AN: wow look at me go, two posts, I'm on a roll haha, I hope you enjoy the chapter, let me know what you think. I'm just going to get it out there that echocardiograms are generally not used on adults, but too bad, Sam is getting one. ALSO big huge thanks to my beta charmed, who even with all her work load still gets these chapters back to me, thanks so much !
Thought I should put this out that I was informed that echos can be used, I am basing my knowledge on echos on what I was told in the hospital, and I was told that they generally don't use Echocardiograms on adults because it isn't a clear enough picture. But so sorry for the confusion.
Pulmonary Functions test: Deals with your breathing and lung capacity.
Echocardiogram: takes pictures of your heart.
Both tests are used to monitor a patients Heart and Lungs because the chemotherapy effects both those areas.
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Disclaimer: See chapter one
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There were many scars that adorned Dean's pale skin, thankfully for him none of his Chicken pox had followed that root. Instead, thanks to the help from his brother, the rash had healed over with very few marks left behind.
"Have to thank Sam for that one" he mumbled quietly as he stood at the front door, his father looking on.
"You boys sure you don't want me to come along?" John asked, wanting to support his boys through Sam's illness, but not wanting to have to go to the hospital if he didn't need to.
"Nah, dad don't worry about it, its just a few tests and we'll be back before you know it, plus you went with Sam to the chemo. A person can only take so much hospital time" Dean smiled as he looked down at his watch his aggravation growing. "Speaking of hospital time… Sam! Lets go!"
"Yeah, yeah" Sam called back, making his way from his room to the front door, the walk slow and drawn out, the youngest Winchester dreading his trip to the hospital. He seemed to be spending more time there than anywhere else. "Lets go" he continued, his voice filled with a sadness that Dean wished he could take away.
"Here" Dean called out, his hand held up, a toque held out to his brother. "Have to take care of that freakishly large noggin of yours" he joked, not used to seeing his brother in the winter hat. Sam's usually thick hair provided him with enough protection, but with that missing Sam had no choice but to wear the winter hat.
"Dean" John started as his oldest continued to talk as he walked out the door.
"What? Sam has always had a freakishly large head, I'm sure if you look at the size on the inside of the hat the tag reads 'Freakishly Large'"
"Thanks" Sam said laughing, following his brother out the door and into the cool air.
AT THE HOSPITAL
The two brothers sat quietly in the crowded waiting room; Sam was scheduled for two appointments, a pulmonary functions test and an Echocardiogram.
The wait for the pulmonary functions test had been short, but the echo was taking far longer than the brothers thought it was going to take, and the waiting in the room was beginning to fray Dean's on nerves. The doctors had fallen behind on their appointments and the patients in the room were starting to become restless.
Dean felt as if the entire room was staring at him and his brother, who had removed his hat, showing his bald head for the entire room to see. Sam didn't seem to notice the eyes, didn't notice how they followed his every move, how the people around him shifted uncomfortably when he moved too close to them.
But Dean not only saw all of the glaring eyes, he felt them as well, and every instinct in his body was telling him to grab his brother and get him away from the people, but he held back his urges, grateful when Sam finally got up.
"Going to the washroom." he said as he handed Dean his hat and he made his way out of the room, oblivious to how people moved out of his way, as if they would catch the disease that plagued his body.
The halls were just as busy as the waiting room, people pacing back and forth, nervous energy and chatter filling the air as Sam made his way past the people, his bladder beginning to ache.
"Damn" he mumbled as he noticed the occupied sign that was up at the washroom, dancing from foot to foot, he was desperate for a washroom so he turned down a different hallway.
His eyes scanning the hallway as he made his way down, his eyes falling on a familiar old lady. Their eyes making contact causing Sam to stop in his tracks, his need for the washroom diminished as his focus drifted to the lady down the hall. His instincts kicked in as he started to walk towards her, his walk quickly turning to a run as the lady started to move as well. Her eyes catching a final glimpse of Sam before she rounded a corner.
Sam ran as fast as his body would allow him, dodging numerous people in the hall as he came up to the corner, rounding it sharply, his mouth wide open gasping for air. His breath was sucked out of him as he rounded the corner and it felt as if he had hit a brick wall, his fragile body colliding with a much taller and older man whom didn't seem to budge.
Sam on the other hand fell to the floor in quite the spectacle. He could taste the copper taste of blood that was beginning to fill his mouth from where he had bit his lip when he had collided with the man.
"Boy, why don't you watch" the man began to yell before he caught a glimpse of the bald man on the floor in front of him causing his attitude to do a 180.
"Are you okay?" He asked as he helped Sam up, "Do you want me to go get you a doctor?"
"No, no, I'm fine. Teachers always told me no running in the hall, now I know why" the younger man joked, "Of course in school we never had to worry about running into a man of your size" he continued, smiling, trying to ease the situation and his embarrassment.
"Yeah, well, you be careful, you could get seriously hurt" the man said before he continued down the hall, leaving a distraught and bleeding Sam, frantically searching for any sign of the older woman, before the pain in his lip convinced him to go back to the washroom and then back to his brother.
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"What took so long?" Dean questioned once Sam finally re-entered the room.
"There was a line"
"Bull, what happened?" Dean questioned further, immediately recognizing his brother's change in attitude and his haggard appearance.
"Nothing" Sam exasperated, grateful when the doctor came in to the room and called his name.
Sam followed quietly, answering the questions robotically as the doctor asked them, his mind taken with the old woman, and what her purpose was for his whole experience, why did she keep making appearances? And could only he see her?
Laying down on his side with his shirt removed, Sam flinched slightly as the cold gel was put on his skin and the doctor pressed hard onto his chest to get the picture of his heart.
'Why is she always around when I'm here?' he thought as he winced once more when the doctor pushed harder into his chest.
'She's always around when I have treatment, when I have those dreams' his eyes widened as he pieced together what he thought of the woman, 'She can't be' he tried to convince himself as he thought back to Dean's experience with the reaper when he was healed. 'Is she my reaper?' he thought, suddenly growing very cold as the notion stuck with him, building his fear of the woman and fear of the situation.
THREE DAYS LATER
It had been three days since Sam had seen the woman, three days of thinking of her cold touch, three days of thinking how she could take him away. But as the third day was coming to an end and Sam had been off of his steroids for eighteen hours he was beginning to forget the woman and focus on his joint pain that was building from a dull ache to a throbbing pain.
Sam was used to the dull pain in his joints that seemed to follow him around throughout the day, but when he came off of his steroids the pain became unbearable, leaving the youngest Winchester shaking in pain, as he sobbed in his bed while everyone slept.
The pain so great that he didn't even notice how loud his sobs had become, he just wished for the pain to stop, to go away.
His wailing cries for help, a help he didn't know he needed, were broken only when he felt a cool hand on his forehead, Dean's comforting voice breaking through the pain that had seemed to create a barrier around Sam.
"Hey Sammy" the older Winchester whispered, holding his hand in front of his brother, two white pills visible in the soft moon light.
"Joint pain again eh buddy?"
Sam didn't respond, he couldn't respond, for the joint pain was beginning to be the least of his problems, his bit lip had quickly turned into a canker sore that seemed to engulf half of his lower lip, causing his lip to swell out. Making it so he couldn't shut his mouth completely, without his teeth resting in the crater of the sore that he was sure was taking over his mouth.
So instead he reached a shaking hand out and accepted the pills Dean had for him, quickly popping the two codeine pills as Dean brought up a glass of water as well. Sam reached out for the water his hands shaking fiercely as he gripped the glass tightly. The shaking in his hands causing the water to spill out over the edge, he sighed in relief as he felt Dean's hand close over his, steadying the glass as he brought it up to his lips.
The simple act of just swallowing some pills had tired Sam out as he gratefully laid his head back down and waited for the pills to kick in. Unable to hide the tears he let them fall freely down his cheeks and into the darkness, while he held back his sobs, he waited for his brother to go back over to his own bed, but Dean made no such move.
Instead the older brother gently shifted Sam over to one side of the bed and took a seat on the other side, his arm draped above his brother's head while his hand rested on his shoulder.
There was no way Dean was going back to his bed, no way he was leaving his brother to sob in pain by himself. It broke his heart to see his brother in so much pain; he had never seen Sam beg for painkillers to start working.
"It's okay Sam, they'll kick in" Dean tried to soothe, but he knew his attempts were lame at best. His own tears starting to build up as he continued to watch his brother sob, mumbling incoherently for the pain to go away, drool escaping past his brother's quivering lips. Dean was quick to wipe it away, causing his attention to be brought to Sam's protruding lip.
"Dammit Sam" he mumbled quietly as he caught a glimpse at the sore that adorned his younger brother's bottom lip, making a note to call the doctor about it in the morning.
Dean sighed as he felt Sam begin to relax, the pills finally starting to kick in and take some of the pain away. Dean watched as his brother's eyes shut and his shaking stopped, his breathing evening out, his face going calm for the first time in a long time. Dean smiled a sad smile as he rested his head back against the wall and settled in beside Sam. Enjoying the moment with Sam, not having slept in the same bed with his younger brother since they were both children.
"Always here for ya Sammy" he said as he drifted off into his own realm of sleeplessness.
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Sam woke up to the dull pain that had started to make its presence known once again, causing him to shift uncomfortably before finally rising. Walking slowly, afraid that his ankles were going to snap as he walked into the kitchen, causing his father to look over from the toaster.
"How are you doing son?"
"Ever felt like your ankles are about to snap with every step you take? Cause I got that feeling right now." Sam said ignoring the harsh words that shot through his mouth as he sat down at the kitchen table.
John felt sympathetic towards his youngest son but he could never find the words to express how he felt, so instead he filled the silence by handing Sam the two pills Dean had left on the table for John to hand to Sam.
The youngest Winchester looked around as he swallowed the pills, noticing Dean's absence, "Where's Dean?"
"He's in the other room talking to your doctor" John said as he buttered the toast that had popped up, handing it over to his son who took it with apprehension in his eyes, not sure how he was going to eat it with the crater in his mouth, "Thanks"
"You know if you tear it up and put it in the back corner of your mouth, you may be able to eat it better" John stated without looking back as he put the toaster away.
Sam just sat wide-eyed, 'How'd he know?' he thought to himself.
John, guessing his son's silence as astonishment, quickly spoke up, "Sam, its not hard to miss how swollen your lip is, and every time you open your mouth you can see the sore that has made itself at home." he finally turned around, smiling at his pale son.
"Son" he continued as he sat across from Sam, "You can't keep things from Dean or I anymore, even the smallest thing you have to let us know."
John paused bringing his hand under his boys chin so they were eye to eye." Sam, you may feel all alone with this, but your not. Your problem is Dean and mine also, just like Deans chicken pox was yours and mine. So please, no more secrets. No more hiding" John pleaded with his youngest, the son he usually fought with, a first in the Winchester family.
If it had been the same Sam that had gone to college it would have been a different situation in the kitchen. He would have argued back, been defiant to his father's words. But it wasn't the same Sam who went to college, his life had turned upside down and as much as he hated to think of losing his independence he had.
He was now more dependent on people than ever before in his life. He was dependent on the doctors, the nurses; on the treatment and most importantly he had grown dependent on his brother and of course his father.
"I promise," he said quietly causing John to smile and bring his boy in for a hug as Dean walked into the room.
"Whoa for a second there I thought I was watching 7th Heaven before I realized that Stephen Collins was looking a little rough around the edges." Dean said smiling at his own hilarity.
However John was quick to respond, he was the one who taught his boys to be quick with the lip, he wasn't about to be outshone by his boy. "Dean… how do you even know what 7th Heaven is about, let alone know a name of one of the actors?"
Dean stopped, his smile fading as he shook his head and gathered his thoughts, quickly changing the subject. "Sam, Doc. wants you to go in for a test ASAP"
"Why is something wrong?" John was quick to ask, concern evident in his gruff demeanor.
"Well she said that the echo that Sam had picked up something unusual in Sam's right atrium, and she isn't sure if it is just a normal abnormality so she wants to run a test called a veinogram. Its just two IVS in each hand so they can take pictures of your chest, and Sam she wants to look at that mouth of yours"
"Two Ivs? Why two?" Sam asked, full of questions about the new test and the new discovery of the object in his right atrium.
"I'm not sure Sam, she didn't go into detail, just said to come in, so get your coat. Dad you want to come? Or you want to stay and get dinner ready?" Dean knew his father didn't enjoy going to the hospital. "I'll call you if anything happens, which I'm sure it won't Ivs are a piece a cake now eh Sammy?" he called out as he followed his brother to the door, leaving his father to worry at home.
AT THE HOSPITAL
The brothers sat once again in a small hospital room, Sam was given advancements in the waiting room which set a worry in Dean that he just couldn't seem to shake as the doctor walked into the room.
"Hey Sam, how are you feeling?" She asked smiling at the pale young man sitting on the hospital bed.
"Been better," he replied, trying to be careful when he spoke to not aggravate his canker sore.
"Oh yes, I can see it from here" she said moving closer, slowly bringing a hand up, "say ahh"
"ahhhhhhhhhh"
Dean watched as the doctor scrunched up her face, "You have quite the sore in your mouth Sam, unfortunately when a patient bottoms out, mouth sores are a common occurrence, I'll give you some acyclovir to help, but just remember to keep your mouth clean. You can wash it out with water and Baking soda in between meals."
"Thanks" Sam said once the doctor finally moved away.
"Now, the reason I brought you here today" she continued as she finished writing the script and handed it over to Dean. "Your last echo test showed an abnormality in your right atrium that other tests didn't pick up. We aren't sure if it's normal or if it could possibly be a blood clot that has attached to your port. But we just wanted to make sure, and that's why your having the veinogram" she finished, looking between the brothers. Sam's face showing no concern while Dean's expression held nothing but concern.
"What happens if it is the blood clot?" Dean spoke up.
"If it is a blood clot then we have ways of dealing with it, but we'll cross that bridge if it comes up. For now a nurse will be calling you into the IV room soon so she can start your two IV'S. You will have one IV in each arm as low on the arm as possible, then you will have contrast pumped through the IV'S while we take pictures of your chest." She finished as she started to walk out of the room, "If you have any other questions, please feel free to call me"
"Sure thing" Dean replied while Sam just nodded.
ONE HOUR LATER
Sam sat in the IV room behind one of the various curtains, a nurse sitting in front of him getting things ready to start the IV while Dean stood behind her, trying to offer Sam encouraging smiles.
The younger brother winced as the nurse hit at his hand and arm trying to bring his veins up to the surface. "This looks like a good one" she spoke up as she rubbed at the protruding vein. Sam resisted the urge to roll his eyes, "Yeah there aren't many of those left"
The nurse offered a small smile laced with pity as she prepared the area, "Yeah, your veins sure take a kicking when your on treatment. Ready?" Sam nodded. "1…2…3"
She slid the needle into Sam's hand, bringing blood back immediately she pushed saline through. Sam winced at the sudden pain, bringing in a quick breath.
"It hurts?" she questioned.
Sam nodded, looking to Dean who looked about ready to jump the nurse.
The nurse looked confused as she pulled back, receiving blood return she tried pushing the saline through one more time, not wanting to give up on the vein. Sam gasped once more in pain as a bubble began to form. "Damn" she muttered accepting failure. "Your vein burst, lets give this hand a rest and try the other side" she said as her smile quickly disappeared as she saw what little she had to work with in the other hand.
So Sam sat, for well over an hour while nurse after nurse attempted to get his Ivs started, each one failing with every attempt, with every dig, much to Sam's frustration and Deans paling skin.
It took the nurses thirteen tries before they got the first IV started, and it took an ultra sound machine in order to find a vein in Sams bicep to start the second IV. Now Sam lay on a cold metal operating table the Doctor and nurses hovering overtop of him.
Sams arms were shaking at the abuse, tears falling freely as sobs wracked through his body once again. He had been doing so well with the constant prodding and digging of the needles up until around the tenth try, when a petite blond nurse decided to step in and try and find a vein.
It was while she was searching around Sams forearm that she dug a little too deep, striking a tendon and sending a whole new kind of pain up the young Winchesters arm, breaking Sam's already paper thin emotions, sending him towards the edge. He felt as if he was crumbling in the wind, the only thing that kept him grounded was Dean's firm grip on his shoulder, which had to leave him when he was wheeled into the operating room where his veinogram was being preformed.
Sam's crying had yet to stop, and he was sure it wouldn't stop until his brother was back by his side and the nurses and doctors had moved away from his line of vision and took the needles out of his sore arms. Sam was trying to catch his breath in between sobs as a nurse hovered over him trying to offer comforting words. His eyes lifted off of her and fell on the familiar old lady who stood across the room, smiling sadly at his shaking figure.
"No…" Sam muttered as the nurse continued to whisper comforting words.
"No, please" he begged, his mind set that the woman was his reaper, coming to collect him, take him away from his brother. "Please, I'm not ready" he continued to beg as the doctor started to pump the contrast and the click of the pictures sounded through the room.
He had failed Dean, he was being taken away, and he would never see his brother again. Sam's vision began to cloud over as the old woman took a step closer, "NO!" he shouted becoming hysterical "No, no please!" he cried out once more as the old woman touched his leg and his vision went dark.
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Dean had called their father as soon as Sammy was wheeled into the room. Both brothers needed their father there, both emotionally distraught from all the iv attempts. Dean was never great with needles, a big reason why he never went and got a tattoo like many hunters do.
John was on his way and Dean had walked back inside, the craving for a cigarette getting the better of him when he stood outside. He hadn't touched a smoke since he was 19 when Sam had caught him smoking and had given him a piece of his mind.
Dean didn't like to admit it but Sam had a lot of sway in his life, if Sammy didn't like something then Dean didn't like it either, and it was the other way around as well and Dean knew it, hell he'd got Sam to come out hunting again and that in itself was something to show how they were inseparable when it came right down to it.
Dean had just walked in when he noticed a nervous energy had filled the halls, a nurse came running through the hall towards Sam's room, pushing the doors open Dean could hear his little brothers cries echo off the walls.
"Sam? Sam!" he called out running towards the door only to be stopped by a nurse who stood in front of him.
"Sir please sit back down" she said in a stern voice.
"That's my brother… " He yelled, panic overcoming him as he heard Sam cry out once more before he heard nothing at all.
"Sam!"
AN: so sorry for the cliff hanger, but you know how it is, I hope you enjoyed the chapter and I am about half way done writing the next chapter, then I just have to type it up. So I hope it won't be too long.
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