Ana tried to ignore the buzzing of her phone, but on the off chance it was something urgent, she decided to answer.
She smiled when she saw her friend's image on the screen.
Ah, Kate. She'll never change.
Her bestie was one of those obnoxious super early-risers, up at zero-dark-thirty to journal, meditate, yoga, smoothie, and shower.
"Kate," she mumbled.
"Good morning, sunshine," her friend chirped. "Your froggy voice tells me you're still in bed."
"Of course I'm in bed. It's five a.m. You know my alarm is always set for six."
"Asthma still misbehaving? I'm hoping we can meet up at Yellow Dot."
"No can do," she said, feeling the too familiar constriction in her chest. "I'll have to skip my run and coffee stop again today."
"Girl, you need to see a doctor. This is so out of the ordinary for you." Kate was right. It was very unusual for Ana to have any serious issues with her asthma.
"I think the flare-up is my own fault. Mrs. McGreevey's kitten got out somehow. She wasn't home, and I brought the sweet thing into my apartment for a couple of hours. Now I have cat dander all over the place."
"You're allergic. Why on earth did you bring a cat into your place?"
"I know I shouldn't have. Remember how you got baby fever when your cousin had her first? Well, I've been having all kinds of maternal feelings, and the kitten just look so cuddly. Is it my biological clock?"
"We're both too young for that. Talk yourself out of it, like I did. Maybe it's that little boy you keep talking about all time. He sounds so sweet and earnest about wanting a mother."
As soon as Ana heard her friend's reasoning, she knew it was an accurate assessment. Teddy had been on her mind quite a bit.
"Well, whatever the reason, I won't be inviting any more felines in for a visit."
"Like I said, you should see a doctor. I don't remember you ever being under the weather like this."
"If things don't improve soon, I promise I will."
Kate was bossy, but she was almost always right, and she was a very caring friend.
"Don't you miss running?" Kate asked, knowing full well how important a morning regimen was to Ana. "If I don't get my yoga in first thing, I get very grumpy."
Ana couldn't decide which she missed more, the exercise or her time of reflection over coffee.
"Yes, I miss my routine. Running and my morning solitude at the Yellow Dot."
"Your routine, or maybe it's the chance to scope out your hottie-in-scrubs," Kate teased. "I haven't forgotten your description...high, tight booty and a chiseled jawline. I want to see for myself. He sounds too good to be true."
"I hope you do get to see for yourself. He's a veritable feast for the eyes. But remember, I called dibs. He's mine."
Both girls giggled, enjoying the exchange.
"It's nice to hear you speaking playfully about a man. Forget chicken soup, wicked fantasies are what's good for the soul."
"If you say so, my very freaky friend. If anyone would know, it's you." Ana smiled at the recollection of her bestie's sexy adventures.
"I do say so. I almost forgot the reason I called. Dad and I were chatting... Actually it was less of a chat and mostly me begging for a promotion and a raise." Kate stopped to laugh at herself.
Ana could picture Eamon Kavanagh, CEO of Kavanagh Media, peering sternly over his reading glasses.
"Don't tell me he finally relented." Ana knew Mr. Kavanagh paid his employees fairly well, but he expected his children to work for less than the market rate. Kate and her brother didn't seem to have any heartburn over it, and instead it had become a running family joke.
"Per usual he turned me down, but he did share news about Elena. She's taken ill, so for the near future, you'll be running some of her old broadcasts. Someone from programming will give you a call, but I thought you might like a heads up."
"Thanks. I better go in an hour early." Ana quickly ran through what she remembered as some of the most popular shows, thinking of how she could search for them with key words. "The most popular shows have dealt with either philandering spouses or bad sex. I'll pull those up so they'll be ready."
"I knew you'd be on it. By the way, after you blocked him, Jack finally got the message. I hear he's moving out of state at the end of the week."
"Thank goodness," Ana said with relief. Her miserable experience with Jack had left her feeling wiser and stronger. "Done and dusted. I hope to never see his face again."
"We need an evening out to celebrate. Dinner and drinks. It's been too long since the two of us have had a bestie date."
"I'd love that. Whenever and wherever, I'm in." She threw back the covers and stretched. It was time to start the day. "I better get going. I meet with my social anxiety group this afternoon."
"How's that going?"
"Very well. I'm leading it under the supervision of Dr. Caldwell, and she's been very encouraging. There are only six clients and the group dynamic is kind and supportive."
"You're almost at the finish line," Kate said, a smile in her voice. "I'm proud of you."
"Thanks," Ana replied, grateful for such a faithful and loving friend. "Thank you for everything, helping me get the job at the station, always being there for me. And I especially appreciate you not saying 'told you so' about Jack. You were right all along."
"Of course I was." Kate laughed. "And I'm right about you needing to see a doctor. Now go have a wonderful day."
As she showered and dressed, Ana sneezed a couple of times, and her throat itched. Then, she began coughing, making the tightness in her chest much worse.
She was fully aware of her cat allergy, but she'd never thought of it as a big deal. It was nothing that an over-the-counter antihistamine wouldn't take care of.
She knew something was wrong immediately after using her inhaler. It usually worked within seconds.
Per usual, Kate was right. It was time to call her primary care physician.
After giving her symptoms to the call screener, she was transferred to the on-call nurse.
"Are you having trouble breathing, Ms. Steele?"
"It's not too bad, but I have a constriction in my chest that doesn't go away."
"How long has it been since you used your inhaler?"
Ana checked the time, but wasn't sure how long she'd been on hold.
"Twenty minutes ago, I think. The inhaler doesn't seem to bring me much relief."
"If you're having trouble breathing, you need to go directly to the ER. I can call the ambulance for you if you don't have anyone to drive you." The nurse spoke with a calm, even cadence.
"No, no, it's not that bad. I can breathe. It's just a discomfort in my chest that doesn't go away." Ana didn't want to sound like a wimpy complainer, but she knew her situation wasn't normal.
"When did your problem start?"
"About a week ago. I've been using my inhaler every four hours. I feel better, but not one hundred percent better."
"When do your symptoms get worse? Do you know what triggers your asthma?"
"I believe this episode began when I brought a cat into my apartment." Ana remembered how sweet the kitten had been, and how much she'd enjoyed cuddling and playing with it.
Half an hour later, she received a call back from her doctor's office. Much to her surprise, her primary doctor had referred her to a pulmonologist.
"You're in great luck. There was a cancellation, so there's an opening this morning at ten."
Ana looked at the time and hesitated. Medical appointments often ran late. Her practicum started at one. She'd have to hustle, but thought she could make it on time.
"Ten will be fine. Thank you."
"In the meantime, please continue with two puffs every four hours as needed." The nurse recited the standard procedure. "If your symptoms worsen, please go to the nearest emergency room."
Feeling defeated, Ana hung up the phone. While she didn't believe her symptoms were severe enough to warrant an ER visit, they were interfering with her daily activities, too bothersome to ignore.
Dr. Grace Grey looked over her new patient's medical charts. The patient, Anastasia Steele, had a history of mild intermittent asthma. For most of her life, her condition had been well managed. According to her records, she'd never been hospitalized or even received a course of prednisone.
As an asthma specialist, her job was to help the patient identify the triggers of their asthma. The next part of her evaluation consisted of developing an action plan for managing triggers. Patient education was a big part of the program; she'd found that most patients did not use their medications correctly. The most rewarding part of her job was working with patients in creating an individualized action plan, which included careful monitoring of long-term medications.
Her office was on the fourth floor of a skyscraper across from the hospital, where she had admitting privileges.
After having 'done her time' in the waiting room and completing half a dozen forms, a petite blonde nurse ushered Ana to the examining room and took her vitals.
"The constant tightness in my chest is worrisome," Ana said. Expressing her fear aloud made her feel less alone.
"How long has this been going on?" The nurse tapped notes into an iPad.
"A week or so." Hearing herself admit that she'd been having a problem for at least a week, Ana knew she should have called a doctor sooner. She was glad she'd come and hopeful that the pulmonologist could get things under control.
After examining her oxygen levels, the nurse practitioner immediately connected her to a nebulizer machine. Through a mouthpiece the machine delivered a fine mist of medicine directly into Ana's lungs.
A few minutes later, the nurse asked how she was feeling.
"Better," Ana smiled in relief.
"On a scale of one to ten? Ten meaning one hundred percent better."
"I'd say a five."
The nurse nodded, making more electronic notes on Ana's chart.
The creak of an opening door signalled the arrival of the physician.
"Hello, I'm Doctor Grey." Her handshake was warm, and her manners conveyed caring and empathy. She carried an iPad and briefly glanced at it to double-check something. "From your medical history, I gather this is your first time using a nebulizer. Most patients enjoy immediate relief from their symptoms. So...this all started with your neighbor's cat?"
"I think so. I've never had a reaction like this."
The doctor nodded.
"Take a deep breath, " she murmured, putting a stethoscope to Ana's back so she could listen to her lungs. "Again...Good."
"I thought I'd outgrown my cat allergy," Ana mumbled.
"It's not usual for allergic reactions to worsen at different points in our lives. In your case, it may have been a combination of cat dander and the amount of dust and pollen on the animal's coat. There could be contributing factors, like our crazy Seattle winters. Sudden weather changes can also affect asthma."
"How long before I feel like my old self?" Ana longed to resume her routine.
"By the time you leave today, you should be close to that. Right now, your oxygen levels are in the moderate range. I'd like to try a biogenic medication. It's an injectable, a class of drugs made from living organisms. I believe it's the right course of action." Dr. Grey spoke in a personable, yet professional manner. She eyed Ana with concern. "Then I'd like to keep you under observation for an hour after the injection to make sure your oxygen levels have risen."
Ana nodded. She didn't really have a choice. With hustle and luck, she'd still have time to make it to her practicum.
"After treatment, we'll meet in my office to discuss triggers and how to manage your case. With the right action plan, I believe we can keep it under control." The physician's kind eyes and confident smile inspired trust.
After receiving the injection, Ana relaxed in an exam room. After a half-hour or so, she was ushered to Dr. Grey's office.
Ana surveyed the room, decorated in pale tones of gray and blush. It was professional, yet conveyed the charm of a woman's touch. After taking a seat, she perused the commendations and certifications hanging from the walls.
Dr. Grey came around her desk and listened to Ana's lungs once again.
"That's certainly much better." The doctor's soothing, reassuring demeanor had a maternal quality. "How's the tightness in your chest?"
Ana took a deep breath and let it out slowly. Her breath was much fuller and deeper.
"It's practically gone," she said, feeling relief and gratitude.
"Excellent." Dr. Grey wrote something on a large notepad, her small, delicate hands moving quickly across the page.
While the doctor continued to make notes, Ana's gaze casually roamed, settling on a framed photo at the corner of the mahogany desk. It was the image of a gorgeous copper-haired boy proudly holding up a fish.
Ana leaned in for a better look. "That's a great picture. I love his handsome smile."
"My grandson, the light of my life. He loves soccer, Legos, camping. He's very bright," she added, her pride on full display. "And I'm not talking about academics only, but emotional intelligence as well. It's wonderful watching him making connections and applying concepts to solve real problems."
"Maybe he'll become a physician, like you."
"As much as I'd love that, I must keep my expectations realistic. He definitely has a mind of his own." Dr. Grey smiled.
Ana opened her mouth to say more, but she sensed their personal moment was over. She and Dr. Grey were back to doctor-patient mode.
"Do you have any questions for me?" The doctor's inquiry followed a thorough review of medications and Ana's new action plan. Among other things, Dr. Grey prescribed a new inhaler for her to take every day, along with her quick-relief inhaler.
"How long will I need to take the new medication?" Ana asked.
"This medication is a preventative, so I generally like to keep patients on it long-term," she paused. "But we can always re-evaluate at a later time. I'd like to see you back in a week. Of course, do call if you have any concerns."
"How about exercise? Before this episode, I ran every morning."
"I'd hold off on exercise until your next visit," Dr. Grey advised. Seeing Ana's face fall in disappointment, she added, "It's only a week. Patience, my dear."
By the end of the appointment, Ana was hungry and anxious to get on with her day.
Feeling much improved, as if she'd been given a new lease on life, Ana practically skipped out the door toward the elevator. She was less than two blocks from the Yellow Dot. As she made her way toward her favorite coffee shop, she thought of hottie-in-scrubs, hoping he might make an appearance.
After ordering the Waldorf chicken salad, she parked herself at a small table with a view of the door. Her vigil was fruitless, as Mr. Hottie was a no-show, but lunch and familiar surroundings left her feeling renewed, ready to lead group therapy.
Unbeknownst to Ana, just as she exited, Christian approached the Yellow Dot entrance.
He strode past her with a smooth gait, intending to grab a quick snack. Per usual, he was in a hurry, with only about twenty minutes to spare before he needed to return to the ER.
He and Ana passed each other and almost made eye contact. A family of six moved between them, blocking their line of vision. The group fell in step beside Christian. Their actions made him steer further to the left, while Ana steered to the right.
Ana felt a shiver as she passed him, but she ascribed it to the overcast Seattle sky and chilly winter air.
As Ana monitored one of Elena's old broadcasts, she reflected on her busy, but productive, day.
Her appointment with Dr. Grey had been so beneficial that she was almost feeling like her old self.
Group therapy had been particularly rewarding and all had gone well. After the session, Dr. Caldwell had been very complimentary of Ana.
The two had discussed Ana's upcoming board examinations and clinical placement. To obtain full licensure in Washington state, she'd need to work three thousand hours or three years under the supervision of a licensed clinician. She'd be paid, but the money wouldn't be nearly as much as she'd earn once she was fully licensed. With hard work, Ana felt sure she'd be able to complete the three thousand hour requirement in under two years.
As she daydreamed about her future, she noticed the light indicating the phone line was live. The fact that it was a repeat broadcast had been announced to the audience, so there was no need for an open line. She reached to disconnect, but something told her to leave the line open.
As she listened to a young wife's complaints about a cheating, good-for-nothing husband, she thought of Jack. If she hadn't jettisoned that relationship, this caller might be her in five years. The thought made her shudder in disgust.
Next time, I'll choose wisely. Surely it's possible to find a man who values the same things I do: family, commitment, emotional security and safety.
The last caller was the mother of a rebellious teen. The anguish in the woman's voice touched Ana.
If only children came with an instruction manual. I wonder if there's a trouble-shooting guide for parents, something simple and easy to follow, a tome that would explain exactly how to respond to children in most any situation. That's a product that would truly benefit families. Most self-help books are too wordy and too theoretical.
She made a note to research parenting books to see if there might be a niche she could fill. She enjoyed writing and was constantly thinking of ideas for future projects.
At eight o'clock she began shutting down the booth. As she went through her mental checklist, the phone blinked. Her first instinct was to ignore it, but she remembered instructing Teddy to call just past eight.
Fearing the caller might give up, she scrambled for the receiver.
"You've reached the The Dr. Elena Show," she blurted. "How may I help you?"
"Ana?" The familiar voice made her smile.
Teddy.
Hello, dear reader!
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