Johnny Angel Ch. 34
Disclaimer: See chapter one.
Author's Note: A huge thank you goes out to everyone who read and reviewed and to the reviewers I couldn't reply to directly.
Previously: "Thanks Bobby, I don't know what we'd do without ya man, You've been like a father to us since Dad…..well, I just want you to know you mean a lot to us too, " Dean stated gratefully.
Scrubbing a hand across the five o'clock growth that studded his jaw as he sat at Sam's bedside a little while later, Dean wished he could just wish this latest setback away. Sam had been doing so well in his recovery from the catatonia, and he was worried this latest obstacle would send Sam into a state of depression, something they definitely didn't need right now if they were going to keep his brother optimistic about getting back on his feet soon.
"Why the hell does fate always seem to have it in for you, little brother?" Dean muttered under his breath as he reached out to grasp his dozing sibling's hand and give it a light squeeze. "I don't know how much more you can take before you finally break."
"That's not going to happen," Bobby stated as he walked back into the room, two cups of hot coffee held in hand, to overhear Dean's comment. "And you wanna know why? Because he's a Winchester and Winchester's never quit."
"But what if this is the straw that finally breaks the camel's back, so to speak?" Dean queried, his voice low as to keep from disturbing his brother's sleep.
"Then we step in and carry the burden for a while. We give Sam all the support he needs until he is ready to handle things by himself again," Bobby answered concisely. "Of course, that won't be anything new to you. You've been there every time Sam stumbled in his life to lift him back up again and you'll be there for him this time too."
"You've got that right," Dean croaked as he fought back the lump that was forming in his throat. "So when did you get to be so smart, huh?"
"You mean you're just now noticing that, ya dimwit?" Bobby questioned sarcastically as he rolled his eyes to lighten the moment.
"You know, if you two would just kiss and get it over with, a guy could actually get some sleep in here," Sam stated with a yawn as he opened weary eyes to see Dean and Bobby sitting at his bedside with steaming cups of coffee held in their hands. "Where's mine?"
"You snooze, you lose, Kiddo" Dean answered with a smirk as he tipped the cup up and took a sip of the brew.
"Gee, thanks for nothing, Dude" Sam pouted, his puppy dogs eyes coming out in full force as he crossed his arms over his chest and looked at the cup longingly. Sure, it was hospital coffee, but it was better than no coffee at all.
"Awww, don't he just look too cute with those sorrowful eyes," Bobby guffawed as he took in the expression that had always had John and Dean giving into Sam willingly so many times over the years. An expression that had worked on him on more than just a few occasions too. "Sorry Sport, but no coffee for you until the doctor okays it."
"But, that's not fa…" Sam's voice drifted off as the door to his room opened and the doctor who had examined him earlier in the E.R. returned.
"Hello gentlemen, I hope I'm not disrupting anything, but I needed to tell Sam here that his tests have been set up and that a lab technician from the Radiology Department will be coming to take him for a Doppler ultrasound exam of his extremities in approximately ten minutes or so," Dr. Joseph Jernigan informed the three men in the room.
"What does that entail Doc? I mean, it won't hurt Sammy or anything as you mentioned earlier, right?" Dean asked, needing to know exactly what his brother would be going through with the test.
"Dean, I can promise you that your brother will experience little to no discomfort at all with this test as it is noninvasive," the doctor answered as he focused his attention on the anxious brother to reassure him reassure him. "And to answer your other question, we will be placing blood pressure cuffs on different parts of Sam's body including his thighs, calves and ankles, as well as on different parts of the arms to record the different blood pressures as the test is done. The technician will then use a handheld device, called a transducer, to scan over the arteries from Sam's groin to his calf. This transducer will be used to view the veins from different angles and to measure how well the blood is flowing through Sam's leg and arms. The device will then transmit the images it picks up to the ultrasound machine that records the images. The radiologist will then view these images afterwards to check for signs of blockages and report them back to me.
"Sounds simple enough I guess. How long will the ultrasound last?" Sam questioned as he glanced up at the doctor from the bed.
"The test usually takes anywhere from fifteen to thirty minutes to complete and then it will take another few hours or so to get the results back," Dr. Jernigan answered with a smile. "At the latest, we should have your test results back by tomorrow morning."
"That's good news at least. Uh, listen up Doc. Sam here was hoping for a cup of coffee. Would it be alright for me to go get him some?" Bobby asked, feeling just a tad bit guilty at not having bought some earlier for the young hunter, especially after having had those doleful eyes of Sam's turned on him.
"Actually, it would be better if he has the coffee after the tests. I don't want the caffeine to have a negative effect on the scanning process," the doctor answered forlornly. "Sorry Sam."
"S'okay Doc. I know you just want what's best for me," Sam replied with a sigh.
"We all do, bro. We all do," Dean voiced seriously as he patted his brother comfortingly on the chest.
~~Supernatural~~
A few hours later found Bobby and Dean standing nervously at Sam's bedside as the doctor delivered the news of the test results.
"Sam, I'm sorry to report that the Doppler ultrasound exam has confirmed my suspicions and that you do indeed have a blood clot deep in one of the veins of your right thigh," Dr. Jernigan stated with a somber expression. "Because of this, I am going to start you on the Heparin, which is an anticoagulant, right away to thin your blood. This will help to keep any new blood clots from forming and will also keep the one you have now from getting any bigger. Instead of administering the medication intravenously which would require a long hospital stay, I am going to start you on the newer form of injections. The injections will be administered through the stomach at least twice a day. Once that is given, you will then start taking the warfarin which will be given by mouth. Once we have your warfarin levels right for your system, you'll be able to go home."
"So how long will he be required to stay until you get his medication levels right?" Dean asked knowing very well that Sam was already anxious to get back to Bobby's place.
"Well, the injections need to be given for at least eight days, but if you or Mr. Singer are willing to learn the proper way to give them, I'd say Sam can go home within the next two to three days," Joseph answered with a smile as he pulled on a pair of sterile gloves.
"I've had a little training as a medic Doc. I'll be more than happy to give Sam his injections as long as it is okay with the Kid," Bobby replied immediately knowing how much it would upset Dean to have to give Sam the injections since the boy never could stand being the cause of his little brother's pain. Of course, he didn't tell the doctor that training was a 'learning on the job experience' during his early years as a hunter.
"That would be fantastic," Dr. Jernigan stated as a nurse walked into the room carrying the vial of medication and syringe he needed to administer the medication. Accepting the items and removing the syringe from the sterile wrapping, the doctor went through the steps with Bobby of how to withdraw the medication from the vial, check for the correct dosage, and how to remove any air bubbles from the heparin before preparing to administer the injection.
"Okay, before giving the injection, the first thing you want to do is locate an site on the abdomen approximately two inches from the navel area. Once that's done, clean the area thoroughly with an alcohol pad and then pinch a section of the skin about three inches wide to form a thick hold," the doctor informed Bobby, demonstrating each step as he went through it. "Once you have that done, you will insert the needle at a ninety degree angle into the skin and then press the plunger slowly, just as I am doing now to inject the medication."
Wincing a little in discomfort as the medication was injected, Sam tried to smile through the burning sensation it caused knowing that Bobby was carefully watching his every move, not to mention his over protective big brother.
Releasing the skin, the doctor then pulled the needle out and told Sam to make sure he didn't rub the injection site as it could cause irritation to the sensitive skin before focusing his attention on Bobby. "Do you have any questions about the procedure Mr. Singer?"
"Nah, I think I've got it covered Doc," Bobby answered assuredly, having given many injections in his career as a hunter.
"Then I would like to witness you give Sam his injection at least once before he is released into your care so I can be assured that you will follow the proper steps in giving the medication," Dr Jernigan told the elder hunter authoritatively as he handed the warfarin medicine to Sam along with a small cup of water to help him swallow the pills down.
"That won't be a problem. Just let me know when you want me to do it," Bobby said as he pulled off his ball cap and tugged a hand through his slightly graying hair As Sam downed his medication.
"Okay, well then, I guess I will leave you gentleman alone. I know it is getting late,' Dr. Jernigan stated as he deposited the used needle into the proper receptacle. Walking to the door to exit the room, he turned around and said, "Get a good night's sleep Sam. Nurse Judy will be here in the morning to give you your sponge bath and to fit your right leg with a pressure stocking."
TBC This chapter is dedicated to my friend Judyann for inspiring the pouting scene with a photo op she shared with me from the NJ Supernatural Convention. Jared was just too cute in the photo!