I would really appreciate some feedback on the first chapter of my book. Any response will be wonderful.
Chapter ~ 1
Gabriella sits at the edge of her bed. Tears stream down her cheeks, drops from her chin and soak into her pajama pants. The restroom is only 20-feet away, but it might as well be at the other end of town. The bottoms of her feet are swollen to the point she thinks they might just pop if they touch the floor. She slowly slides her foot off the bed, leaving it dangling an inch from impact. She looks up and inhales deeply then slowly lets the breath escape from her lips. She stretches her leg until her big toe reaches the floor. Immediately she jerks it up, pain creased in her face. She slams her head back to her pillow, and screams.
She takes a moment, sucking down breaths, to adjust to the increased pain. Gabriella rolls over on her stomach. Tears continue to flow; this time from intense pain, not just from the anticipation of it. Slowly she slides, using every ounce of the strength in her arms to grip the sheets until her knees rest on the floor. The bathroom is within sight, but she wonders if she can make it. She slides through the carpet on her elbows and knees like an infant learning to crawl, but in her condition it is like crawling through nail studded burning coal. She strains to keep her toes from touching the floor, but is unable. Her response is immediate; she rolls on her side whaling, and waits helplessly for someone to come.
Intermittently, this had become the new norm for this 38-year-old married mother of five. She clings to life. Her undying love for her husband and children, the only reason she struggles to survive.
Her doctor has informed her and her Husband Robert that she would be lucky to enjoy her family six more months. That is, if you call this enjoyment. The families’ savings hade been drained on medical expenses, sometimes peaking at $6,000 a month after insurance payments. Here children want their mommy, but are instructed by their father, “Let mom rest.” Normal life to most, like housework and cooking are no longer possible and Gabriella feels her life is nothing short of a burden to everyone around her.
One week earlier: (date
Robert drove to Dr. O’Sullivans office with Gabriella for her monthly checkup. He had no reason to believe this wouldn’t be like all the other routine doctor visits that they had become accustomed to. They would sign in, wait twenty to thirty minutes to be called to a room. And finally after another ten-minutes or so Dr. O’Sullivan would walk in holding a book in his hands, that was Gabriella’s chart. In the beginning, the wait bothered them, but now, after several years of the same, it was just a regular part of their routine.
They sat in the exam room discussing what they needed to say to Dr. O’Sullivan. He walked in. “How are the Maloney’s today?”
Robert stood up, as he always did, and reached over to shake the middle-aged doctors hand, “I guess as well as possible considering Gabriella’s condition.” Robert sat down and placed his hand in hers. She squeezed it and forced a smile.
“Well looks like Gabriella’s creatine level is (?), that is not good but it is stable. Were you able to get your new insurance? I see a note from last month that you were changing.”
“Everything has changed over now.” Robert replied.
“That’s great.” He looked up from the chart, “Mrs. Maloney would you come and sit on the exam table? Lets see how everything looks.”
“Sure.” She released Robert’s hand. Pain entrenched in her brow as she stood. Robert stood up and put his arm around her 98 pound frame, “Hold on Hon, I will help you up.”
Dr. O’Sullivan began his examination by looking at Gabriella’s ankles for swelling, “Any new symptoms Mrs. Maloney?”
Robert interceded, “The cellcept is really effecting her now. The side effects are terrible. She has constant diarrhea, dizziness, and----. Her weight has dropped dramatically.” Gabrielle reaffirmed the symptoms with a nod.
“Ok Mrs. Maloney you can step down.” Robert helped her to her seat. “Her weight loss is substantial. She can ill-afford to loose another pound. I know a college in Boston. She is using Stem Cells Treatments to replace the immune system of lupus patients like Gabrielle. I think it is our only alternative at this point.
“What is the treatment called?” Zelphoe asked.
“It is a stem cell transplant and I believe it has a good success rate. But I need to research it again to make sure. It has been several months since I started looking at this as a viable treatment for you. And at this stage, it is probably our only one.”
Robert smiled as he saw a sparkle of hope light Gabriella’s eyes, “Give us any information you have and we’ll research it.”
“Let me note your chart and see what I can find. I’ll be back in a minute.”
The door closed, Robert reached over and caressed Gabriella’s hand, “This sounds promising. I’m not sure what a high success rate is, Chemo has a 20 percent successes rate for putting Lupus into remission. It has to be higher than that.”
“I don’t want to get my hopes up again. I don’t think I can handle another failed treatment.” Tears formed in both their eyes, and Robert leaned in and kissed her.
“It has to work,” he said as he leaned back against the seat, “I know it will.”
“What if it’s like the chemotherapy, steroids, Emeron, and all those other medications that seemed to only exasperate the symptoms I already had and caused new ones.”
Dr. O ‘Sullivan walked in, “All right. I updated your chart and typed a referral for Dr. Trynor in Boston. The treatment is a stem cell transplant. It is fairly new for treating lulus, but the results are promising.”
“At this point I am ready to try anything.” Zelphoe replied.
“Yes, it seems like all we’ve done the past few years is just prolong the agony.” Robert interjected.
“Well I believe Blue Cross Blue Shield will cover the treatment.”
Robert looked up at Dr. O’Sullivan, “We don’t have Blue Cross Blue Shield.”
“I thought you just switched last week.”
“We did switch. I closed one business and opened another. So I had to drop the insurance plan I had and open another. That is why we had a thirty-day lap in coverage. But I switched from one Lovelace plan to another.”
Dr O’Sullivan leaned back against the exam table, “I thought you told me you were switching to Blue Cross blue Shield.”
“I wish we had Blue Cross Blue Shield, but the Albuquerque Chamber of Commerce doesn’t offer it.”
Nervousness started to express itself in Zelphoe’s face as she noticed a change in the doctors demeanor, “That doesn’t matter, does it?” Robert asked.
“Well Lovelace won’t cover the treatment until all other possibilities are exhausted.”
Robert stood up and took a step toward Dr. O’Sullivan, “I thought you said it was our only viable treatment.”
“There is at least one other treatment that Lovelace will want us to try before we ask for the stem cell transplant. It is IVIG. It is a hemoglobulin treatment. You will be given it through an IV drip in an outpatient setting. It will have to be monitored closely and if it isn’t successful we can refer for the stem cell treatment.”
“Why can’t we just do the stem cell treatment now?”
Zelphoe joined in, “You said it was the best treatment at this stage.”
“I know, but I’m sure Lovelace will not approve it unless all other options are exhausted. I’m sorry. I thought you had Blue Cross Blue Shield now. I don’t see any other way, but I will send the request anyway.”
Robert glanced over at Gabriella, the glimmer of hope had been lost. He turned toward Dr. O’Sullivan, “If that is what we have to do, lets get it done as soon as possible. If the IVIG works, great. If not we’ll get you the stem cell treatment. All right honey?”
Gabriella wiped her cheek, and replied in a whimpering voice, “If that is the only way.”
Robert placed his hand on Gabrielle’s check, “That seems like the fasted way. If Dr. O’Sullivan thinks it is the best, then we should do it.” Then he wiped some tears with his fingers.
“I just want the pain to stop.” She whispered through her cry.
Robert reached down and gently squeezed her hand, “I know.”
Dr. O’Sullivan spoke out, “All right then. We need to get some baseline blood and urine test. I will get the orders ready and set up for the IVIG. My nurse will be in shortly to go over the details with you. Do you have any other questions? I know this is difficult for you.”