Dreams Upon A Silver Pine Branch

Chapter 11: Standing By Each Other

"There," the physician straightened the tubes that came out of the catheter and filter attached to Chiharu's abdomen. "I've infused her with her usual dialysis solution. This is only a short term management of her condition, though, so I recommend that she starts switching from bimonthly peritoneal dialysis to regular hemodialysis at least three times a week for three hours each. She might eventually require a minor surgery where the surgeons make an opening in a blood vessel by connecting an artery to a vein. For now, she's stable and her pain should be gone soon. You know my number if the pain persists."

"Thank you, but where did her pain come from?" Lee asked the physician while gently holding Chiharu's pale hand. "Is it her uric level? But she's been taking her Allopurinol religiously. Those tablets are supposed to control the uric acid in her blood, aren't they?"

"I might have to increase the dose or pair it with a different medicine altogether," the physician said while removing her stethoscope and reaching for a pen and a sheet of paper in her briefcase, jotting down a prescription. "I can't confirm anything yet until I send your wife for an x-ray or MRI and biopsy, but I suspect she's become immune to the Allopurinol at her current dose. I'm prescribing soursop leaves extract for now. The leaves have high content of vitamin A and vitamin B, which could help her body break down crystalized uric before they become kidney stones. The natural flavonoid content could also inhibit the enzyme xanthine oxidase and prevent more uric acid build up. Just make sure she doesn't take the leaf extract on an empty stomach."

"I understand." Lee nodded quietly, still not letting go of Chiharu's hand. "There's another thing I'd like to know more about. Lately, my wife finds it harder to stay asleep at night and even when she manages to sleep she always wakes up not feeling well-rested enough. Sometimes I would caught her breathing become shallower in her sleep. Is this a cause for concern?"

"Does her breathing ever stop abruptly and then start again? If that cycle of breathing and not breathing goes on throughout the night, that's a symptom of sleep apnea, commonly found among thalassemia patients with comorbidity of decreased renal function," the physician frowned. "If you don't mind, sir, perhaps it would provide your wife some relief if we get her airway pressure machine. It works by keeping her airway open while she sleeps."

"Anything to help her." Lee said with a tremor in his voice. "Are her kidneys still functioning the same way they do per her last check up or have their rate of waste filtration worsened?"

"That's to be determined by ultrasound and CT scan at the nephrologist's office," the physician explained. "In the meantime, watch out for signs like unusually infrequent urination and greatly diminished appetite. She should also reduce consumptions of highly processed grains and salty foods. As for foods that she should consume more, try incorporating foods high in vitamin D like herring, sardines, almond milk, egg yolk, and spinach. Also limit intake of coffee if possible."

"Thinking about the progression of her degenerative disease makes me feel a bit hopeless." Lee sighed softly as he watched the dialysis equipment cleaned out excess waste from Chiharu's bloodstream. "But it must be even more distressing for my daughter. She doesn't say much but she fools no one."

"Your daughter is very mature for a teen," the physician nodded as she took notes of Chiharu's blood pressure and heart rate. "But even the most mature teens still need their mothers. What you can do for now is to keep on ensuring you're a safe person for her to lean on when she's sad."

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While the physician was tending to Chiharu, Ezekiel had left Kenta's room to check on Akira. He found her sitting by the koi pond and staring at the magenta sky with Miyuki and Sebby curled up at her feet. Gently, the boy called her name and she turned to him with wet eyes.