Estelle's son had delivered on his promise. Within a few days, he was able to get his mother into the same facility his grandmother had lived. It was actually pretty easy. Estelle often visited with the other patients and delighted the staff with her warm continual presence while her mother was there. They all knew her very well and wanted to return the favor.

Chase now had the task of telling Estelle what was about to happen. She was getting much stronger and had surgery scheduled the morning after tomorrow. She needed time to prepare herself for the dramatic changes in her life, so today was the day she needed to be told.

"Good morning Mrs. Anderson," Chase said delivering a smile as he entered the room.

"Oh, there is that lovely smile on that pretty doctor again," she replied. "I'm never going to get tired of seeing that."

Chase grabbed a chair, pulled it next to the bed and sat down. "You are finally done with one doctor after another coming in here. We have a very good idea of what all your issues are and how to treat them."

"Too bad," Estelle replied jokingly. "I was actually enjoying all the attention."

"You are scheduled for surgery the morning after tomorrow," Chase started. "There are a few benign tumors that we need to get out of your liver and kidneys, and we will take care of that clot in your brain. We also found a herniated disk in the middle of your back that will be removed and the two vertebrae will be fused together."

"That doesn't sound too bad. That's all you have to do?"

"That is just what can be fixed with the surgery. After the surgery we are going to slowly start you back on some medication. You will have to go back on levothyroxine for your hypothyroidism. For your high blood pressure, I'm going to prescribe an ARB called Atacand since you have kidney issues and there is far less risk for other drug interactions. No more ACE Inhibitors for you."

Estelle looked at him attentively ready to hear the long list of other drugs/problems that would be addressed next.

"After that, the diagnosis got a little tricky. We looked at the list of symptoms that were left and found that while many of them were indicative of other conditions, there was one particular problem that they all fit into. The conclusion is that you have fibromyalgia."

"I read up on that carefully before I got sick. I was convinced I had it." Estelle confirmed.

"There is good news and bad news with that diagnosis," Chase continued. "The good news is that many of your medications can be eliminated. The bad news is, it is a painful disease in which there is no cure."

"There has to be medicines to treat it. I at least need pills for the arthritis and muscle pain."

"You don't have arthritis," replied Chase. "Muscle and joint pain caused by fibromyalgia cannot be treated the same way. The disease is also causing your rhinitis, irritable bowel, headaches, diarrhea, numbness of hands and feet, and the dizziness. You will not be given medication anymore for any of those problems. If we did put you those medications, they would interfere with one another and continue to destroy your liver."

Estelle looked very worried. "I need the medication. Without it, I'll be in constant pain."

Chase started talking in a tone of complete reassurance. "With this disease, there are methods that will work just as good if not better than any drug. There is no drug that is going to take it away. Since the depression and anxiety is linked to the fibromyalgia you will get to go back on an anti-depressant but this time one that promotes better sleep. Other than that the treatment is learning how to manage and live with pain. If the muscle pain is too bad, occasional acetaminophen will help. You will get cognitive-behavior therapy and continue frequent acupuncture sessions. "

"That can't be all there is too it." Estelle had a sense of desperation in her voice. "I need those medicines. Isn't there any other over the counter drugs or vitamins that can help?"

"All those things were poisoning your body. A carefully followed treatment plan is all you need. It all starts with sensible self-care. If you reduce stress and get enough sleep, then the pain will get better. You will also need to start doing some exercise. That will not only help with the fibromyalgia but other problems as well such as the osteoporosis. You will also need to eat healthier. Junk food will no longer be permitted regularly."

Estelle started fighting back tears. Her lower lip was quivering as she tried to understand what she was faced with. "I'm too old to be changing my habits," she said shakily.

"Mrs. Anderson, its okay to be upset. Lifestyle changes are scary, plus I know from the psychologist that many of your self-care problems are due to your low self-image. Don't worry, you will be getting help." Chase tried to be as positive as possible.

"How so? I have had to do everything by myself. No one has ever wanted to help me." Tears were slowly slipped down her face, although she was fighting them back.

Chase's heart sunk as he knew it was time to deliver the rest. "That is the other thing we have to discuss. Do you need a minute before we go on?"

Estelle took a deep breath and said in a shaky voice, "Go on, I'm ready."

"I originally thought that your memory and concentration issues were also due to the fibromyalgia. When Dr. Foreman saw you though, something else was diagnosed. You are in the early stages of dementia."

Estelle's face instantly drew looks of deep panic and alarm. "No, I can't have that. I take care of patients that have that. They can't care for themselves. I'm not like that at all. It must be the fibromyalgia."

"I'm sorry Mrs. Anderson, but the MRI showed degradation in your brain. The head injury you suffered as a teenager has slowly caused it. The psychological tests also support the diagnosis." Chase as usual was firm with his presentation of the facts so he would leave little doubt, but he knew he was breaking this woman's heart.

"Please, no, that isn't it." She replied desperately. She was fighting her emotions hard, but the look in her eyes showed that she was unable to accept such a fate. "I will do everything you say. I will start taking care of myself. When I get home I'll get rid of all the pills and only follow your instructions."

Chase looked her somberly, knowing he was about to deliver the final blow. "Estelle, you aren't going to get to go home. I had a talk with your son. I'm afraid we had to give him the legal right to exercise power of attorney. He is now going to be making decisions for you. He has arranged for you to be admitted to the same nursing care facility that your mother was in."

Estelle broke down in intense sobs. She tried to speak but had trouble. "No…don't..let..my..son.." She had to stop there.

While Estelle had her moment of falling apart, Chase remembered what he read in the psychological profile. Estelle often avoided crying and dealing with emotion. She always kept everything in. Such a release would feel so good later, but for now, it had to be very traumatic. While she continued her extreme weeping, Chase sat there holding her hand, offering a sympathetic and supporting gaze. After a few minutes she tried to talk some more, but kept having to stop because she would cry harder.

"Estelle, it is okay. You need this emotional release. Crying is the body's natural way of dealing with intense despair. It is good." Chase told her as she kept getting frustrated by not being able to control herself.

"I wouldn't let myself cry at my own mother's funeral," Estelle said with a quivering voice. "I hate crying. It always makes me feel bad. I hate feeling bad all the time. What am I going to do? My life is over. Those homes treat their patients like dirt. I won't get to have all my things there, and I can't come and go as I please. I might as well be dead."

Chase silently looked at her with deep empathy. He needed to give her another minute or two to absorb the news before saying anything else.

"No, I can't go into a home," she said, still in denial. "I need all my stuff. I can't give up everything. That is all I have. You can't take my life from me."

Chase knew what he was about to say would be more upsetting. "Unfortunately, another serious mental condition you have is called Hoarding. The collecting and piling you were doing was a serious health and fire risk. Your son let me search your home and I found toxic mold underneath all the stuff you were piling in your apartment. The place had to be condemned and all items removed."

Estelle broke into sobs again. "I'm such a failure. I have never been able to do anything right in my entire life. I'm even not allowed to go home because I'm such a crappy housekeeper."

Chase then grabbed her hand tighter and looked her straight in the eye. "It isn't bad housekeeping. You have a serious condition where you can't control your actions. That was the reason why your son got power of attorney. It is not your fault. You are finally going to get the help you need. That isn't failure. That is relief."

Estelle wasn't convinced and was still rather hysterical. "A nursing home? That is for old people that are in the last stage of their lives. I'm not that old. I'll be going there to die."

Chase gazed at his hysterical patient with deep sincerity in his blue eyes and offered an optimistic glance. "Come on, you have been working for a few years in such a place. You have done wonderful things for the patients and made many friends. You can do so as a resident and will be near family and friends again. You are just emotional right now and need time to think about it."

"I'm so scared. I don't know if I'll be able to adjust."

"Trust me," he replied, "I have had to go through a major change in my life recently. It is scary, it is hard, but it happens for a reason and you are better for it."

Estelle calmed herself down by taking deep breaths while examining the sincerity in Chase's eyes. "You are right," she said with a slightly calmer disposition. "I don't know why, but I always hear the bad and never the good. My mother was always like that too so the reaction is natural."

"You have had a lifetime of unwanted feelings and behaviors," Chase assured her. "The Cognitive-Behavioral therapy will help you with that. If you think about it, it's all good."

Estelle looked down, too emotionally exhausted to take anymore. "It might be nice to have someone finally take care of me for a change," she said in a way that she was still trying to convince herself while tears were still streaming down her face.

"Estelle, you are tired and this is a lot to take in at once." Chase calmly told her. "Why don't you get some rest. Everything will seem better after a little sleep."

She nodded wearily and didn't say anything else. She was still too distraught.

Chase put his hand on her shoulder before leaving. "It will be okay. Just give it a little time to sink in."

Estelle wasn't sure about her young doctor's view, but for right now sleep was all she wanted. She needed to slip away for a while.