Give All My Secrets Away

Black-Angel-001: so now we know what pete wanted from chris. let's see what chris is gonna do

Give All My Secrets Away

"Tell my mother, tell my father, I've done the best I can to make them realize this is my life I hope they understand."-Shinedown, 'Second Chance'

Chris waited almost nervously in Dr. Brackett's office. He hadn't told the doctor much more than what he'd told his family; he had a couple of questions about something and it was fairly personal. He knew it worried his parents, but until he did talk to Dr. Brackett, there wasn't much he could do about that. The door opened, Chris turned to see Brackett come in, closing the door behind him.

"Hi Chris, sorry about that," the doctor said about his lateness.

"No problem. Thanks for seeing me, I know it's short notice."

Kel sat down behind his desk, hands folded in his lap. "Anytime. Now, what's going on?"

"Um, could this be confidential? At least for now?"

Kel frowned. "Unless it seriously endangers your health."

Chris paused, shook his head. "It's questions, mostly. I just don't want dad or Karen to find out about this until I know as much as I can."

"What's this about Chris?" Brackett leaned forward, his arms propped up on the desk. Chris was silent a moment and he waited. Finally, Chris told him about his bilogical father, the trip to Palo Alto, meeting Kayla and Ryan. About Ryan having hepatitis B.

"I want to know about that, the disease I mean. I read up on it at the library, but I'm not sure I get it."

"Okay. First of all it's an infection of the liver with two phases, acute and chronic. Which does Ryan have, do you know?"

Chris nodded. "Chronic."

"Then you should know that at this point the disease may never go away completely. It can be managed with medication, regular checkups with a physician, and even a proper diet and exercise plan. Kids have a greater chance of getting chronic hep B than adults. If it gets severe enough, the liver can become affected with a type of scarring known as chirrosis. Do you know what that is?"

"It's supposed to be in alcoholics, right? When they drink so much their liver fails?"

"That's what it's commonly associated with, yes." Brackett had to admit, he was impressed with the attention Chris was giving this; not many kids his age would be able to sit through it without fidgiting. "Although the liver can heal itself, chronic hepatits B can cause liver failure, resulting in the need for a liver transplant, or even a type of liver cancer. Statstically speaking, about 15 to 25 percent of people with this infection die of liver disease."

Chris thought about that, finger tapping on the arm of his chair. "So it isn't something lots of people get? I mean, if only 25 percent die of liver disease with this?"

Brackett shook his head. "No, it's actually the most common serious liver infection, worldwide. About 350 million people are chronic carriers, and more than 620,000 of those will die from liver related disease each year. In the US, about 800,000 to 1.4 million Americans are carriers, which causes about 3,000 deaths each year."

"Okay, so it's common," Chris said, surprised by the information.

"But preventable. An effective vaccine has resulted in a 82 percent decrease in the number of new infections reported here in the States."

"So, Ryan could have gotten it pretty easily then, and gotten it treated just as easily."

"That's the case most of the time. Most commonly the hepatitis B virus, or HBV, is transmitted through unprotected sex or sharing dirty needles."

"Ryan told me he fell on a needle playing in an alley when he was like, eight. He never told his parents about it until the doctor told them about the blood tests."

Brackett nodded. "That would do it. You can't transmit or get the disease from sneezing, coughing, hugging, shaking hands, or casual contact."

"Yeah, I got that much from the books," Chris grinned. That was good information to know, as it was a common misconception about how you could get not only hep B but anything.

"I'm glad you understand that, Chris." Brackett thought some, recalling everything he could that might be relevant. "The most common symptoms for HBV is flu-like, although there are other, more common symptoms as well, that usually develop within 1 to 4 months. Some don't even have symptoms and never realize they're sick.

"When chronic HBV has developed, there may be symptoms of liver damage, or failure. Persistent jaundice, or yellowing of the eyes and skin. Weigh gain, weight loss, loss of appetite, blood in vomit, bleeding from various areas, and excessive sleepiness, mental confusion."

Chris frowned, thinking back to his trip. "Ryan's skin and eyes looked yellow, and he looked kinda starved."

Brackett nodded knowingly. "That means he's experiencing liver damage, possibly failure."

"That's what Pete said, that he's almost in advanced stages."

"Then he's being looked at as a candidate for a transplant. Depending how bad it gets, and how available a liver is, he may not get one until he's on life support."

"But, Pete asked me to donate some of mine," Chris said, maybe a little angrily.

"Chris, the chances that you are a blood match to your half brother are significantly low." Brackett leaned forward again. "If you are a match, there may be other factors that prevent you from donating."

"Like what?"

"Various diseases, infections, or defects for one. Your parents for another."

Chris scowled, arms crossed over his chest. "What do they have to do with it?"

"You know very well what they have to do with it. You're underage and would need parental consent before you'd even be considered for a live transplant."

"What's a live transplant? I thought doctors had to get organs from dead people."

"The most common practice is to get organs from cadavars, yes. There's a whole system and process that goes into this, Chris, so it's safe for all parties involved. Transplants aren't my field of expertiese, but I can put you in touch with a transplantation doctor, if you'd like."

Chris nodded vigourously. "Yes, please."

"I'll have him call you, then." Brackett stood, as did Chris, and the pair shook hands.

"Thanks doc, this really helped."

"I'm glad it did." He hesitated. "Chris, you should talk to doctors about this with your parents present. That way, you all have the information you need."

Chris looked vaugly guilty, but determined. "I know, but I want to be able to make the decision first, and make any arguments necessary. Besides, I don't think they'll object. Too much," he grinned.

"Good luck," was all Kel could say.

As promised, Dr. Brackett had one of the transplant surgeons call Chris and set up a time to talk at the hospital. It worried Roy and Karen that Chris was going there so much; it worried them more that he wouldn't tell them what it was all about. Despite the little twinge of guilt Chris felt everytime he didn't say anything, he stubbornly kept his silence. If he had no control over anything else that was happening, at least he had control over this!

Dr. Joe Martinez was about Dr. Brackett's age, with dark Latino features and an easy manner. Although Chris was nervous, he felt he could trust this man to tell him the honest truth.

"So, Kel tells me you want to know about organ transplants, specifically, of the liver." Chris nodded and Dr. Martinez smiled sympathetically. "Family member?"

"My half brother," Chris replied, surprised. If Dr. Brackett had told him the particulars, Dr. Martinez would've said something more specific, not so vauge.

The doctor nodded. "That's usually the case, when someone wants to know. Or, they're a med student. Well Chris, what'd you like to know?"

"Could I be a live donor to my brother?" That was his most important question.

"I honestly couldn't tell you. Donors are matched based on blood type, body type, and general weight. If even one of those things don't line up, the person isn't considered. Since he's your half brother, I don't think chances are good."

"But if I am, hypothetically, and I'm able to donate, what would happen?"

Dr. Martinez leaned forward, gesturing with his hands. "You would have a series of tests done to determine if your liver is viable. Meaning, if it can be used. Blood will be drawn, x-rays will be taken, and you'd have an overall physical. If you have something like a cold, or you're physically unable to because of various reasons, you will be unabe to donate."

"But if I can," Chris said impatiently. "If I can what happens?"

"When it's determined you are a good candidate and that you can donate, you and your brother would be scheduled for surgery. This will be major abdominal surgery on both your parts. A piece of your liver, which would be about 50 percent of the recipient's current liver size, would be put into your brother. In six to eight weeks, both pieces of liver will have grown to normal size.

"After surgery, both of you will be taken to the intensive care unit, where you'll be monitored closely. When you're fully awake, able to breath on your own, all your tests come back clean and there's no sign of infection, you'll be taken out of ICU, usually takes about three to four days, and most likely be put in CCU, or critical care unit. Average hospital stay with no complications is about three weeks."

"There's a lot of 'abouts' and 'most likelies' here," Chris said dubiously. "Why?"

"Because while this is all exact in theory, it may not be in real life. There are a number of things that could go wrong: infection of the drainage tube, infections in general, high blood sugar, high blood pressure, bleeding, even pnuemonia from the breathing tube. Although there will be a number of people looking to monitor and prevent this, it could still happen."

"So, after the surgery. What then?"

"You'll see the transplant surgeon or hepatologist, liver doctor, about one to two times a week over three months. After that, you'll see your regular physican reqularly once a month for the first year after the transplant. After the year is up, it's all individualized. You'll be given a series of pre and post transplantation medications. In your case though, not as many as your brother. That's about it in a nutshell; the team who actually does the transplant will get more in depth with you and your family. Any questions?"

Chris felt too overloaded to think of any. He shook his head, shook hands with Dr. Martinez, and went home.

Three days later, Chris was standing in front of his parents, Jenny and the twins in their rooms, shifting nervously. He looked his dad and Karen in the eye, stopped shifting and stood straighter. When he spoke, his voice was loud, clear, and had no doubt whatsoever.

"I want to donate a piece of my liver to my half brother Ryan."

Black-Angel-001: ta da! all the information about hep b and liver transplant is begotten from webmd, very helpful. i know that in the 80's early 90's (the time this is set) there might be a slight difference, but overall it's sound. please review!