Jay finally got some decent sleep for the first time in what felt like forever. He only got up once to use the bathroom overnight. He hadn't had any pain meds in a while so it did catch up with him around two am. Hailey convince him to let the nurse give him some morphine so he could continue to rest.
The next day Jay continued to improve. He was in the bathroom less, requiring less pain and nausea meds, even tolerated his "breakfast" of broth in the morning.
Dr. Morelock was pleased with his progress. He changed him to a low residue diet as planned, added some oral pain meds and switched the steroids to by mouth. "Wow, sitting up in the chair, in real clothes, you look like a new man Jay," he joked. "I think we'll be able to send you home tomorrow. You should continue to see an improvement over the next week or two as the Remicade continues to take effect. I'll set you up with a steroid taper, we have to reduce the dose slowly, steroids are not something you can just stop. Going forward we might have to adjust things based on your labs and symptoms but this is a good start. Let's have you try a low residue diet like we discussed yesterday and I want you to get up and walk a few times. Take a few laps around the floor for me. I'll be back in the morning, I'll try to get you out of here early if I can."
Jay had a relatively good day. He only needed pain meds once, pleased that the oral pain meds worked well enough. He tolerated his low residue diet and even convinced Hailey to sleep at home for the night. "There's no reason for you to be tired too, I'm feeling a lot better, I'll be fine by myself."
He was walking around the floor with Hailey as instructed. IV pole, free finally, his fluids were finally discontinued. "What's going on with work anyways?"
"Not sure, Voight made me take the week off. People were really concerned Jay."
"I know, I won't let it get this bad again. I really didn't think it was anything serious."
"Or we're you just being your stubborn self?"
"Could be," he obliged, shrugging his shoulders. "Maybe Kim could come over to the apartment tonight instead of coming to visit me. You need a little break, some time to relax."
She was hesitant but ultimately gave in. "Yeah that would be nice actually." She thought Jay might need some alone time too.
Jay appreciated the quiet night. He wasn't back to normal just yet but was thankful for the improvement. He hadn't realized how bad he had been feeling. Will stopped in after work again, happy to see him awake. "How's it going?"
"Better. I had some real food, walked around a bit, convinced Hailey to go home for the night."
"Good I'm glad Jay. I'm sure this whole thing surprised you a bit but don't wait this long next time alright?"
"I know, I know." Jay rolled his eyes, "I think I'm just going to have to get over it, stop being so stubborn." Will was taken aback, not expecting his swift shift in mindset.
"What is it with you and hospitals anyways. Is it Mom? Is it from the army? I know you were seriously injured on your first tour and I know I wasn't exactly around then."
Jay sighed, "maybe a bit of both. Things with mom were so intense toward the end. We were young, I was still trying to work through a lot of the physical and mental trauma I'd experienced. I know you know our humvee was hit by an IED and I almost died, but I don't think that was the worst part. I barely remember any of the actual accident itself. I just remember waking up in the chopper. Field medicine is far from gentle and I was bleeding out. It's the most pain I've ever felt and there was nothing I could do about it, I was in shock I couldn't speak. I was too unstable, they were trying to keep me alive, pain management wasn't something they had time to worry about it. I just remember the searing pain in my groin from the shrapnel, they were digging around in there trying to clamp the artery. The details are fuzzy but I just remember so much coming at me at once, hands, needles, restraints. I couldn't stop moving they didn't have a choice. When I woke up in the hospital there was so much attached to me it was suffocating."
Years ago Will would have been shocked by this conversation but Jay had grown so much, he had worked so hard to move on from all the trauma. He still didn't talk about it often, but he would occasionally open up to people he trusted. Will couldn't imagine going through all of that and then coming home to a terminally ill mother while you were still trying to recover. And then to have to go back after all of that. "I'm sorry you had to go through all of that, I'm sorry I wasn't here."
"It's okay, you were young too, in med school and residency. I used to blame you but it's not like you had a choice." Jay gave him a tight smile.
They were interrupted by the arrival of his dinner, Jay removed the cover revealing some plain pasta with butter, some applesauce, a dinner roll and some chocolate pudding. Jay slowly picked at it as they finished their conversation.
"I had a good conversation with Dr. Morelock. He made me realize if I want to get back to work, feel like myself I have to take this whole thing seriously. I'm too old to still be this stubborn about seeing a doctor and my health can no longer afford it."
Will smiled, "what a revelation." Jay chuckled softly, smiling back at him. He continued to pick at his dinner managing half of the pasta and a few bites of the dinner roll. Jay felt like his stomach was about to burst. Will noticed his discomfort. "Still working on that appetite, huh?"
Jay huffed, "Yes, it feels like my body forgot how to digest real food." He pushed his tray away and leaned back closing his eyes, trying to take some deep breaths.
"You need meds?"
"Not yet, let's give it some time." Jay quickly changed the subject. "The cubs playing tonight?"
"Yeah I think so, last game of the series." Will found the remote, turning on the tv. They started talking about all things Chicago sports and settled into a light banter. After a few inning Will decided to leave, wanting Jay to rest. He had been watching Jay, he still seemed pretty uncomfortable. He noticed the grimace as Jay rushed to the bathroom. Once the door was closed he could be the groans coming from inside. When Jay came out he clearly needed some pain meds.
"At least take some oral meds Jay." Getting back into bed he shook his head yes, pressing the call light.
The night nurse appeared quickly. It was just after change of shift and he hasn't met her before. She was an older, seasoned nurse. "What can I do for you sir?
"Can I get some pain meds please?"
"What's your pain on a scale of 1 to 10."
"Seven," he replied.
"Okay, I'll go grab some morphine then."
"Can I have the oral meds instead?"
"Well your pain score qualifies you for IV medication."
"I know but I'm supposed to go home tomorrow," he insisted. "I won't have morphine at home, will I?"
The mild mannered but serious nurse shrugged, "I'll have to note it in your chart."
"That's fine."
She left quickly returning with the meds. After watching him take them. She took his vitals and assessed him. Removing his dinner tray from the meal she looked at how much he had finished. "Food still giving you some trouble."
"A little," he answered. "Sure you're ready to go home tomorrow, sir?" She was clearly a no nonsense nurse.
"Yes, and please call me Jay." She watched him cradle his abdomen, taking deep breaths while waiting for the meds to take effect. "Sure, I'm Carol. I'll be with you tonight. Do you want a hot pack for your stomach while waiting for the meds to kick in?"
Jay shook his yes silently. She returned with the hot pack already popped. Placing it on his abdomen he felt his muscles relax, providing some relief.
Will sat with him in silence for a bit. When he seemed more comfortable, he decided to leave for the night letting him rest.
The next morning Jay awoke to the aroma of coffee. Hailey was already sitting in the chair. "You got a cup for me," Jay pouted. She pulled a cup out from behind the chair that she had been hiding, "only if the nurse agrees."
He jokingly glared over at her, "fine, you run a tight ship Mrs. Halstead."
The nurse had come around shortly after. He brought Jay's breakfast, thankfully he agreed that he could have a proper cup of coffee. Vitals were taken and assessment were completed before Jay could eat.
As Jay started eating Hailey asked, "how was last night, you get some rest."
"Not bad, was a bit rough after dinner but the night nurse gave me a pain pill and hot pack. That took care of it. I think I got up at night once for the bathroom but no nausea so that's a win."
"Hopefully we can get out of here this morning."
"Fingers crossed." Jay continued to work on his breakfast, he did well, finishing most of it, before Dr. Morelock arrived.
"Good morning, how we feeling?"
"Pretty good."
"I looked over your chart this morning. Labs look better. Inflammatory markers are down even more, still high but that's to be expected. Electrolytes look good, your hemoglobin is even up a respectable amount. You were probably passing small amounts of blood that didn't know it. I looked at your intake and output. No vomiting only four bowel movement yesterday correct?"
"Sounds right," Jay responded.
"How's the appetite this morning, doesn't look like you tolerated dinner all that well last night."
"Better."
"And what about pain, the night nurse wrote a note that you were reporting pain at a 7/10 but refusing the IV morphine as prescribe and requested PO pain medication."
"Some mild cramps right now, that's all. I just didn't want to rely on the morphine knowing I was going home today. Carol's a tattle tale."
Dr. Morelock chuckled, "fair enough. Alright let me do a quick exam."
"So everything looks good, I'd like to see you eating more so I really need you to focus on that at home. I think you're still fine to discharge today. Like we talked about yesterday try to avoid too much fiber for now, white grains instead of whole grains, no nuts or seeds. If you do have fruit or vegetables, especially vegetables try to remove the skin. It won't be like this forever but let's give your digestive system a break. Keep it bland for now."
"I will write you a script for the steroid taper, that should be completed in a couple days. The steroids do increase your appetite and can make you pretty restless so as you taper you might notice a bit of a dip. I will also send you home with a script for zofran and a small pain med prescriptions. If you need something milder for pain you can take tylenol. Mild pain relievers that also treat inflammation like ibuprofen and Aleve are off limits. I'd like to start you on medication called mesalamine, unlike the Remicade which targets your immune system this medication works in the bowel itself to reduce inflammation. You take 800 mg, 3 times a day. I would suggest taking it with meals, sometime it makes people nauseous on an empty stomach."
"The Remicade should continue to improve your symptoms over the new week or so. There is a follow up appointment scheduled for you in three and a half weeks. At that point we will take some lab work again and reevaluate your symptoms. Based on that we'll determine your next infusion."
"If before that appointment your symptoms are starting to get worse again or if you notice any blood in your stool call my office."
"Like we discussed on Wednesday I want you to take next week off. You can return to light duty the following week. I really want you to see you put on a bit of weight before I release you for field work. You can do some light cardio, but nothing crazy okay. What questions can I answer?"
Both Jay and Hailey were overwhelmed, but Dr. Morelock was exceedingly thorough. "I think I got it all., what about you Hailey," Jay asked.
"I think I'm good too."
"Great, I will start your discharge paperwork. The nurse will bring all that in once it's done. It will have all the information we just talked about, the details for your follow up appointment will be on there, as well as the number to the office and the after hours line. Let's see if we can get you out of here before lunch., I'll see you in a few weeks." Dr Morelock shook both of their hands before saying goodbye.
About an hour later they were on their way home.