After receiving several doses of IV steroids at the higher dose that evening and overnight Jay was all set up to receive his first infusion of Remicade in the morning. The day nurse came in promptly at eight am and started getting everything ready. She explained the side effects of this new medication and warned him of any adverse reactions. They would go slow the first time, to make he was not having any sort or reaction.
Jay was still miserable, so she gave him some pain meds and asked him if he wanted to try some broth. He looked at her meekly, "I don't think my stomach is ready for anything, sorry."
"Hey, its okay. We'll see how you're feeling this afternoon." She did a quick assessment and left him to rest. Hailey had been sleeping in the lounge chair next to his bed. She was so exhausted that she slept through the first half of the infusion.
At nine thirty the nurse came into check on him. While the nurse was checking the pump, his IV and making sure he was feeling okay, Hailey stirred. "Hey," she said sleepily. "What did I miss?"
The nurse spoke. "So we started the Remicade infusion about an hour ago. He seems to be tolerating it fine so I'm gonna increase the rate. We've gotten some pain meds this morning as well." Jay nodded as she continued. "How are those working Jay?"
"Good." His pain wasn't gone but was certainly much more tolerable. "Great, I should be back around eleven. The Remicade will be done and I'll have your next dose of steroids. Do you guys need anything else right now?"
Jay shock his head no. Hailey then interjected, "Is it okay if I go home and get him some regular clothes to wear, like sweats and a sweatshirt?"
"Yeah, of course. Sweats are fine, I would just do a loose t-shirt so the IVs don't get messed up on accident. When you're ready to get dressed just let me know and I can unhook your IV for a minute. Alright I'll be back around in a little bit. Press your call light if you need anything please. "
The nurse left, then Hailey and Jay started chatting. "How are you feeling this morning?"
"Okay, maybe a little better. I was still up a lot last night in the bathroom but maybe not as much. I don't know. I'm not so nauseous so maybe I'll try something small for lunch."
"Good," Hailey smiled. "Let me go grab some clothes from the apartment and take a shower. Do you want me to bring anything else?"
"Maybe the iPad. I'm starting to get a little bored here."
"Sure," she finished and gave him a quick kiss goodbye.
Around eleven the nurse returned as promised. She stopped the Remicade and gave him the IV steroids. "How about that broth?"
"Uh Let's try." Jay said soft with a slight smile.
"Coming right up."
Jay was "eating" the broth slowly when Dr Morelock walked in.
"Well look at that, good to see you trying some clear liquids. I can see a very slight improvement in your inflammatory markers on your blood work this morning . We'll continue to trend them for the next few days. If they continue to decrease we will start lowering the dose of IV steroids. Hopefully over the next week you will continue to see an improvement in your symptoms if the Remicade is helping and we'll be able to get you home. Maybe tomorrow we can see if you will tolerate a low residue diet with some more solid food and then possibly get you discharged the following day. How does that sound?"
"That would be great." Jay perked up as he took another spoonful. "What changes will I have to make to my diet when I go home?"
"Going forward anything high fiber should be avoided in excess. So mostly white rice, white bread, white pasta, plain cereal etc. Think root vegetables like carrots and potatoes instead of lots of salad. Eggs and dairy are fine. Not too much fruit, again because of the fiber. I will have the nurse bring in some education materials so you have a guide for when you go home. Let me do a quick exam okay?
Jay agreed and Dr. Morelock quickly assessed him so he could get back to his "lunch." He noted the discomfort still present while palpating his abdomen. "I saw you had a total of 8 bowel movements yesterday, does that sound right?"
Jay shook his head yes as he swallows another bite. "It's still a lot, but moving in the right direction, the steroid are definitely helping. Anything else I can do for you today?"
Jay looked up and hesitated, "Umm this might be stupid but I can still be a cop right? This won't affect my job?"
Dr Morelock looked at him with a kind smile and sat down next to him in the chair. He could tell from his first meeting with Jay that being a police detective was vitally important to who he was as a person. "I don't see any problem with you returning to work. However, because of the physical nature of your job I would like you to put bak on a bit of the weight you lost and make sure you can maintain a decent appetite before returning to any intense physical work. Hopefully we'll be able to send you home on Friday. I want you take next week off to rest and build up some strength. After we follow up in a few weeks I'll release you for full duty."
On one hand Jay was relieved, on the other he was far from happy that he would have to take almost a month, in addition to all the days he had already missed out of the field. Dr Morelock could see the disappointment but insisted, "I know. I know, but you're coming out of a severe flare here. Your body needs time to recover. I really think you're going to have to slow down a bit to ensure a successful return to work and your long term health. Part of managing a chronic condition like this is managing stress well and obviously you have a very stressful job. I need you to understand that taking care of yourself and being proactive will allow you to remain as healthy as possible. Additionally these new medications make you immunocompromised, so you need to be careful. A small infection could become serious quickly."
"As long as I can still do my job."
"I have no doubt Jay. Just give yourself some time to adjust. I'll see ya in the morning okay."
"Thank you really." Jay murmured as Dr Morelock left. He continued to slowly finish his broth. By the time he was done he could feel the growing discomfort in his abdomen. He was starting to feel really nauseous, pushing the table away he laid his head back attempting to breathe through it. He tried to wait it out, but eventually gave in, pressing the call light.
Several minutes later his nurse appeared. By this point he was on the verge of vomiting. He lifted his head up from the pillow, holding his stomach. "I finished but I'm really nauseous."
"I'll be right back with some zofran." She returned quickly with the zofran. After administering it, "I'll come check on you in a bit." She placed an emesis bun next to him just in case Jay continued to lie there with his eyes closed simply trying not to puke.
Will got a lunch break around 1300, taking the opportunity to go check on his brother. As he was rounding about to enter Jays room he heard the sound of retching and a barely audible "fuck." Entering the room he saw Jay dry heaving, the emesis bag already full of bile. He grabbed another bag off the wall, disposing of the bag in the bathroom, noting how much was in there. He left the bathroom with some mouthwash, handing Jay an empty cup to rinse and spit. Jay did silently before collapsing back into the pillows. He still looked rather green. Will silently pressed his call button. Jay muttered softly, "thanks."
"I would ask how you're feeling but…"
"Yeah the broth won this round, next time though."
Will smirked as the nurse walked in, "What's up Jay?"
Will took over, "He just vomited about 500 mLs of bilious emesis. Could he get something for nausea."
"I just gave him some zofran twenty minutes ago, maybe less. Let's try phenergen this time. How's the pain Jay?"
"Getting worse.."
"You want some morphine too?"
"Please," he answered and the nurse was on her way. Will wasn't sure if he was impressed or concerned by Jay's honesty.
"Hailey called, said she was at a standstill on the Dan Ryan expressway. Some big accident apparently. Said she tried to call but you didn't answer."
"Yeah, I was really focused on not puking."
The nurse returned with drugs in tow. Shortly after administering Jays eyes were getting heavy, giving into the sedative effect of the meds. "Just sleep Jay, it's okay."
Will sat next to a sleeping Jay for the rest of his break. He was about to leave when Hailey finally arrived. "Sorry, sorry traffic was the worst."
"He's been sleeping mostly. I guess he tried some broth around lunchtime and it didn't go so well. When I came up here he had just finished throwing up even though he had already had some anti nausea meds. The nurse gave him phenergen, the heavy duty one and some morphine. Been out since."
"Has Dr Morelock been in?"
"I would assume so, but not while I've been here. I need to head back down, maybe I'll come back up after my shift."
"Okay." She waved bye, parking herself in the chair next to Jays bed. She looked through her phone while Jay continued to sleep. While driving she had gotten a text from Voight asking if Jay was up for visitors. She hesitated but eventually responded, telling him that Jay was sleeping and she would ask him when he woke up. Knowing Jay was very private she wasn't sure how he would feel about it.
Jay continued sleeping for another few hours. "Hey sleepy head, you feeling better," she asked when he started to rouse, as she playfully messed with his hair.
He sighed "yes." Looking back at her, "it look that bad?"
"No, just sticking up all over the place," she giggled "very boyish Halstead." He grinned before taking a sip of ginger ale that had appeared while he was sleeping. "I brought you some clothes."
"Yesss," he started to stand up, grabbing the sweatpants. After getting those on, he attempted the T-shirt but quickly got tangled in his IV tubing
"I think that's why she asked us to call her remember" she said as she hit the call button.
"Hey Hailey," the nurse said as she entered the room. "Got some clothes I see, let me pause your fluids so you can put your shirt on." Unhooking the tubing asking, "do you want to try some more clears you seem a little less green."
"Ummm… maybe something smaller, I think the broth was too much at once?"
"Let's do it, how about some jello and apple juice?
"Yeah that sounds okay."
"You get dressed and I'll come back with some. How's your pain?"
"Not bad, thanks for the meds earlier."
"Of course, be right back." He removed his gown and quickly put the shirt on while the nurse was gone. "Can we switch spots for a bit?"
"I will gladly take the bed Jay," she smirked sitting down on the side of the bed. "Don't act like you didn't nap in our nice comfy bed at home," he joked back. The nurse walked in, hooked his IV back up and set the apple juice and some red jello down on the bedside table. "Let me know how it goes."
He slowly ate as he caught Hailey up in his conversation with Dr. Morelock. He set the empty jello cup on the table victoriously. Even a small cup of apple juice and jello felt like progress at this point. "Proud of yourself," she teased.
"Why yes I am."
"Voight texted me earlier to ask if you were up for a few visitors?"
"Yeah that's fine." However she could sense is hesitation. She raised her eyebrows, clearly questioning him. "It is, might as well rip the bandaid off."
"What do you mean?"
"I waited so long, no sweeping this under the rug. Plus they're gonna notice when I'm out of the field for another month."
"I promise it won't be a thing Jay, you can give as much or as little detail as you want."
"I know, I know. It just feels really personal. What exactly have you told them?"
"Nothing much. I told Voight you were diagnosed with ulcerative colitis and that you'd be on some medications to help control it and might have to make some changes. That it's. I was a bit more vague with Kim. I figured she'd let everyone else know."
"Who's coming anyways?"
"Uh, let me check." She glanced down at her phone. "Adam, Kev and Voight. Kim is staying home with Mikayla. She was hoping to stop by tomorrow."
"Okay, yeah," he nodded. She pulled out the iPad and they bickered back and forth about what movie they were gonna watch. "Patients choice, right Mrs Halstead?"
She rolled her eyes, knowing that he was just teasing. "I suppose, you gonna be able to sit through it Mr. Halstead," she teased right back as he picked out Starsky & Hutch.
"Fair point," he said as he feigned hurt feelings. They watched the movie for another hour or so. Jay was just coming back from the bathroom , rolling his IV pole with him, when the team arrived. He was grateful that he was wearing real close and that Hailey was still claiming in the bed. He felt a bit more like himself this way.
"Hey man," said Adam giving him a quick bro hug, followed by Kev. Voight trailed behind with a quick cursory wave and nod. Hailey sat up on the side of the bed as Adam and Kevin leaned against the low window sill. Voight naturally stood in the corner. "How are you feeling," they seeming all asked in unison.
"Better, getting there." They could all see the improvement, he had some color to his cheeks and showed no obvious signs of discomfort. Kevin was the first one to ask, trying not to pry too much. "They figure out what going on?"
"Yeah, so I've got Ulcerative colitis. I guess my immune system is overactive and thinks my large intestine is some kind of foreign object or infection that's it needs to fight off," he clumsily explained. "They started me on some steroids to help with the inflammation and an immunosuppressant. I'll have to change my diet a bit and take some time out of the field, but should be back to normal soon. Just something I'll have to manage." He shrugged, that was clearly all that Jay was willing to divulge.
All three nodded. Kevin interjected, "glad you're on the up and up Jay, you were starting to worry us this time."
"I know," Jay muttered as he rolled his eyes. They quickly moved on to chatting about work, the cubs; and random small talk. Voight mostly kept to himself, glad that his detective seemed to be doing better, but also trying to get a read on him. Jay certainly had a reputation of being stubborn, almost neglectful of his own medical care. He ate healthy and was clearly in the best shape of them all, but avoided doctors to a fault. Voight couldn't tell if Jay was shocked into acceptance by a lifelong diagnosis, still in denial or a mix of both. He looked to Hailey for an answer but she seemed to be just as bewildered.
After about thirty minutes the boys got up to leave. Hailey had made them promise that they wouldn't stay too long. While Jay looked better they weren't completely fooled, still noting the signs of fatigue and weight loss. "It was good to see you, keep getting better, and listen to our girl over here."
"Thanks for stopping by, guys " Jay said as they waved goodbye before walking out. He looked to Voight who hadn't moved, but was thankful that he didn't have to ask him to stay behind. He wanted to talk to him about time off and desk duty in private. Before Jay could start Voight asked, "so how are you really doing?"
Jay stopped to think for a second, "I really am feeling better. I'm still nauseous and uncomfortable , in the bathroom more than I'd like but my appetites improving. Everything is getting better." Voight looked to Hailey to see if he was being honest and she looked convinced. "I just wanted to talk to you about returning to work. My GI doctor thinks I can go home on Friday, but he wants me to take next week off. He says I can come back on desk duty for a few weeks and once I follow up with him he will hopefully be able to clear me fully."
"Take whatever time you need Jay."
"I just wanted to keep you informed, I'm gonna have to make some adjustments, make sure I'm focused on taking care of myself properly so I can do my job. Ulcerative colitis can come and go. You can have period of no or minimal symptoms and periods of intense symptoms like I've been having. So this is something that I'll have to be aware of going forward. It's hard to predict how easy or hard it will be to manage right now. Some cases are easier or harder than others. The medications, the immunosuppressants are apparently pretty strong so I have to be careful, especially in the winter time."
Voight was appreciative of Jay's honesty, impressed that he was being so open. He could certainly could see the growth in his detective. Years ago Jay would have only divulged the least amount of information possible, managing everything himself to the point of self destruction.
"If we need to make adjustments we will. We'll figure it out," he said flatly. "I'm gonna head out, I just wanted to check in. If I can do anything let me know." He waved goodbye and promptly left. Jay was grateful to be alone, it was still relatively early but he was exhausted.
The night nurse came in shortly after to introduce herself and get his vitals. She followed with a quick assessment and asked him if he needed anything. Initially he said no, but she asked him if he wanted to try a small snack like a popsicle and he agreed. He took another trip to the bathroom, when he returned Hailey had resumed her usual spit in the chair. The nurse had left the popsicle on his bedside table. He sat in bed feeling like a little kid eating his popsicle before bedtime. They continued to watch the rest of their movie while chatting until exhaustion won. Hailey looked over and Jay was sound asleep. She covered him up a bit more and tiptoed over to the light switch to turn it off and made herself comfy for the night.
Will stayed late to finish up his notes. He walked up to Jays room just after nine, surprised by the darkness he returned to the nurses station. He got a quick update from Jay's nurse and was relieved that Jay seemed to be improving.