FTEC, Thursday (3/24)

[showmetheproof.livejournal.com]

Scully was reading up on journal articles; drugs, long-term effects, types of intervention. And hoping for something silly today. A stubbed toe. A gremlin bite. Possibly the world's worst hangover.

[open and ocd-free!]

Comments

[sorella-vecchia.livejournal.com]

Triela had no stubbed two, or gremlin bite, or a hangover. In fact, she was just fine.

Relatively speaking.

Scully had wanted her to check in.

[showmetheproof.livejournal.com]

Yes she had. And overall, this was a... well. Saying it was a good thing would be an exaggeration. Necessary, though, definitely.

"Hello, Triela." She closed up her journal and stood, greeting her with a restrained smile. "How are you feeling?"

[sorella-vecchia.livejournal.com]

"Fine." Of course. "How are you?"

[showmetheproof.livejournal.com]

"Fairly well," Scully said, feeling inane. She'd known she had to get specific. "How are you feeling compared to two weeks ago? Better, worse, same?"

[sorella-vecchia.livejournal.com]

"There's been documentably more points of memory failure in the past couple of weeks." Simple. Matter-of-fact.

[showmetheproof.livejournal.com]

Not good. "How many more?" Scully got up to lead Triela into the examining rooms, and said, "Would you object to either an electroencephalograph, or a PET imaging scan today? I'd like to get a look at your brainwaves and activity."

[sorella-vecchia.livejournal.com]

"That will be fine. Though you'll have to purge any records when we're finished."

[showmetheproof.livejournal.com]

Scully paused a moment, reaching for the EEG leads and rubbing them to get them warm enough not to sting, and asked, "Can I show the results to Raven? We were talking about different options for your case, and it might help if she can try to heal you."

[sorella-vecchia.livejournal.com]

Triela paused, thinking about that one. "I suppose that as long as I hold the copies, that would be acceptable."

[showmetheproof.livejournal.com]

"That should work," Scully said. After all, it wasn't like she was looking to publish a paper on this, or needed to report it to any kind of superior. "I've spoken to Dr. Jones, too. We're all going to look for options." She carefully placed the disks on Triela's forehead in a row, and said, "Okay, lie down, and remember these seven words: Pink, clock, book, sky, dog, cloud, water." She turned on the machine and said, "This will take about fifteen minutes to get a definite reading."

[sorella-vecchia.livejournal.com]

"That's fine." Triela was comfortable enough with medical tests that she could just sit there and wait.

[showmetheproof.livejournal.com]

Scully monitored the machine, and was relieved to see normal brain wave activity. No spikes, no irregularities of brain waves in one range or another (such as beta or theta, which would speak to sleep disorders). Just a nice, regular rhythm of activity. After fifteen minutes, she stopped the machine and tore off the sheet, to show it to Triela, reaching to remove the disks. "You'll be happy to know your activity for now, at least, is normal. That doesn't mean there's not damage, but the kind of damage you might have shouldn't lead to seizures or strokes. I'll need to re-check this again later, but for now, at least, that shouldn't be a concern."

[sorella-vecchia.livejournal.com]

"That's good." Triela supposed.

[showmetheproof.livejournal.com]

"It is," Scully said with determination. "Right. To do a PET scan-- that's Positron emission tomography-- I need to inject you with a very tiny amount of a radioactive isotope. It's inert, and shouldn't interact much with any of your tissues; it's just so the machine can pick up on the electrical activity and active parts of your brain. Are you okay with that?"

Always, always ask. Maybe the damage wasn't increasing as quickly as Triela thought it was.

[sorella-vecchia.livejournal.com]

"Sure." Same flat tone.

[showmetheproof.livejournal.com]

React, Scully resisted asking her. Have an opinion. But ... not yet. And not here. She was here for Triela, not the other way around, so asking her for anything was not appropriate.

She gave Triela the injection, and then carefully got her settled her into the PET imager, then watched the images slowly coalesce.

She was glad Triela couldn't see her face fall. The amount of damage (http://www.cbc.ca/gfx/images/news/photos/2009/07/14/alzheimer_pet-scans090714.jpg) to her brain was consistent with mild impairment now. But it was much more than it should have been for anyone Triela's age.

A second scan was run, to look for different activity (http://www.cbc.ca/gfx/images/news/photos/2006/12/20/ept-brian-scans.jpg), and Scully let out a slow breath.

She shut off the machine, and took the images in to Triela, her face sober. "We have a few things to discuss here."

[sorella-vecchia.livejournal.com]

"Okay." Triela was listening. She didn't seem too disinterested.

[showmetheproof.livejournal.com]

She handed Triela the two images, then pulled up another set on the computer.

"The areas of dark blue on the first photos are areas without activity," she said carefully. "Where glucose is not stimulating the brain to react. The left is an Alzheimer patient's. The right is normal. Yours... is somewhere in the middle."

[sorella-vecchia.livejournal.com]

"Ah. That makes sense. I suspect that there are similar shots in my file."

They probably had a time-based analysis.

[showmetheproof.livejournal.com]

Scully showed her the second set. "This is a picture of the areas where there's, mmm, entanglement. Ganglions with plaque. This is why the activity is limited in some places. We'll do a second set of these in a week, and calculate..." The rate of deterioration. "Your progress." Even if it was re-inventing the wheel, from the Welfare Agency's point of view.

She sat back, evaluating Triela's reaction to this. "At a guess, the drugs you're being given are responsible for this. Would you ever consider trying to go off them?"

[sorella-vecchia.livejournal.com]

"No." The question had been asked, but she'd never really even considered it as an option.

[showmetheproof.livejournal.com]

Even expecting this, it was a hard thing to hear. Scully let out a slow breath, and said quietly, "Then I'd say your associates in Rome are probably right about your prognosis, barring some magical intervention. I'm not giving up yet, but...I don't want to give you false hope, Triela. I think we can slow this. But I don't know how to stop it yet." She looked down at the images again, feeling cold at the story they revealed. "Can I ask, how are the drugs administered? I think you told me there was a shunt? Is it a regular timed dosage, or in response to some detected conditions in your body?"

[sorella-vecchia.livejournal.com]

"Regular release supplemented by intravenous injection when necessary." Triela had a case in her pocket for that if it proved necessary.

[showmetheproof.livejournal.com]

A grimace flickered across Scully's expression and then was gone. She'd hoped that restoring the rest of Triela's body to better health might decrease the drug concentration in response and buy more time, but if it wasn't that precise, then there would be no effect on the dosage. "I see."

She sighed. "Okay. Are there any questions you want to ask me now?"

[sorella-vecchia.livejournal.com]

"None come to mind." Triela just didn't... sound all that interested.

It wasn't that she didn't care, it was that she didn't care for herself. Only for the people she'd leave behind.

[showmetheproof.livejournal.com]

"How are you dealing with this emotionally?" Scully bit her lip, looking uncertain. "I'm not wanting to push you here. But do your other friends know? Do you need anything from them, or do you want to talk about how to cope if things continue to get worse?"

Not just cope emotionally, but practically. Someone was going to have to look out for her, make decisions... "Or when to contact Rome. Do you know, if it comes to that, when you want them to be part of your treatment?"

[sorella-vecchia.livejournal.com]

"There are regular reports being sent back. From me and... some other people." So that was taken care of. "As for my own state, it's fine. That's one of the things the Conditioning is designed to handle, after all."

[showmetheproof.livejournal.com]

The flinch, Scully kept internal. 'Fine' had been her world to Mulder for 18 months, when she had not been fine. Just functional, and needing not to deal with his reactions on top of her own. If she'd really been fine, and he'd believed her... well. She wouldn't be 16 again.

Steeling herself, Scully said quietly, "I had cancer for a year and a half. At one point, I came very, very close to dying. I coped. I didn't lose hope. But that's not actually the same thing as being fine." She studied Triela. "I know that the drugs are dampening your reactions, and lowering your affect. But I'm worried about what might happen if they start to fail. Think about this. Think about what you want to do, who you want to depend on. These are the sorts of things a family would look after, if they were here. Talk to someone you trust. Work out the next part. Please." While you still can went unsaid.

[sorella-vecchia.livejournal.com]

Triela managed a slight smile. "I've already... done most of what I need to. The girls back home... they'll have someone to look after them." Claes was dependable, even if she was a bit cold.

"I'm as prepared as I suspect I'm likely to get."

[showmetheproof.livejournal.com]

"Okay." Scully didn't have it in her to cheerlead,to say, we'll go down fighting in this instance. She'd offered Triela what hope she could, and next week, maybe they'd be able to make a small difference, with Raven's help. "Do you remember the seven words I asked you to memorize when you came in?"

[sorella-vecchia.livejournal.com]

"Yes. Pink, clock, tulip, sky, dog, cloud, mountain."

[showmetheproof.livejournal.com]

Pink, clock, book, sky, dog, cloud, water.

Five out of seven. Compared to seven out of seven two weeks ago. Scully kept her voice mild. "seventy percent. Still within normal range, but it's less than two weeks ago. We'll check it again, next Thursday."

[sorella-vecchia.livejournal.com]

Triela blinked. "What?"

She'd gotten all of them.

She thought.

[showmetheproof.livejournal.com]

Scully's voice softened. "Pink, clock, book, sky, cloud, water. You substituted water for mountain, and tulip for book. Probably an association of ideas." She watched Triela for any reaction to that, trying to keep the worry off her face.

[sorella-vecchia.livejournal.com]

"Oh." Triela tried to keep her voice controlled, but it was harder than she'd thought it would be. Some of the tension probably bled through.

[showmetheproof.livejournal.com]

She'd wanted a normal reaction, unnerved by Triela's stoicism. It ached to actually get it, though. Scully said quietly, "Don't attach too much importance to that. Like I said, it's within the normal range." More memory tests on Thursday. Yes. She reached out for Triela's hand, and just held it lightly. "Can I do anything else for you right now?"

[sorella-vecchia.livejournal.com]

"Not for me," Triela muttered.

She sighed and shook her head. "No. I'm fine." Or... as fine as she got.

[showmetheproof.livejournal.com]

"Go have some coffee, something sugary, and find a friend to talk to," Scully said. Try not to worry. Try to be normal, for a while. "Call me if you have questions, or if you just need to talk." She squeezed her hand. "Otherwise, I'll see you around the dorms before next week."