Read Online When It All Falls Apart (Book One) by Lucinda Berry - Free Book Online Page B
Authors: Lucinda Berry
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sit back down, David continued to stand. As Dr. Koven read the nurses’ notes in Rori’s computer, he began to pace back and forth across the cramped room. “How are you guys holding up?” she asked.
“We’re doing alright.” I responded.
She looked down at Rori and concern passed across her face before quickly replacing it with ambivalence. “I’m afraid I have some bad news.”
The room rolled and then stilled itself. I held onto my chair with each hand. David looked as if he might throw up on the floor.
“Rori is very sick. We got the test results back from the lab and there are some serious abnormalities. I’ve called in a team of geneticists from UCLA and Children’s Hospital to consult on her case. They should be here within the hour.” She paused, giving her words a moment to sink in. “Unfortunately, Rori isn’t getting better. Her test results revealed that she’s experiencing acute kidney failure. It’s why she isn’t going to the bathroom and also why her ketones are so elevated. They’ve reached critical levels. Her entire body is completely acidotic. Our job is to figure out why.”
“What are we supposed to do? How do we treat it? What’s the next step? Is she going to be okay?” David asked.
“It’s important to remember that metabolic acidosis and kidney failure are not a diagnosis. They’re symptoms of an underlying disease. The only way to correct the acidosis and get the kidneys functioning again is to determine the underlying cause. Once we’ve done that, we can begin the appropriate treatment. It’s why we’ve called in a team of geneticists. We’ve ruled out all of the common causes and now we have to begin looking at rare and less common diseases. However, kidney failure is very serious and we have to begin treating it immediately even without knowing the cause of it.” Her face was emotionless. I wondered how she kept it that way.
“How do we treat it?” David’s voice was thick with emotion.
“We’re going to have to begin dialysis.”
“A four year old can get dialysis?” I’d never heard of such a thing. I thought dialysis was something reserved for the elderly.
Dr. Koven nodded. “It’s necessary when the kidneys are failing and unfortunately, Rori’s kidneys are failing. The job of the kidneys is to get rid of the waste products in the blood and when they stop working, the waste products begin to build up in the blood causing serious problems. This is what we’re seeing in Rori. Dialysis allows for a machine to artificially remove the waste in her blood and the excess fluid her body is retaining before putting her blood back into her body.”
“So, you take it out and then she gets better? How long does it take to get better?” David had managed to stop pacing and was leaning against the far wall, arms crossed, anxiously rubbing his hands up and down his arms.
“I wish it were that simple. Until we find out the root cause, she’ll have to continue to be on dialysis and I have to tell you that there are instances in which dialysis doesn’t work.”
“What happens then? What’s the next step?” I asked.
This time Dr. Koven couldn’t hide her emotions. I saw the lump of them rise in her throat and watched as she swallowed them back down. How many times a day did she have to go through this with parents?
“If dialysis doesn’t work, we’ll begin looking at a kidney transplant. In some cases–”
“A kidney transplant? Are you serious? How is this even possible? Three days ago she was perfectly healthy. She was totally fine. It doesn’t make any sense...” David was rubbing his arms hard enough to rub them raw. He looked like he might crumple on the floor at any minute. I wanted to reach out and take him into my arms, but I couldn’t. I was frozen to my spot. My brain heard the words she was saying, but they didn’t register.
“We don’t know, but I can assure you that she’s going to be in the best hands possible. The
“We’re doing alright.” I responded.
She looked down at Rori and concern passed across her face before quickly replacing it with ambivalence. “I’m afraid I have some bad news.”
The room rolled and then stilled itself. I held onto my chair with each hand. David looked as if he might throw up on the floor.
“Rori is very sick. We got the test results back from the lab and there are some serious abnormalities. I’ve called in a team of geneticists from UCLA and Children’s Hospital to consult on her case. They should be here within the hour.” She paused, giving her words a moment to sink in. “Unfortunately, Rori isn’t getting better. Her test results revealed that she’s experiencing acute kidney failure. It’s why she isn’t going to the bathroom and also why her ketones are so elevated. They’ve reached critical levels. Her entire body is completely acidotic. Our job is to figure out why.”
“What are we supposed to do? How do we treat it? What’s the next step? Is she going to be okay?” David asked.
“It’s important to remember that metabolic acidosis and kidney failure are not a diagnosis. They’re symptoms of an underlying disease. The only way to correct the acidosis and get the kidneys functioning again is to determine the underlying cause. Once we’ve done that, we can begin the appropriate treatment. It’s why we’ve called in a team of geneticists. We’ve ruled out all of the common causes and now we have to begin looking at rare and less common diseases. However, kidney failure is very serious and we have to begin treating it immediately even without knowing the cause of it.” Her face was emotionless. I wondered how she kept it that way.
“How do we treat it?” David’s voice was thick with emotion.
“We’re going to have to begin dialysis.”
“A four year old can get dialysis?” I’d never heard of such a thing. I thought dialysis was something reserved for the elderly.
Dr. Koven nodded. “It’s necessary when the kidneys are failing and unfortunately, Rori’s kidneys are failing. The job of the kidneys is to get rid of the waste products in the blood and when they stop working, the waste products begin to build up in the blood causing serious problems. This is what we’re seeing in Rori. Dialysis allows for a machine to artificially remove the waste in her blood and the excess fluid her body is retaining before putting her blood back into her body.”
“So, you take it out and then she gets better? How long does it take to get better?” David had managed to stop pacing and was leaning against the far wall, arms crossed, anxiously rubbing his hands up and down his arms.
“I wish it were that simple. Until we find out the root cause, she’ll have to continue to be on dialysis and I have to tell you that there are instances in which dialysis doesn’t work.”
“What happens then? What’s the next step?” I asked.
This time Dr. Koven couldn’t hide her emotions. I saw the lump of them rise in her throat and watched as she swallowed them back down. How many times a day did she have to go through this with parents?
“If dialysis doesn’t work, we’ll begin looking at a kidney transplant. In some cases–”
“A kidney transplant? Are you serious? How is this even possible? Three days ago she was perfectly healthy. She was totally fine. It doesn’t make any sense...” David was rubbing his arms hard enough to rub them raw. He looked like he might crumple on the floor at any minute. I wanted to reach out and take him into my arms, but I couldn’t. I was frozen to my spot. My brain heard the words she was saying, but they didn’t register.
“We don’t know, but I can assure you that she’s going to be in the best hands possible. The
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