Author's Note:

Chapter 10, right here! It took me somewhat longer to write due to the beautiful weather (finally), but here it is! I hope you will enjoy it because this story has almost come to an end. There are about two chapters left before it's over. I hope you guys won't attack me now. It feels like it's the right time now as 'm gonna have a busy year of school ahead of me, going into my second year of college. I just won't have the time to write anymore. I hope you guys will still enjoy this chapter. I know I did while writing it.

Warm regards,

Isabel Konijn

Disclaimer: I do not own Grey's Anatomy or its characters. I'm just borrowing them for my own fun.

Chapter 10: One of extremities

''I don't know but he… he can't breathe. His lips are turning purple Mer, I don't know what's happening. I called 911, they will be here soon.'' He said and felt a pang of guilty in his gut for not seeing what had happened to him.

''Oh god.'' Meredith cried and immediately hung up.

''They will be here soon, Derek. Please hang on'' He said as he saw Derek's eyes slowly beginning to close…

''BP is 120 over 80, sats are at 90!'' the paramedic yelled as the ambulance sped through the streets of Seattle. ''Heart rate is through the roof!''

Mark was barely able to hear what the paramedic was saying through the ear deafening siren of the ambulance, but he kept his eyes on Derek who was as pale as a sheet, a clear oxygen mask covering his face as he lay unconscious on the gurney. His body connected to heart monitor showing that he was close to getting into tachycardia.

''He's getting into tachycardia. I need the paddles, NOW!'' the man shouted as the other man quickly handed them to him.

''Charge to 180'' He said as the machine was preparing for the voltage it was gonna give to Derek's heart.

When the beeps of the defibrillator filled the air Mark closed his eyes. He didn't want to see Derek's body flying upwards as an incredible amount of voltage traveled to his best friend's heart in order to get it to start beating regular again.

''Heart rate is getting back to normal again.'' The paramedic replied and Mark breathed a sigh of relief, giving Derek's hand a good squeeze as in saying 'thank you for that'.

''How many more minutes till we arrive?'' The same paramedic yelled to his driver as he checked Derek's stats again and started an I.V.

''Just a few minutes'' He yelled back.

Mark watched him as he placed the I.V right next to where the previous one was still visible and he sighed, shaking his head.

''It's gonna be okay, sir'' The other paramedic in the rig said as he saw the scene in front of him, and Mark just nodded at him, not having the energy to argue with him when he was just trying to show him some support.

As the ambulance rode into the ambulance bay, Altman and Bailey were already waiting for them and when the doors opened the whole circus started all over again.

''Derek Shepherd, 39, has trouble breathing. BP is 124 over 81, sats are at 90. We had to shock him once to get his heart to start beating regular again. Has been unconscious ever since we arrived at the scene. '''The paramedic rattled off.

''Mark, what happened?'' Teddy asked carefully while they took Derek out of the ambulance.

''I… I don't know. I was cleaning up Zola and when I got back into the living room he was hunched over and I heard him wheezing. He was struggling for air but I don't know what happened. I was only gone for a minute.'' Mark said, his face displaying all sorts of emotions.

''It's gonna be okay. Okay?'' Bailey said as stepped into the rig, her arm circling his waist as she was trying to get him to stand up.

''I need this hallway clear, please!'' Teddy yelled as they entered the E.R.

''Trauma Room 1 is prepped and ready for you, Doctor Altman.'' Nurse Kathy yelled as Altman disappeared between the double doors to the Trauma Room where Owen and Richard were already waiting for them.

''Cristina! I need to see Derek!'' Meredith practically yelled while Cristina was trying her hardest not to let Meredith out of that room.

''You can't now, and you know that Mer. Altman, Hunt, and Webber are with him. He got the best we've got.'' She replied, hoping to get Meredith to calm down a bit.

''I know, I know..'' Hearing who were in that room helping her husband was calming her down a bit, much to Cristina's pleasure.

''He will get through this, like he got through all the other crap that's been thrown at him. Altman is the best and she and Hunt and Webber will make sure nothing happens to him.'' She reassured her and put a genuine smile on her face to give extra power to her words.

'''Will… will you check on him Cris?'' Meredith asked as she wiped a few tears away, giving Cristina no other option to give in to her request.

''I will, Mer.'' She nodded.

''Now, please. I need to see how he's doing.'' Meredith pleaded as she practically looked through her person's piercing brown eyes.

''Okay…Okay'' Cristina replied softly. Finding it only fair that if Meredith wasn't allowed to be in that room, she could at least let her person now how her husband is doing.

Hunt and Webber had barely put on their gowns when Teddy burst into the room, immediately shouting off orders as Derek was moved to the center of the room.

''I need a tox-screen, chem-panel, x-ray for the chest and a ventilator stand-by.'' She uttered and Hunt and Webber immediately got to work.

''What happened, Doctor Altman?'' Owen asked while he drew some blood.

''I don't know. Mark doesn't know either. He said he was in the kitchen for a moment and when he came back he found Derek wheezing on the couch.''

''Could it be acute respiratory distress syndrome?'' Owen asked carefully as he glanced at Teddy for a moment.

''No, I don't think so'' She replied as she had pondered his question for a few seconds.

She then quickly grabbed the portable x-ray and shot some images of his chest, hoping that they would tell her what was going on with his lungs.

''Sats are still at 90'' Richard said as he monitored Derek's stats closely.

''Okay, put him on 5 liters.'' She replied and waited anxiously for the images to develop while Owen grabbed his penlight and shone into Derek's eyes, who still lay unconscious on the table.

Altman observed the scene in front of her as she thought hard of a possible diagnosis. Because of the hypoxemia she could easily be seduced to a possible complication of the hypoxemia, but his stats weren't worsening and that confused her. For it to be acute respiratory distress syndrome his stats would have worsened rapidly by now but it stayed steady and his heart rhythm didn't show any abnormalities either.

''Wheezing, shortness of breath…'' She thought out loud just as the images of Derek's chest x-ray rolled out of the machine.

She quickly grabbed them and put them on the light board. A confused frown on her face as she looked at the images and spotted a pneumomediastinum in both of his lungs accompanied with an infection.

''Asthma…'' She said, bewildered. ''He has asthma...'' She said again and turned around to face her colleagues who looked just as bewildered as she did.

''Are you sure?'' Richard asked, a deep frown on his face.

''Positive.'' She replied and Richard walked up to the light board, needing to check it himself even though he trusted Altman for 100%.

''How? How is that possible?'' He asked after having studied the films.

''It most likely is a result of the severe hypoxemia he's had. It's rare, I know, but it's my only explanation. ''

''Does it run in the family maybe?'' Owen spoke up, trying to come up with other explanations.

''Not that I know of but I'm almost 100% sure it's because of the hypoxemia.'' Altman said. ''But I'II ask him when he wakes up.''

''Could it be permanent?'' Owen asked, but before Altman could answer, Cristina burst into the room.

''How's he doing?'' She asked as she looked from Derek to Altman and to the rest of her colleagues in the room, including Owen.

''He's stable now.'' Altman replied as she began disconnecting the wires from the devices in the room to make him ready for transport to the CICU.

''Do you know what's going on with him?'' She then asked, genuine concern and worry for her person's husband.

''We're pretty sure it's asthma.'' Teddy replied and Cristina face changed from worry to confusion in an instant.

''Asthma?'' Cristina frowned. ''But, how?''

''It most likely is a result from the recent hypoxemia he's had. We don't know if it's permanent yet but I will do some tests first, check his heart if there are any abnormalities there but considering the past week I'm positive that his tachycardia and unconsciousness is just a result of severe stress and not a life-threatening heart and/or lung condition.''

''But if you will excuse me now'' Teddy said and unlocked the brakes of the bed, Richard coming up on the other side and helping Teddy moving Derek out of the Trauma Room and into the CICU.

As the evening began to set in, Teddy opened the door to Derek's CICU room, and much to her surprise it was empty besides Derek who was still lying motionless on the hospital bed. The only sounds in the room coming from the ventilator and the heart monitor.

She sighed once again before stepping into the room, a full tray of equipment with her. She set it by his bedside and turned on the echo before throwing his gown back and revealing his still battered bare chest, the scars of his recent severely injured sternum lying open for the whole world to see.

She splayed the gel on his chest and began searching for any abnormalities he might have in his heart.

But after going over his heart for the second time, wanting to make sure she didn't miss anything, she was finally able to smile for the first time since he was brought in as his heart didn't show any abnormalities whatsoever.

It was that moment that the door opened and Meredith walked in, a tray of food and drinks in her hands. She almost dropped it when she saw Teddy in the room and Altman quickly stood up, smiling slightly to try and reassure her a bit.

''His heart is okay, Meredith. No abnormalities.'' Teddy smiled as Meredith relaxed considerably. She had heard from Cristina that Altman was gonna check his heart by the end of the day but her head was killing her at the moment and she had completely forgotten about it.

''I'm sorry, Teddy. I completely forgot that you were gonna do the echo this evening. This day has just been..'' Meredith said but her words got lost and tears started to form in her eyes again and she could barely keep them at bay.

''I know… '' Teddy replied, laying a comforting hand on her shoulder.

''I know It's hard, for the both of you, but he will get through this. His heart is fine, that's a big relief and we still have to wait and see of the asthma is permanent or not. His lungs have had a lot to endure the last few years but he's strong. Even if it turns out to be permanent, there's nothing to worry about. It's very treatable.'' Teddy said, hoping to reassure Meredith a bit that even if Derek's asthma turns out to be permanent, it can be treated well.

''I know, Teddy. I just don't know if he can handle it. First there was the shooting, then the plane crash where he injured his hand so badly that he may have permanent damage and might never operate again, and now this. It's just, maybe too much.'' Meredith said, as she looked at her husband, pale and motionless on the hospital bed. Numerous tubes and wires snaking in and out of his body.

''I understand.'' Teddy said and followed the direction of Meredith's eyes, staring at Derek's lifeless form.

''When will he wake up?'' Meredith asked as she sat down in the chair next to his bedside and grabbed his hand, plating a soft but loving kiss on it.

''I expect in a few hours now that his heart didn't show any abnormalities. But we just have to wait and see.''

''But he will be okay?'' Meredith asked, her medical knowledge completely gone.

''He will, Meredith. We don't know how he will react when he will come off the ventilator and I have to admit it was touch-an-go for a while but after seeing his blood work and his heart, I have no immediate concerns regarding his health.''

''Good.'' She said and smiled slightly as she gave his hand another squeeze and Altman excused herself, leaving the two of them alone again.

''Do you hear that, Der. It's gonna be okay, so please don't pull anything funny on us. I love you.'' She said and planted a loving kiss on his forehead before placing a hand on her stomach, feeling a strong kick.

''Yeah, that's your daddy, and he loves you very much'' She said as tears build up in her eyes again at the moment, and a lonely tear escaped her eyes and landed on his hand. His soft, strong, surgeon hand she already missed having around her at night.

It was barely 2 hours later that Derek's CICU room was fairly crowded. He was finally starting to wake up and Altman, the Chief, Owen, and Mark and Meredith were watching that moment as if it was something special, something precious, and for them it was this time around.

''Doctor Shepherd?'' Altman said as she saw his eyes slowly opening.

''Doctor Shepherd?'' She asked again and made some steps forward when she saw that he was getting more aware of the situation he was in right now. And from her spot she could now easily intervene if he was gonna fight the tube.

It wasn't long after that when he started fighting the tube and Altman directly intervened, making sure to calm him down.

''Doctor Shepherd, you have to calm down now, okay. I know it's hard but the tube will come out soon.'' Altman said, trying to calm him down but with no success.

''Derek, sweetie, you have to calm down now. The tube will come out soon. I promise'' Meredith tried with success and he calmed down. She squeezed his hand and smiled slightly, making him feel more at ease now.

''Doctor Shepherd'' Altman spoke up and Derek diverted his eyes towards his colleague who had an relaxed, laid-back look on her face that made his nerves ease a bit. ''I'm gonna listen to your breath sounds now and if they're good, I'm gonna extubate you, okay?''

He nodded immediately and Meredith took some steps backwards to let Doctor Altman do her work.

After listening to both his lungs, she hung her stethoscope around her neck again and smiled at him.

''It's all good.'' She smiled and Meredith grabbed his hand again, smiling brightly.

''Okay, you know the drill. I want you to take as deep as a breath you can muster and on three I want you to blow it out, okay? Can you do that?'' She explained and he nodded fiercely. Not wanting to waste anymore seconds.

''Okay'' She smiled slightly and disconnected the ventilator before grabbing the tube. ''On One… two… THREE!'' She counted and on three Derek blew out as hard as he could and what followed was a painful coughing fit that made Meredith's and the rest of the people in the room twist their stomach.

''Take long deep breaths'' Altman instructed and grabbed an oxygen mask from the cart.

''What… what.. happ…happened'' He croaked but was immediately silenced by Altman.

''Don't try to speak just yet'' She said and watched the monitor carefully for any changes.

Once the coughing fit subsided he became aware of all the people in the room who were all staring at him with a smile on their face, happy that their colleague, their friend was doing better.

''What… happened?'' He tried again, and this time he got an answer.

''Mark brought you in, Derek.'' Meredith explained and he landed his eyes on his best friend who looked at him with pity, or guilt maybe, even though he couldn't have done a thing to prevent this from happening.

''You were having trouble breathing and after some tests... after some tests.'' Meredith choked on her words and Altman looked at her, knowing she had to proceed now.

''We discovered you had asthma.'' She said and Derek's gaze landed immediately on Meredith who was trying her best not to cry again. He looked at all his colleagues in the room, a sad expression on their faces. He thought about what Altman had just said but it still hadn't processed in his brain. Asthma. How could he have developed asthma?

''We don't know if it's temporarily yet. It's most likely a result of your recent hypoxemia. We won't ever know that but it's our only explanation. We will just have to wait and see if this turns out to be permanent or not.'' Altman further explained but Derek's was only half listening as Meredith's sobs got louder and he turned his attention to his wife.

''Mer…'' He said, trying his best to reassure her a bit. ''It's gonna be okay.''

''You don't know that. What if this turn out to be permanent? What then?'' She replied, her voice a bit harsh.

''Like I said, it's very treatable, Meredith.'' Altman cut in. ''We will give him albuterol inhalers and other supporting medicine.''

''See, it's gonna be okay, Mer'' He said and reached for her hand.

''Aren't you angry? Sad? Hurt?'' Meredith frowned, confused at his light behavior and lack of interest in his own health.

He sighed, not knowing how to answer her question.

''I am, Mer. But it's not gonna change anything. We will just have to deal with it. We have a beautiful daughter and a baby on the way.'' He said, tears glistening in his eyes at the thought of their baby, growing safely in his wife's uterus. ''We will get through his, together. I know we will.''

Meredith's sobs subsided and for the first time she fully looked him in the eyes, understanding what he meant. She laid a hand on her stomach as their baby made itself present again and she smiled softly, realizing what she still had in her life.

''Mer, you ultrasound is tomorrow.'' Derek suddenly chimed in and he looked over at Altman immediately.

''Can I go, please?'' He asked, setting up his McDreamy face again and Altman smiled softly.

''If your further test come back positive and I've explained you how to use your medication, you're free to go.''

He smiled brightly at her answer and he turned his attention back to Meredith again who had the same smile plastered on her face, as well as everyone else in the room with them. Their problems simply forgotten for a while as the two of them only focused on the positive things they could control in life.

1 day later…

''Derek, are you sure you wanna go? I can just go alone, I don't mind, really.'' Meredith said as the two of them walked towards the OB-wing.

Since he was released from the hospital this morning she had become overprotective. Even though Altman had given him the 'Okay' and Callie freed him of the walking cast she still wouldn't let it go.

''Mer…'' He sighed. ''I'm okay and I'm going with you. I can't wait to see our baby for the first time'' He smiled. Whenever he mentioned their unborn child he was smiling like an idiot. He was over the moon about it and Meredith could tell instantly. That sparkle in his eyes, the way his mouth twitched, he really couldn't wait and that made her heart swell with pride.

''Okay, fine'' She said and smiled slightly. They took seats in the waiting room and barely half a minute later they were already called in.

''So, how are you two doing?'' Vanessa, their obstetrician, started the conversation as Meredith took place on the exam table.

''We're doing okay'' Meredith replied as she took a quick glance at Derek who nodded understandably. They didn't want to bring it up again, not now when they were going to look at their child for the first time.

The obstetrician then grabbed her supplies and spread the gel on her slightly swollen abdomen before starting the ultrasound.

''You're at 20 weeks now so we will be able to see the sex of your baby. Do you guys want to know it or do you wanna wait?'' She smiled politely and Meredith turned around to face Derek who began to smile brightly.

''Do you?'' He asked and Meredith smiled immediately before nodding fiercely.

''Yes'' She said to Vanessa who took one last glance to be absolutely sure before turning their attention to the couple again.

''It's a boy! Congratulations!'' She smiled and Derek couldn't contain his tears. He looked at his wife in pure happiness and squeezed her hand before bending over to give his wife the most loving kiss he could muster.

''Oh Mer…'' He cried and quickly wiped his tears. ''We're gonna have a boy!'' He smiled from ear to ear and Meredith joined him.

''We really are'' She smiled as tears began to flow freely from her eyes too. ''We really are…''