Ultrasound

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Ellie has now been here for three weeks, we've been working on getting her healthy and she is starting to make improvements which is encouraging, she is still pretty unwell though. "Alright sweetheart, I'll get you to sit back down now" I sigh, looking at the number on the scale as I help Ellie back onto her bed. I am pleased that she is gaining weight, but it's happening too fast, she has gained 4 kilos. While that is a good thing, she hasn't been eating enough to make that happen. She has been vomiting most mornings and honestly, I would only have expected her to gain a maximum of 2 kilos with the rate she is going. 

"What?" Ellie asks, breaking me from my thoughts. "How has your stomach been feeling lately?" I ask, "full" she mumbles. "Full of food?" I question, "just full" she replies and I nod. "I might get you to do another ultrasound today, would that be ok?" I suggest, quickly formulating a plan in my head. To my surprise, Ellie shakes her head, "no thanks" she replies, avoiding eye contact and bringing her knees up to her chest. I look to her, confused, "what's going on sunshine?" I ask and she looks down. "I can't... I can't have another person... touch me" she whispers. I sigh, looking down, unsure of what to do. I take my patient's hand and inhale deeply before speaking, "could I get Ash to do it?" I suggest. After some hesitation, she gives me a little nod, "only Ash" she says softly. I nod, paging Ash to come down.

Ash walks in shortly after my page with a smile on his face as he pulls the machine behind him, "hello sweet girl" he says cheerfully. Ellie sends him a half hearted smile, "hey" she says. His smile turns sympathetic, "you're gonna be ok sweetie, it's just pictures" he says. Ellie nods as Ash takes a stool and wheels over to her. "Let's get this over with quickly sweet girl. Can I get you to lay down for me?" he asks. Ellie sighs but does as she's asked, pushing the blanket down under her hips. Ash smiles at her softly, "thanks sweetie" he says, pulling on some gloves. "Can I get you to do what we did last time and tuck this in and lift up your shirt for me?" he asks, handing her a towel. Ellie nods, taking the towel and pushing it into her waistband. Ash smiles, "ok Ellie, I'm just gonna have a little look around now" he says softly, putting the gel on the probe. Ellie gives him a little nod and he smiles before letting it rest over her stomach. He starts moving the probe around the upper areas of her abdomen, checking for any abnormalities there. We aren't expecting much, the abnormality is likely to be in the lower abdomen but we still need to check. 

"Alright sweet girl, there's your NG" Ash says, pointing to the nasogastric tube in Ellie's stomach, explaining to her what he is doing. Ellie nods before Ash moves on to her lower abdomen. Ellie whimpers at this as Ash pushes into her lower belly and pelvis. "Sorry sweet girl, deep breaths for me" Ash says, I keep my focus on Ellie, not the screen because I need to make sure she is ok. My attention is quickly diverted when Ash fails to stifle a heavy sigh. Tears form in Ellie's eyes as she looks to the monitor, identifying Ash's concern. She doesn't know what it is but Ash and I do... she's pregnant. 

Her last ultrasound must have been just before six weeks... the fetus is visible. I look to Ash and he looks back to me, "viable" he says softly. I sigh, this isn't good. I can't just ask her to have an abortion. Even if I am going for custody, it's her decision. I just don't know if her body is strong enough for a pregnancy right now. I take Ellie's trembling hand and she looks to me with tears in her eyes, "what is it?" she asks, looking at the mass inside her uterus. I sigh, rubbing my thumb over her knuckles, "it's a baby sweetheart" I say softly. Ellie shoots her head to Ash and he just nods. Tears slowly slip down Ellie's cheeks, "what do I do?" she asks. I sigh, "at the end of the day, all I can make are recommendations. It's your decision whether you want to go through with it or not" I say carefully. Ellie shakes her head, "I'm not letting it go" she whispers. I sigh, I thought this might happen. "That's your decision sunshine, and I support you in what you choose, but it is likely that this is going to be really hard on that little body of yours" I say. She looks to me sadly, "I need this" she says quietly. I look down, "it's really dangerous to put yourself through that kind of strain while you're this sick" I say. Ellie shakes her head again, "what if this is as healthy as I'm going to get? What if I have an abortion but I never get to carry a child again?" she asks and all I can do is sigh. "I've lost everything Mike... I'm not losing this too" she says, squeezing my hand. I just nod.

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