“How do you always…. Never mind. Not sure yet. I’ve only had one period since the boys were born. I have an appointment with the OB next week.”
There was a tightness around her eyes that, even though she was acting like it was no big deal, showed that it was. Wanting to lighten the mood, I waggled my eyebrows. “You know, statistically speaking, once you’ve had one set of twins, and if you’re a twin yourself, you’re more likely to have twins again.”
Demi let out a whimper. “I know.And yeah, I can do it again, if that’s the case. But Luke already said he’s getting snipped before I have this one. Whether we’re a family of six or seven, that’s enough. I’m not Mom.”
I nodded, approving of this. I swiped a thumb under her eyes. “Mom and Dad did a really good job of not parentifying us older kids, and making sure we all had individualized attention. And I wouldn’t give up any of our siblings for anything. But ten kids is too many.”
Demi nodded fervently in response. “Yep. We’re happy with what we’ve got. Now let’s get out there so Roman can see the fit. But I think we’re both good.”
I was sure the tailor wouldn’t want to make any changes. He was an older man with a Slavic accent of some kind, and he hadvery firm opinions on things. But he was also exceedingly good at what he did, and the alterations, as well as my custom suit, fit perfectly.
“We’re getting lunch after, right?”
“Hell yes,” Demi agreed, frantically nodding. Then her face fell and she looked devastated. “Ah dammit. We can’t go to Nozomi!”
I hid the smile because I knew she wouldn’t appreciate it. “You can eat sushi if you stick to the cooked kind.” The look she gave me, as though I was a fucking idiot for even suggesting it, had me holding up my hands and chuckling. “You’re right. That was dumb. We’ll plan a postpartum trip instead, okay?”
“I suppose,” she grumbled. Then a second later, her eyes lit up. “Stueben’s?”
I was a fan of the diner so I readily agreed. With my sister happy again, we headed out to get our final fit check so we could get on with our day.
Nick’s cooking was amazing. Not better than Mom’s—I would never be so stupid as to think that, let alone say it out loud—but different. It made sense. He was a Michelin starred chef. Why he was temporarily cooking at a ranch in nowhere Colorado was a mystery. I sensed there was a story there but I certainly wasn’t going to go digging. Carter and his PA had vetted the man and that was good enough for me.
Tonight’s fare was family-style Italian. Two different kinds of lasagna, antipasto, manicotti and chicken alfredo, along with garlic knots and green salad. I’d always been a fan of Mom’s lasagna, but Nick’s was otherworldly. Instead of thick layers ofcheese, it had a different sauce and a depth of flavor I hadn’t expected. I wasn’t the only one enjoying it, but I noticed that at least my siblings had made sure to pile on Mom’s version as well.
The table was fuller than ever. It seemed like everyone and their significant others had made it to the evening meal, including Wyanne, her wife, and their boyfriend. Russ sat next to Dad at the head of the table, Aria was covered in sauce, and Payton had more than his share on his shirt as well.
Talk leaned toward the upcoming wedding week festivities. Not only were all the Harringtons together, but Luke’s family was coming in as well. Not only his parents, but his brother who was the best man, his wife, and their three kids. Luke’s uncle and his family would also be in attendance since he was performing the ceremony. Apparently Uncle John was a Montrose County judge and loved to do weddings.
Then there was Wren and whatever entourage he was bringing. Demi’s closest friends from college and their families and Luke’s best buddies from high school. It was going to be a packed house for sure, especially after all the folks from town who’d been invited showed up. But the week leading up to the ceremony was going to be filled with activities as family and close friends filtered in.
Ville was going to get plenty of time to put his expertise to good use. I could practically hear the gears working in his mind as all this information came at him. I knew a lot had already been discussed with him, but things were ramping up now with the big day getting closer.
My phone rang and I jostled Judson as I pulled it out of my pocket. He socked me in the arm as retaliation and I shoved his head as I stood up and stepped away from the table.
“Excuse me a moment,” I said to the table at large as I beelined for the front door. I answered as I stepped onto the porch. “Hi, Luz. What’s up?”
“Dr. Harrington,” she said warmly. “Sorry to bother you on your day off.”
“No problem. How can I help?”
“I have a patient of yours here at Urgent Care” the nurse practitioner said. “Andrea Fuller. Break through migraine q 2 days. Pain at an eight. Vitals stable but heart rate is only fifty-eight. You prescribed propranolol two months ago for prevention.”
“Which explains the low heart rate, so we can’t up her dose,” I murmured as I searched my brain. This particular beta blocker was also effective in migraine prevention and reducing anxiety. I saw enough patients that I couldn’t remember all the details for every one, but I remembered this. “She already failed at topiramate, right?”
“Yes,” Luz agreed. “I discussed with the patient either going to Nurtec or an injectable, but she very kindly asked to consult with you before deciding.”
That was surprising, but it pleased me. It was taking a while, but I was building a rapport with my patients. I could tell by Luz’s tone that she actually meant the patient had been kind, rather than using it as sarcasm.
“My gut says to go with the injectable. What’s your take?” I didn’t have the patient in front of me, so I wanted her opinion.
“I agree,” she said. “I discussed the benefits with the patient as well, and she’s amenable to that. She just wanted your opinion as well.”
I hummed. “All right. We’ll have to get prior auth, but considering she’s failed two other migraine medications, let’s hope it’s not too hard. Given the severity of her migraines, and the number of breakthroughs she’s had, let’s do Aimovig 140 migs. Send me the chart when you’re done and I’ll add my note and sign off.”
“Excellent, thanks. I’ll get the PA started online now and hopefully it approves automatically.”
“Let me know if I have to do a letter of med necessity. And if we have any samples of Aimovig, make sure she gets some until she can fill the new script.”
