my disclaimer: I don't own Lizzie McGuire or any other LM characters. I don't own any of the schools, websites, books, etc. that may be mentioned in this story. I don't even really own the idea for this story…got that from a paragraph in a Madeleine L'Engle book…I only own Brenna. The lecture text used in the chapter is not mine; it's from Kuby Immunology, the Mayo Clinic Family Health Book, and the Harvard Family Medical Guide.
Ok, just a few notes…some people may find this chapter boring or over their heads…that's fine. I had to do a lot of research so that this stuff wouldn't be over my head…and a good part of it still is. However, I need to include most of this so that what goes on later makes sense. So bear with me. And, just a fair warning, this next chapter may take me several weeks to write; for a couple of reasons. 1) I need to do a lot more research for it. I understand the immunological stuff going on here, but I'm completely lost on the clinical stuff that I need for the rest of the story, so give me some time to work that out. 2) I'd like to thank my evil sadistic work for not giving me anytime off and having me open at 8:30 in the mornings…big thanks to y'all…you suck! I can't wait to quit! Ok, enough ranting…
And thanks to everyone who's reviewed so far…keep reviewing…if you like it, even if you hate it! And if you don't care either way, tell me your favorite cookie…mine's butterscotch chip…
Ok, enough notes. Without further adieu…on to Chapter Three!
Lizzie finished her volunteering hours by early afternoon on Sunday and decided to spend the rest of her day doing some research on med schools. Not wanting to deal with her slow computer and even slower dial up Internet connection, she headed to the school library. After finding an empty computer, Lizzie realized she wasn't entirely sure how she should go about her research and finally decided to go school by school. She started with some of the top schools, schools that had sent her applications, but she knew she didn't have much of a chance to get into. She went through Columbia, Harvard, Stanford, Mayo, and began searching other schools.
After nearly four hours of research, Lizzie gave up in frustration. Each school had their strong points and an area of medicine they emphasized, but aside from that, the schools were overwhelmingly similar. Since she wasn't sure yet of which area in medicine she wanted to go into, Lizzie thought her best option was to apply to the ones that were in interesting states or cities. It seemed like a terrible way to pick a medical school, but Lizzie wasn't sure what else to do.
Four days later Lizzie still hadn't made any headway on her med school decisions. After working for nine hours in her lab, Lizzie came home to her empty apartment; she assumed Brenna was still at work. She sat herself down on the floor in the main room of her apartment with a bowl of Cocoa Puffs and a banana – not the most nutritious dinner, but safer than if she'd tried to cook something herself – and surrounded herself with her Mayo Clinic medical reference book, a massive guide to medical schools in the U.S., several booklets from various medical schools, her medical terminology lecture book and her laptop. She figured the only way to start narrowing down her list of schools to apply to was to figure out what areas of medicine she was interested in.
She logged onto the Princeton Review website, her new favorite website since she'd found a class to help her study for the MCATs. Intending to research separate schools as she'd been doing, Lizzie clicked on the "Medical" school button and instead found a series of article on getting into and choosing med schools. Clicking on the first one, on comparing med schools, she began to read.
Half an hour later, Lizzie felt like she was making more progress than she had all week. She knew she wanted to work in clinical practice as opposed to doing laboratory research, and discovered that helped narrow her options down quite a bit. And she realized she didn't have to know exactly what area of medicine she wanted to work in just yet; she wouldn't have to decide until her second or third year of med school. She jotted down a list of about fifteen schools to do some more research on and logged off and shut down her computer.
Just then, the phone rang and Lizzie jumped,, not expecting it and nearly spilled her half empty bowl of cereal. After steadying her bowl. Lizzie lunged for the phone, which was sitting on the coffee table in front of her, lying under her thirty-pound reference book.
"Hello?"
"Lizzie?"
"Matt? Is that you?" Lizzie couldn't tell. He sounded so quiet and…young. Something was wrong.
"Yeah."
"Matt, what is it?" The suspense was driving Lizzie crazy.
"It's Mom. She's in the hospital."
Lizzie dropped the phone and pressed her hands to her temples, squeezing her eyes, trying to block out the memories. She wasn't sure how long she sat that way.
"Lizzie? Can I come in?" Her mother tapped on her bedroom door. Lizzie, enjoying the second day of her winter break in her junior year, was lying on her stomach on her bed, reading a Harry Potter book for the twelfth time.
"Sure Mom." She answered, setting the book beside her and sitting up.
"How are you doing?" her mother asked, sitting on the bed next to her.
"I'm happy to have a bit of a break. "Lizzie replied honestly. "This last semester was pretty rough."
Her mother smiled. "Lizzie, there's something I need to talk to you about."
Lizzie stared at her mom, a feeling of unease growing inside of her. "Okay." She responded slowly.
"You know I haven't been feeling well for some of the last several months." Her mother began. Lizzie nodded. In their weekly phone calls, her mother had mentioned she thought she was getting the flu a couple of times. In other conversations, she mentioned she'd seen their doctor about it.
"Well, Dr. Haley referred me to a specialist, Dr. Cooney. She's been running some tests on me the past few months and the last of the results came in a couple of days ago."
"Oh my God, you have cancer." Lizzie immediately jumped to the worst conclusion she could think of. Her mother laughed.
"No. I don't have cancer." Lizzie sighed, relieved but confused.
"Then what…?"
"I've been diagnosed with a disease called systemic lupus erythematosus. It's what's called an autoimmune disease, which means–"
"That your immune system is recognizing parts of your body as foreign and attacking them." Lizzie recited, fresh from a semester of immunology.
"Right." Lizzie's mother smiled again. "Now–"
"What's it attacking?" Lizzie interrupted.
"What?" Lizzie's mother looked surprised.
"What is your immune system attacking?" Lizzie repeated.
"My red blood cells and platelets." Her mother told her, looking slightly amused.
"Oh." Lizzie sat back thinking. Her immunology class had only spent one lecture on autoimmunity and about ten minutes on lupus, so she was now at a loss.
"My specific case isn't serious." Her mother continued. "I have some of the normal symptoms, fatigue, bruising, and a little bit of arthritis in my wrists, but Dr. Cooney doesn't expect we'll have any other problems or any complications. I only wanted you and Matt to know so you wouldn't worry if you noticed I was more tired or feeling weaker than usual."
"Okay." Lizzie said hesitantly.
Her mother gave her a hug and said, "I'm glad you decided to come home for Christmas. It wouldn't have been the same without you." Lizzie smiled. "Dinner's in half an hour, alright?"
Lizzie nodded and picked up her book, hiding behind it. When she heard her mom shut her bedroom door, she tossed the book aside and sat down in front of her computer. She logged onto the Internet and pulled up the CU–Denver webpage. She found the page for her immunology class, clicked on the lecture that included autoimmune diseases and quickly found what she was looking for.
Another important non-specific autoimmunity is systemic lupus erythematosus (SLE), a chronic rheumatic disease characterized by multiple auto-antibody production against targets such as cell nuclei and cytoplasmic proteins, DNA, histones, host immunoglobulins, red blood cells, platelets and others. Interaction of these auto-antibodies with their specific antigens produces various symptoms, including fever, weakness, arthritis, shin rashes, pleurisy, hemolytic anemia and thrombocytopenia.
These reactions can cause substantial immune complex formation in some people, leading to Type III hypersensitivity. The immune complexes activate the complement system and generate membrane-attack complexes and complement split products that damage the wall of the blood vessel, resulting in vasculitis and glomerulonephritis, which may cause kidney damage and failure.
Lizzie stopped reading and tried to digest what she had just read. She understood most of the first paragraph; it just meant that a person's immune system recognized specific things, like a cell nucleus or DNA, as being foreign and attacked it. However, she couldn't remember what hemolytic anemia and thrombocytopenia were. She opened another window and pulled up WebMD. Looking up each of the terms, she found that hemolytic anemia was a loss of blood cell due to their destruction. In the case of lupus, the loss was because the red blood cells were being destroyed. Thrombocytopenia was a shortage of platelets in the blood, causing a bleeding disorder; which included the symptom of bruising. So far this agreed with what her mom had told her.
The second paragraph was infinitely more difficult. Though they were included in the lectures, her immunology professor hadn't spent a lot of time going over specifics of diseases and reactions; as it was a 300 level course, he just wanted his students to understand the basics of immunology. As much as she could get from it, the paragraph told her that lupus could cause kidney damage or failure in some people. Lizzie didn't dwell on that one too long; kidney failure could be dealt with easily these days, with transplants. She went back to the lecture and read the last paragraph about lupus.
SLE affects about 1 in 3,000 to 4,000 people in the United States, and affects women nearly ten times more than men. For most people, the disease is mild; about 20% recover from it spontaneously. Many others can lead a normal life, even with the chronic symptoms. However, for a small percentage of people, the disease cannot be controlled and its effects are devastating. For about 2% to 3% of affected people, it is fatal, despite all therapeutic efforts.
Lizzie sat in front of her computer in stunned silence, reading the last sentence over and over again.