Page 25 of Guarded King

Miraculously—especially after I let my temper slip past my professional façade—I made it through my first week as Roman’s assistant without getting fired. It’s not like me to behave that way. But around him, I can’t seem to help it. The simmering tension, which I’ve decided is irritation at his cynical aloofness, keeps getting the best of me.

I’ll have to celebrate staying employed later, though. Right now, my focus is on what Dad’s rheumatologist has to say. Dad sees him every two months while they work to stabilize his condition.

“Managing,” Dad says. He’s never particularly talkative during these appointments. I know it’s frustrating for him, but downplaying his pain won’t help. He knows that, but he’s stubborn, so I’m the one who has to give the doctor the complete truth.

“Dad’s still experiencing a lot of pain and swelling,” I say. “And his fatigue can be quite bad at times.”

Dr. Clarke nods. “Unfortunately, fatigue is one of the hallmarks of rheumatoid arthritis.” He looks at Dad. “Have you had any recent flare-ups?”

“Some.”

“He’s had several flare-ups in the last couple of months.” I side-eye my dad. “They’re rough. Even getting out of bed can be hard for him some days. I’ve been logging the symptoms and when they occur.” I slide a notebook over the desk.

With a nod, Dr. Clarke picks it up. “That’s common. The inflammation during acute periods of increased disease activity affects not just the joints but overall well-being.” He flips through the pages of notes I’ve taken. “This is helpful, Chloe.”

Turning to his computer, he taps away for a moment. “Given the frequency of flare-ups and the lack of response to the current medication, I think it’s time we consider biologic treatments. I think Rituximab will be the best option. It targets the inflammation directly and is relatively successful in reducing pain, slowing disease progression, and limiting potential joint deformity.”

“Are there any side effects?” I ask.

“How much does it cost?” Dad speaks at the same time.

Frowning, Dr. Clarke assesses Dad, then focuses on me. “There’s a risk of increased infection among other things, but the potential benefits are considerable. We would of course monitor everything closely.”

“And the cost?” Dad asks again, his tone brusque. When I look at him, though, his eyes shine with worry, not annoyance. It’s warranted. A new treatment could make a world of difference, but whether we can afford the price tag is another issue.

Dr. Clarke taps his pen on his desk. “Rituximab is typically administered via infusion, which does mean that it’s more expensive upfront. Each infusion can range from five to ten thousand dollars, and you’ll likely have your first and second doses within two weeks of one another. If you respond well, you’ll receive a maintenance dose every six months.”

Dad shakes his head. “No.” He turns to me. “That’s too expensive.”

“Before you decide,” Dr. Clarke says, his voice soothing. “We can look into applying for patient assistance programs that the manufacturer offers to reduce the cost.”

If this is Dad’s best chance at improvement, I’ll find a way to make it work. “My new job pays better. That’ll help.”

“You shouldn’t have to worry about this.” Dad’s mouth is pulled down at the corners. “Or worse, spend all your savings. You should be using your money to go out and have fun, not look after me.”

Gently, I lay my hand over his swollen fingers. “There’s nothing else I’d rather spend my money on,” I tell him. “We’ll figure this out. And once you’re well enough to paint again, I’ll make all the frivolous purchases you want.” I keep my tone light and give him a bright smile.

He shakes his head, though his lips twitch upward. That expression reminds me of what we’re fighting for. Dad would be so much happier if he could pick up a brush and paint the way he used to. Right now, the pain in his fingers is too acute to allow him to hold one for longer than a few minutes at a time.

“I can help you apply for the patient assistance programs,” Dr. Clarke says. “There’s a fair bit of paperwork involved, but it should make it a little more affordable.”

“That would be wonderful,” I say. “I’m happy to do whatever it takes.”

“Do you have any other questions for me today?” he asks.

“How long will it be before we can get in for the first infusion?”

“If we can submit the documentation fairly quickly, I’d guess about six weeks.”

I smile at Dad, and when he gives me a crooked grin in response, my chest expands. Though there’s still a shadow of worry in his eyes, I can’t help but feel hopeful.

“Okay.” Dr. Clarke clasps his hands together on his desk. “I’ll get my receptionist to email you a list of what we need for the paperwork and then we can go from there.”

As we leave the office, I hold Dad’s arm, helping him walk slowly and carefully to the waiting Uber. My heart feels lighter than it has in months. “Do you want to stay out for a bit, or would you rather head straight home?”

He looks up at the blue sky. “It might be nice to spend some time outside.”

“How about we go to Central Park and sit in the sun for a while, then?”

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