“But you’re confident I have this?” I pressed, hardly daring to breathe.
“I am.”
A sob caught in my throat. “Why didn’t anyone else diagnose it? I’ve seen so many doctors over the last year, and none of them even mentioned this as a possibility.”
“MCAS is notoriously difficult to diagnose,” Dr. Hayes explained. “One of the biggest reasons is that its symptoms can overlap with other conditions, sending doctors chasing the wrong illness.”
I glanced between Blake and Dr. Hayes.
“So, why did you guys figure it out?” They exchanged an amused look, and I rushed to clarify, “I didn’t mean that like it sounded. I just meant … why now? Why did you test for this?”
Blake stopped pacing, running a hand through his hair. “Remember that dinner party a couple of weeks ago, when I noticed that red mark on your arm? I noticed you sniffling?”
“Yeah, you were worried I had been crying.”
Something softened in Blake’s expression. “That’s exactly it. I noticed because I was worried about you.” He paused, seemingto wrestle with something. “The sniffling, the allergies, the hives, the gastrointestinal issues, the fatigue … I remembered a conference presentation about MCAS last year. Something clicked, and when it did, I called Dr. Hayes.”
My heart squeezed. This was the Iceman, who normally kept his distance from everyone. The only reason he’d figured this out was by allowing himself to become emotionally invested.
#Irony
“So, what does this mean?” I asked, my voice small. “Is it terminal? Curable?”
Dr. Hayes shook his head. “It’s not terminal. MCAS can’t be cured, but it can be managed. The goal is to stabilize your mast cells and block the chemicals they release through antihistamines, H2 blockers to reduce the histamine in your stomach, mast cell stabilizers, and potentially Leukotriene Inhibitors to block inflammatory chemicals. Now, the trick with mast cells it thatsomethingis triggering them. It can be triggered by all sorts of everyday things: allergies, certain foods, fragrances, even mild illnesses. Our first step is to get your current flare under control. Then we’ll work on identifying what specific triggers are causing these reactions. Once we understand those patterns, we can look at tapering down your medications, potentially using them only when you experience flares.”
I nodded.
“We’ll monitor your symptoms and adjust your medications as needed.”
“You’re positive I have this?” I repeated.
“I am.”
“And you think this is why I got sick a year ago?”
“What I’ve typically seen with cases like this is that there is some inciting trigger in your body. Typically, that is a virus or bacteria that activates your mast cells. It’s likely you had aninfection over a year ago, and that’s what started all this. And once your mast cells were angry, for lack of a better word, they have been misbehaving ever since.”
Yes. I was sick with that flu/lung thing right before this all started.
“Do you have any questions?”
“Probably,” I admitted. “Not that I can think of right now; to be honest, this is a lot to digest.”
After Dr. Hayes left, promising to send in prescriptions and schedule a follow-up, I sat there in stunned silence. Blake moved to sit across from me, his eyes intent on my face.
“I didn’t realize how much I’d given up until now.” My voice paused on account of thick emotions strangling it. “After everything … I convinced myself that freedom meant accepting I’d never get answers.” I swallowed hard. “But avoiding my health—that wasn’t freedom. Getting this answer, facing it head-on … that’s the only way I’d have ever been free.” And now, at long last, I had it. I smiled. “You have no idea what this feels like.”
“I don’t,” Blake said softly. “But I want to. Please try to describe it to me.”
I eyed him curiously. “Why?”
“First of all, anything to do with you, I want to understand completely. Understanding what you’re going through helps me support you better.”
My heart stumbled in my chest. How did he manage to say exactly the right thing with such simple sincerity?
“You said, ‘first of all,’ which means there’s something else?”
He scrubbed his jaw, settling more deeply into his chair. “I suppose the doctor in me needs to hear this too.”
