Chapter 53

The pain implant was a short stay, in and out procedure which was the only reason Cuddy agreed to House having it at another hospital. Cuddy had offered to push through approval for the surgeon to have privileges at PPTH but he declined and House told her not to be such a control freak. St. Anne's managed to be a good hospital despite it's mass. It's Cardiac, Neurology and Maternity units had excellent reputations. As they approached, she saw the sprawling nightmare of wings, a hodge podge of additions in a variety of architecture styles from the last century.

The morning of the procedure Cuddy drove House to St Anne's and went through the admitting process for which House had no patience. The admitting nurses asked questions about his medical history, his weight, his medications, and allergies.

"I faxed the answers to all these questions," House sputtered. "And don't tell me you didn't get the fax, because I got a confirmation. Unless you've lost or miss-filed the paperwork since yesterday. Idiots." He growled.

"House", Cuddy said in a calming voice putting her hand on his shoulder, "let me handle this." She looked at him in concern. She hadn't seen him this irritable in a while. She wondered if he was actually in pain right now.

In the end the nurse had found the fax, with all the forms and questions answered so she just had House look over it and sign.

They had given him the diagnosis of Complex Regional Pain Syndrome (CRPS), and even though House called it crap, pun intended, he was willing to let it stand to get the implant. House was not talking much today. Even though his irritation wasn't directly aimed at her, she began to feel cut off from him and his inner thoughts and at times like these she didn't like it. She tried to catch his eye from across the room and it seemed as if he was avoiding eye contact, shutting her out. Why? Why now?

Of course she hadn't been gung ho about the pain implant, infact she had been resistant, but she had got on board, once she saw he was determined, it reminded her so much of the argument they had had about the Methadone, where she had threatened him and he had quit, saying he had no choice. She hadn't been quite that heavy handed, but in a way she felt it was her job to drive him to the wall to see if this really was a last resort option. She couldn't quite make the argument that he could die, despite the possible rare side effects, and he couldn't quite make the argument that what he put in his body was his business even if it was. And of course he couldn't quit, because of all the commitments they had recently made, the baby growing within her was irrevocably binding in the way rings, certificates and promises never would be.
Cuddy also knew it wasn't a point of choosing the surgery over her or their family, he was doing it for them even more than for himself. She knew he believed that and it was not possible to convince him that they didn't need him to be perfect. Even though he didn't need to ask why she wanted him to be happy, he did ask did she think he could be happy as long as he was in pain.
"House you don't do happy, pain or no pain. You don't believe in it."
"Not for myself no, but I want the people I care about to be happy and that means you and the kids. I can't make you happy as long as I'm miserable. All I can do is bring you down to my level."
"Making me happy is not your job House... but I don't want you to be miserable. " She paused and feeling her acquiescence and then the steel of support flooding in to her she agreed. "I want you to get relief from the pain and if this procedure is the only way you feel you can then let's do it."

They were finally taken to patient pre-op and House changed into a hospital gown while Cuddy read the warnings on the consent form. Adverse events may include: undesirable change in stimulation described by some patients as uncomfortable, jolting or shocking; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, and surgical risks. She then went on to read the contraindications.

Diathermy - Do not use shortwave diathermy, microwave or therapeutic ultrasound diathermy (all now referred to as diathermy) on patients implanted with a neurostimulation system. Energy from diathermy can be transferred through the implanted system and cause tissue damage at the locations of the implanted electrodes, resulting in severe injury or death.

Warnings

Avoid sources of strong electromagnetic interference (eg, defibrillation, diathermy, electrocautery, MRI, RF ablation, and therapeutic ultrasound) can interact with the neurostimulation system, resulting in serious patient injury or death. These and other sources of EMI can also result in system damage, operational changes to the neurostimulator or unexpected changes in stimulation. Rupture or piercing of the neurostimulator can result in severe burns. An implanted cardiac device (eg, pacemaker, defibrillator) may damage a neurostimulator, and the electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device.

Reading it gave her a sudden chill even though she had seen the information before and discussed it with House. He was set on having this and he would have it. She had tried dissuading him, but logically there was no reason to do so, despite all the dire warnings many people had this procedure and did very well for years and it was a good alternative to pain meds. That was the clinical part of her, but the emotional part was a bit afraid and it was not like her. Yes, she was cautious about hospital patients but that was due to legal reasons, what she felt now was just a plain instinctual fear. Based on the numbers getting these implants, the rate of complications was very low.

After talking with the surgeon and the anesthesiologist, the nurses began to prep House for surgery, inserting an IV. hanging a drip, taking his vitals, making sure he had eaten nothing since midnight. Then they asked him his pain level and he said a seven, which was not surprising because she had noticed him rubbing his thigh earlier. They said the the drugs would relax him and dull the pain but not totally, since they needed to know when the pain was eliminated during the lead and electrode placement. They were about to wheel House away, when she swooped down, to kiss him holding his hand all the way to the O.R. She was getting ready to leave when House pulled her hand bringing her close.

"Thank you for being here. I know, you are not sold on the need for this procedure, but the fact that you are supporting me, means a lot." His voice was raspy, but his gaze was piercing electric blue beam that went straight though her as she felt her lashes get wet.

"Don't make me cry House", she whispered, blinking the tears back. "I love you, what else could I do but support you?"

"Um, continue fighting me tooth and nail like you've been doing for the last few weeks?" He said with an amused smirk.

"Like that would have changed anything. This not about a patient, it's about you. I know you, House, and stubborn doesn't begin to describe it. It doesn't help that you are right 99% of the time." she said on a sobbing laugh biting her lip.

"Yes, but that makes that 1% fail look huge. Cuddy, he said almost hurting her hand in his sudden tight grip. "I love you, so much. Please remember that, no matter what."

Cuddy nodded giving him another quick kiss as she released his hand and he was wheeled away."

Cuddy was taken to a private waiting room where she would be able to watch the surgery from live O. feed. The surgery took a little over an hour, and she was able to hear house's responses as they prodded him to find the right places to place the leads and receptors along his spine. Hearing his voice, was very reassuring. Then in no time the surgery was over and he was being wheeled into recovery. He was very groggy, because that had given him a pain killer, for the surgical pain. She was able to squeeze his hand and kiss him before he went to sleep. They said he should spend a couple hours in recovery and then he should be ready to go home, but at the end of that time House, was slow to wake up. The doctor suggested he stay overnight and even though House insisted it wasn't necessary, she agreed with the surgeon. Better safe than sorry. She thought he only finally relented because he was worried about her, so she stayed with him until midnight and he insisted that she go home. She really would have stayed, but somehow, he had Wilson come and lend his insistence, saying he would stay for a while longer. When she was home and finally in the bed, she called Houses' cell phone. Wilson answered and told her House was sleep and she needed to get some rest while she could, because House would be home tomorrow. She had to be content with that which was a poor substitute for hearing House's voice. She fell asleep rubbing her tummy as if it was the warm curved surface of genie lamp, the faint motion of her rousing the child within her, and the responsive fluttering movement within served as the House connection that eventually sent her off into a warm relaxed sleep.

A loud knocking blunt forced into her consciousness. Her dreams left abruptly, running from the cold reality of the rapping that would not be denied. It's urgency was telling, only policemen and firemen knocked with such loud, thundering authority... an emergency. What now? A brief irritation was shattered by arrow of abject fear, piercing enough to make instantly nerveless and incontinent. She threw the covers off before reaching for the lamp switch. Oh my God, House. Something was wrong. She never should have left the hospital. She barely had tied up her robe as she opened the door to an agitated Foreman.

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