Chapter 2: Pain, the ER, and a Diagnosis

The next thing he knew, Ziva was shaking him, "Tony, wake up. We need to strip the bed." He opened an eye to see her looking at him and trying not to move in any way that hurt.

"What?"

"We need to get up so that we can strip the bed. I sort of made a mess. My period started while we were sleeping, and it got all over the sheets." Tony sat up quickly and looked where Ziva was pointing. The bright red stains on the sheets were much larger than he expected.

"Why so much?"

"I haven't had a period since I came back from burying my father. I figured all the stress was messing with my cycle. And of course, my body had to pick tonight to start."

"You go get cleaned up, take a shower if you want. I'll strip the bed and put these sheets in the washer and put on fresh sheets." Tony started removing the sheets from the bed. Ziva slowly walked to the bathroom, headed for the shower.

As she showered, she noticed red on the shower floor. She figured out that she had already soaked through the tampon she had inserted less than an hour ago. As she moved to change the tampon for a heavier duty one, she was gripped by abdominal cramps. She doubled over in pain just as Tony was coming to check on her.

"Ziva, what's the matter?" Tony had a look of alarm on his face. "Are you okay?"

"I am fine. I have cramps, which is not unusual for how heavy the flow seems to be. I will be okay, Tony." Something about the tone of her voice made Tony unsure if she was trying to convince him or herself. When she stayed doubled over, he was even more concerned. "Let me get things taken care of with my body, and then we can go lay back on the bed."

He finished putting the fresh sheets on the bed, and put a folded extra-large bath towel on Ziva's side, so that she would have some padding under her. He helped her put on a pair of sleep shorts and move back to the bed, and she lay down curled on her left side with her knees drawn up. "Does it still hurt? Are you cramping a lot? I can get you some pain meds if you need."

"I just want to sleep. Come lie next to me, please?" Ziva sounded as though she was in pain. He lay down next to her and moved as close as he dared. "It is okay to spoon, Tony. I would like that."

Tony moved to Ziva's back and carefully wrapped his arm over her. "Let me know if that hurts your shoulder." Ziva moved slightly to curl into him and sighed. They fell asleep again.

About an hour and a half later, Tony was awakened by Ziva's moans of pain. He felt her trying to double over even more and her whole body felt warm. Gut instinct told him something was seriously wrong. He sat up and noticed tears streaming down Ziva's face. "I am going to help you get out of the bed and we will get you to the ER, Ziva. This is not normal."

"Okay," she responded through gritted teeth. "It hurts so much."

Tony moved around to Ziva's side of the bed and tried to help her stand up. She went limp in his arms. He gently placed her back on the bed and grabbed his phone, dialing 911 as he checked her pulse and breathing. He explained the situation to the 911 dispatcher, giving the man the address and telling him how to find Ziva's apartment. "The ambulance should be there in about five minutes, sir. Stay on the line with me until they arrive, in case they need to have you buzz them in."

Tony unlocked and opened the door as he waited, then went back to Ziva. He noticed that she had curled up into the fetal position and that her breathing seemed better than just a few minutes ago.

"Mr. DiNozzo? EMTs are here." A male voice called from the door. Tony walked to the door, and told the dispatcher that help had arrived.

"Hope it goes well, Mr. DiNozzo." The dispatcher ended the call.

"Back here, in the bedroom," Tony led the EMTs to Ziva. "She had been complaining of bad cramps, and then when I woke up again, she was hurting worse than before. When I tried to help her up, she passed out on me."

The lead EMT looked at Tony and then at Ziva. "Were you in an MVA two or three nights ago? Sorry, motor vehicle accident."

"Yes, both of us. Were you there?" Tony didn't recognize the man, but he had been unconscious until they had arrived at the hospital.

"I thought I recognized you two." The EMT moved to examine Ziva. "Wow, she really bruised up from the accident!"

Tony sighed, "She also was in a fight with a perp about twenty four hours ago, and so she has been beat up on top of being bruised from the accident. We got the guy, so there is some payback."

"What's her name?"

"Ziva."

The EMT tried talking directly to Ziva, "Ziva, if you can understand me, nod your head." Ziva moved her head. "Can you talk?" Ziva nodded again. "Where does it hurt?"

"Feels like my guts are being ripped out. Abdomen mostly." Ziva had tears running from her eyes again.

"Okay, we're going to get you on the stretcher and evaluate you more as we go to the ER." The other EMTs brought the stretcher in and gently lifted Ziva on to it. "We're going to put a blanket over you, and also put up the sides to keep you from rolling off. We have to get you down the stairs, so we are going to put a loose strap restraint over your legs and chest. Are you okay with that?"

Ziva nodded and reached for Tony. He took her hand in his, assuring her that he would stay with her. As the EMTs took Ziva down the stairs, Tony grabbed his and Ziva's phones and his keys and slipped a t shirt over his head. He had put on a pair of jeans before the EMTs arrived.

Outside, the head EMT asked Tony if he wanted to ride in the ambulance with them, or drive and follow the ambulance. Ziva made the decision for him by asking Tony to stay with her. After the stretcher was loaded in the back, Tony climbed in and sat beside Ziva, holding her hand and stroking her face.

"We are going to ask some questions as we go to the ER, so that we can give the doctors as much info as possible. Are you ready?" Tony and Ziva both nodded. While the questions were asked and answered, the other EMT was putting monitors on Ziva and taking vitals.

"On a scale of zero to ten, how bad is your pain?"

"Eight." Tony squeezed Ziva's hand lightly; he had not realized it was that bad; he would stay with her no matter what.

"Have you had this type of pain before?"

"No."

"Do you have any known medical issues that could cause this type of pain?"

"No."

"Are you pregnant?"

"No. "

"Have you had any bleeding?"

"Yes, but I thought it is my period."

"Are you having any other pain or cramps?"

"No," Ziva gasped and drew her knees to her chest.

"Same pain?" Ziva nodded. "Stabbing or tearing feeling?"

"More like really bad cramps. Feels like someone is trying to rip my insides out through my navel."

"How did you get the bruises on your abdomen?"

"I was thrown against a metal railing during a fight."

"Okay, we are almost there. We will try to keep your husband with you." Ziva nodded and neither she nor Tony bothered to correct the EMT's assumption. Tony was more concerned about the level of pain Ziva appeared to be experiencing. He stroked her cheek with his hand, looking into her eyes and seeing the pain.

"I'm here for you, Zi." She squeezed his hand and returned the gaze. Tears were running from her eyes.

Once at the hospital, Ziva was immediately taken into an exam area. The nurse attached monitors to Ziva and checked vitals. She took the report form from the head EMT and skimmed over the information. She lifted the sheet and looked at Ziva's bruised body.

"How did you get all of these bruises?" The nurse looked at Tony with a suspicious eye. He met her glance, and did not back down.

"Car accident and a fight with a perp." Tony responded.

"I want to hear it from her." The nurse glared at Tony.

"Accident and fight." Ziva replied. "We were here three nights ago. Both of us." Tony nodded as the nurse glared at him more.

"I will check the records." Tony felt the woman staring at him. If he were not law enforcement, he would probably be getting upset right about now. But he had seen what one human being could do to another, and DV calls were the worst.

The doctor came to check Ziva just as Tony was about to say something to the nurse.

"Abdominal pain. Ziva, I am going to touch your abdomen. If it hurts, tell me." The doctor gently prodded Ziva, noticing her wince with each touch. Tony felt Ziva's grip on his hand tighten with each touch and he noticed tears leaking from her eyes. She gritted her teeth, "It hurts."

The nurse returned with a tablet and showed the doctor the information from the previous ER visit.

"Left AMA, and the x-ray of the shoulder shows no bone damage, but indications of soft tissue injury were noted. Looks like they both left AMA."

"Ziva, are all the bruises on your body from the accident?"

"No. I was in a fight with a perp."

"About twenty nine hours ago," Tony added. Ziva leaned into Tony's hand on her face. He stroked her cheek and held her hand, watching the doctor closely. Why did they need to rehash the old stuff; just get Ziva some needed relief and help.

"This may hurt, but we are going to do a sonogram on your abdomen to see what damage may be causing the pain. We are also going to start you on an IV, so that we can give you medications once we have a plan."

"Okay." Ziva and Tony responded together. The nurse removed the tampon and put Ziva on a waterproof pad and then added additional padding.

Ziva was moved to the sonography suite and Tony went with her. The sonogram tech took Ziva into the room almost immediately. She squeezed some gel on Ziva's abdomen and prepared to use the wand.

"With all of your bruises and the pain you are experiencing, this is probably going to hurt, but it is the best way to get a picture of what is going on inside you." Ziva nodded that she understood and squeezed Tony's hand. As the tech placed the wand on her, Tony thought Ziva might break his hand. He said nothing, allowing her to have a way to diffuse the pain.

The tech looked at the screen, and made some notes. She moved the wand, and Ziva gasped. "Sorry, I am trying not to hurt you."

"I will be fine."

Tony looked at Ziva; there was no way she was 'fine.' He stroked her cheek and told her to look at him. "Look at me, Zi. Look into my eyes; I'll help you through the pain." Ziva locked her gaze on Tony's eyes. He could see the pain in her eyes, those chocolate orbs that never shut up as far as he was concerned. If he could take her pain away, he would do it in a heartbeat.

The tech moved the wand and made some more notes. She turned to the pair, "Do you want to see your baby?"

"WHAT?" They spoke together.

The tech turned the monitor, and pointed out the developing baby. "You are about twelve weeks pregnant based on the size of the baby." She looked at the pair with their surprised looks. "Did you not know you were pregnant?" They both shook their heads no. "Oh. I am going to get these results to your doctor, and get you back to ER. He will give you a plan for treatment after he reviews the results and pictures."

Too stunned to say anything, they both nodded at the tech. As she left to call to have Ziva moved, Tony turned to Ziva. They met gazes.

"Pregnant?" Ziva was shocked. It hadn't even occurred to her that the reason for the missed periods could be pregnancy.

"I know." Tony was in shock as well. "That's about three months along. Wow."

The orderly came to move Ziva to the ER. Tony walked alongside the stretcher as they navigated the halls. He held Ziva's hand when he could, and was on autopilot, still wrapping his head around the news they had just received. He was going to be a father and Ziva was going to be a mother. OMG.

Ziva was settled into an ER exam room again, and the doctor came in within fifteen minutes. "Now that we know what is going on with you, we can give you something to stop the cramps and help with the pain. You are being admitted, and will be transferred to a room as soon as the process is completed. You will be given naproxen for pain and magnesium sulfate for the cramping via the IV. Both meds are safe for your baby. We will get you started before we move you to a room."

Tony and Ziva both nodded, still trying to grasp the news and wrap their heads around what they had just been told.

The IV meds were started and Ziva was moved to a room on the third floor of the hospital. Tony was allowed to stay with her, not that he would have left even if told he had to. He sat with Ziva, holding her hand. Once she was settled into the bed in the room, Tony placed a kiss on her forehead. Ziva tugged his hand, and pulled him to her. She kissed him on the lips, and he returned the kiss.

The pair rested foreheads on each other and looked into the other's eyes. "Parents; we are going to be parents," Ziva whispered. "I do not know what to say."

"I know," Tony whispered back. "You're going to be a mother, and I am going to be a father. WOW. I'm still trying to wrap my head around it all."

The pair sat gazing into each other's eyes, talking with their eyes for nearly half an hour. Ziva started feeling sleepy, as the meds started working their magic. "It's okay to sleep, Zi. I'll be right here. I'm not leaving you." They shared a few more kisses and Tony sat back in the chair, keeping Ziva's hand in his. "Laila tov, Ziva."

"Night, Tony." Ziva had noticed that that bleeding had almost stopped. She had been put on an absorbent pad in case the bleeding continued.

Both drifted to sleep, hands locked together.