Figure of Speech
Page 3

Spencer felt he did not have ALS. After all, he could still speak and function normally other than the tingling and weakness in his body. It was beginning to spread to his hands now, and he’d already lost use of his legs. If it spread to his upper extremities as well he would be utterly dependent on others for even the simplest things.
Jim was determined to be that someone. He wasn’t there when his brother was growing up, but he was here now, dammit. And unlike his father, Jim planned to do the right thing.
“Time to get weighed, Mr. Strickland.”
“Oh, joy.” Spencer blinked up at him. “Help me?”
“Of course.” One of the things Jim liked best about his new shifter status was his increase in strength. He couldn’t bench press a Buick or anything, but he could easily lift his brother into his arms.
Spencer had lost five pounds since the last time they’d gotten weighed together. “You need to eat more.”
“Can I has McDonald’s and a lollipop when we’re done here, Daddy?” Spencer gave him the biggest puppy-dog eyes Jim had ever seen outside of anime. “I promise to be good.”
The man was a pain in the ass. Jim put the brat back in his chair. “Get your butt in the exam room, smarty-pants.”
Spencer wheeled after the nurse, Jim right behind him. In the exam room, Spencer amused himself by popping wheelies and giving Jim a minor heart attack every five seconds.
The door popped open, and a middle-aged man with a stethoscope stepped into the room. “Mr. Strickland?”
Spencer held up his hand after landing on all four wheels. “That would be me.”
“It’s nice to meet you, Mr. Strickland. I’m Dr. Abbot.”
“Nice to meet you too, or at least I hope it will be.” Spencer pointed toward Jim. “This is my brother, James Woods.”
Dr. Abbott nodded to him, but kept his attention primarily on Spencer. “We have the results of your tests, Mr. Strickland.”
“Okay.” Spencer nodded jerkily. “Lay it on me, Doc.”
The doctor smiled and settled on the stool next to the built-in desk. “The good news is you do not have ALS.”
“Yes!” Spencer pumped his fist into the air, high-fiving Jim when Jim held out his hand. “We are so getting Big Macs!”
Jim laughed. His brother was a nutter. The man was twenty-four and acted fourteen.
Dr. Abbott smiled. “That’s the good news.”
Jim didn’t like the way the doctor had emphasized good. “So, what’s the bad?”
Dr. Abbott turned to his computer screen, the smile leaving his face. “Your brother has a rare autoimmune disorder called chronic inflammatory demyelinating polyneuropathy, or CIDP.”
Spencer looked stunned. “Can you say that in English?”
Dr. Abbott spun to look at them once more and picked up a picture labeled Typical Neuron Structure. To the untrained eye it might look like a weird alien flower, but to Jim, a veterinarian, he was all too familiar with it. “Basically, CIDP is a disorder that causes the myelin sheath surrounding the peripheral nerves to be destroyed. This causes weakness in the limbs and, if not correctly diagnosed, wheelchair dependency.”
“Right. Okay.” Spencer patted the arms of his chair nervously. “What’s a myelin sheath?”
“The fatty tissue that surrounds the nerve and protects it. It assists in transmitting the electrical impulses from nerve end to nerve end. Without it, the signal is degraded. In the case of CIDP, this means you think you’ve lost strength in your legs, when in actuality it’s the nerve signal that’s not quite reaching where it needs to go rather than true muscle weakness.”
“What causes it?” Spencer tilted his head, his expression confused.
“We’re not entirely sure. It’s a disorder closely related to Guillain-Barré syndrome, but that is treatable and will usually clear up with no side effects. What we believe is that, unlike GBS, it is an autoimmune disorder that is not set off by a preceding illness.”
Jim asked the only question that mattered to him. “Is it fatal?”
“No.”
Spencer glanced at Jim and grimaced. “Is there a cure?”
Dr. Abbott slowly shook his head. “I’m afraid not, Mr. Strickland.”
Spencer blew out a breath and leaned back in his chair.
“But we can slow, even stop, the progression of the disorder through the use of corticosteroids, intravenous immunoglobulin treatments and plasmapheresis. And with physical therapy you may even regain some use of your legs.”
Spencer looked up at Jim. “Plasmawhat?”
Jim translated. “Okay. Think of it this way. Your immune system is the Empire. It’s decided that your nerves are the Rebel Alliance, and it wants to stomp them into submission. In reality, your nerves are loyal followers of the Emperor, so they can’t understand why they’re being pounded into the ground. Their shields are failing, and they have nowhere to turn.”
“Enter Han Solo?” Spencer was grinning.
“Sort of.” Jim ignored the doctor’s quiet laughter and continued his explanation. “That would be the treatment options. The prednisone would be the X-wing fighters, swooping in to battle but might not wind up sticking around. The immunoglobulin treatments are the Mon Calamari Star Cruisers, the heavy guns, and the plasmapheresis would be the, um…” How would you use Star Wars to describe a process where your blood was removed, the plasma filtered out, and new plasma introduced?
“If you say midi-chlorians I’ll be forced to beat the stupid out of you.” Spencer rolled his eyes. “Fine. I’m going to be poked and prodded on a regular basis. Got it.”
“We’ll be starting treatment soon, unless…” Dr. Abbott frowned. “I see here you’re going to be moving, Mr. Strickland?”
Jim turned to stare at his brother, joy racing through him. Had Spencer finally decided?
“Yup. I want to be closer to my family. That would be him.” Spencer hitched his thumb toward Jim.
Dr. Abbott closed the file. “In that case, I’ll refer you to an associate of mine closer to Halle, Pennsylvania. I can assure you she’s good, and I’ll make sure she’s familiar with your case.”
“Thank you, Doctor.” Spencer held out his hand. “It’s nice to finally get a real diagnosis.”