Day 30: The hospital, day 2
The hospital moved me from ER to my assigned room at 4 a.m. A few hours later, the day began with a consult from the neurologist.
He talked for a while about Guillain-Barré syndrome (GBS). My case isn’t presenting like normal GBS, but then there isn’t really a norm. It’s rare and they have little more than a collection of anecdotes to trace its lifecycle. “Typically,” symptoms progress for 4–6 weeks and then things stop getting worse. That low point can range from needing a walker to total paralysis. After that point, the patient starts a rehab process that can take months or a year. How much mobility is recovered depends on how bad things get.
The neurologist talked about the tests they’d do (on top of the bloodwork and CT scan from yesterday). An MRI could show something else going on in the brain, something that would probably have a worse prognosis than GBS. After ruling those out, a lumbar puncture could point to GBS if the spinal fluid contains telltale signs of GBS-caused breakdown. Its absence, however, could just mean that GBS hasn’t progressed enough.
The other possibility is that I have a virus that’s attacking the muscles, in which case it’ll just run its course and I’ll get better. Barring identifying one of those worst cases from the MRI, the best course is to start treatment for GBS, which involves plasmapheresis. If it’s not GBS, the treatment is benign. If it is GBS, earlier treatment will lessen the damage.
I had the MRI this morning. I have a mild case of claustrophobia, so that was not fun. I had to ask them to take me out right after they put me in, and they gave me some medicine to relax. I slept or hallucinated through the rest — all 90+ minutes of it.
Then I had the lumbar puncture this afternoon. I was worried about that one, recounting epidural horror stories from birthing classes. It turned out to be very easy. They had a live X-ray machine guiding them to the appropriate place in the spinal chord, and I felt nothing. It was easier than most shots.
The funny thing is that as I was waiting for the MRI, I began to think that my body was returning back to normal. I tamped down my expectations; this could just be wishful thinking temporarily overriding my physical reality. By the time I returned from the lumbar puncture, I was certain that I was 80–90% of normal. I was a little weak, but I could go through full ranges of motion with feet, arms and hands.
I won’t see the neurologist until the morning, and the night could bring something else (the muscle aches have tended to get worse overnight). But my best guess is that I had a short-lived virus that attacked the muscles in my limbs and that it’s basically run its course with no long-term damage. We’ll see shortly.