Izzie failing the breathing test shook Alex up, he'd wanted her to pass so much he hadn't even considered she could fail. He hadn't prepared himself mentally for what failure would mean. Failure meant a new plan, protocol, getting Izzie off the vent was going to be a much slower process than he'd anticipated.
Her doctors were away working out the specifics of the plan but he had a good idea how it would happen. They'd have to do it slowly, give her lungs a chance to get stronger and build up endurance. The thought of it made heart ache; the next week was going to be so much harder than the last one.
The last week had been trying and stressful, he'd been worried about Izzie but there hadn't been a lot he could do for her. He kept her company but she'd been so heavily sedated he didn't even know if she could hear him, and he'd had the wedding stuff. Organizing the wedding had been keeping him busy and was a welcome distraction from the monotony of the hospital, of playing the role of the loved one.
He wouldn't be able to do that this week, Izzie needed him to be with her. Her sedatives were much lighter now, if he shook her hard enough he could get her to wake and she'd wake on her own too. Every few hours she'd stir and become agitated, she'd try to pull at her tube and move around in the bed, when ever that happened he had to calm her down, sooth her back to sleep.
It was hard, he hated that she had to be so uncomfortable, that he couldn't just take the tube out but he knew she needed it and she knew she needed it. If he talked to her and explained what was happening she would always calm down but he had to do it every time she woke. Almost every time she would freak out a little, panic and not remember what was happening to her. It was exhausting explaining it to her over and over but there wasn't any other option. On a good day Izzie had problems with her memory, now with the extra medications running through her system getting her to retain anything between sleeps was virtually impossible.
***
The days went by in a painfully slow regular pattern. In the morning they'd completely stop the sedatives, wait for her to become fully conscious and then change the settings on the vent. They were using positive pressure now to assist her and every day they'd make her work a little harder. It was working, she was getting stronger, every day she worked harder, and every day she did better.
The breathing tests lasted a couple of hours and then they'd turn the vent back on and let her rest. They'd sedate her just enough to make her comfortable but not enough to make her unconscious and then let her sleep until late afternoon when they'd do it all over again.
They were at day three now, two more days and it should be over. It was late morning; Izzie lay in bed sleeping while Alex sat in a chair beside her reading a book about writing a wedding service. Izzie wanted a church wedding and he had no idea what that entailed. The book was eye opening and surprising, like so many things with this wedding there was more to it than he could have imagined and it was slightly overwhelming. Sighing he ran his hand over his head and glanced over at Izzie, she was looking incredibly peaceful today, her chest rising and falling with the click of the machine. For a moment he just sat there watching her and then the door to her room started opening.
He expected it to be one Izzie's doctors or nurses but it wasn't, standing in the door was a young woman. She was holding a baby and looked incredibly unsure of herself. She stood in the doorway, not sure whether she should go in or not. Alex stared at her trying to work out where he knew her from, why she was there.
"You can come in." He told her wanting her to come closer.
She took a step forward and glanced at Izzie, he watched her eyes quickly turn away. "I thought she'd be awake by now." She said her voice shaking just a little.
"Not yet," Alex sigh and then he finally recognized the girl. Last time he'd seen her she'd just had a baby, she looked quite different now.
"Okay." He could tell she was uncomfortable being there. "I wanted to talk to her and a lady at your apartment said that she was here, that she was sick. I thought she'd be better." The girl looked sad, she had her body angled towards the door, she wanted to leave.
"She's getting better." Alex said picking his words very carefully. "You can still talk to her." He stood up from his chair and stepped towards her. "She can hear what you're saying and she'd probably like some company beside mine."
He could see the pull in the girl's eyes; she was looking for a reason to leave. "I…" Right on cue her baby started crying. "I should go." She took a step away but Alex stepped after her.
"Kate," he said using her name for the first time. She stopped, looked back at him, surprised that he knew it. "Stay. I'll take him for you." She looked down at her child and then back at him, she didn't look convinced. "You've come all the way down here. You should talk to Izzie."
She still looked unsure but she'd stopped moving away. Alex walked the final steps towards her and held out his arms. "I'm good with babies." He told her. "He'll be okay." It was with much reluctance that she handed her son over. Alex smiled and pointed to the chair he was in earlier. "You can sit there," he began instructing. "Take her hand so she knows you're there and just talk."
She sat down in the chair and did as Alex told her, she wrapped her hand around Izzie's and smiled up at him, he gave her a nod encouraging her to talk and slowly she began speaking.
"Hi Izzie, it's me Kate." She began saying. "I've got some good news. I got a letter in the mail from one of the colleges. I'm in, full scholarship and all."
Alex watched as the girl began telling Izzie everything. Once she started talking the words seemed to flow freely from her mouth. It was amazing to watch, to see firsthand the impact Izzie had had on this girls life. She talked about the classes she could take, the day care the school offered, and thanked Izzie profusely for all her help and support. It was amazing to hear and Izzie seemed to react well to it as well. She woke up a little without getting agitated; instead she just rolled her head sideways and opened her eyes. She stared at Kate as she talked to her and it was beautiful.
That afternoon was amazing, one of the better ones he'd had since this mess had started. Izzie showed clear signs of improvement and he had new company. He liked Kate; the girl had spunk and reminded him of Izzie. He could see Izzie being just like her when she was younger, full of determination and potential. And he loved her baby as well. It had been several weeks since he'd held a baby and he hadn't realized how much he missed it. For the first time it made him wish with the longing and need Izzie had for their own children.
The hours went by quickly and soon it was time for Izzie's afternoon breathing. Alex told Kate she could stay but she'd already stayed later than she'd planned. She left just as they cut the sedatives off completely.
***
Izzie felt trapped in her own body, like there was a fog inside her head and she couldn't get through it. She hated the feeling, she wanted to get off the sedatives and off the vent so bad. She wanted to be able to talk, communicate, and remember things. At the moment that was hard to impossible, communicating was limited to blinking with the occasional hand squeeze and her memory was shot. Sometimes she'd wake up and know exactly what was happening to her but most of the time she had no idea, she relied on someone to remind her and then it would all start flooding back.
She could remember the failed breathing test and how scary it was to not be able to breathe properly, and she remembered all the tests since then. None of those had been as scary and now they were downright frustrating, she was ready to breathe on her own, it had been five days since the first failed test, she was ready.
"Izzie," She felt Alex trying to rouse her from her semiconscious state, he had his hand on her shoulder and was shaking her gently. "You have to wake up, it's time." He told her. "One more quick test and you're breathing on your own." There was excitement in his voice, she opened her eyes and looked towards him. "There you are." He smiled down at her and she felt his hand squeeze down on hers. "Are you ready?" She gave him the two blinks he was accustomed to seeing and his smile spread. "Good. Now you have to sit up more for this one." He began adjusting the bed until she was sitting upright then he reached around her and slipped on a nasal cannula. "Okay, we're turning the vent off now."
She felt the machine stop working and she squeezed down hard on his hand, she concentrated on breathing properly and after fifteen minutes she still felt good. There was no way she was going to fail the test again, she wouldn't let herself. After thirty minutes she was still going strong and Alex told her it was enough, they were going to extubate her.
"You need to take a deep breath," He told her, "and then blow out as hard as you can." She nodded, did as he said, and as she blew out she felt the tube slide up and out her airway.
The first breath she took without the constraints and assistance of the machine wasn't what she was expecting. It hurt, she hadn't expected her mouth and throat to be so dry and raw feeling, breathing now had a new form of uncomfortable, and she couldn't talk, she could move her mouth but no sound came out. Alex saw her discomfort, he reassured her it was okay, that it was normal and wouldn't feel like that for too long, that she'd get her voice back soon enough. She nodded and for the first time in weeks she gave him a smile.
***
Her smile was beautiful, and it gave Alex a warming feeling inside. She was still there and it was going to be okay. She was breathing well on her own, she looked a bit uncomfortable but she was keeping her oxygen levels up.
After that the hours seemed to race by, Alex started telling Izzie all about the wedding and all the work he'd done for it. She got excited, her smile just kept getting wider and a few times she even clapped. She'd beaten the hard part, now all she had to do was finish healing.