Annie had volunteered to have Allison spend the night with her. Teddy was on call overnight and planning to stay at the hospital to be on hand as they were short attendings and Owen had gone on a beaver scout camping trip with Leo. Josh had gone to Portland to see some old high school buddies. Annie had been invited but hadn't felt up to the road trip then sitting in a bar with them all night watching her husband drink with people he saw once a year and she had only met twice.
Teddy dropped Allison off around lunch time, "are you sure this is okay?"
Annie nodded, "were going to have fun. I have a few errands Ali bean can help me with then we're going swimming. Then we'll come home, I'll do her hair and make dinner and we can curl up with your Disney plus account and watch princess movies with popcorn and ice cream."
"She has her bathing suit for swimming," Teddy said, "are you sure you want to go swimming?"
Annie nodded, "I have one bathing suit right now that fits. I actually bought a maternity one so I could keep swimming as long as possible. I feel better when I swim less stress on my body then trying to dance or run."
Teddy nodded, "if your sure."
"I am," Annie said, "Allison and I will have fun."
"You always do," Teddy said, "not many of these left though. She'll miss them."
"They'll change but she can still come sleep over and see me," Annie said, "I'll take them a few times in the summer and give them a break from daycare. This will be the last sister day for a while I think."
"You say that now," Teddy smiled, "wait till you have a newborn."
"Mama it's fine," Annie said, "plus I'll make sure Josh is home to help me. People assume they are my kids when I take them out anyway. When I took Allison with me somewhere last week this little old lady asked her if she was excited to be a big sister and told me I have a beautiful daughter. Allison set her straight."
Teddy laughed, "have fun but don't wear yourself out sweetheart. Allison I have to go to work come say good bye."
Allison put the cat down and ran to Teddy, "bye bye mama. Are you fixing broken hearts?"
"I am," Teddy said, "you be good for Annie baby girl. I love you."
"Love you mama," Allison said.
Annie gave Teddy a hug, "we're good. Go be awesome."
"I'm always awesome," Teddy said, "bye girls."
"Bye mama," Annie and Allison chorused.
When the door closed behind Teddy, Annie called, "Ali bean let's get organized."
"Bean reporting for duty," Allison smiled with a mocking salute.
Annie rolled her eyes, "snack, get cleaned up then we'll go. Go put your bathing suit on my bed."
"Okay," Allison said.
"Do you want yogurt and berries or toast with peanut butter for a snack," Annie asked.
"Toast and jam," Allison asked.
"I have the good raspberry jam," Annie said, "I promise no strawberries in my kitchen."
Allison's eyes went wide, "really? I have to tell my friends mommies I'm allergic to them."
"I can't eat them either. We found out you're allergic to them because I gave you some rice when you were about one that had sesame seeds on it and they did all the allergy tests on you," Annie said, "I almost gave you my epi pen that day."
"Did mama bring you mine,"Allison asked.
"I think yours is in your bag but there's always one in my purse, one in the kitchen and one in my bathroom do you want me to show you where they are," Annie asked.
"After snack," Allison agreed.
"Snack then epi pens," Annie agreed.
They ate their toast at the island then got ready to go swimming.
Annie walked into the water first holding Allison's hand.
"Come in bean," Annie said, "what are you scared of?"
"All the big kids are staring and I want to go down the slide," Allison said.
"You go get in the slide line and I'll meet you at the bottom. I can't go down the slide with you," Annie said.
"But you always take me," Allison complained, "or daddy does."
"I'm sorry sweetheart I can't right now it's not safe for the baby," Annie said, "I will one day I promise. I'm not allowed on the slide now."
"Would you get in trouble,"Allison asked, "would they call mama like when Leo hit me at daycare?"
Annie shook her head, "they won't call mama but they won't let me on the slide. I know it's no fun. I like the slide."
"Will you walk with me," Allison asked.
"I will and will tell the lifeguard at the top I'll be waiting for you at the bottom," Annie promised.
Annie walked Allison to the top of the side then hurried down to where she could meet her baby sister. Annie knew Teddy wouldn't be thrilled with this idea but it was her only way of letting Allison have one trip down the slide. They spent the rest of their time at the pool splashing in shallow water and working on Allison's front and back floats and getting her to kick with her whole leg. Annie enjoyed floating in the warm water and the sense of weightlessness it gave her.
"It's almost dinner time," Annie said, "let's go dry off then I'll wash your hair at home."
"Already," Allison wined.
"We've been here three hours," Annie said, "I'm hungry."
"Annie what's for dinner," Allison asked.
"Build your own mini pizza, carrots, bell peppers cucumbers and cherry tomatoes," Annie said.
"Can I have a veggie face again," Allison asked.
"I can make a veggie face," Annie laughed, "if you eat the broccoli ears."
Annie smiled making faces or pictures out of veggies or fruit was her way of tricking Allison into eating them. The little girl hated fruits and vegetables and would only eat cheese if they let her.
In the change room Allison asked, "why is your tummy moving?"
"That's the baby moving her arms and legs," Annie explained, "she likes to swim in my tummy. It makes her strong like swimming makes you strong."
"She doesn't have a lot of room to swim," Allison observed.
"She isn't very big yet," Annie said. Annie on the other hand was feeling fairly big.
"How much longer until I can see the baby," Allison asked.
"Seven weeks," Annie said, "about two more months. She still has to grow more."
"Too long," Allison said, "can it grow faster?"
Annie laughed, "no it can't bean it's just how things work. I can't make you grow faster either."
They finished getting ready to go home. At home Annie asked, "how bubbly do you like your bath?"
"A bubble bath," Allison said, "mama doesn't let me have bubble baths she washes my hair then it's bedtime."
"You're at Annie's," Annie laughed, "here we like bubble baths. It's just you and I bean. Orange, or vanilla scented?"
"Nilla," Allison said.
"Good choice that's my favorite," Annie said adding the bubble bath to the tub and turning on the water, "bring your pajamas in here."
Allison returned with her pajamas.
"In you get," Annie said holding Allison's hand so she could step into the tub. Annie sat on the floor leaning against the wall while Allison splashed and played with the measuring cups in the bubbly water.
"Time to wash your hair," Annie said.
"Don't get soap in my eyes," Allison begged.
"I won't," Annie said, she looked in Allison's bag, "mama forgot your shampoo. I need you to stand on the bath mat while I get mine."
"Isn't this your bathroom," Allison asked.
"We share this one with Duncan," Annie explained, "I usually wash my hair in the other bathroom. I need you to stand on the bath mat and not in the tub while I go get my shampoo."
"Annie, do you want me to help with something," Duncan called.
"Can you grab my shampoo and conditioner from the master bathroom," Annie asked, "green bottles there's an apple on them."
"I can do that," Duncan called.
He brought the shampoo over to Annie and Allison.
"I thought you were busy tonight," Annie said, "Allison and I are having sister night."
"Shawna cancelled," Duncan said, "her kid is sick."
"They need mom when they're sick," Annie agreed.
"They do," Duncan said, "I offered to go help but she said they're fine. Do you need anything?"
"When I'm done with her hair and she's in her jammies can you watch her so I can shower," Annie asked, "I was going to let her have my ipad on my bed."
"We can play go fish," Duncan agreed, "Grace just send her out when you're done."
"Thanks Duncan," Annie replied.
"Annie why do people at the hospital call you Grace but mama, daddy, Josh, uncle Nathan and auntie Meghan call you Annie," Allison asked.
"When I was a little girl my nickname was Annie because Grace was too grown up and Annabeth was too long," Annie explained, "they called me Annie like we call you bean. I gave you the name bean when you were still in mama's tummy. The first picture I saw of you looked like a very cute little bean."
"I'm not a bean," Allison whined.
"Just an Ali bean," Annie teased, "head back so I don't get water in your eyes."
Annie gently washed Allison's hair and day dreamed about the day she would do this for her own little girl. Hair washed Annie held Allison's hand as she climbed out of the tub. Annie supervised as Allison put her pajamas on.
"Can you climb up on the counter and I'll do your hair," Annie said, "braids are easiest when your hair is wet."
Annie put Allison's hair in two French braids.
"I look pretty," Allison said.
"You are very cute miss bean," Annie said, "can you go play with Duncan for a few minutes so I can shower."
"Okay," Allison bounced out of the bathroom.
"Thank you miss bean," Annie smiled.
Annie made sure the main bathroom was tidy and took her shampoo back to the master bathroom. She quickly washed and braided her own hair into one long braid. She walked out of her room in her pajamas.
"Come make your pizza," Annie called.
"You sure you're not a mom already," Duncan teased walking through the kitchen.
"My siblings have given me practice," Annie admitted, "not a mom yet. 7 more weeks and I'm starting to worry that I don't have a nursery."
"I move out in a week ," Duncan said.
"Six weeks isn't much time to be ready," Annie pointed out, "everything for the baby is in our room, the garage or the office. I want to get it all set up soon. We're repainting the whole house this week including your room."
"I know," Duncan said, "I'm overstaying my welcome. This has been my first real home. It's hard to leave."
"I know," Annie replied, "I hate pushing you out but she needs somewhere to sleep."
"I hoped things would be better with Shawna by now and I could suggest moving in with her but her son still doesn't like me," Duncan said.
"Can we eat soon I'm starving," Allison said.
"I'll put them in the oven then it's only 15 minutes," Annie promised, "I'm hungry too."
Annie took the veggies out of the fridge and arranged them into a face for Allison and threw some lettuce and vegetables in a bowl as a salad for herself.
Annie and Allison sat at the kitchen island with their dinner. Allison told Annie all about her friends at preschool and daycare and the birthday party she was going to the next day.
After watching Aladian, Annie decided it was time for Allison to go to bed.
"Ali bean time for bed," Annie said, "go brush your teeth then you can sleep in my bed."
"Nee I'm scared," Allison whimpered.
"Nee," Annie said, "you haven't called me that in a while. Do you want me to sit with you until you fall asleep?"
Annie knew Allison sometimes had trouble falling asleep in new places and was afraid of the dark. She also knew Teddy and Owen were trying to help her over the fear of the dark and how they were doing it.
"Please stay," begged Allison.
Annie folded back the blanket on Josh's side, "crawl in. I'll sit with you until you fall asleep."
Annie sat beside Allison and stroked her hair. She watched as her little sister fell asleep. Annie smiled at Allison seeing the sleeping girl made her look forward to holding her own baby. She had one hand brushing Allison's hair and the other on her stomach where she could feel her own daughter kicking. When she was sure Allison was sound asleep Annie went back to the living room to tidy up and read for a bit before going to bed.
Annie flopped on the couch and texted Josh, "how's your night?"
Josh, "good. Are you doing okay with Ali?"
Annie, "were fine. Swimming, pizza, movies. How are the guys?"
Josh, "good. They don't believe we're going to be parents."
Annie, "do you want me to send the picture I took earlier ?"
Josh, "for me yes. I have some from last weekend that are pretty obvious."
Annie, "what are they up to?"
Josh, "same old. Work, party repeat."
Annie, "are you having fun?"
Josh, "I do this to please them. I don't really care."
Annie, "so we can avoid it when we come down for our boards?"
Josh, "we should see them. We weren't married yet last time they saw you. I get to show off my wife and daughter."
Annie, "see how we feel after boards and seeing your mom."
Josh, "okay baby will be what 6 weeks?"
Annie, "tops. She's due 6 weeks before. She's still measuring on the small side."
Josh, "you're not very tall."
Annie, "I know but you are and mama is a lot taller than me. "
Josh, "we've never seen your bio dad's side."
Annie, "I know. I miss you already."
Josh, "it's one night babe. I'll be home tomorrow."
Annie, "after this no nights away from me until after she comes."
Josh, "you feeling okay?"
Annie, "hips and back are bugging me. I think I overdid it at the pool. Ali is asleep in our bed. I might have a bubble bath."
Josh, "relax. I'll be home around 1 tomorrow and your off we can have a lazy night."
Annie, "I miss you. Ellie misses you."
Josh, "I miss you too. What are you doing?"
Annie, "trying to read but more watching some one dance."
Annie pulled her pj top up and quickly videod the wiggling their daughter was doing you could see the baby moving through her skin. She sent it to Josh.
Josh, "that is active. A couple of the guys saw it and are calling our daughter an alien."
Annie, "Ellie is not an alien. I'm going to go have a bath see if it helps my hips and back."
Josh, "love you I'll be home tomorrow. Tell Ellie I love her."
Annie, "we love you too. See you tomorrow."
In the morning Allison whined, "nee stop poking me."
Annie smiled, "You're the one that came to cuddle with me. Go back to the other side and your niece won't poke you. I can't stop her."
"But I'm cozy,"Allison complained.
"I'm going to get up and start breakfast in a few minutes," Annie told Allison.
"Waffles," Allison asked.
"With raspberries and whipped cream," Annie promised.
"Can I have tea," Allison pestered.
"I have one you can have," Annie replied, "no caffeine for either of us."
As they were eating breakfast Annie's phone rang , "good morning mama."
"Hi sweetheart I know you were having a lazy morning with Allison but I need you to come into the hospital," Teddy said.
"We're just finishing breakfast we'll get dressed and head in," Annie replied, "why do you need me?"
"Peds cardio case being flown in from Spokane," Teddy said, "they don't have the tools to deal with it. 10 year old boy is all I know. But it's your specialty so you should come."
"We'll be there in 20," Annie replied, "is Evelyn getting Ali?"
"She is," Teddy replied, "see you soon."
"Bean that was mama," Annie said, "put your dishes in the dishwasher and we're going to work."
"Why," Allison asked.
"A patient is being flown in for mama and I," Annie explained, "should be there in 45 so I need to get there fast. Go get dressed."
"I'm going," Allison said. Annie was already dressed but needed her contacts and make up before going to work. When they were ready Annie drove to the hospital. Evelyn met them and took Allison for the day.
Annie changed to scrubs and went to the helicopter pad on the roof with Teddy.
"I can do that now but I won't always have that flexibility to do this," Annie told Teddy.
"I know," Teddy said, "that's why I wanted you to come today."
The helicopter touched down and Annie took over patient care. Once he was stable she met with the family.
"I'm dr Grace Altman," Annie introduces herself, "dr Grace works you'll have two dr Altman's on your sons case."
Teddy entered, "I'm dr Teddy Altman. The chief of surgery and a cardiothoracic surgeon. Dr Grace Altman is a fifth year resident specializing in cardiothoracic and pediatric surgery. She's going to be taking the lead on this."
"We're Matthew and Lorie Johnson," the dad introduced himself and his wife.
"Do you have children, Dr Altman," the mother asked.
"Three," Teddy replied, "Grace is my eldest."
"This is my first," Annie replied.
"Mother daughter surgical team," the dad said, "that's unusual."
Teddy acknowledged, "it is but we work well together. We understand how stressful this is as a parent. I've spent my share of time sitting beside my older two in the hospital. it's never easy seeing your child in the hospital."
"What's wrong with him," the mother asked.
"Based on the preliminary tests from Spokane I would say there is a viral infection in the pericardium," Annie explained, "I have ordered an MRI, as well as a CT angio. I would like to do a new echo and ekg. I've already ordered labs."
Teddy nodded, "we're going to work from the viral theory until we have more information."
"How do you treat it," asked the dad.
"For now we begin with stabilization," Annie explained, "he's dehydrated. I've already ordered IV fluids and we're giving acetaminophen to reduce his fever."
"When will you know," asked the father.
"It could be a couple days unfortunately," Teddy said, "we need time for cultures to grow and to do all of the tests."
Annie started getting tests back a few hours later.
"Mama there's a lot of damage," Annie said walking into Teddy's office.
"What are you thinking," Teddy asked.
"LVAD for now preferably a portable one to allow some quality of life," Annie said, "but I think we need to call a transplant panel."
Teddy nodded, "wait for all the results then meet with the parents."
Annie replied, "I just need the cultures. I've been really pushy about getting my scans done. I've gone all mama bear on radiology today."
Teddy smiled, "get all the data then inform the family."
"Josh should be home soon. Is it okay if I wait for the test results at home," Annie asked.
"Have you heard from him." Teddy asked.
"He texted he was on his way a few hours ago," Annie replied, "I think he missed me. We don't do being apart very well."
"Go home and see him," Teddy smiled, "you just want him to hold you. "
Annie nodded, "Allison was in my bed and does not stay still. I had baby who decided to keep me up and Allison thrashing I just need a nap."
Teddy laughed, "you want your husband. Who probably missed you just as much."
"He texted that he barley slept," Annie said.
"Go home and see him," Teddy smiled, "I'll call you if anything changes with Jonah."
Annie pulled into the driveway and smiled the truck was already there Josh was home. She found him sitting at the island with a glass of water. Annie walked over to him and grabbed him by the collar pulling him in for a kiss.
"I missed you too," josh smiled.
"Don't do that again for a while please," Annie whispered, "I miss you too much."
"All I could think about was coming home to my girls," Josh replied, "are you off? Where's Allison?"
"Allison is with Evelyn. I got called in for a kid," Annie explained before telling him about her new paitent.
"Interesting case," Josh agreed.
"How was your trip," Annie asked.
"It was good. Brett and Jasmine are coming to Seattle in a couple weeks and want to hang out," Josh said.
"They know I'll be an absolute whale by then right," Annie asked.
"They know you're pregnant," Josh said, "most of them have kids."
"That they don't see," Annie grumbled.
"They had them right out of high school," Josh acknowledged.
"And aren't with the mothers. So help me if you ever walk away from Ellie I will kill you," Annie snapped.
"I will never walk away from either of you," josh promised.
"What else is going on," Annie asked.
"A couple are getting married or buying places," Josh said, "they wished you would have come down."
"Four hour drive," Annie said, "no way right now. I don't know if I can do the two to the cabin Easter weekend."
"We'll take breaks," Josh said, "let you stretch."
The next day Annie had her cultures back and sat down with the family, "mr and Mrs Johnson I have some bad news. Your son has a virus that has severely weakened his heart. The damage is irreversible."
The father asked," what do we do? Can we treat it?"
Annie nodded, "we have three options. The best bet would be a transplant, I can convene the transplant panel for tomorrow morning and get him on the list. The wait could be a couple years to match blood type and size. I am able to implant an LVAD that takes over the work of his heart but he would need to be connected to a battery pack or plugged into electricity at all times. The third option is experimental and has only been done In Switzerland. I have a call into Dr Yang at Klausman to see if Jonah is a candidate. It would involve us using a combination of procine and 3D printed parts to repair what we can."
"Could we do one of the others while we wait for a transplant," mr white asked.
Teddy added, "we can do either surgery while we wait for a transplant as a permanent solution. I would recommend doing the LVAD as soon as we can get one. Jonah will need to be under 24/7 observation until he gets one and we are sure it is working."
Seeing the parents getting emotional Teddy suggested, "why don't we move this to my office. Grace why don't you stop and ask Angela to send tea and coffee in."
"I will," Annie replied. She hung back for a moment as Teddy guided the panicked parents away.
Annie rubbed her belly whispering , "please be healthy baby girl."