Going Through the Motions Ch. 14
Disclaimer: No, I don't own them. I only wish I did! Making no profit either here folks. Unbeta'ed so all mistakes are mine.
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Previously: Shane blanched as he heard the rasping sounds coming through the stethoscope. "Son of a bitch" he thought. The last thing this kid needed was problems with his heart.
A Shane continued to assess his patient, he became more convinced then ever that Sam was suffering a secondary infection, one that had settled around his heart causing Sam to have chest pains and a little difficulty with his breathing. He knew he would have to order an EKG and blood tests to confirm his diagnosis, but he was ninety nine percent sure that Sam was suffering from pericarditis, especially after he had Sam lean forward and heard the unmistakable sound of a friction rub in his heart sounds. The sound was relatively easy to recognize since it resembled the sound of squeaky leather.
"Sam, I'm going to give you a shot of codeine with a strong sedative in it to help you relax and to relieve the pain. It should take effect fairly quick so don't fight it" Shane stated as he pulled a sterile needle and a small vial of fluid from the locked medicine cabinet. He quickly withdrew the needed dose and then injected it into Sam's IV. Within minutes, the pain lines faded from Sam's face as he feel into a deep and restful medicated sleep.
After the codeine took effect and his patient succumbed to sleep, Shane looked up into the worried faces of Sam's father and brother. "After examining Sam and evaluating his symptoms, I'm almost positive that he is suffering from a condition called Pericarditis. Basically that means that Sam is suffering an inflammation of the pericardium or the sac that is surrounding his heart. I am going to order an EKG and some blood tests to confirm that my diagnosis is correct.
"How dangerous is this in Sammy's already weakened condition?" John asked nervously as he rubbed a calloused hand through his graying hair.
"I'll be honest with you John, my biggest concern right now is that it could lead to cardiac tamponade which means that too much fluid could build up in the pericardium. If the fluid increases enough in volume, it will put pressure on Sam's heart and prevent the ventricles from filling properly leading to a stroke and even possible death.
"Holy shit" whispered Dean as his face drained of all color and he dropped into the chair beside Sammy's bed. "God little brother, why does everything always have to happen to you?" he questioned as he put his head down on Sammy's bed and allowed the tears to fall.
John walked around to the side of the bed that Dean was sitting on and placed a comforting hand on his first born son's shoulder. He could feel the miniscule tremors going through Dean's body and worried about how much more bad news his oldest could take without completely shattering. Looking at the doctor with bloodshot eyes, he asked "So what happens next, how do you treat this pericarditis?"
"We're going to have to move Sam back to the ICU where he will be monitored at all times. We'll start him on a regiment of anti inflammatory drugs such as Naproxen and Ketorolac that will hopefully reduce the inflammation and the fluid already in the pericardium. If push comes to shove, I'll have to perform a procedure called Pericardiocentesis. What that entails is having a thin needle inserted through the chest wall into the pericardial sac to drain the fluid located inside." Dr. Michaels said in answer to the question.
"One more thing doc, how long before we'll know whether or not the drugs are working?" John asked needing to know.
"I wish I could tell you John. It could be anywhere from twenty four to seventy two hours. The length of time we can wait will depend on just how much fluid builds up in the pericardium around your ailing son's heart."
"Okay, thanks for being honest with us doc. Can we have a few minutes alone with Sammy before you move him back to the ICU." John asked
"Sure, just let us know when you're finished" Shane said before walking out the door to give the small family some time alone together.
After Shane had left the room, John reached out a sterile glove covered hand and brushed the sweat soaked hair from Sammy's face. "You know kiddo, you really are causing your old man to go gray before his time. So how about we make a deal. You work on getting better and I'll working on being a better father to both of you boys. I'll work on listening more and arguing less. Please Sammy, you're all that Dean and I have left and we can't lose you tiger."
"Dad's right Sammy, you are all that we have left and we would never survive if we lose you dude. So you better fight with everything you've got little brother because if you leave me, I'll follow you and haunt your ass into eternity. You hear me Sammy? You fight damn it because I love you and I don't want to lose you." At this point, Dean began to sob harshly as the tears flooded his eyes and fell down his face. He felt his knees go weak and started towards the floor only to be caught by his father's hands before his knees could impact with the cold linoleum.
John quickly lowered himself and Dean to the floor as he pulled his oldest into a firm hug. "I've got you Ace, I've got you" John stated while he rocked his oldest in his arms as Dean finally let everything out. He saw the door to Sam's room open and Dr. Michaels start over towards him and Dean but waved him off whispering "I've got him." He nodded as Shane informed him that they were moving Sammy up to the ICU. His heart nearly broke in the next minutes as he heard Dean whispering over and over "Please don't die Sammy, please don't leave me."
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A few minutes later, Bobby and the others returned to the hospital carrying a bag of burgers and fries for both John and Dean. They were in a good mood after having taking the time to stop by their motel room and freshen up with a shower. Their moods instantly deflated however as they walked into the room that Sammy had been in to find the bed empty and John cradling a sobbing Dean on the floor.
"Oh my God, Sammy" Bobby whispered brokenly suspecting the worst from the sight that met his eyes.
Knowing immediately what Bobby was thinking, John stated "He's still alive but he suffered a major setback and they had to take him back to the ICU."
"Damn it, what happened?" asked Joshua as he bent down and massaged Dean's shoulders with his muscular hands.
"Sammy got some really bad pains in his chest after he threw up earlier. The doc thinks that he is suffering from pericarditis." John answered
"Pericarditis? What in the hell is that?" questioned Caleb.
"It's inflammation of the sac that surrounds Sammy's heart. The doctor said it is a secondary infection that was caused by the MRSA bacteria in Sammy's body. The kid also has fluid building up in there and they might have to insert a needle in his chest to draw it out if the medications they're giving him don't work."
"How dangerous is this pericarditis?" Bobby questioned knowing there had to be more with the way Dean was acting.
John scrubbed a hand across his weary face as he looked up at the others with glistening eyes. "Very dangerous! The doc says that if they can't handle the fluid build up quickly enough, it will put too much pressure on the ventricles in Sammy's heart leading to a stroke or even death."
Pastor Jim chose that very moment to walk into the room. "We just have to believe that God knows best John. I'm sure He will guide the doctor's hands and that Samuel will come out of this with flying colors."
"I'm not sure I believe in anything anymore Jim after everything my family has been through. When will it finally be enough? It's like the Winchester name is cursed and things just seek us out to hurt us."
"I know it seems like the bad side is winning John, but you've got to stand strong. Mary wouldn't want you to give up, she'd want you to be the solid foundation for your boys to take their strength from. Time will heal the wounds you and your boys have incurred. Trust me."
"I'm trying Jim, but I just don't know if I have the strength to take much more" John informed his dear friend as his shoulders slumped seemingly in defeat.
"That's when you lean on us John. You and the boys will never be alone in this fight. We'll always be here by your side" Bobby said as he placed a firm hand on John's shoulder. "Let us help carry the burden for a while"
John sighed loudly as he nodded his head and closed his eyes in exhaustion and leaned back against the wall with a now sleeping Dean still held firmly in his arms.
Caleb pulled the blanket off the bed and wrapped it around the two weary Winchesters. Looking over at Caleb and Bobby, he said "Jim and I will stay here and watch over these two until they awaken. Why don't you two got sit with Sammy in case he wakes up. John and Dean wouldn't want him to be alone right now."
"Yeah, you're right" said Joshua as he clamped a hand on Bobby's shoulder. "Let's go old man, we've been put on guard duty to protect and watch over a certain little tiger."
"Old man my ass. I'll have you know I can out run, out fight, and out shoot you any day of the week ya damned idjit" Bobby stated with a growl.
"Sure ya can Bobby sure ya can. Now let's go, I'm anxious to get to Sammy." Joshua said as he walked out the door. He needed to see that the kid he had loved since he was a toddler was still alive and fighting with his own eyes. He couldn't help but think of the time he had first met the toddler at Bobby's place.
He had been sitting at the table at Bobby's place getting ready to eat breakfast when suddenly he felt a tug on the leg of his jeans. He looked down to see a chocolate haired toddler looking up at him with the most expressive puppy dog eyes he had ever seen in his life. Sammy had his chubby little arms reached out towards him in a gesture clearly stating that he wanted to be picked up. As he placed the toddler in his lap, Sammy reached into his plate and grabbed some of the scrambled eggs in his little fist and took them up to his mouth. By the time that Sammy had finished eating, Joshua had scrambled eggs mixed with Sammy slobber all over his jeans.
As Joshua walked into Sammy's room at the ICU, his heart broke at the sight of seeing the kid he loved so much hooked up to a heart monitor and once again on oxygen. It scared him to see sow many wires were attached to the kid who was so pale that he almost blended in with the pristine white hospital sheets. He walked over and stood by the bed as he took one of Sam's hands into his own. He reached his other hand up to swipe the long bangs away from Sammy's face. "We're here for you tiger and we'll be right here as long as you need us. Don't worry about your dad and Dean, they're getting some much needed rest with Caleb and Jim watching over them. You just worry about getting better kiddo."
TBC