Mitch entered Meghan’s room and saw the hydrocortisone drip already hooked up. Meghan looked much improved. “Hey there, Mitch! I’m not sure what y’all just gave me, but that stuff is awesome!”

Mitch chuckled. “Well, we gave you some hydrocortisone.”

“Hydrocortisone? What is that supposed to do? I’m only familiar with it as a cream for bug bites and such.”

“It can be used topically like that, yes, but in this instance, we’re treating a low cortisol level. Have you ever heard of Addison’s disease?” Mitch pulled over the rolling stool and took a seat.

“I think I’ve heard of it in passing, but I’m not familiar, no.”

“It’s an issue that affects the adrenal glands. There’s two types, and one affects the pituitary gland, which in turn affects the adrenal glands, and the other type is an issue with the adrenals themselves. Dr. Woodruff is fairly certain that you have Addison’s disease, and that tonight was a case of adrenal insufficiency, or Addisonian’s crisis.”

Meghan looked sufficiently shocked. “So, then, this could happen again.”

Mitch nodded, gravely. “Yes, it could. But now that we know what we are dealing with, we can get you started on treatment to prevent a recurrence.”

“Will I be able to go back on the rig?” she finally asked.

“Dr. Woodruff will be better able to answer that,” Mitch replied. “I called him earlier this afternoon and spoke with him about your symptoms. Of course, that was before everything came to a head tonight. I also asked him how this would affect your being able to work on the ambulance. He seemed to think that, once you got regulated on the medications, you should be able to go back to work with no issues.”

“I’m glad,” she replied, quietly. “It would be very hard to have to step down from helping people on the ambulance. I’d have the teaching gig, but it’s not the same.”

“Yes, I know,” Mitch sympathized.

“When, and will, I have the opportunity to meet with Dr. Woodruff again?”

“He’s currently writing your admissions paperwork. I can have him stop by before he leaves, if you want.”

“Yes, please. I want to get things regulated as soon as I can.”

Mitch smiled. “I know you do. Just remember that it’s a process, and – “

“And that takes patience. I know,” Meghan finished for him.

**********

About half an hour later, Dr. Woodruff walked back into Trauma Two. He glanced at the monitor, pleased to see the Meghan’s vital signs were stable and within the normal ranges. He smiled as he approached her bed.

Meghan had been dozing, but woke up when he entered. “Dr. Woodruff?”

“Yes. You seem to be feeling better,” he stated, pulling up the rolling stool and having a seat next to her gurney.

“Oh, yeah. That’s an understatement!”

“I know that Dr. Branston came in and explained to you that we strongly suspect you have Addison’s disease, correct?” He waited for Meghan’s nod. “Were you at all familiar with this prior to tonight?”

“No. I’d heard the term, but I don’t think we’ve ever covered it in an EMS class. Mitch said there’s two types: one that stems from the pituitary, and one that stems from the adrenals themselves. Do we know which kind I have?”

Dr. Woodruff shook his head. “Not yet. I’m going to be admitting you to the ICU for a couple of days. We need to do some lab challenge tests, a CT scan of your abdomen, and an MRI of your brain to help us know exactly what is malfunctioning. This will help us know exactly what medications we need to put you on to keep you going strong.”

“Okay, but why the ICU? I’m feeling better.”

“I know you are, but if you’ll notice we have you on two drips to keep you that way. We need to keep a very close eye on your condition, especially since I’m going to have to wean you off of the cortisone drip to do those challenge tests.”

Meghan nodded in understanding. “Okay, I just wondered. It wasn’t an easy time of it the last time I wound up there.”

“I know – I glanced through your chart,” he added, seeing her raised eyebrows. “I can’t guarantee anything, of course, but I can say that I don’t think you’ll have to worry about needing a ventilator anytime soon.”

Meghan smiled. “That’s good.”

“Okay, I’m going to get out of here. I think they said that a bed will be available soon. I will come see you in the morning, and if everything remains stable overnight, we will wean you off of the cortisone drip tomorrow and start testing the next day. I only want to do one challenge study per day, to keep the stress levels down, but we will see about both imaging studies tomorrow.”

Meghan nodded. “That’s good to know. Okay, Dr. Woodruff. Thanks for responding to Mitch’s call. I’ll see you in the morning.”

He chuckled. “You’re welcome. Get some rest!”

**********

Meghan was wheeled up to the ICU about an hour later. A flurry of techs and nurses helped her transfer over to the bed, being careful of all of the wires and tubes attached to her. Techs got her back onto the monitor, hooked her back up to the nasal cannula, and got her tucked in. One of the nurses, Kimberly, started doing her assessment.

“Hello again, Meghan. I’m Kimberly. I helped take care of you the last time you were here.” Kimberly smiled.

“Yes, I remember.” Meghan nodded.

“It seems like you’ve had a rather rough night, according to the report I got from the ER.”

“That’s an understatement. But at least we are pretty sure we know what’s going on now, and I’m grateful for that.” Meghan wiggled in the bed, getting as comfortable as she could.

“I’m going to do a quick assessment and ask you a bunch of questions. And I’m sure Dr. Anderson will be in soon to do the same thing,” Kimberly laughed.

Meghan was subjected to the typical poke, prod, and 100 questions over the next ten minutes as Kimberly assessed her breathing, her heart, checked all of the leads and tubes, and double-checked the rates on the IV drips. “Do you need anything right now?” Kimberly asked, finishing up.

“Just a good night’s sleep,” Meghan replied, yawning.

“I think you’ll have to wait a few more minutes for that, Meghan,” Dr. Anderson laughed as he entered her room. “When I told you last time to come visit, this wasn’t how I meant.”

Meghan smiled. “Well, it wasn’t how I planned to do so, either. I figured I’d say hi when picking up someone to transport.”

“Well, according to the admission notes, Dr. Woodruff is fairly certain you have Addison’s. Has that been explained to you?” He pulled over a rolling stool and took a seat.

“Both Mitch – Dr. Branston – and Dr. Woodruff have told me about it, and Dr. Woodruff has also told me about the testing over the next few days to confirm it. I’m just glad that we have a good idea as to what it is and that we can treat it.” Meghan yawned.

“I see that you’re tired, understandably so. Let me do a quick exam, and I’ll let you get as much rest tonight as you can, okay?”

She nodded. Dr. Anderson stood and listened to her heart and lungs. He felt her abdomen, checked her feet and legs for pulses and edema, and asked some questions. Satisfied, he patted her arm. “Okay, kiddo, get some rest. I’ll round with the doctors in the morning before I head out.”

He left Meghan alone. She was thankful that they had closed the curtains in front of the glass wall of her room. The lights in the hallway were dimmed at night, but it was still a lot of light if the curtain wasn’t closed.

As Meghan lay there, listening to the faint beeps of monitors and whooshes from ventilators, people chatting in low tones, and feet walking to and fro in the hallway, she reflected on the events and revelation from that evening. Her last thought before giving in to sleep was, where was Fred?