From: "Pat Filer" Date: Sat, 23 Jun 2007 01:41:38 -0400 Subject: Mulder, F. and Strep. A. and Then Some... , by Pattie Source: revision Title: Mulder, F. and Strep. A. and Then Some... Author: Pattie Rated: PG-13, and educational, too! Category: Post-Ep., MT, Angst. Summary: After all that suffering in Tunguska and his recovery from the black oil virus, Mulder suffers some serious health complications. Spoilers: Tunguska and Terma. Feedback: Yes please, at: patfiler@hotmail.com Archive: I put them up everywhere I can, and if you want it, please ask first. Disclaimer: Chris Carter, Ten Thirteen Productions, Fox Studios, Yada yada yada... No mon., no copyright infringement intended. Author's Note: I must give credit to the doctors and other researchers who have made treatment of the diseases I am about to write about possible, and their amazing tenacity in their everyday life-saving interventions. Also, this story is dedicated to my grandfather and a very dear little boy who makes my life happier. *From an article referring to glomerular diseases, and that part is titled: "Infection-related Glomerular Disease". It can be found here: http://kidney.niddk.nih.gov/kudiseases/pubs/ glomerular/ The time to recover from the black oil experiment had passed and Mulder was regaining his strength. His life had nearly been over and done with, and so had Krycek's. He was so thankful, but wished that traitorous S.O.B. the worst and went back to work three weeks after his return from Tunguska. Scully had to practically tie him down to get him to take the time off, but there were strict orders from "UPSTAIRS" at the Bureau as well. At least with Krycek presumed dead, that was one less problem on their hands. One Tuesday morning he was so glad to enter the office and go through the garbacious paperwork Scully had had to deal with and found some of it most disconcerting and the rest rather amusing. He chuckled to himself as he read over some of the comments. Scully smiled as she peered into the office. "How's The FBI's Most Unwanted?" "Ah Scully, you really should have sent me these while I was in hospital and after I went home. Priceless!" "It was serious, Mulder!" She hung her purse on the coat rack and passed him a coffee. "Wake up just like I did, Mulder, because we're not out of the woods yet. You now what they're out to do." "Yes, I do. And thanks for the coffee. I... just can't believe some of the... " Scully put her hand over his. "Mulder, if you want to talk about it, you know I'm here." Mulder shook his head. "'SENATE SUBCOMMITTEE ON INTELLIGENCE AND TERRORISM REPORT' my ass. All they wanted to do was beat the crap outta me, work on their agenda and imagine what the taxpayers would say if they ever found out about this? Think THEY'D believe it?" Scully sipped her coffee and shook her head. "Sometimes I don't know what to believe myself, Mulder. But I'm getting the education of my life working here, and dammit, I resent the lies, too. But we can still do some good in the other areas of investigations, and I'm happy just to do that for now." "I'll just get back to the reports. It's going to be a long time before I get to the end of my side of it." "Then I'll leave you to it and get some other things done here. Glad to be home?" Mulder appeared uncertain. "Hard to contain my excitement. Can't you see I'm just overflowing with enthusiasm?" For a moment, he felt his throat. "Mulder? What is it?" "Nothing. Maybe just a little soreness. When they checked me out of the hospital they said to expect the nodes to act up for awhile." "I'm aware of that. Just, don't take any chances. Okay?" "Yes, Doc. Now let's see some work!" Scully shook her head and smiled. Yes, workaholic Mulder was back, and she was happy. *** NEXT MORNING 9:32 AM The partners had left a debriefing with A.D. Skinner and returned to the office. Scully had noticed Mulder was looking rather pale but thought nothing of it as he had been through a lot in the past few weeks. When he began coughing was when she began to be concerned. "Are you okay, Mulder?" He looked up from his file. "Oh, yeah. Just a cold coming on I guess. Man it's hot in here." Scully stood up from her chair and felt his forehead. "I don't think so. I think you have a fever. Let me get my bag out of the car and check you out." Mulder smiled slightly. "Any excuse to probe me. Go ahead. Enjoy yourself. Seems like a lot of others have." "Get a drink of water and I'll be back." When she did return, she popped a thermometer into his mouth and palpated his lymph nodes. "Does that hurt? They seem a little swollen." "Uh huh." She removed the thermometer. "101.5, Mulder. Fever." "Okay. I have a sore throat. It's probably just a cold." "Let me look." "Why? For any alien probes or black oil virus?" "Open up." She shone her pen light into Mulder's mouth. "Red as a beet! I want to do a culture and send it off to the lab." "Scully, I've had sore throats before," he protested. "Can we just dispose of this junk on the desk and in the inbox and get it over with?" "Just want to be sure," Scully assured him, as she reached for a swab. "I promise I won't make you gag. There. Done, and I'll just send it off to the lab." "Is this really necessary, Scully?" "Yeah. After all you've been through, it is. It's probably nothing, but it never hurts to find out. I'm sure it's nothing serious, and you'll be running all over the country chasing freaks of nature, ghosts and aliens in no time at all." "You're turning me on, Scully. Even if I have a headache." "Headache?" "Just a little headache. Please don't send me for a CT scan." *** 4:15 PM The office phone rang and Mulder was in the men's room trying to cool off. "Scully. Yes, I've been waiting for it. Thanks for putting it on priority. Are you sure? All right. Thanks. And I owe you one." Mulder walked into the office looking like death warmed over. "If that was my landlord, I was in Russia." "No, Mulder. It was the lab. You have streptococcus aureus, commonly known as strep throat. I'm going to prescribe an antibiotic and a few days off for you. At least a week, maybe ten days." "But we... " "I can do most of the work, and you have to do the recovering. It's probably a secondary infection after that virus you were subjected to. DON'T violate your doctor's orders," she warned him. "Now you have a chance to write that rent check you owe your landlord. You go home. I'll get a prescription filled and take it to you as soon as I can. Come to think of it, I just might take some blood then to see what your white cell count is. Now go!" Mulder sighed. "All right. I know the drill." He stood and grabbed his jacket. "Maybe I can catch up on my reading. See you later." "Take care. And go to bed early, Mulder." *** 2630 HEGAL PLACE, ALEXANDRIA, VA. 6:50 PM Scully found Mulder's door left unlocked and strode into his apartment to find him watching the local news. "You know, you really should lock the door especially now," she warned her partner. Mulder sat up on the couch and his appearance was one of a very sick, tired and feverish man. "Oh, I'm a Federal Agent, remember? A big boy like me can take care of himself." Scully took a pill vial out of a pharmacy bag and told him to take one 500 mg. capsule of the antibiotic three times a day with food for ten days. "Oh, you really ARE my drug dealer." "What?" "Never mind. Something I once said to a cop. So, what about all that paperwork that still needs doing?" "I can bring it to you tomorrow, and do not push yourself Mulder. Now, I'll get you a glass of water and something out of the kitchen, then you stay put until I can get some food back here for you seeing as you never do have much stocked, and I don't think you're going anywhere." "Why?" "Because I said so." She made her way to the kitchen wondering what would get her partner next. *** OFFICE OF THE X-FILES TWO WEEKS LATER MONDAY MORNING 8:00 AM Mulder had awakened this morning with his face slightly swollen on the left side, figured it could be the beginning of the mumps, but went into work anyway because there was going to be a staff meeting. This was one he couldn't afford to miss. However, when Scully entered the office and saw his face, she immediately took his temperature and probed at his lymph nodes yet again. "Oh Mom, you're always poking at me for something. Can't you just leave me be?" "It's no joke, Mulder. I'm going out to get my bag and take your blood pressure. Seems to be a little edema. I want to find out what's going on. Stay put." Mulder threw up his hands in resignation. Yes, he was feeling sick, but not totally out of commission! He hungered for a road trip after ten days of confinement to his apartment and then, to make things worse, eleven days of desk duty. And he DID make sure to come in on the weekend to catch up. When Scully saw the b.p. reading she was shocked. "Mulder, I think we should get you to a hospital." "No." "Look," Scully sternly said as she stared him a very serious look, "We need to know what's going on with you. Since you've come back from Tunguska, you've been sick a lot." Then her tone softened. "Look, I'm your partner AND your friend and you have me worried. We can miss this meeting, even if Skinner said it was a must that we attend. I'll tell him as a doctor that you need emergency medical attention. Now, let's get going and I can call him on the way out to my car." Mulder shut down his computer and closed the file folders on the desk. "All right. Let's go. But if this is just a reaction to Chinese food or something, I will get even." "Don't bet on it." *** 3:35 PM Scully sat with Mulder in the ER cubicle while they waited for some blood work and results from yet another throat swab. Neither had even had lunch, but then Mulder wasn't really in any condition to eat and Scully wanted to stay there until the results came back. "Go get something to eat," a tired Mulder urged his partner. "I'm not sure I should after what's happened since you went off to Russia with Krycek, Mulder. Who knows what's happening?" Mulder smiled weakly. "Now you're paranoid, too. I have taught you well, Grasshopper." Scully frowned. "Well, what IF they did something else, added a little something into the antiviral, injected you with something to start a recurrence?" "Then you get the desk." Just then a man in a white coat arrived with some folders. "Hello, Agent Mulder. I'm Dr. Simmons. I was called down from Nephrology. How are you feeling?" Scully began to really worry now. "Nephrology?" "I'm not too sure. How am I?" "Well, I'm afraid your leukocyte count is sky high, you're a little anemic, and we're concerned about the high red blood cell casts and protein levels in your urine. I'm afraid you may be experiencing kidney failure." Scully put her hand over her mouth, then stood. May I see those results, Dr. Simmons? I'm Dr. Dana Scully." "Sure, but please give them back to me when the orderly comes to wheel Agent Mulder to Nephrology. We want to start treatment as soon as we possibly can. He should be on his way down now. We're going to get Agent Mulder on a restricted diet and have him on medications as soon as possible. If renal function is not restored within a few days, we may need to do a nephritic biopsy and a possible transplant, but I doubt it will proceed that far." Mulder had fallen asleep as they were talking. Scully followed Dr. Simmons to the Nursing Station. "So you suspect he has acute glomerulonephritis?" "Actually, since he did have a strep infection, it's more likely acute post streptococcal glomerulonephritis. We're hoping it's not chronic, because if it is, there will already be a lot of damage. Here comes Burke now. I'm afraid your partner will need to be in ICU up there until we get his treatment plan established and underway." "Of course." Scully returned the files and followed the doctor and the orderly as they took Mulder up to the fourth floor of the hospital, where the nurses settled him in and Dr. Simmons conferred with his peers in the Nephrology Department. As using her cell phone wasn't a great idea around all the machines, she called Skinner from a payphone in the hallway. "Sir, I'm calling from the hospital. He's stabilized. We won't really know what's happening for a while yet but he appears to have a kidney problem. Yes. I'll keep you posted. Well, I'd appreciate that, Sir, but I don't think he's in any condition to receive visitors right now. I will. Thank you." *Now comes the worst part,* she thought. *More waiting.* She peered through the window of the Intensive Care Unit and silently prayed she could visit Mulder soon without gowning and gloving. A nurse walked to her and said softly, "There's not much going on right now. You should go get some rest." "I'm okay. I just want... " "Now how much good are you going to do him if you get let yourself get run down?" Scully gave the nurse a faint smile. "You're right. It's been a long day, I should go home and I do need something to eat anyway." So, she went home, but not before stopping off at the University Medical Library to access a few files pertaining to the disease and sending the links to her personal computer. She spent the rest of her evening reading, eating a salad with some tofu, and keeping the hot coffee handy. By midnight, she had had enough research for one night, took a bath and managed to sleep until about 6:00 a.m. *** GEORGETOWN UNIVERSITY MEDICAL CENTER 8:15 AM Scully arrived at the Nephrology Unit and announced herself at the Nurse's Station and was told to take a seat in the waiting room. Somehow, she just didn't like the prospect of watching the TV all day, so she had taken the time to print out most of the information about renal diseases and the damage they could cause. She prepared herself for the possibility of acute kidney disease or chronic disease and damage. Why she toiled at this for so many hours the previous night in some form of self-torture while her partner lay in a hospital bed and she hadn't heard the specific diagnosis yet, she didn't know. It was a form of self-torture, but she persued her goal to learn about this kidney disease. Dr. Simmons peered over her shoulder at about 10:00, seeing the information she was silently reading: 'The Streptococcus bacteria do not attack the kidney directly, but an infection may stimulate the immune system to overproduce antibodies, which are circulated in the blood and finally deposited in the glomeruli, causing damage. PSGN can bring on sudden symptoms of swelling (edema), reduced urine output (oliguria), and blood in the urine (hematuria). Tests will show large amounts of protein in the urine and elevated levels of creatinine and urea nitrogen in the blood, thus indicating reduced kidney function. High blood pressure frequently accompanies reduced kidney function in this disease. PSGN is most common in children between the ages of 3 and 7, although it can strike at any age, and it most often affects boys. It lasts only a brief time and usually allows the kidneys to recover. In a few cases, however, kidney damage may be permanent, requiring dialysis or transplantation to replace renal function.'* "Great reading, but kind of depressing." "Yeah. How's Mulder?" "We're sending him for a scan to find out if there's any visceral infection, but I think this is the acute form of the nephritis, so we just want to... " "Be sure. After all he's been through, I'm not surprised." Scully rubbed her forehead. "Look. You're not doing yourself any good reading up on all this. I just told you it's probably readily treatable and I don't see any reason to suspect permanent damage to the nephrons. There isn't likely any focal segmental glomerulo- sclerosis, scarring, but we're not suspecting that yet. I am starting him on Prednisone today. That should help heal any nephritic damage." "He's on an antibiotic, right?" "Yes. And the urine is getting a bit lighter, the CBC is much better, fewer red cells and casts, and we've given him acetaminophen for the fever. Very little evidence of flank pain. Oh, and his head circumference is... " That brought a smile from Scully. "Okay, I know. Stop being so obsessed. Doctor Simmons, I know you're doing your job and just let me know when I can see him, okay?" Simmons smiled, suspecting that this was not a simple working relationship. "Yes. Now, I've got to get moving on my other patients. Results should be in from Radiology in a few hours. The system is... " "Over-burdened. I know. Go on. I'll just um..." "Not read any more and relax." "Yeah." Oh, she might not read, but she wasn't ready to relax just yet. She couldn't help but worry. *** GEORGETOWN UNIVERSITY MEDICAL CENTER 12:37 PM Assistant Director Walter Skinner arrived to find Agent Scully sitting in the waiting room looking over at the Nurse's Station in the hope that someone might have news about Mulder. "Sir. I didn't expect to see you here. Sit down." "I took an extended lunch. How's Mulder?" "Seems a bit better, so I'm told. Once they get the latest test results back, we'll know what's happening." She stared down at a half-eaten egg salad sandwich and shook her head. "I can't believe this is all just coincidence. First the experiment, then the strep throat. Now this." Skinner sighed. "Well, we know the conditions in the prison in Tunguska were less than hygienic, but do you believe anyone would deliberately set him up for this?" There was a long silence before Scully answered. "Do you?" Skinner sighed. "I've seen and heard some things I didn't want to know about. I just don't know. Maybe I could try to find out, but Krycek was there with him, and he's presumed dead." "Yeah. Wouldn't he just die when we need to get at him the most." "Look. I have to get back to work. Let me know when you hear any more about his condition, okay?" "Certainly. And, thanks for coming. Mulder would appreciate the fact you took time out to personally see how he was." Skinner stood and straightened his jacket. "Well, a lot has changed in the past few years you've been under my direction, so it's part of my duty as well to see to it that my agents are safe." "Thank you, Sir." "Take it easy, and take as much time as you need to help get him through this." "Yes, Sir." Maybe she did want to eat the rest of her sandwich after all. A salad entered her mind, too. As for Mulder, he was resting and having the foods the staff had ordered for him. 2:37 PM Dr. Simmons read the Radiology report to Scully and handed it to her to read for herself. "So you're sure there's no permanent scarring?" "Pretty sure. There are a lot of white cells in the nephrons, but I'm certain filtration will begin to return to normal in the next few days. He'll need to do a morning test strip for proteinuria for a few weeks while the course of steroids is followed, and with any luck he'll be released in three or four days. Tapering off of the steroids with a preprinted schedule is recommended so the natural production of steroids from the adrenal glands resumes, and we'll see how things turn out. In a couple of months, we'll go over the strip readings and adrenals and see if there's any permanent renal impairment." "When can I see him?" Simmons smiled. "He's out of ICU and in a regular bed. You can see him right now. Room 407. Good thing his plan covers a private room." "Oh believe me, it's for security. Thank you so much!" "Just doing my job, Doctor. And put those articles out with the garbage." "I found it rather educational. Should I leave the FBI I might just take up medicine again. I'd better get in there." She nearly ran to his room, and was greeted with a smile. "How are you doing Scully? Did you notice my new gown?" "It's a change from your usual attire, but how are YOU doing?" She pulled a chair up to his bedside and sat down. "I'm told I'm doing much better. They said I'd have to take a few weeks to recover, and that's a real bummer, but what can you do?" With a grin Scully replied, "Watch videos, finish up that report of your adventures in Russia and heal up. Get back in shape so you can go one on one with one of your basketball buddies." "The thought of anything strenuous is exciting, given the boredom of constant convalescence. You know, rumour has it that I may be having potatoes with parsley for supper." "Well, things ARE looking up for you. Listen, I don't know where you contracted the Strep A, but until we figure that out, I don't think we can be too careful. So, since I'm your personal physician, I am going to make sure you recover, and as your partner at the Bureau, I'm going to see to it that nothing else happens." "He's dead, Scully." "But the rest of them aren't." Mulder grinned. "Don't go and kill all of them. Then I won't have anything to do when I get out of my enforced vacation. I guess it doesn't hurt to be on the safe side." "No. No, it doesn't. Listen, I'm going to get a few things from your place and bring them here. Except for those videos. Three or four days can seem like an eternity in a hospital." "Yeah. Scully, you look beat. Go get some rest. I'll be here when you get back." "You're sure?" "As senior Special Agent, yes that's an order. Go on. I'll be sort of out of it for a while anyway." Scully kissed Mulder's forehead and whispered, "I only follow orders if you do. Have a nice nap." DANA SCULLY'S APARTMENT 4:50 PM She was just finishing up cleaning the kitchen when the house phone rang. "Scully." It was Skinner. "It turns out there were some cases of Strep here at the Bureau, so don't worry about anything deliberate. How's Mulder?" "He's doing a lot better, Sir. I'm going to see him tonight. I'll let you know later what's going to be happening, but it looks like he's going to be away from the Hoover for a couple of weeks." "That's a relief. I'll be in later to see him myself. Tell him to take it easy." "I will. I need to run a few errands." "I understand. I'll talk to you later." After Skinner hung up, Scully called the Gunmen. "What? No kidding!" Langley exclaimed. "Hey guys! You gotta hear this." Byers and Frohike drew close to the phone as Scully explained Mulder's illness through the speaker phone. "Now take it easy on him, guys. Make the visits short and none of the conspiracy talk until he's home." "I'm sure we'll do our best to refrain from anything conspiracy related or paranormal," Byers said. "How you doin', pretty one?" "Save it, Frohike." "Well, at least SHE'S fit as a fiddle," Frohike quipped. "Give the big guy our love. We've got an issue to get out tonight, but we'll make it there tomorrow." "I'm sure Mulder would appreciate that. I'm running late. 'Bye." "Take care," Langley reminded her. *** GEORGETOWN UNIVERSITY MEDICAL CENTRE THREE WEEKS LATER 10:35 AM Dr. Simmons met with Agents Mulder and Scully to review test strip records, urinary turbidity and blood pressure readings. "Agent, Mulder, congratulations. I pronounce you fit for duty, and you're in remarkable health." Mulder heaved a sigh of relief and Scully was overjoyed. "So, do we need to watch out for anything like this in the future?" "Well, any blood in the urine, swelling and pain after a secondary infection can cause a return of glomerulonephritis. When we treat this as early as possible, there's no permanent damage. I'd still be on the safe side and seek medical attention. It rarely recurs unless there's a genetic predisposition to the various nephritic syndromes, but I'd say your chances of that are pretty slim." Well, you see, the reason I'm asking that is my father had a kidney problem and was on medication at the time he was murdered, so I thought maybe..." "It has occurred, but the chances are actually not that great." Scully put her hand on Mulder's shoulder. "Quit while you're ahead, Mulder. Now you can play some b-ball and get back into running. Let's get back to work." Simmons closed his folder and smiled. "You run?" "Yeah. I can't live without it." "I know. I run four miles when I can get a couple of hours free without being on call, and it's... " "Amazing. The runner's high. Even run out in... " Scully thought to herself the enthusiastic banter would go on forever, but sighed and blocked it out until the nephrologist was paged. She was grateful her prayers had been answered and that patient, Mulder, former sufferer of acute glomerulonephritis was back to being himself. This was the Mulder she preferred. Yes, Agent Fox Mulder had definitely fully recovered. END