A New Cullen Sister

Chapter 8

Late afternoon could not have come soon enough for the Cullen matriarch. Carlisle had caved after Esme begged to allowed back to the hospital. She waited somewhat impatiently outside the ICU until Dr Anderson had taken pity on her and allowed her in. They had lifted the sedation and were waiting for Amelia to wake up before extubating her. Esme and Carlisle noticed the subtle changes before Dr Anderson did, and when Amelia somewhat groggily awoke, her new mom would the first person she saw.

"Hey there, sweetie," she murmured with a smile when Amelia focussed on her, "welcome back."

Amelia took a moment to assess her surroundings, her brow crinkling as she recalled the events that led her to the ICU, and registering the endotracheal tube that was hindering ability to speak. She tried to breathe on her own and choked.

Dr Anderson took over. "Amelia, we are going to take that tube out now, okay? You know the drill, cough when we tell you to." Amelia nodded and winced when she did. Esme rubbed her shoulder. Carlisle deflated the cuff, then Dr Anderson nodded at Amelia. She coughed and the tube was removed. She continued coughing until her chest was clear and Carlisle placed an oxygen mask over her mouth and nose. When she had regained her breath, Dr Sanders had joined them. Swapping over to a nasal cannula, Amelia looked at the people gathered in front of her expectantly.

"You've all gathered here today," she began, prompting them to get to the point. A handful of exasperated laughs met her statement and she grinned cheekily.

"We need to chat to you about your health Amelia," began Dr Sanders. Amelia nodded, and looked at Dr Anderson, for she knew that she was the one who would be speaking as she was the lead on the case.

"You had a nasty bleeder. You have a fungal infection superimposing the bacterial infection, so while we were embolising we suctioned out as much as we could," began Dr Anderson.

"Aspergillus again?" Amelia asked.

"Correct. You are on a course of strong anti-fungal medication, cortisone and some antibiotics. Your lung function has dropped to 25%. For now, your liver and kidneys are holding out, but I am concerned about your heart. We are monitoring it, but you are in the beginning stages of right heart failure. Your ankles will start to swell up from fluid retention in the near future. Your lips are blue and now your tongue had gone blue as well, and your fingers have clubbed. These are not good signs, Amelia."

"It's a sign that my body is failing, isn't it?"

"Well, technically the signs themselves merely indicate the presence of a chronic lung, heart or liver disease, but in your case, yes, these signs coupled with everything else lead us to that conclusion."

"And my options are a double lung transplant or no transplant? If I choose to not have the transplant, then what?"

"Correct. Without a transplant, you will die. And sadly, it will be sooner rather than later. It's January now. At the rate your lungs are declining, I'm sorry to have to tell you this, but you are unlikely to see this Christmas. If you choose the transplant route, there are risks involved. Bear in mind that lung transplants are the most commonly rejected transplanted organ. I cannot guarantee that we will find you a match in time either, it's a lottery ticket really as to who gets it. Tissue typing needs to be done, once you are identified as a potential recipient, we will assess your state of health. If you are too ill, and are unlikely to survive the operation, you will likely not receive the organs."

Dr Anderson did not mince her words as she laid down the facts for Amelia, something for which Amelia was grateful. Her options were limited. Even if she survived the transplant, she would have to spend the rest of her life taking medication. But it would be different. She would still have the disease, still have the Diabetes and digestive problems and everything else, but her lungs would be free from disease. The risk of chronic rejection was great, as most patients went into rejection within five years. Subconsciously, Amelia had reached for Esme's hand while Dr Anderson was talking.