you might have. As I said, this is all very new and scary and a lot to digest all at once. For the next few days I'm going to keep you on the liquid diet to see how your kidneys start to function and then the day before you go we'll start you back on regular food and send you on your way. Nothing else was damaged internally so that is very positive. Matt?"
"Yeah…I uh….six months…"
"You are looking only at the negative. You have your life back. You suffered no brain damage and so far there have been no other internal complications. I have given you all the straight up facts and I'll come back a bit later with all this outlined in writing so you'll see that it's not me taking pleasure in seeing you so dejected by all this."
"I just want…to get back to normal."
"And you will be," Dr. Tennyson replies as he gives his shoulder a small squeeze. "You're going to be just fine Matt…with a little bit of time."
"Okay."
Casey's weary eyes watch Dr. Tennyson take his leave and then rest on Severide's heavy frown. "I uh…Kelly I'm sorry about earlier," he starts as Severide slowly nears his bed. "I didn't mean to sound ungrateful but um…I was just…"
"Angry?"
"Scared," Casey admits in a sad whisper. "I'm scared Kelly," he admits as he looks up with soft frown. "I didn't want to die but this…this is all so overwhelming. Medication for the rest of my life?" He barely manages as his throat tries to swallow the large lump of emotion that has just formed. He leans back in his bed, turning his head as a few tears escape. He quickly wipes them before he turns back and looks up at Severide in misery. "I'll never be able to retu…"
"No way," Severide quickly interjects. "Don't you dare think about quitting. You're not a quitter."
"I can't work like this!" Casey half shouts as his fists ball and he tries to sit up. But he instantly feels the pressure upon his fresh wound in his lower back and instantly cries out in pain. "AHHHHHH!"
"Matt!"
"Mr. Casey ar…"
"I'M FINE!" Casey shouts as he looks away in anger. "I'm…fine!" His voice lowers as he looks at Severide in misery. "I'm fine," his voice dies out into a soft whisper as Dr. Tennyson returns with a strained expression.
"What happened?" Dr. Tennyson asks in haste.
"I…I tried to sit up and…I'm fine."
"It hurt?" The older man asks in a kindly tone as Casey returns a small nod of defeat. "That's normal and a good warning sign for you to just take it easy today. No sudden or harsh movements."
"Point…taken."
"Today will have been the hardest through this all Matt. You've recovered from a serious operation and then woke up and told your life has changed overnight without your input. But it will get better, I promise. I want to do a private examination for both of you. Mr. Severide…"
"Kelly."
"Kelly. You're first," Dr. Tennyson gestures for him to get back to his own bed. Casey watches Severide head back to his side of the ICU recovery room and the curtains drawn; turning his eyes back to the monitors a few seconds later. He watches them continue to steadily beep away but that doesn't numb his misery, if anything the monotonous tone adds to his inner contention. Six months…I'll be useless for six months! I'll be no better than…no I'll be lesser than a candidate…I can't do this…can't go back and tell my team…I…his voice trails off as he hears Dr. Tennyson telling Severide his own personal modified recovery schedule and feels his heart sink.
Severide looks up at Dr. Tennyson with a strained expression before he looks away. "Doc…six months?" He asks in a hushed whisper as he looks back up.
"He's going to be fine. It's hard for active young men, especially, to be told that things are going to change that drastically at first. I know he sounds resentful and that might build over the next few days while he remains in the transplant recovery area until he's discharged. Don't take it personally."
"I won't but um…doc it's hard to hear that also."
"I know it is. But it's obvious you care for him."
"He's the only brother I've ever known."
"He will be just fine. Now…let's talk about you. We were able to perform the surgery by Laparascope so the recovery time will be considerably shorter than if we had to do it by open incision. Now with this surgery, typically it can take as short as four weeks, but I tell my patients that it can be as long as twelve and especially in your line of work you don't want to rush anything. My recommendation to Chief Boden will be eight weeks of recovery time."
"Two…months?" Severide manages as Dr. Tennyson rewards him with a weak smile as they both hear Casey offer a small curse. "Right…"
"Much like Matt you'll have to come back for a few checkups to see how things are but since you didn't take anything new into you, I only have to prescribe something for the pain…which you can stop taking once it goes away."
"Does he really have to be on medication for the rest of his life?"
"If he wants to live he does," Dr. Tennyson answers in truth. "When you come back for your first checkup we'll make sure that no infection has occurred, if it has then we'll give you antibiotics. But having seen your past medical history and recovery time, I think you should be just fine."
"Okay."
"Much like Matt at first you refrain from driving for the first few weeks of recovery and then make sure you have kept up daily exercises to strengthen yourself so you're able to get back to that task. I know you guys have to keep yourself in pretty good physical shape, so recommending a daily exercise routine shouldn't be something too hard to keep up. But I don't want you to take anything for granted either."
"That's it?" Severide asks with a small frown as Dr. Tennyson continues his examination.
"In a few hours I want you to get up and try to go for a walk with Matt. He might not want to and that's up to him, but the sooner he is up and mobile the better. Walking is very important for your recovery and if you can walk every day and a bit further, even better. The final day for you I want you to walk a flight of stairs. But we'll discuss that a bit later. If you feel, tired rest. Plenty of rest, fluids and a normal diet are important to help your body recover as fast as possible."
"And Matt?"
"The better care he takes the faster he'll recover. If he's strict with his medication and self-care, the recovery time could be reduced. But please, I don't want you to agree with him to push himself too soon. It could have serious repercussions on his health. I am going to recommend no travel outside the US for at least three to four months to allow the wound to fully heal stave off foreign infection and…and that's all I'll say right now," Dr. Tennyson concludes with a warm smile. "I'll come back with a full write up for you also. You're both going to be fine and now share a very special bond."
"I just feel…he's so resentful about all this."
"He'll come around. I gave him all the hard facts and there are no more surprises waiting. He'll be fine. How's the catheter insert?"
"When can it come out?"
"Well don't shoot the messenger," Dr. Tennyson lightly smiles, "these two intravenous lines will remain so that we can keep you hydrated and much like Matt, administer some liquid pain medication; he has a few other things in his. We also need to monitor your bladder and kidneys to make sure everything is functioning normally, on track or if something is impeding the recovery process. You might not have to urinate much today, and as you see from the bag, much like Matt, very little overnight. The body doesn't have much fluid in it yet and it's still trying to compensate with the new changes. But in about two days they'll come out and everything will start to work normally again; at least that is the plan. A few hours after they come out, try taking in some water and see what happens. All goes well you'll be back on solid food and normal drink within no time. I would recommend to limit your alcohol intake while on the strong pain medication."
"Wow…okay thanks doc…just a lot to take in."
"Take a look…the scar isn't infected and everything seems to be on track. I'll check on Matt and then let you two talk things through a bit more on your own."
"Thanks doc."
Casey quickly looks away; not wanting to seem like he was listening intently, despite the fact he was. His recovery time is twelve weeks at most? That…that isn't fair…he gave you a part of him! Don't be selfish! Casey's mind argues back in two different directions and he knows the latter part was right. How could he blame Kelly for his current plight? Without his selfless intervention he could be dead. It's not fair for me to put my own personal misery onto my friend who…who literally saved my life.
"Okay I'll tell you the same I told Kelly about the catheter, how long it has to stay in and the purpose of the tubing and kidney function."
Casey listens to all that Dr. Tennyson has to say, his eyes intently watching the older man as he checks the fluid bag and what the purpose of each one was. He notices a male nurse near and instantly tenses.
"Roger is going to help me turn you onto your side. Maria is going to hold up the mirror so you can see where the incision was made and how it's healing."
"Okay," Casey replies in a somewhat timid tone, feeling suddenly isolated and alone in a room with only strangers and the curtains drawn keeping Severide out. He feels his stomach tighten and as soon as Dr. Tennyson's hands start to gently touch his lower back and move lower his whole body seizes and his monitors start to get excited. Even more so when the strange male nurse starts to bodily handle him.
"Matt…I want you just to relax. I'm just going to check the wound to make sure it's as it should be."
"Sure," Casey agrees through gritted teeth as he clutches his pillow and closes his eyes.
Dr. Tennyson notices Matt's back starting to gently shake and his monitor's continue to get excited and whispers to Maria to get Severide.
"Everything okay in here?" Severide asks as Casey looks up in haste. At first he gently frowns, his mind further agitated that he's got less privacy, but as he looks at Severide's sympathetic expression his heart rate starts to slow and his vitals return to normal.
"How's it look?" Casey asks softly as he gently winces.
"Does that hurt?"
"Yes. Is it supposed to?" Casey asks in worried concern.
"Yes. It will be tender for a few days and that is normal. But everything looks on track right now," Dr. Tennyson states as he covers up the wound, pulls Casey's gown back down and then helps him return to his normal position; Maria and the male orderly taking their leave.
"Feeling tired…for both of you for the next few days especially is normal…Matt for you more so. The only time you really need to worry is in a few weeks, when you are eating, sleeping and exercising normally."
"Normal…" Casey manages through gritted teeth as Severide frowns and Dr. Tennyson offers him a small smile.
"Yes believe it or not life will return to normal in a few months. Okay I'm going to get started on a few things for you both and will be back later. Remember what I said…a bit of walking will help you both. We have a lovely terrace at the end of the floor. Do you have someone coming who can bring you a few personal things?"
"Yeah we do," Severide mentions as Casey looks up in wonder. "Thanks."
"Okay. I want you just to rest now. A few hours of sleep, and then try to get up and go for a walk into the hallway and down a few meters and then come back and rest. I'll be back later."
Both of them watch the doctor leave and then Severide quickly turns to Casey in concern.
"How are you feeling?"
"I'm just…angry and scared and agitated and…angry. I did this to myself…I…I should have let the baby die…" his voice dies out as his eyes water. "Kelly…I'm sorry…I couldn't do that either."
"I know. It's not in you to do that…not in any of us. Hermann wanted to go…we all would have," Severide reminds him in a kind tone as his fingers rest on his shoulder and gently squeeze. "You heard the screams…you couldn't have just turned and let it suffocate and then burn to death."
"No…no I couldn't," Casey lightly laments as he looks away and then tries again to swallow. "A few more seconds…I could have moved a few more feet and…"
"What if that beam landed right on your head? You said only part of the beam but it was mostly your helmet. But what if that beam landed right on your head and killed you instantly? Or your spine and paralyzed you?"
"I know…I just…I know…I know it could be a lot worse," Casey huffs as he looks back up. "Boden's coming by today?"
"And Shay. She's bringing us both a care package. And I told her a deck of cards and my portable DVD player."
"No scary movies."
"Oh really?" Severide snickers as Casey purses his lips. "You uh…wanna walk for a bit?"
"No. I just…I'm tired and want to…wallow."
"Is it safe to enter?"
Both of them turn to see Shay hovering near the entranceway with two duffle bags in her grasp. "I missed the hug right?"
"Like this?" Casey asks weakly as she nears his bedside.
"Oh a half hug will suffice," she lightly groans as she hugs Severide and then leans over the bed rail and hugs Casey. "See…easy."
"We're content to watch you do it," Severide teases her as she looks at his gown.
"Nice."
"You brought my robe right?"
"Yes and Casey's too and a few other things. So catheter…gotta love those."
"Want mine?" Severide tosses back in sarcasm as she holds up her hands and shakes her head no.
"Everyone is asking when they can come visit. I told them all tomorrow after you two have rested up a bit more."
"Thank you."
"So how does it feel to have a Kelly inside you?"
"Why when you ask like that does it sound perverted?" Casey retorts with a groan as she wags her brows and then laughs; Severide shaking his head at his roommate's lame joke.
"Any issues so far?"
"Uh…no," Casey replies, holding back his own personal disdain about his modified life for the next six months.
"Ok-ay," Shay replies with a small eye roll as she places Casey's duffle bag onto the table beside his bed and hands Severide his. Shay stays for about an hour, talking with them about their recovery and how they were feeling after their surgery and then telling them that Boden would be by a bit later in the day as he was held up with some stuff at work now that 51 was back in full business. Casey finally tells them he's feeling sleepy and the Shay gives him a hug and a kiss on the cheek and then her and Severide step outside to talk a bit longer.
"So what isn't Matt telling me?" Shay asks as soon as they were out of earshot.
"He uh…he'll have to be on modified work duty for maybe up to six months."
"Six…wow."
"Yeah…so he's…"
"Bitter."
"And a bit resentful," Severide replies with a small sigh. "At least it happened at work and he can get some compensation but…I don't blame him I just…"
"Kelly you saved his life. He'll come around. If not, you can just smother him with a pillow," Shay gently teases as Severide offers her a small smile. "But you know I'm in this for the long haul too okay? I'll help in any way I can."
"I'm glad you're here and I'm glad we can take care of Matt together. At least at first."
"That's what friends are for right?"
"Right."
The two of them talk a bit longer before Shay notices Severide trying to hold back fatigue and gives him one more hug, telling him she'd try to stop by the next day if possible, either that the day after. Severide watches her go and then turns and heads back toward his shared room with Casey, hoping his friend is sleeping and getting the rest his body so desperately needs.
Severide rounds the corner to their room, but instead of offering his sleeping friend a kind smile, he looks at the empty bed in surprise. He slowly heads for the bathroom to see if maybe Casey had gone in to clean up a bit or whatever. He lightly knocks and then waits.
Silence.
"Matt?" He calls out before he opens the door; only to find it empty. "What the…" he huffs as he quickly turns to see Casey's duffle bag gone.
Another nurse pokes her head in and Severide looks at her in wonder. "The man that was just here…Matt Casey…where'd he go?"
"He left."
"I can see that but where he'd go?"
"He left the hospital."
"WHAT?"
A/N: Okay so I know this chappy was heavy on the medical jargon and I hope it wasn't too boring but sometimes TV shows gloss over recovery for surgery and I wanted to show just what Casey was facing b/c that's what he'd face in RL (those are the basic stats for kidney recovery operations but of course they differ with each person). Not sure how long this story will be (will depend on your reviews and if you want more) and I won't drag out the recovery either but I just had to show what our boys – both of them would face after such an operation. Hope that's okay! So where has Matt gone? Did he really just get up and leave? And when he sees just how modified things are will his resentment surge and strain their friendship? Please do review with your thoughts before you go and thanks so much!
