She turns her laptop to show an X-ray. “Your X-rays are negative for spine fusion. Which is a good thing. You have what is referred to as Non-radiographic Axial Spondyloarthritis. The other subtype of axial spondyloarthritis is ankylosing spondylitis, which is what Dr. Holmes was talking about.”
She explains for a few minutes on what the condition means in the long term and about the complications Zara might experience. “Spondyloarthritis is different from other forms of arthritis. In the other forms, patients do better with lots of rest. In SpA, that tends to exacerbate the stiffness and pain. Which is why you experience more stiffness and pain when you get out of bed and why you’ve had trouble sleeping. The condition is also linked to loss of appetite, which you mentioned you’ve experienced over the past few weeks.”
The last part is news to me. Hell, a lot of what Dr. Winfrey just said is news to me.
Apparently, Zara’s been keeping things from me, not letting me know the full extent of what she’s been dealing with.
Dr. Winfrey hands Zara a pamphlet. “This contains more information on SpA and tips for managing the pain, including different types of recommended exercise. Such as yoga. Going for walks. We have other pain med options we can try, but I would like to see if we can manage the condition with lifestyle changes first.”
“Okay.” Zara appears relieved compared to when we arrived at the clinic, the small crease between her eyes smoothing out.
“It’s possible you’ll experience flare-ups from time to time that exacerbate the pain. This is often the case during periods when you’re dealing with high levels of stress. If that’s the case, you might need to go on one of the other drugs for the short term or longer. The goal is to give you the highest quality of life possible, while using the holistic treatment approach as outlined in the pamphlet.”
High levels of stress. That would make sense. Zara has been under increased stress lately with the expansion and the issue with the broken pipe at Picnic & Treats. Those could be what triggered the eye inflammation and why lately she looks so exhausted—more so than she usually does when she’s stressed.
I take the pamphlet from Zara and flip through it. “Are there any restrictions with exercise?”
Zara laughs, the soft sound a low rumble in her chest. “I’m pretty sure that daily killer run you and Kellan go on would fall under the category ofdon’t even attempt.” The corners of her mouth quirk into a quick grin.
“I recommend starting slow and listening to your body, Zara,” Dr. Winfrey says. “Pushing yourself too hard might only make things worse. If your body tells you to slow down, slow down. If it tells you to get moving, get up and move. Go for a walk. Do some gentle stretches.”
Her mouth curves into a reassuring smile that she splits between Zara and me. “I know it’s a lot to take in. Read the pamphlet. It’s by the Spondylitis Association of America. Their resources on the website should answer a lot of your questions too. I’m here to answer any others you might have, and I can provide additional guidance if you should need it.”
Zara and I nod. My mind whirls with all the ways I can help her manage the condition that is conducting warfare on her beautiful body.
“If you have any questions referring to your specific case,” Dr. Winfrey adds, “you can contact my office. I would like to see you in three months, to keep on top of things with your condition. But if you experience flare-ups that make the lifestyle changes—such as exercise—too difficult to do, let me know so we can alter your medication, if necessary.”
Zara visibly relaxes with the last hit of information. She now has answers, a direction to take. And now we know what she’s dealing with, I can help her. Because hell if I’m letting her face this alone.
She’s my best friend.
The woman who has stuck by my side since the day she told my elementary-school bully where to go.
Zara and I walk to my Explorer in the parking lot. Her movements are stiff again, no doubt from sitting so long on the drive here and during the appointment. And now we have a long drive home.
“Do you need to get back to Maple Ridge right away?” I ask, my hand on the SUV passenger door handle.
Biting her bottom lip, she eyes the Explorer like it’s a mouse scurrying her way. “I’m not expected anywhere anytime soon. But don’t you need to get back to work?”
“I have a bit of time before I need to get back.” I don’t, but screw rushing to go home just yet. I don’t want to make things worse for her by hitting the road so soon. “There’s something I want to buy. And I thought we could go for a walk, in a nearby park, before we head home.”
Zara’s eyes brighten and turn skyward as if in a silent prayer of thanks. She knows why I suggested the walk. “What do you wanna buy?”
“You’ll see.”
I drive to a store that sells outdoors sports equipment, and we walk to the kids section.
“A child backpack carrier?” Zara’s gaze roams over the metal frame with the canvas seat and zippered bag at the base of it.
“I’ve been wanting to take Peony on hikes on the local trails. This will let me do that. And I thought maybe you and I can go for daily walks around the lake or on Warrior property. This way Peony can also join us.If that’s okay with you.” Of course, all this would be a lot easier without the ticking deadline.
Excitement sparkles in Zara’s eyes, its shine a backdrop to the skeptical bend of her mouth. “I would love it if Peony joins us. It won’t be like those killer runs you go on with Kellan, though, will it?”
“Definitely not. It’s about me spending time with Peony and helping you manage the spondyloarthritis.”
It’s about helping my best friend and being the father Peony deserves.
Being the father Cooper and Clarke don’t get to be, because I failed them.