Johnny Angel Ch. 13

Disclaimer: See chapter one

Previously: "Anytime Champ," Dean retorted as he watched his baby brother fade off to sleep. He just hoped Sam could sleep through the rest of the night, knowing that he would need all the rest he could get once Sam's physical therapy was started.

Awakened early the next morning by the sound of soft feet treading across the polished tile floor, Sam opened his eyes to see the doctor who had spoken to him the previous evening approaching his bed with a smile upon her face.

"It's good to see you awake Sam, how are you feeling this morning?" Dr. Alison Thomas questioned with a whisper, upon noticing the other two men in the room still sleeping in the reclining chairs that had been brought in for them to rest in throughout the night.

"M'okay," Sam answered, watching the doctor intently as she grasped his wrist and wrapped her fingers around it to take his radial pulse. "I'd be much better though if you would take this damn tube out of my nose."

"I'm sorry Sam, but you need the nasogastric tube to stay in until you can start taking in nutrients yourself," Ali apologized as she reached out to brush away the errant bangs that were falling into her patient's expressive blue-green eyes.

"So give me something to eat," Sam retorted with a weary sigh.

"It's not that easy I'm afraid," the doctor informed her patient with a somber smile. "Your stomach isn't ready to handle solid foods just yet."

"Lady, you don't know me well enough to know what my stomach can and can't handle," Sam responded a little scathingly at the doctor's presumption of knowing what he was or wasn't ready for.

"Sam, the doctor's right," Dean stated, entering into the conversation after having been awakened by the chat between his brother and the doctor. "Just give it a little time for your body to adjust to being awake again."

"Damn it Dean, I'm not a baby. I've been eating like a big boy for a long time now," Sam rebuked angrily. How the hell was he supposed to get out of the hospital soon if they kept treating him like an invalid.

"I know your not, Tiger. But you've got to realize you've been out of it for quite a while now. You're digestive system has to be reintroduced to food slowly or it's going to cause you a lot of discomfort and possibly make things worse." Dean stated calmly. He could understand his brother being upset, knowing just how badly his sibling hated hospitals.

"Dean, please, I just want to get out of here. We can go back to Bobby's. I promise to let you two help me until I get my strength back," Sam begged as his eyes misted over.

"Tell ya what, I'll make you a deal Sam. If you can get out of that bed and stand on your own two feet, then I'll do as you ask." Dean offered, much to the horror of Sam's doctor who was standing nearby.

"O-Okay," Sam agreed, as he took a deep breath, willing his body to co-operate with him on this one. "Help me up?"

"Yeah, of course," Dean replied, knowing exactly what would happen to his brother once Sam became upright. Wrapping his hands around Sam's shoulders, he gently pulled his brother up into a sitting position.

"Thanks De…" Sam started to say, just before his eyes rolled up in his head and he passed out from the sudden drop in blood pressure, his body unaccustomed to being in a vertical position.

Catching his brother as he slumped forward, Dean wrapped his arms around Sam for just a minute and hugged him tightly before gently laying him back down on the bed. "Looks like you'll be staying here kiddo," Dean whispered, ruffling his sibling's hair as Sam regained consciousness.

"Wha-what 'appened?" Sam queried upon waking up to realize he was once again in a prone position on the bed.

"You passed out, Champ," Bobby answered, scratching a hand through his five o'clock shadow of a beard as he walked over to join the others. He had been watching the brothers from across the room as Sam tried to persuade Dean into letting him leave the hospital. He had almost blown a gasket when he had heard Dean agree, but then he also knew Dean wouldn't put his baby brother's health at risk. He was glad to see that he had been right.

"But, I don't understand how…?"

"Basically, you experienced what is known as Postural hypotension Sam. What that means is your body suffered a sudden drop in blood pressure when you sat up after a period of prolonged bedrest from the catatonia. Normally, when a person sits up or stands, gravity causes blood to pool in the lower extremities. Usually, your body compensates by increasing your heart rate and constricting your blood vessels, thereby ensuring that enough blood gets back to your brain. But in your case, your body failed to compensate for the change in altitude which caused a drastic reduction in blood pressure, thereby causing you to faint." Alison explained, making sure Sam understood the medical reason for his fainting spell.

"In other words Sammy, you're here for the duration, or at least until I'm satisfied that you're healthy enough to leave and that Bobby and I can take care of things," Dean added, wanting his brother to know in no uncertain terms that he was staying in the hospital whether he liked it or not. "Am I understood?" Dean questioned in his best John Winchester imitation.

"Okay, for now," Sam agreed with a yawn, knowing there was no way he could win this argument, not when he was so damn weak. But as soon as he regained enough strength to stand on his own, he was going to renegotiate the deal. That was his last thought as he drifted off to sleep once again.

"Sleep well Tiger, you're going to need it," Dean whispered as he carded his fingers through his brother's chestnut colored hair. Once he was sure his brother was in a deep restful sleep, he decided to get a little shut eye himself knowing that they had a long few weeks ahead of them.

Pulling up a chair as Dean faded off to sleep, Bobby sat down to watch over the children that he now considered his own.

~~SUPERNATURAL~~

Sam had just woken up later that afternoon and was talking to his brother and Bobby when he noticed a man of approximately thirty years of age and a rugged build come striding confidently into the room. Giving the scrub clad man a quizzical look, he hoped he wasn't there to give him a sponge bath. No way in hell was he going to let another man bathe him.

"Hi Sam, my name is Brian Matthews and I'll be your Physical Therapist while you're here in the hospital," Brian stated with a smile as he walked over to his patient's bed to grasp Sam's hand and give it a firm handshake. He sighed inwardly as he noted the lack of strength in Sam's grip. "I wanted to come meet you and talk with you about what to expect with your upcoming rehabilitation exercises. Now, before we get started, can I ask who your support system is?" Brian inquired as he nodded towards Dean and Bobby with his head.

"Yeah, okay. The one to my left is my brother Dean and the one in the grungy ball cap is our Uncle Bobby." Sam answered, watching as his brother and then Bobby reached out to shake the therapist's hand.

"It's nice to meet you gentlemen. From what Ali, I mean Dr. Thomas, has told me, you both have expressed an interest in helping with Sam's PT. Is that correct?" Brian asked, glad to know that Sam had a family who was so willing to participate so fully in his recovery.

"Damn straight," Dean replied, giving Sam's arm a light squeeze. "He's my baby brother and I'd do anything for him, we both would."

"That's great. I'm sure it will help Sam recover much more quickly," Brian intoned as he pulled up a chair to sit down and turned his attention towards the youngest Winchester. "Sam, I'd like to explain to you and your family what to expect from your physical therapy for the next few weeks. Because you've been in a catatonic state, I plan to start with what is referred to as passive therapy exercises. In other words, I will be manipulating your muscles by doing some range of motion exercises. Afterwards, we will move to some muscle strengthening exercises where you will be required to participate in putting forth some effort to rebuild your muscle tone which will prepare you for the ambulatory exercises. The ambulatory exercises will be the main goal of our rehabilitation…to get you up and walking on your own again. Of course, we will also work on some general conditioning exercises which will help to improve your overall fitness as well as cardiovascular fitness. I'd like to start tomorrow if that's okay with all of you."

"That sounds great Brian, but I'm concerned how the PT is going to affect Sam to start with. I mean he couldn't even sit up without passing out earlier and I don't want to put too much on him too soon," Dean informed the therapist.

"Actually Dean, Alison already talked with me about Sam's orthostatic hypotension or sudden drop in blood pressure and I have already made plans to combat the problem. Since Sam has basically been on bedrest for quite a while, we will use a tilt table to retrain his blood vessels to constrict and dilate appropriately in response to changes in posture. How long Sam will remain on it depends on how well his body tolerates it and how well he responds to it," Brian apprised Dean.

"So basically what you're saying is that once Sam can handle sitting up again, he can begin the more rigorous part of his physical therapy sessions, right?" Bobby asked, wanting to make sure he understood everything correctly.

"Exactly," Brian answered with a grin.

"So, how do we do our part to help the kid then?" Bobby asked, smiling when he saw Sam roll his eyes upon being referred to as a kid.

"By helping Sam with his range of motion exercises when I can't be here to help him. Together, we will decide on what is the best plan for Sam and then I will instruct you as to how to perform the passive exercises in the correct way to help keep Sam's muscles and joints as healthy as possible. And once he starts the more aggressive part of the therapy, Sam is going to need your encouragement to get through the rigorous workouts. There's bound to be times when he'll feel like giving up, that's when he is going to need your support the most," Brian stated bluntly. He wanted the family to know that Sam was in for some very tough times ahead.

"Don't worry Brian, you can count on me and Bobby to give Sammy all the support he needs," Dean declared vehemently. He'd always been there for his brother, and that wasn't about to change now. Come hell or high water, they were getting their Sammy back.

TBC