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Frank woke up that morning to the familiar sensation of Brendon running his fingers through his hair, something the older man always did on the days he didn’t have to go into work.
Frank hummed as he turned his head to rest his chin on Brendon’s chest.
“Hey, finally awake?” Brendon asked.
Frank hummed as he slowly blinked his eyes open, his gaze still filled with sleep. “That depends,” he mumbled. Brendon let out a questioning hum, asking Frank to continue. “Are you going to stop what you’re doing?”
Brendon let out a deep hum. “Maybe,” he said. “We can’t stay in here all day.”
Yeah, annoyingly, Brendon was right about that.
“Are you saying we have to get up now?” Frank asked.
The smile on Brendon’s face widened. “No,” he said. “Not yet.”
Frank then turned his head to rest his cheek against Brendon’s chest, letting out a contented breath.
“Are you going back to sleep?” Brendon asked, amusement clear in his voice.
“Just five more minutes,” Frank mumbled. “Your bed is too comfy.”
“Are you complaining about my bed being too comfy?” Brendon asked.
“No, I’m not complaining,” Frank said. “That’s why I need five more minutes.
“Five minutes,” Brendon said as he continued to draw circles on Frank’s head.
The five minutes came a lot sooner than Frank would have liked.
Brednon nudged Frank’s shoulder. “Come on,” he said. “We really need to get up now.”
Frank rolled over onto his back, letting out a displeased moan. “Do we really need to?” he asked.
Brendon smiled as he picked his hand up, and using his finger, began tracing lines over Frank’s naked stomach and chest, a move that he knew always made Frank squirm, just like today.
“Are you seriously going to do that now?” Frank asked as he lazily swatted Brendon's hand away.
“That depends, are you going to wake up now?” Brendon asked.
“Yeah,” Frank yawned as Brendon continued to draw circles over his body. “I guess we finally should, got plans today and everything.”
“And what plans do you have?” Brendon asked as he ran a finger down Frank’s chest, going down to run circles around his left nipple.
“Getting lunch with Cole,” Frank said.
Brendon hummed. “If I didn’t know any better, I’d think he’s trying to take you away from me.”
Frank let out a small laugh. “Then it’s a good thing you do know better.”
“Where are you going?” Brendon asked.
“The new Greek place that opened up in Bloomfield,” Frank said. “I think it’s called Mikey’s or something like that.”
“Have we been there yet?” Brendon asked.
“No,” Frank said. “Cole found it last week, and he insisted on bringing me there himself to try it.”
Brendon hummed. “Well then, remember how it is, I want to know if we should go there ourselves.”
“I thought you hated Greek food,” Frank said.
Brendon shrugged his shoulders. “I’ll be willing to try each restaurant once. Maybe they’ll change my mind,” he said.
“I’ll take detailed notes then,” Frank said.
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Cole Bettencourt was someone Frank had met during rehab. He was a nurse from Presbyterian, who had gone through the whole rehab program himself five years ago and now volunteered there from time to time.
They had formed a sort of friendship while Frank was there, though if asked, Frank had no clue how he would exactly describe it.
Frank was told he had needed a sponsor, someone who had been through the whole addiction recovery program before, and preferably someone Frank didn’t have a close personal relationship with already.
So that left Cole.
Cole was the one who asked, actually. And Frank didn’t know if that was how things were supposed to work, but neither of them seemed to care. It worked for both of them.
Now they met up about once a week, when they were both off of work. Which right now meant whatever day of the week Cole wasn’t working. Though Frank had a feeling that once he finally returned to work, scheduling this would become a lot harder.
That was a matter for July though, it was only April right now.
As he walked down the street, Frank spotted Cole standing right outside the entrance to the restaurant, waiting for him.
“How did you find this place again?” Frank asked as they both got a table and grabbed menus.
“I told you, my girlfriend tells me about all of these places and the ones I need to try,” Cole said. “She recommends the chicken gyro, by the way.”
Frank hummed as he read the menu over. There weren’t any pictures, annoyingly, but from reading the brief descriptions everything had sounded pretty good. He wound up ordering the chicken souvlaki.
As they placed their orders and waited for their food to come out, they talked about everything except the obvious elephant in the room.
At least, Cole held back from really questioning him until their food was brought out to them. And of course he asked right when Frank was in the middle of his second bite.
“So what’s up with you then?” Cole asked. Frank looked up as he chewed. “I can tell something is bothering you.”
Frank swallowed. “How are you able to read me so well?” he asked.
Cole chuckled. “I get that a lot, it must be a gift I have.”
“An annoying gift,” Frank muttered.
“So then what’s bothering you?” Cole asked again.
Frank let out a breath, and leant back in his chair. The movement sent a small flare of pain through his spine, but by this point, he had expected it. By this point, it didn’t even phase him.
Though it still bothered him. He still wanted to know what was causing it and put an end to it. Because this was a small and manageable pain right now. It got worse, especially when he first woke up in the morning.
And the more he thought about it, the less and less sense it made.
He told all of that to Cole, who was silent for a moment, thinking as they continued to eat their food.
“What if it has nothing to do with the injury you had?” Cole then asked. Frank gave him a confused look. If not the injury, what else could it be?
“What else could it be?” Frank asked.
“Just hear me out,” Cole said. “Last summer my girlfriend had started getting this weird pain in her hands out of nowhere, right? Couldn’t recall anything that might have hurt them, all the x-rays she took didn’t show anything either. Pain kept continuing, eventually one of her doctors brought up the possibility of rheumatoid arthritis. She took a couple blood tests for it, and what do you know? That's what was going on.”
“So what are you saying?” Frank asked. “Becausr it's my back that’s been hurting me.”
“I know that,” Cole said. “But there are similar conditions. Ankylosing Spondylitis affects the back and spine.”
“Ankylosing Spondylitis?” Frank asked. “How long have you been thinking about this?”
Cole shrugged his shoulders. “I was in a google rabbithole last night,” he said.
Ankylosing Spondylitis.
Frank repeated the term in his head a couple of times. He had read about it back when he was in med school, and could recall a couple patients coming into the ED who had it, though it was never what brought them into the ED.
“I’ll look into it later,” Frank said.
Frank did some googling when he got home later that afternoon. And as much as he hated to admit it, because looking at it now, it was so obvious that this could be something, how had he missed this before?
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Frank let out a relieved groan as Brendon’s knuckles dug into his back. Even if he wasn’t dealing with this constant mystery of back pain, this would be great. The fact that it got rid of his pain for at least a day or so, even better.
If only they could figure out what was causing it to attack the actual problem rather than the symptoms though.
“If you ever want to quit being a surgeon, you could make a great massage business,” Frank mumbled into the pillow beneath his head.
Above him, Brendon chuckled as he gave the back of Frank’s head a gentle hit. “Not nearly exciting enough,” he said. He dug into Frank’s back again, right below his shoulders, amd Frank let out another moan in relief.
“This isn’t getting any better,” Brendon said as he finished and Frank sat back up on the couch.
“Whatever it is you do makes it a lot better,” Frank said as he sat back on the couch, reaching over to grab Brendon’s hand and link their fingers together.
“Only temporarily,” Brendon said as he moved Frank’s legs to sit on the couch next to him.
“You said that you looked at the x-rays and CT that were taken,” Frank said, recalling the conversation they had shortly after Frank moved in. “Did you see anything?”
“No,” Brendon said, annoyed with both himself and the entire situation. Everything looked clear on the x-rays. Whatever injury Frank had when the pain started was healed now, but the pain associated with it obviously hadn’t gone away.
“Last week, when I got lunch with Cole, he was thinking it could be Ankylosing Spondylitis or something like that,” Frank said. “I don’t know much about it though.”
“I know what it is,” Brendon said. “Can’t say your symptoms don’t align with it.” Brendon thought it over. “That would take a while to show up on an x-ray,” he said.
Frank nodded. “That’s what I was thinking. In the early stages it would only show up on a blood test, something Hagan never did.”
Now that Frank was thinking this might not be an injury but an autoimmune condition, he was kind of peeved. If Hagan hadn’t wanted to give him more pain med when the first prescription ran out, that was one thing, something he could accept. But that Hagan didn’t help figure out the cause of the pain in the first place.
“Ankylosing spondylitis, that would be something that falls under rheumatology?” Brendon asked. Frank nodded. “I’ll get you a referral to them,” he said.
“You don’t have to-”
“Don’t mention it,” Brendon said. “You’ll need a referral to schedule an appointment with them, I’ll get one for you. And I’ll make sure you don’t have to wait six months for an appointment.”
Frank closed his mouth, knowing that there was no point with arguing about this. And if he didn’t have to wait upwards of six months to see if they had any answers for his back pain, even better.
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Walking into the PTMC for the first time in nearly six months was weird, Frank felt out of place. As if he was walking into somewhere he shouldn’t belong.
He wasn’t here because he was coming back to work. No, that almost sounded too good to be a thought at this point.
He wasn’t here because he had a meeting with the HR department, like he had so many of the first couple of weeks after he had gotten out of rehab.
He wasn’t here to meet up with anyone, he still hadn’t had any contact with anyone working down in the Pitt since that day Robby had kicked him out, and that was almost six months ago now. While he was in rehab was one thing, but not even a Merry Christmas text?
It didn’t matter, he told himself. If anyone else was in his position, he couldn’t be sure he would reach out to them either. The fact that out of everyone, Brendon had, was a crazy idea.
Frank still couldn’t believe what his and Brendon’s relationship was right now.
As Frank walked up to the main entrance of the hospital, he had a fleeting thought about what he would do if he ran into anyone from down in the Pitt. Even though he wouldn’t be going down there today, they occasionally had to come upstairs, it wouldn’t be that odd to run into anyone.
But it was 11 a.m. what would be the middle of the shift. And he was going through the main entrance of the hospital, a floor up and on the opposite side of the building from the ED entrance. The chances of him running into anyone from down there today were virtually none.
At least he didn’t drive any sort of memorable car, he thought as he drove into the parking garage attached to the hospital building. No one would think anything if they saw the old gray Honda CRV Frank had been driving around since his sophomore year of undergrad.
He walked into an elevator and pressed the button for the fourth floor, where most of the outpatient doctor offices were located. He never realized just how slow this machine was, never having to take it before. The elevator going from the ED up to the OR floor and helicopter bay was an express one.
Walking off, Frank’s first thought was that this floor had a completely different feel than three floors down.
There wasn’t any of the chaos and sense of urgency necessary in the ED. The only sound was just a calm typing on the computer from the receptionist behind the check in desk and the air blowing through the vents overhead. In the waiting room, no patients were getting annoyed and irate over the wait times, only Frank and one other woman sitting calmly and waiting for their names to be called.
Sometimes he thought about what his life might be like if he hadn’t gone into emergency medicine but another specialty. Then he quickly stopped thinking about it. Maybe his life might have been less stressful, but he liked the chaos sometimes, could even say he thrived on it.
He was sitting in the waiting room for no more than ten minutes before his name was called.
Dr. Mark Fields was the rheumatologist he had been scheduled with. From what Frank had heard about Dr. Fields, which wasn’t much, he was one of those men who showed up in the morning, did his work, good work granted, and then left in the afternoon. Frank couldn’t really blame him for that.
Dr. Fields had Frank take his shift off and go through some light stretches, watching his back and feeling along his spine a little. Then asked Frank a series of questions about exactly what his pain felt like and when it had started.
“From everything you have described, it sounds like you might have ankylosing spondylitis,” he said. “It usually presents in people your age. The start of the symptoms likely started while you were recovering from the injury last year, so everyone you’ve seen previously probably thought they were related. I’ll put in an order for x-rays and labs to see if there is any deterioration on the bones.”
“But I’ve had x-rays taken of my spine already,” Frank said. “I was told there was nothing out of the ordinary.”
Dr. Fields nodded. “Those were at least six months ago, correct?” he asked. Frank nodded. “In the early stages, there often isn’t anything on the x-rays, things slowly develop over time. I’ll order another set of x-rays of your back, see if we can see anything on them now. I also want to get you some blood tests. Measure some markers for inflammation. CRP, ESR, and a couple others.”
“And if I do have this?” Frank asked. “What then?”
“There are a lot of possible treatments nowadays,” Fields continued. “If as you said, NSAIDs had little effect before, we can start off with trying a biologic. Humira is often the first one we start people on. It would be one injection every two weeks into your stomach or thigh. Any questions?”
Frank shook his head. All of this sounded pretty standard and straightforward.
After everything, it felt like he didn’t have any sort of special case afterwards.
Ankylosing Spondylitis.
Two words, granted two, not so simple words, but two words.
Two words and if it worked, a relatively simple treatment plan.
Dr. Fields said it looked like he was still in the early stages for the disease, if the medications worked, likelihood for any type of surgery or spinal fusion was low.
Of course, after everything he had to go through to get to this point, the answer would be so simple.
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Frank opened the door and walked inside, hearing Brendon puttering around the kitchen. He took his jacket off, hanging it on the hooks right next to the door, and then walked further inside, finding Brendon going through the pantry.
“So, what did Fields say?” Brendon asked when Frank met him, wrapping his arms around Frank and pulling him into a hug from behind.
“He thinks it's a strong possibility I have ankylosing spondylitis,” Frank said as he rested his chin on Brendon’s shoulder. “Like Cole thought. All my symptoms point to it. Just waiting for the lab results to confirm it.”
Brendon was silent for a moment, thinking. “If the labs indicate it, what would that mean?" he asked.
“There’s a couple drug regimens he said we could try,” Frank said. “He said TNF blockers are the most common when OTC stuff doesn’t work.”
Brendon turned around in his arms, managing the action without Frank's arms having to let go of him. He leant forward slightly and pressed a quick kiss onto Frank’s forehead. “We’re finally figuring out what’s wrong, this is great,” he said.
“Yeah, answers,” Frank said. “My immune system is attacking my spine? Yeah,” Frank laughed. “Of course that would be the cause of my problems.”
If only Hagan or someone had asked to do a blood test when he was still in pain and the x-rays weren’t showing anything. It would have saved him a lot of anxiety and angst this past year.
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The next day the results of the blood test came back, and reading them over in the patient portal, Frank didn’t need to have completed four years of a rheumatology residency to know what he was looking at.
His CRP values were above what the machine could measure, his Mono Absolute was double what the normal range was considered, and the HLA-B27 gene test was positive. Combined with the persistent back pain, ankylosing spondylitis was all but a guaranteed diagnosis.
Why had it taken him so long to figure out this could be the problem?
Two years of unnecessary pain and his life imploding, all for what? Something that could be determined from one blood test and could be fixed with a medication that wouldn’t put him in trouble with the medical board.
Sometimes it felt like there was some force out there that hated him.
“We can start you on Humira,” Fields said when Frank went in for the follow up appointment with him. “It’s one of the most common meditations people start on. It’s a biologic, injected into your thigh or stomach, every two weeks to start. It comes in a nice little auto injector so you don’t have to draw the stuff into a needle yourself.”
“I’m fine with drawing stuff out myself,” Frank said.
Fields chuckled as Frank said that. “Oh, you’d be surprised at how many doctors I have as patients that get queasy at the thought,” he said. He brought out a sheet of paper then and set it on the table between Frank and himself. “Now there is a list of possible side effects I’m required to go over with you before you agree to take this, but most of them only come up when you’re switching from another medication to this one.”
The rest of the appointment flowed pretty uneventfully. All Frank could think about was why at this point, everything seemed so simple. Such a simple answer to a problem that had brought him untold amounts of grief and headaches.
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Fields had told him that when he started on Humira, to not expect instant results. It could take upwards of a couple of months for the medication to take its full effect. But not even three days after the first injection, Frank could already feel a distinct lack of pain in his back when he got up that morning. And that should be an illuminating thought.
The lack of pain was more noticeable now than the pain being there.
That was saying… a lot.
When he woke up fully, Frank sat up in bed and stretched his arms out to the side, no pain. He then twisted his torso left and then right, still no pain.
He smiled then laid back down on bed and turned over onto his side, looking at Brendon’s still sleeping form. Sleeping Brendon was something else, someone he could watch sleep for hours, just like Tanner and Penny. Sleeping Brendon was completely different from work Brendon, and even off work at home Brendon.
Though it seemed he wouldn’t be able to watch Brendon sleep for hours, because just like every time Frank tried to watch him, Brendon seemed to be able to sense his staring and would wake up after a couple of minutes.
Brendon opened his eyes, then without lifting his head, turned his gaze up to Frank. “What’s with that smile on your face?” he asked, his voice still half filled with sleep.
“It doesn’t hurt,” Frank said.
“It doesn’t… what?” Brendon asked as he blinked the sleep out of his eyes.
“My back doesn’t hurt anymore,” Frank repeated, a wide smile on his face.
Brendon’s eyes widened as his mind woke up and he connected the dots. “Really?” Brendon asked. “No pain?”
“No,” Frank said. “I mean, it had hurt less yesterday, but now? I don’t feel anything!”
Brendon smiled, that half asleep relaxed smile. “That’s great,” he said as his eyes drifted back closed.
Frank frowned as he reached an arm out and nudged Brendon’s shoulder. “Don’t go back to sleep,” he said.
“Oh, that’s rich coming from you,” Brendon said. “Telling me that I have to get out of bed.”
Frank moved then, leaning over Brendon’s chest, his face only a couple inches above the other man. “I never said we need to get out of bed,” he said, his voice lower.
Brendon’s lips formed into a small smile. “Oh, really?” he asked as he felt a pressure forming on his leg right where Frank was pressing his body against him. “You sure you’re not in pain?” he asked.
“Yes, I’m sure,” Frank said.
Brendon moved fast then, before Frank could do anything to stop him or even prepare for it. Frank was suddenly on his back, Brendon pinning him to the bed.
“If I had known getting rid of your back pain would’ve given you this much energy, I would have written you that prescription myself.”
Frank laughed as Brendon leant down, pulling Frank into a kiss. As they broke apart, Frank said, “Oh you say this now, but just ask Abby. You might get tired of it.”
Brendon laughed as he moved to roll them over, putting Frank on his back as he straddled him. “Is that so?” he asked.
Frank smirked up at him. “How do you think we had two kids in less than two years?”