I'm tired

Part 6

"An autoimmune disease?" Nick asked slowly. "Yes. Dr. Grey you have been under a lot of stress the past few weeks or even months probably, right?" Dr. Thomas asked, receiving a nod from Meredith.

"Well, when you are stressed your body produces stress-hormones such as cortisol and adrenalin. These hormones are there to support the body in its peak performance. On the one hand, cortisol provides the body with energy by increasing the blood sugar level and transporting fat-acids into the blood. On the other hand, it suppresses the immune defence. As soon as the stress reaction is over, the amygdala regulates the number of hormones again, the hormone level settles down, the metabolism and all body functions return to their normal state. If a short stressful phase is followed by a recovery phase, the body can recover and restore the necessary balance. However, if the stress continues – for example due to a stressful job as in your case - it can lead to imbalances in the hormone balance. And this can result in a chronic illness such as an autoimmune disease." Dr. Thomas explained to both Nick and Meredith who just sat there in complete shock. Meredith had moved her head down, her mind filling with thousands of questions while Nick continued staring right at Dr. Thomas, still not believing what was going on here.

"The immune system reacts in stressful situations by releasing increased amounts of steroid hormones to stimulate certain immune cells that cause an inflammatory reaction in the body. This also stimulates the activity of lymphocytes. When this happens continuously, it has a pro-inflammatory effect. And the immune system gradually turns this defensive reaction on itself. It becomes misdirected and begins to attack the body's own cells." Dr. Thomas continued as he didn't get a reaction from neither of them.

"Okay that's enough, we're both surgeons we know how autoimmune diseases work." Nick said a little harshly, just wanting Dr. Thomas to finally shut up. "I am not- going to die right?" Meredith asked vulnerably. It felt as if her entire surgical knowledge was suddenly gone, she had no idea what to do nor what to think.

"No, you are not going to die. Autoimmune diseases are indeed chronical illnesses but they are more treatable nowadays. Cortisone for example slows down the typical inflammatory processes, painkillers with anti-rheumatic and anti-inflammatory agents largely relieve discomfort or pain. And there are a few more options if this doesn't work. But first we'll have to admit you and do some more tests to find out what type of autoimmune disease you have and then we'll work out a treatment plan." Dr. Thomas explained calmly.

It all made sense now. How exhausted and weak she was, how much weight she had lost, the pain, her red eyes and that she kept rubbing them every few minutes, it all made sense now. Her red eyes weren't bloodshot because of not having slept in a while but because of an infection.

"Meredith have you experienced any of the typical symptoms of autoimmune diseases?" Dr. Thomas asked, grabbing a pen to write along. "Uhm-" she started, looking at Nick from the side. "Do you want me to wait outside?" he asked, thinking that she might be embarrassed about some of her symptoms since she had obviously experienced some of them but just thought it would be because of the stress. "No, please stay." She whispered before continuing. "Well- I've been really tired and even if I tried to sleep I sometimes couldn't. Some- pain and digestive issues and I've had a rash on my abdomen. And- I guess I lost some weight." She sighed.

"Why- didn't I see that earlier?" she asked herself, starting to nervously scratch her arm. "Hey, can I see your arm?" Nick asked, sticking out his hand, thinking he had just seen some red skin underneath her long sleeve shirt. Very carefully he pulled up her right sleeve, seeing that her whole arm was covered in dark red spots, some of them even a little bloody. "You knew about this Mer." He stated, not being able to move his eyes away from her arm. "I thought it was an allergic reaction or anything I- I didn't know." She replied, pulling her arm away from his grip and pulling her sleeve back down.

"Have you been sick more often than usual during the past few months?" Dr. Thomas asked after making a note about her arm. "No- I've always had a shitty immune system and got sick pretty easily." She replied, her voice giving away that she just realised something else. "That- could mean that it's genetical?" she added, her statement sounding more like a question than a fact. "Yes, it could be that you do have a genetic marker for a certain autoimmune disease and it was now triggered by the immense stress you're experiencing. That explains why you always got sick easily and why you only started to show symptoms now." Dr. Thomas explained, writing down something else.

"So, what are we going to do now?" Meredith asked. "Well, like I said, we'll admit you and do some tests. Those symptoms you are experiencing narrow it down to three different types of autoimmune disease and in order to be able to treat them properly we need to find out which one exactly, and which parts of your body are affected." Dr. Thomas continued. "Please fill out this form, I'll make sure a patient room will be prepared." He added, giving her a clipboard with about a dozen of papers before getting up and walking out.

Meredith just sat there, staring at the forms. "I'll be here for every single test Mer. If you want me to." Nick said softly after a few minutes in silence had passed. "This is- a lot and if you need any help- here or with the kids I could get an apartment here in Boston to help out." He added, immediately going into supportive mode. "You don't have to. It's already so complicated between us." She mumbled, grabbing the pen that was laying on the desk. "What's between us doesn't matter right now. Like you said. We're taking a break from fighting. At one point we'll figure everything out but right now, you'll tell me what you need and I'll do my best to help you."

And then she looked at him, a small and sad smile on her lips. She looked so tired. "Thank you Nick." She replied, her eyes getting slightly watery what made her turn her gaze away again. "So, only for a little while, until we figure everything out, we'll be a team again." She summed up quietly, receiving a reassuring smile as Nick nodded.

"Okay good." She said, starting to fill out the forms. Nick moved his chair a little closer to hers, starting to gently stroke her back as she continued to fill out the papers. From now on, everything would be different. But he would be there for her, not leaving her side a single second. 

Let me know what you think so far =) love reading your comments!