The Wolf In sheeps clothing

"You're Not Using Ni As A Guinea Pig!"

Niall could not help it, he squirmed anxiously in his seat as Gordon Hayes-Hamilton busied himself pouring coffee and passing cups to Louis and Niall. Louis, in total contrast to his friend, was leaning back in his seat, seemingly totally relaxed. Only the very observant would notice the tense  muscles in his jaw.

"Gentlemen, shall we get down to business" Hayes -Hamilton put down his own cup and picked up a thick manilla folder that was on the table beside him. "These are the results of your recent tests, Niall, also reports from the Cardiologist and Nephrologist." He looked at Niall who nodded once, totally unable to speak. Hayes-Hamilton waited a moment to see if Niall would say anything but the young Irish man remained silent. Hayes-Hamilton sighed to himself then began to recap what tests had been done, and why. Niall began to fidget and a light sheen of sweat covered his face. He just wanted the man to cut to the results.

"Please...." Niall said hoarsely  "Can we get to the outcome?" He was unable to contain his impatience to wait  any longer. Hayes-Hamilton sighed again and put the folder down, leaning forward, he rested his elbows on his knees,hands clasped.He seemed to be considering something carefully then he spoke.

"Niall, the tests and their results are important but I understand your anxiety. It appears that your kidneys and heart have, to some extent, already been affected by the Lupus. Not too seriously as yet" he noted Louis sudden fearful expression and Niall's anxious shift in his seat "but, none the less, still affected. This can cause problems if the Lupus isn't controlled as well as possible."

"So, can you control it?" this time it was Louis leaning forward, his eyes locked onto those of Gordon Hayes-Hamilton. "And what do you mean, Niall's heart and kidneys are already affected?"

"Let's start with the second question...Niall experiences kidney and heart problems when he  has a flareup in his illness chest pains, kidney function is impaired.... This is normal in many Lupus patients but, with each flareup, more damage is done. So far, with Niall, the damage appears slight but every flareup increases the risk of more and more damage . If this isn't controlled, both heart and kidneys continue to weaken with each attack." Hayes-Hamilton paused.

"And how can you control it?" Louis questioned.

"We are constantly doing research and new drugs are being developed the whole time.There have been some good results using immunosuppressant therapy." Hayes -Hamilton said, sitting back in his chair and sipping his coffee, his expression bland.

"Immunio..whatever it is..?" Niall joined the conversation, suddenly aware they were finally talking about what he wanted to know.

"Immunosuppressant therapy" Gordon Hayes-Hamilton repeated.  "In it's simplest form, it's  a drug, or collection of drugs that suppress the immune system. Lupus, MS, illnesses of that nature, are caused when the body attacks its own immune system. Suppressants help switch off that attack by reducing the activity within the immune system. They damped down the system, if you will." He took another sip of coffee then continued. "We already have some good drugs available but we also have a few that are in the phase three stage which show signs of being most promising."

"Phase three?" Louis didn't like the sound of that..it sounded, somehow, incomplete.

"All drugs are required to go through lots of tests to gauge their safety and effectiveness. When they reach the phase three stage, they are trialled on humans." Hayes-Hamilton was very matter of fact but Louis was beginning to see red. Were they planning on using his bandmate and friend as a  guinea pig? No, Louis wouldn't stand back and allow that.

"I don't like where this is going." Louis said bluntly, fixing Hayes-Hamilton with a steely look in his blue eyes. "You're not going to use Ni here, as a guinea pig."

"Mr Tomlinson..Louis...I am not suggesting that. I was merely pointing out that we have some possible excellent drugs coming up that are still in the testing stage. I........." he was interrupted by Louis.

"So why mention what isn't available then? Admit it, you want to experiment, don't you?" Louis snapped.

"Lou, calm down" Niall's soft voice broke into the silence that had developed as Louis and Gordon Hayes-Hamilton glared at each other. " Let him explain." Louis shrugged but sat further back in his seat, arms folded across his chest , jaw clenched.

"As I was saying, we have drugs available.. fully tested "  Hayes-Hamilton looked at Louis as he spoke "And some trial  drugs. Niall's test results have shown that his current treatment isn't effective so we need to switch up his treatment to find the drug or drug combination that will benefit him the most."

"OK, so suppose Ni goes with this suppressing drug, what happens to him? I thought the immune system stops us getting sick , so if you switch it off,  then surely Ni will get sicker?" Louis wanted to know.

"The drugs can potentially switch off or dampen down the Lupus effects which will limit the effects of the illness on him. However, when this happens, the immune system becomes more vulnerable to infections...simple colds can become more serious, minor illnesses can escalade rapidly. The patient can't fight off illness  as easily as they would have pre treatment so they need to limit their exposure to possible triggers." The Specialist looked at both men then asked " Questions?"

"A few" Niall decided he'd better be more active in the conversation. After all, it was his body under discussion. " This treatment you're talking about, what drugs were you thinking about?"

"There are several" Hayes-Hamilton responded "As I said, some already in use, some phase three. All have their uses and also their side effects. There is also stem cell treatment available."

"Stem cell treatment, I've heard of that" Louis said suddenly "They've used it on MS. I read about it, it's terrible, involves chemo and stuff before it's done." He shuddered.

"Yes, it's been very effective but there is another type that we've used and Niall might consider. Fetal Stem cells are harvested then  are injected into the body, no risk, no side effects." Hayes-Hamilton replied. 

"NO!" Niall roared , a look of complete horror on his face. "No, not for me" he said more quietly. He hadn't practised his Roman Catholic religion since his X-Factor days but this was a step too far.

"OK, I understand. It isn't for everyone but please read up on it before you dismiss it. I'll make sure you're given the information." Niall nodded but didn't speak so Hayes-Hamilton moved on to outline various available drugs, their effectiveness and their side effects. Niall and Louis both feeling totally overwhelmed as the information spilled out of his mouth.

"So that's the one you recommend?" Niall asked over an hour later. He rubbed his head as the throbbing increased, heralding the arrival of a migraine.

"Yes, at least I believe it could be a good one for you. You'd start with what we call a loader dose, 100mg for three weeks then drop it to 10mg. It gives you a boost to start  with and then when we can see how you get on with the lower dose, upping it if we need to do so.." Hayes-Hamilton said, eyeing the pale man. He needed to get this tied up and allow Niall to leave to get some much needed rest.

"And side effects?" Louis jumped in quickly, also casting a worried glance at his friend.

" increased risk of infection and viruses, vomiting, digestive problems, bleeding, nausea, diarrhoea, tremors, fatigue......" he shrugged . "Those are the most common And you would need very regular monitoring, blood tests and so forth." He stopped then continued. "Niall, you're exhausted. Go home, get some rest. Here.." he handed Niall another file " this has all the treatments I suggested, their pros and cons, the information on the stem cell treatment and the.ah..phase three drugs. Study it and think about it. When you're read to discuss it, ring my secretary and we'll arrange to talk." He stood up, Niall and Louis following. They shook hands and left.

"You OK, mate?" Louis asked, turning his head slightly to look at Niall "You're really quiet." Niall had been almost silent since they had arrived back at Louis home where he had been staying with his friend.

"Tired, Lou. Look, I'm going to bed" he smiled and left the room. Louis sat staring into space then picked up the abandoned file and flicked through it, his eyes catching sight of the  pages on the phase three drugs. He started to read, his face getting more and more serious. He shook his head as he delved further and further into the information., his one thought a resounding 'No!"