Yet now as she sat there . . . her hands shook.
Dr. Sandy walked in the room only minutes after Emma had changed and made herself comfortable on the exam table.
“Good morning.”
“Hey.”
“How was your weekend?” Sandy sat on a rolling stool and focused her attention on Emma.
“Good. Great, even.”
“Glad to hear it. I’m going to run another blood panel.”
“Yeah, you said that. What are the numbers?”
“You didn’t log in to the portal to look?” she asked.
Was that a thing? “I didn’t realize I could do that.”
“Well . . .” For the next five minutes Dr. Sandy talked about iron saturation and how the number for Emma’s body was unusually high. Then she talked about binding capacity . . . and then something called a ferritin level. Super high. Sandy paused. “My suspicion is that you have hemochromatosis.”
“What is that?”
“It’s a genetic disorder that makes it so that your body doesn’t process iron like everyone else.”
“So, my bones are stronger?” Emma knew almost nothing about blood iron.
“No. Your body can’t burn off iron. But before we go there . . . let’s run the tests and make sure.”
“It could be a fluke?”
Dr. Sandy’s smile didn’t convince Emma.
“You mentioned liver enzymes . . . what does that have to do with this?”
Sandy took a deep breath. “If you do have hemochromatosis, the iron in your bloodstream has to plant itself somewhere in your body. One of the first places it goes is your liver.”
Everything in Emma’s body stilled. Her eyes widened. “What does that mean?”
“Your liver enzymes are only slightly elevated . . .”
“Which means you know the iron levels aren’t a mistake.”
“We need to double-check,” Sandy said.
“But my liver is telling you you’re right.”
Emma met Sandy’s eyes. “Most likely.”
“And then what?”
“I don’t want to ‘then what’ yet,” she said.
Emma snapped her head up. Her hand shook. “‘Then what’ anyway. What am I looking at?”
“Before we go there . . . let me examine you. Ask a few questions.”
“Okay.”
Emma sat there, eyes wide. What did this mean? She had zero idea what Dr. Sandy was talking about.
“Lie back.”
Emma tried to relax on the half table while the doctor poked around, asking if something hurt.
Nothing hurt.
Wasn’t that an indication of a problem?
“How is your energy level?”
“I’m a little tired. But I’ve been running. Moving . . . traveling. Starting a business.”
She poked at Emma’s hands. “Any pain in your joints?”
Emma shook her head.
“What about your bowel movements? Constipation, loose . . . different color?”
She felt a glitch . . . a memory . . . “A few times it’s been light.”
“In color?”
“Yeah.” In Italy.
“All the time?”
“I don’t look all the time.”
Dr. Sandy stopped examining her and stood back. “Any headaches?”
“A few.”
“One a week? A month?”
“I take something over the counter a couple times a week. I’ve been a little stressed.”
Dr. Sandy smiled.
But it didn’t meet her eyes. “This is what we’re going to do. I’m going to repeat the blood tests. That’s where we start. I’m going to order an MRI of your liver, get that started, and hopefully your insurance will approve sooner.”
“Then what?”
“If . . . if your bloodwork continues to point in this direction, I’m going to request a consult with a hematologist and a hepatologist . . .”
-Ologist this and -ologist that. Emma shut off.
Nothing else went in.
Nothing registered.
Sandy talked and Emma turned off.
The nurse walked in . . . drew her blood.
As Emma left the office, she had the information for the patient portal. Something she never thought she would need to look at. And a follow-up appointment.
A numbness fell over her like nothing she’d ever felt before.
She’d been told words she’d never heard. And considered everything she did know about liver disease.
None of it good.
Her phone rang as she drove home. It was her mother. There was no way Emma could talk to her . . . not with her head spinning on everything she’d just been told.
She let the call go to voice mail and finished the rest of the drive on autopilot.
At home, Emma dropped everything on the kitchen island, found her computer, and started typing in all the new words that had been added to her vocabulary by her doctor.
The printout of her previous bloodwork sat in front of her.
Within an hour she started to understand.
If your body couldn’t process iron, that iron needed to stick somewhere in the body. The liver . . . head, heart . . . joints.
Emma flexed her fingers.
No pain.
It was genetic. Not something brought on by diet or too much wine.
Nearly every article she’d found on the disorder had disturbing images of patients with diseased organs. Too much iron in your liver meant disease if untreated, and that seemed to be a resounding theme.
Emma found herself down the rabbit hole of liver disease. Alcoholic and nonalcoholic liver disease. The results were the same. None of them pretty.
It was when she looked up cure and treatment for hemochromatosis that Emma cringed.
“What the hell?”
“I hear you have a girlfriend.”
Gio looked up from the office desk, where he was working on the inventory and employee scheduling.
Salena stood in the doorway, pointing her finger in his direction.
“Who told you that, Instagram or Facebook?”
“Both,” she said without apology.
Gio dropped the pen he was holding. “Sometimes the internet doesn’t lie.”
Salena smiled and scrambled to sit across from him. “She’s beautiful.”
“I know. I’m a lucky man.”
“You met her in Italy?”
Gio paused. “You’ve been talking to Chloe.”
“Your sister is my best friend. That’s a given.”
“I did in fact meet her in Italy.” He pictured her standing there with a bag in place of a suitcase. “She’s special.”
Salena’s jaw slacked. “Oh my God . . . Chloe wasn’t kidding.”
“What?”
“You’re all in.”
He glitched. Like a computer not completely syncing with the internet connection.
“Holy crap . . .”
Salena started to laugh. “Yeah . . . holy crap. No one is going to believe it. Giovanni D’Angelo is off the market.”
Gio pictured Emma with her hair piled high, standing in a room of people that didn’t matter smiling at him. “I’m beyond off the market.”
Salena sat back and a tear ran down her face. “I’m happy for you.”