CHAPTER 8
Alexa could barely sit still as she and Gage met with Taylor Douglas at her clinic office. Outside, sporadic sun was trying to peek through the snowy gray clouds rolling across the Wind River Valley. To the east were the Salt River Mountains, still covered at the top with snow. Alexa gave Gage a quick, anxious look, but he was sitting back, casual and relaxed while she was fidgeting like a wild horse.
She liked Taylor, whose blue eyes were warm, her voice low and calming. She was about five feet nine inches tall. Alexa admired her sun-streaked blond hair gleaming with highlights. And, best of all, she asked that they call her Taylor, that she was a physician’s assistant and didn’t need the title doctor, even though some of her patients liked to refer to her with that title. Alexa liked Taylor because she seemed genuine, friendly and low-key.
“Okay,” Taylor said, opening up her computer with Alexa’s case results in it. “I know you’re dying to find out about your cortisol lab test.” She turned the computer screen toward them and with a pencil, pointed and said, “Your cortisol is out of normal bounds at eleven a.m. and spikes again at ten p.m. What this means is that you are a candidate for the protocol.”
Alexa pressed her hands to her heart in relief. “Oh, thank God,” she breathed.
Taylor gave her an understanding look. “With the abnormal spikes at these times, it means that you’re most anxious about an hour before lunch. Then the anxiety begins to recede and is back to normal at about five p.m. And then around ten p.m., it goes outside normal limits again. I would think that you have broken sleep until about four a.m., when your cortisol goes back to normal levels. Am I right?”
Gage swallowed convulsively, surprised at the PA’s accuracy.
“Yes,” Alexa said. “I’m fine in the morning when I get up, but from about eight a.m. through eleven a.m., I can literally feel that anxiety ratcheting upward.”
“And you feel most anxious at eleven a.m.?” Taylor asked, making notes as Alexa spoke.
“Yes.” Alexa said, “Gage is always worried that I don’t eat enough, Taylor, but I keep telling him I’m so jumpy and hyper around noontime, I have no appetite.”
“Right,” Taylor said. “That’s how it works. The anxiety circumvents your hunger. The last thing you want to do is eat at those high cortisol peak times. You simply don’t have an appetite. When you’re feeling threatened and danger is lurking just around the corner, it is impossible to want food. When you’re under threat, your digestion shuts down, and the energy moves over to the perceived or unperceived threat to give you more energy in case you have to fight.”
Gage shook his head. “That explains so much,” he said gratefully, looking sympathetically at Alexa. She reached out, her hand damp with nervousness. He wrapped it comfortingly into his warm, dry one.
Taylor gave him a kind look, too. “She’s lost weight because her cortisol has spiked up. It wasn’t that she didn’t want to eat, Gage. It was, I suspect, that Alexa’s trauma either occurred at around eleven a.m. or ten p.m. When the cortisol spikes at a certain time, it’s because the body remembers the trauma it received at that time and the alarm bells go off within.”
Drawing in a sharp breath, Alexa looked at Gage. “We were captured near eleven a.m. at that Afghan village. The examination they gave me in that cave was at ten p.m.” Alexa pressed her hand to her throat, giving him a stunned look. Gage held her other hand, squeezing it to give her support.
“Then, that’s verified,” Taylor said. “I’m so sorry this happened to you, Alexa.”
“I hope the other women . . . those who had to go through it with me, can receive this information. Maybe it can help them, too.”
Leaning back, Taylor said, “Well, let’s get you on this adaptogen first.” She handed Alexa a large white plastic bottle that contained a thirty-day supply of capsules. “This is a one-month bottle of the medicine you’re to take, Alexa. Most people feel their anxiety go away between the third and fourth day. Of course, there are always exceptions, but the anxiety will dwindle down until you feel at peace again. And if it works on you as I hope it does, then you can contact the women who had to go through this brutality with you. Share your experience with them. It’s their decision if they want to try this treatment or not. They can come and see me, or they can go to the functional medicine website online. There’s a directory of people who are FM specialists who may be closer to where they live.”
Gage released Alexa’s hand. “Okay,” she whispered, holding the bottle, staring at it.
“We decide the prescription on the adaptogen based upon your saliva test results.” Taylor tapped the computer screen on Alexa’s graph. “Your highest peaks are at these two times. And you are to take one capsule at each of those times. And that’s all. Some people think the more you take, the better off you are, but that’s not true. The adaptogen has to be given at those critical times, when the cortisol is at its peak. I would love for you to email me the day your anxiety stops, and once it stops, it should not occur again. Okay?”
“Yes,” Alexa whispered, touching the bottle. “It just seems so simple. And you said that once I finish my thirty-day supply, I don’t have to take it again?”
“That’s right,” Taylor said, leaning back in her chair and rocking it a bit. “Three months later, my office will send you another saliva test. You’ll mail it off to an overnight courier to the lab in Seattle, Washington, and then they’ll email me the results. I’ll call you, and we’ll compare the before-and-after tests. And then I’ll know where to go with you at that point.”
“What about becoming a mother?” Alexa asked.
“You and I talked about that earlier. What I’d like to do is get your cortisol within normal limits first, and then I feel you should go to your gynecologist to discuss it.”
“But . . . can I get pregnant?”
Taylor smiled warmly. “Of course you can. The adaptogen has nothing to do with it. But I strongly counsel you to wait until the anxiety is gone.”
“Oh, I will.” Alexa gave Gage a huge smile of relief. “Isn’t this wonderful?”
“It’s a miracle,” he agreed quietly.
Taylor nodded somberly. “It really is a miracle. I’ve seen men and women with lab tests a lot worse than Alexa’s. They take the adaptogen, and the anxiety disappears. It doesn’t get rid of nightmares or flashbacks, but just getting the anxiety capped and under control by the brain is a huge step toward helping them heal and feel closer to normal.”
Gage stirred. “Then why don’t more doctors know about this protocol, Taylor? Or the Veteran’s Administration?”
Sighing, Taylor said, “Because it’s considered an alternative medicine treatment. This country bases its medical intervention on drugs to handle symptoms. Now, an adaptogen isn’t a drug, but it can stop the cortisol and the anxiety in anyone. If you’re a doctor and you were trained to use the traditional drug system, you probably won’t consider nontraditional methods such as herbs, vitamins and minerals, homeopathy, chiropractic, naturopathy, or Eastern medicine. Most MDs weren’t taught other ways of helping a patient to heal.”
“But you did it,” Gage pressed.
“Yes, but I’ve never been one to rely first on drug medication. I was raised differently,” She smiled faintly. “My mother is a microbiologist. She looked into adaptogens for a health food company she works for, and that’s how I found out about them, even as a teenager. An adaptogen is a natural substance that helps the body adapt to stress, and it exerts a normalizing effect upon it when needed. A good example of an adaptogen is ginseng root. What you can say about the class of natural adaptogens found out in nature is that they are anti-stress and fatigue fighters. I never took any drugs until I was eighteen and in college, and even then, it was only aspirin. I’ve seen alternative medicines cure symptoms just as well, or better, than a drug can, because of my mother’s work in the herb industry. And medical drugs never cure. They simply suppress the symptom. If you stop taking the drug, the symptoms come back.”
Taylor pointed to the bottle Alexa held. “This is a case in point, Gage. Once the cortisol receptors are shut down, the master pituitary gland in our brains takes over the control of the adrenal glands and the hormones it makes and releases into our bloodstream when we need them. The adaptogen gives the master gland a chance to take back control of the adrenal gland’s hormones once more. And once it does, you don’t need to take the adaptogen again. You’ve handed the control of hormones back to its natural boss, the pituitary gland. That’s as good as it gets.”
“I see. But if you’re traumatized again, you need to take it again?”
“Right. Sometimes, a person will get into an auto accident. Or an elderly person falls and goes into shock. Trauma is perceived differently by each person’s body. And in the cases where high cortisol is running loose and out of control again, I would have you retake the saliva test to check the peak times it’s outside normal boundaries. Then I’d give you probably a one or two-week course of the adaptogen once more to shut down the cortisol receptors.”
No one wanted this to work more than Gage—except, of course, Alexa.
Taylor sat up and turned the computer screen toward her. “Alexa, I would urge you to go on your three-month sabbatical. You can start taking the adaptogen right now.” She held up her wristwatch. “It’s eleven a.m. Take your first dose here.” She stood and went to a water dispenser, filling a paper cup and walking back to Alexa. “Let’s get you some much needed calm.”
Giving Taylor a grateful look, Alexa opened the bottle and took out one capsule. In no time, she’d swallowed it and drank the water.
“Take the next one at ten p.m.,” Taylor said, smiling as she sat down. “So? Any other questions?”
Alexa looked at Gage. “Do you have any?”
“I do. Will it help Alexa sleep?”
“Usually, once the cortisol is capped and controlled by the pituitary gland in her brain, she’ll sleep well. In some patients, it’s not a full eight hours, because they might still have nightmares or flashbacks that wake them, but not as often. Everyone gets better sleep,” she said. “How much depends upon the individual.”
“I’m wondering if I have high cortisol,” Gage told Taylor. He hadn’t said much about his military past to her. This appointment was for Alexa, and he’d remained silent for the most part, wanting to be a support for her.
“There’s only one way to find out, and that’s to take the saliva test. I can give you a box, and you can take it home with you. Take the test and send it in. The lab results will be sent to me.”
Alexa reached over, her fingers falling across his lower arm. “Do it, Gage. You have some anxiety, too.”
“Not as bad as yours,” he teased. “But yes, I have anxiety.”
“And you were in the military, Gage?”
“Yes, I was.” Gage didn’t want to elaborate. “Let me take the box home with us, and I’ll give it a whirl.”
Taylor nodded and smiled a little. “Sounds good.” She directed her attention to Alexa. “Remember, contact me by phone or email once your anxiety tamps down.”
“Oh, you’ll be the second person I contact,” Alexa said, hopeful. “Gage will be the first to know. He’s so sensitive to my mood changes, he’ll probably know before I do.”
*
Tal and Matt dropped by for a visit four days later. It was a late Saturday morning., the sky a bright blue, the air chilly. Alexa wasn’t expecting her sister and brother, but was happy to see them. Gage was out back at the small barn, working.
Tal grinned as she stepped into the kitchen after stomping snow off her feet on the mud porch rug.
“Hey, Matt and I were slumming in the neighborhood and thought we’d unexpectedly drop in.”
Alexa grinned and came over, hugging her tall older sister. Tal wore jeans, work boots, and a red sweater beneath her heavy gray wool coat. “Come on in. What a nice surprise!”
Matt entered and shut the door behind him, shrugging out of his black leather jacket and dark green knit muffler. “Hey, baby sister, you’re looking better,” he said, and he moved around Tal as she hung up her coat on a nearby wooden hook.
Alexa closed her eyes, hugging her twin, inhaling the fresh, clean air around him. “I’ve missed you, too.” Since deciding not to go to Artemis on weekends, she’d seen a lot less of them. That was something she missed terribly. Releasing Matt, she said, “Would you two like some coffee? We can sit at the kitchen table and chat.”
“Yeah,” Matt said, looking around. “Where’s Gage? I didn’t see him when we drove in.”
“He’s out in the barn. That’s what we get for wanting a wood-burning fireplace. Every Saturday is wood chopping day for the coming week.”
“I’ll go out and see him, give him a hand,” Matt said. He gave Tal an evil grin. “I suspect the girl talk will drive me out of here, anyway.”
Punching him playfully in the upper arm, Alexa muttered, “You men! You’re all alike. Fine, go see Gage. It isn’t like you don’t see him five days a week at Artemis.”
“Yeah,” he said, grabbing his jacket and muffler. “But I can keep him company out there and we can talk football while we work.”
Rolling her eyes, Alexa shook her head. “Get out of here, twin.”
Matt leaned over, kissing her hair. “We’ll grab some coffee with you in a while.”
Tal poured coffee for Alexa and herself and carried it to the table, sitting down. “Matt and I were dying to find out how that appointment with the functional medicine specialist in Wyoming went,” she said, sliding a mug over toward Alexa.
Alexa pushed her hair off her shoulders and sat down at Tal’s left elbow. “Well, I’m afraid to say anything yet,” she said. “But this morning I woke up and I felt calmer. Usually, my PTSD ramps up to high at eleven a.m.”
“And?” Tal coaxed, sipping her coffee, watching her closely.
Shrugging, Alexa whispered unsteadily, “I don’t have the anxiety at this time today, Tal. Honest to God, I don’t.” She took in a ragged breath. “And I’m afraid to tell Gage. I’m afraid it won’t last. Or that it’s my imagination.” She curved her hands around the bright yellow ceramic cup.
Tal nodded, reaching out, gripping her shoulder. “That’s good news.”
“It will be if it lasts, Tal. I’m just not sure. I’m shaky about it.”
“Well, I’ll stay mum,” she promised. “You know, you don’t look as tired as before. Are you sleeping a little better?”
“Yeah,” she mumbled. “Last night, I slept all night through. I never realized what sleep deprivation does to you until you feel good again from a solid eight hours under your belt.”
“I don’t see shadows under your eyes like I usually do,” Tal said, smiling a little, holding Alexa’s concerned gaze.
“Taylor said it would sneak up on me. That I wouldn’t realize it until that gnawing anxiety wasn’t there the way I expected it to be. The sleep is a blessing, let me tell you.”
“But the anxiety? It’s completely gone?”
“Today is the first day,” Alexa admitted, frowning. “It’s like someone shut off a faucet inside me. I feel the way I used to before I was captured by the Taliban. I’m calm, and I even feel more like my confident old self.” She flashed Tal an uneasy smile.
“Wow!” Tal murmured. “I never realized that medicine could do so much for you so fast.”
“Well, let’s just wait and see, okay? I’m on pins and needles because the anxiety is gone, and I’m worried it’s going to come back and hit me hard.”
“I can imagine you’re jumpy about it.” Tal gave her a sympathetic look. “Are you and Gage getting ready to fly to the Keys? I was talking to Mom earlier this morning, and she said she’s baking up some of your favorite Turkish food to take with you.” She grinned. “I think Mom should start a catering business on the side.” They both chuckled.
“I’m packing, and so is Gage,” Alexa said, gesturing down the hall toward their open bedroom door. “We’ve got a ways to go yet.”
“When will you fly the Stearman down there?”
“Andy, my mechanic, and I have some stuff to attend to. Mechanical inspections. We might leave two or three days from now . . .”
“You are a grease monkey, no doubt,” Tal said, smiling as she sipped her coffee.
Alexa held up her hands. Her fingernails were short and she pointed to them. “I’ve been out there two days in a row with Andy, and I can’t get the grease out from beneath my nails.”
“Well, you’re the one who likes hands-on mechanical stuff,” Tal drawled.
“I know. I think I got my mechanics gene from Dad.”
“For sure. When he’s home, he’s always out in the garage tinkering with the lawn mower, the weed whacker, or anything else he can get his hands on,” Tal grinned.
“Well, come March, I’ve got to have my hands looking nice,” Alexa said.
“How are the wedding plans coming along?” Tal asked, seeing her sister’s eyes alight with happiness.
“I told Mom yesterday that I was going to look at the booklets from several fashion designers and take them with me to the Keys. I want Gage to look at them with me, too.”
“That will be nice,” Tal agreed. “Mom’s already got a couple picked out for you, like she does for me.”
She and Gage were to be married in March. And then, Matt and Dara were going to be married at Uncle Ihsan’s villa in Kuşadası come June. Tal and Wyatt’s wedding was going to take place is Kuşadası, Turkey, in August. It was certainly a year like no other—all three of them would be married, which Alexa found amazing and wonderful.
Smiling fondly, Tal said, “I think it’s incredible that all of us are getting married in the same year. Could you look back on our lives and see something like this happening? What are the odds?” She opened her hands, shaking her head.
“Hey, we met men who are incredible,” Alexa said. “Gage is such a hero to me.”
“Wyatt’s a royal pain in my ass at times, but I do love him despite his Texas ‘go big or go home’ attitude,” Tal drawled, chuckling.
Giggling, Alex agreed. “Matt has the nicest woman in the world who loves him. Dara is just so kind and gentle.”
“He really got lucky,” Tal agreed, giving Alexa a mischievous look. “It never hurts to have a doctor in the family. The next thing that will happen is that everyone will become fertile myrtles at the same time, mark my words. We do things in triplicate around here.”
Alexa sighed. “I so want to settle down, Tal. I want a family. I hunger for it.”
“How does Gage feel about it?”
“He’s worried about my anxiety and PTSD. If this adaptogen works, Taylor said I should take three months and then talk to a gynecologist about getting pregnant.”
“That sounds pretty reasonable to me. Is Gage ready for fatherhood?”
Alexa knew that Tal was aware that Gage had lost his family when he was young. “Yes, we’ve discussed it a number of times. He’s more than ready.”
“He’ll make a good father,” Tal agreed quietly.
“His dad was a great role model for Gage, and I’m sure he’ll pass that on to our children.”
Tal said, “I was thinking, maybe, just maybe, you’ll end up loving motherhood and family so much, you won’t want to work at Artemis anymore.”
Alexa knew that Tal was an excellent judge of character and had deep insights into people. “I was thinking the same thing, Tal. Gage thinks I should stay away from the Safe House Foundation, that it brings up too many memories and upsets me too much right now.”
“I agree with him,” Tal murmured.
“Could you get along without me, Tal?”
Tal gave her a fond look. “Well, you won’t be very far away from us, Alexa. No matter what you want to do, my instinct is that you were made for motherhood, and that you and Gage will have a bunch of kids. I think what’s happened to you may have moved your life course in another direction, but I believe it’s going to play to another strength of yours: being maternal, loving children, and wanting to be a mother. That’s always been there in you, big time. You were the one that always wanted to play with dolls, not me.” Tal grinned.
Alexa nodded. “You’re right, Tal. I’ve always wanted a big family, like Mom’s Turkish family. I love the warmth between all our relatives.”
“Well,” Tal murmured, finishing off her coffee, “I can see you and Gage with three kids for sure. He lost his family, and yours could be a replacement family for him, a starting-over. A nice one. The guy deserves some good things to happen to him after his lousy start in life.”
“He deserves so much happiness,” Alexa said, her eyes tearing up.
“He’s good for you, Alexa, and he has rare qualities of honor, integrity, and kindness in his bones.”
Alexa wiped her eyes. “Gosh, all of sudden I’m so teary.”
“Could it be that the adaptogen is working?”
“I don’t know. It could be. I’m not feeling numbed out like I usually do. My emotions seem to be on tap within me again, and I think that’s a good sign.”
“Are you still calm inside?” Tal looked at her watch. “It’s noon.”
“I still do. It’s so wonderful, Tal, I can hardly believe it. I’m beginning to feel a tiny bit like I did before all that trauma.”
Tal smiled warmly. “I think it’s a miracle. Mom’s brothers have been going to their mosque to pray for you every day since you were kidnapped. That’s pretty significant.”
“Yes, Uncle Ishan emailed me when I told them I was on this adaptogen.” Her voice lowered, and she sniffed. “I don’t care what the religion is, Tal. If you’re praying from your heart for someone else, it works.”
“You’ll get no argument from me,” Tal said. She heard the back door open and the tramping of feet, then the door closing. “Sounds like Matt and Gage have arrived. Can I help you in the kitchen and we’ll make lunch?”
Smiling, Alexa stood. “Sure can. Lucky for us all, we just roasted a turkey breast yesterday. Turkey sandwiches sound good?”
Tal rose. “Yep, they sure do.”