One Year

Disappearing

A month had passed by. It hadn't passed by quickly, the weeks were long, the days were long and sometimes even each hour felt like an eternity to Casey. Severide had 'Casey proofed' the house, he'd joked to Casey, as best as he could. All medications were now locked in a large plastic box. There were grab rails in the bathroom and by the steps at the front porch. Casey had a new bed, thanks to the money Herrmann had gathered for their holiday it hadn't been a stretch to get an adjustable bed with their budget, Severide had wanted to get guard rails for it but he knew Casey wouldn't wanted them and Shay had pointed out that Casey so rarely fell out of bed that it was unneeded expense, Severide just wanted to make sure he was as safe as possible, that nothing else would set him back.

Severide and Casey were sat in the doctor's office, Severide was fairly certain Casey would soon drift off, he'd not slept well last night and this was an early appointment that couldn't be rescheduled at such short notice.

Doctor Wright was looking through Casey's pain and symptom diary, although it was Severide and James who kept track of it the best they could, "I see his nocturnal enuresis hasn't improved?"

"His what?" Severide frowned, a little annoyed that he didn't know what the doctor was talking about, he knew Casey's medications and schedule off by heart, how come he'd not heard of this phrase?

"Bedwetting," he replied simply.

"Oh," Severide looked over to Casey, worried the conversation would upset him, embarrass him, but he was in a world of his own looking out of the window to the world outside, "No it hasn't… erm… so is this it? That won't improve?"

"It may, we can't be sure what's causing it, whether it's the pain from the CPS and he doesn't want, or doesn't realise that he needs to get up, the pain could be overriding everything else so he just doesn't realise. Or…"

Severide already knew the other option, "Or it's neurological, damage from the oxygen deprivation."

"You said last time that this never happened before the OD?"

"It happened once, but not like this. He'd had a nightmare and was almost hysterical because he knew what had happened. He doesn't remember it happening now, think it's confusing that me or James are helping him wash and change and getting him back into bed once the sheets have swapped, but he never mentions it when he wakes up a few hour later."

"His short term memory is worse?"

"No," Severide shook his head, he glanced over to Casey who was now dozing quietly in the chair, his Truck 81 cap had slipped, obscuring his face, "His awareness, focus… it's all the meds, not his memory, but… but without them, with a lower dose of sedatives, he's in too much pain too often."

"Is he ever completely free of pain?" the doctor asked.

"He has good hours and bad hours… used to be good and bad days, good and bad weeks," he scoffed, "Now it's hours."

"And the pain is mostly..."

"Burning pain," Severide finished.

"In his hands and feet?" The hands and feet were the most common places for the burning sensation to be experienced in CPS patients.

"All over," Severide supplied, "Then there's, what he describes as flashing pain, in his arms and legs. He still has the migraines on top of everything."

The doctor was looking down at the notebook. "He's not had any grand mal seizures," he noted with a small smile at the positive news, "Just a couple of absences."

"We're in control of the epilepsy," Severide stated, "It's the pain. He's best after he's slept, that is if he's slept, sometimes he's up all night out his mind with confusion because the pain has kept him awake for too long," he rushed, frustrated, "I don't think the Lidocaine infusion did anything. We didn't notice the CPS right away because of the painkillers he was getting after the seizures, can't we give him them again?"

"We can increase the Ibuprofen dosage again but we really don't want to compromise his cognitive function or his memory, and we're at risk of damaging his liver, his kidneys, his heart, especially with the risk to liver that his anticonvulsants have. There are specialists, not just pain management specialists but specifically for CPS, I think it'll be worth going down that road."

"I'm going to assume there isn't one in this hospital?"

"No, there isn't," he replied, "And since there are so few, even though CPS is quite rare, it can be difficult to get an appointment."

"Sounds like it's the only option," Severide sighed, wishing something could just be easy for once.

"I think it's the best option, I'll speak to some of my colleagues, see who they recommend, send over his medical files and try and get an appointment, now if it's the other side of the country…"

"Just do it," he stated, "Will you increase the Ibuprofen dose? I understand the risk, I mean, you guys are already testing his monthly to check for liver failure, would you check more or…"

"We'll keep the daily dosage the same but when he has, let's call them attacks of pain, when he has these, when the T.E.N.S machine does nothing for him, I'm going to prescribe some Codeine, works well with Ibuprofen." The doctor had his concerns about the narcotics; the side effects were no better than overloading Casey with NSAIDS and sedatives and from his research sometimes they didn't even scratch the surface for some patients with CPS. It was all trial and error and he only hoped they would find the right solution for Casey. "I'll give you five and if it works for him I'll write another 'script, and you'd need to get Metamucil with that too."

"Already have some from before the anticonvulsants were changed last year," Severide commented, but he noted it down in the notepad on his lap.

"Ok," he nodded, "Now how did the appointment with the nutritionist go? Helpful at all."

"Informative," Severide replied, "Helpful for Casey? Not so much."

"Yeah, it was requirement by managements new scheme, doesn't take every case into account. You know him better than anyone, better than himself at times, do you think there's anything…"

"Anything short of force feeding him?" he scoffed, "We can't do that, it's a matter of making sure when he's up for eating to try and give him plenty, the high calorie bars, they work better than the shakes, he prefers them, doesn't protest… It's hard… he's disappearing right in front of me no matter what I or anyone else does..."

Casey felt too nauseous to eat half the time and the other half of the time he was so lethargic that Severide almost had to physically help him to eat, even just to take a few bites, drink a carton of Ensure, even just to drink a glass of water. Severide wasn't just worried about the lack of food but dehydration too. Casey's weight had dropped in the last month, he didn't look dangerously thin, but it did make him look ill. The lack of food made him even more tired, and taking his medication on an empty stomach only increased the nausea, it was an endless circle, one that Severide was desperate to break.

The doctor had been scribbling away and handed Severide another prescription, "One of these an hour before he eats."

Severide noted it down in medication section of Casey's organiser, "God… he's swallowing more pills than food."

"This will help," he stated and Severide slotted the prescription into the organiser. He moved on, another important topic to discuss, "Physio's made little improvement?"

"Nothing noticeable," Severide replied, taking a moment to look over to Casey was more, a terrible sadness in his eyes, "He never really liked physio, loved swimming, swimming was fun it wasn't 'physio' and now his shoulder's put him out of action, out of action for months."

"His shoulder will heal," Doctor Wright reassured him.

"Yeah," - but nothing else will - he nearly added.

"He's getting out of bed every day?"

"Yeah, make sure of it," Severide replied, "Sometimes he'll walk around the block with me and Sam, most the time getting to the couch is a big enough task. He tries to downplay it though, he used to cope by doing that, used to tell everyone he was fine when he really wasn't… I don't think he's doing that, no, he's not doing that now, I think he is genuinely coping, think he… think he doesn't realise how bad it is, refuses to use the cane but still ends up groping the walls and furniture… thought he'd be embarrassed… don't think he notices most the time. I think that might be partly due to the drugs."

"Like you said he's not swimming, any other activities?"

"No," Severide shook his head, "Think I worry more than him." They'd been to the park a few times with Sam, nothing disastrous had happened, in fact nothing bad had happened at all. Severide was worried at what another setback would do at this point.

"About what?"

"He struggles to walk up and down stairs, crowds, anything busy, just overloads him, he doesn't think about it, not until something happens," Severide explained. Sometimes Casey would look completely and utterly lost, like he'd been totally unaware but talking and walking and suddenly find himself somewhere, not knowing how he'd got there, not knowing what they were doing. Or he'd be perfectly happy, perfectly 'with it' and then suddenly not want to move, he'd stay so still because movement meant there would be pain. Casey felt a constant ache gnawing at his bones, his flesh, it was difficult for him to explain, there was no cause and sometimes it got worse. He'd be sat on the couch, at the dining room table, playing a game of cards with James, using the iPad, and he'd cry out as his skin burned, or his arms and legs sent painful stabbing shocks firing around his body. It was random. They'd tried to keep track of it as best as they could, wanting to know what medications worked, if anything triggered or worsened the attacks of pain. There was no more joking that it was his - fucked up brain - because when it happened there wasn't anything he could do or say, his world was consumed in the moment.

"And how are you doing?"

Severide looked down at his cast free hand, "Cleared for duty, took an extra week though."

"That's not what I meant."

"I know…" he sighed, "Like I said, I worry about him, probably too much but it's not without reason. We're nearly done?" the doctor nodded. Severide proceeded to gently wake Casey up, he often joked with him that they should add narcolepsy to the growing list of ailments under his name. "Hey sleepy," he smiled when Casey's eyes opened blearily and slowly took in the surroundings.

"Sorry…" Casey muttered when he realised he had no idea what was happening, and he always apologises when he figures he must have done something wrong, and waking up and not knowing what was happening was wrong.

"You should be," Severide teased, "Been waiting hours for you to wake up."

The doctor watches the exchange, expects Casey to take Severide literally, he doesn't, he pins him with a glare and states with some conviction, "No you haven't."

"No we haven't," Severide smiled and looked over to the doctor because this was the part of the appointment where it was Casey's turn to talk.

"How are you doing Matt?" the doctor asked him with a smile.

"Ok," Casey replied simply. This is the reason Severide keeps track of everything, writes down Casey's mood, pain, notes down anything significate; Casey lives in the moment.

"We've been talking about your pain meds," he explained, "I'm giving you something stronger to try, is there anything you want to know?"

Casey looked over to Severide, gained some reassurance, and looked back to his doctor, "It's not stopping." – the pain is always there -

"It won't stop Matt," the doctor saw no point in holding back the truth, Casey understood what was being said, he just struggled to process, struggled to remember at times, "That's why your meds keep changing."

"Remember," Casey nodded.

"Good," he smiled, "Have you got any questions?"

The doctor gets the same response at every appointment, a shake of the head and a questioning "No," because he thinks he should have something to ask.

The next day Severide walked into Casey's room and opened the curtains, the autumn light lit up the room. "Getting out of bed today?" he questioned. Casey had already been up and out of bed a few hours previously, Severide had changed the covers as Casey sat in the armchair and struggled to stay awake before Severide helped him to change and get back under the fresh sheets.

Oblivious to the early morning antics Casey replied, "Yeah," but he didn't move.

"Any time soon?" Severide smiled.

"Yeah just ... nothing hurts right now," he replied. He was half sitting, half lying, legs position upwards ever so slightly, he was perfectly still and content.

"Right now?"

"What if it does when I move?"

"What if?" Severide smiled, Casey wasn't supposed to understand, to think of the what if.

"What if what?" he frowned having lost track of the conversations.

Severide just smiled and repeated, "Getting out of bed today?"

"Yeah... all the way to the couch," Casey muttered.

"No, Shay's coming over, we both need to get new suits," Severide explained, in truth he didn't need a new suit but he knew without even pulling one of Casey's out of his wardrobe that all of them would hang off his slight frame.

"The wedding?"

"Yeah, you gotta look the part," Severide commented.

"I have to go?"

"Thought you wanted to go to the wedding? You are the best man."

"No, no… the… the suits," Casey explained.

"Yeah you need to try some on, Shay will be over soon, we'll get it over and done with as quick as possible," he replied, he'd asked Shay for her help, not exactly for fashion advice but she was good with Casey, and it gave Casey someone to talk to, to interact with. Severide was worried about the wedding, worried about the chaotic atmosphere Casey would feel, even more so now since he was rarely getting out of the house.

Severide helped Casey up, helped him dress, it had become routine, Casey didn't object, didn't mind, he excepted his limitations, excepted help from Severide because he constantly acted like it was completely normal, like it was no big deal, to help a grown man wash, dress, eat… the list went on and on but it was their normal, nothing was odd or untoward when Severide helped to slip on Casey's boxers when he was too dizzy, too weak, or helped wash him when he was too tired, too out of it. It was their normal.

TBC