{"id":68443,"date":"2023-02-21T07:36:06","date_gmt":"2023-02-21T14:36:06","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=68443"},"modified":"2024-12-23T14:26:08","modified_gmt":"2024-12-23T21:26:08","slug":"guillain-barre-syndrome-diagnosis-an-immune-attack-on-the-nerves","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/guillain-barre-syndrome-diagnosis-an-immune-attack-on-the-nerves\/","title":{"rendered":"Guillain-Barre syndrome diagnosis: When the body’s immune system attacks the nerves."},"content":{"rendered":"
<\/div>
\"Cameron
Cameron and Jen Armagost walk with their sons, Colt and Levi, on a brisk winter day in Fort\u00a0 Morgan, Colorado, two years after Cameron battled a severe case of Guillain-Barre syndrome. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

No matter how hard he tried, Cameron Armagost could not rid himself of the pain in his feet and legs.<\/p>\n

\u201cI thought I had bad boots,\u201d he said. \u201cI even told my wife (Jen) I needed new ones.\u201d<\/p>\n

The next day, he tried to celebrate Jen\u2019s birthday in their hometown of Fort Morgan, but the pain was unrelenting and unbearable. He went to bed hoping it was just a pinched nerve<\/a> that would work itself out, but the following morning, he began to panic.<\/p>\n

\u201cI couldn\u2019t feel my feet,\u201d said Armagost, market president at Bank of Colorado in Fort Morgan. \u201cIt was hard to talk. My speech was slurred. I couldn\u2019t feel my hands and thought, \u2018Did I have a stroke?\u2019\u201d<\/p>\n

\"Cameron
Cameron Armagost is market president for the Bank of Colorado in Fort Morgan. There was a time after his GSB diagnosis when he thought he might never work again. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

Armagost, then 35, headed to the closet to get dressed, but he lost his balance and fell to the floor. Jen, who was in the kitchen with their 1-year-old son, came running. She called their neighbor, a family doctor and close friend, who rushed over and did a quick assessment on that morning back in April 2021.<\/p>\n

“All I can remember is the look on his face when he said he’d take my son and we needed to see a doctor, now,” Cameron recalled.<\/p>\n

Their neighbor told them: “Don\u2019t stop in Fort Morgan. Go to Greeley or Denver now.”<\/p>\n

“I don\u2019t remember much of that morning, but that replays in my head,” Cameron said.<\/p>\n

Jen loaded her husband in the car, and they drove an hour to UCHealth Greeley Hospital<\/a>. As he lay in a hospital bed, doctors in the emergency room told him they suspected he had Guillain-Barre syndrome (GBS). Cameron had never heard of such a thing.<\/p>\n

GBS is a century-old mysterious disorder that often follows on the heels of a bacterial or viral infection. This rare neurological disorder wreaks havoc on the nerves as the body\u2019s immune system which is supposed to attack germs that get into the body. In people afflicted with GBS, the immune system mistakenly attacks healthy nerves outside the brain and spinal cord. This damage prevents the nerves from functioning properly, which leads to weakness and, sometimes, paralysis.<\/p>\n

When diagnosed early, GBS is treatable. Although weakness and nerve pain can be severe, many patients fully recover. Armagost\u2019s case would prove more challenging, and it tested every ounce of his strength and sanity.<\/p>\n

\"Cameron
Cameron and Jen, with their sons, Colt, left, and Levi., about two years after Cameron was hospitalized for Guillain-Barre syndrome. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

What is Guillain-Barre\u00a0syndrome (GBS), and how is it diagnosed?<\/strong><\/h2>\n

The first symptoms of Guillain-Barre syndrome are usually weakness and tingling in the extremities, but it can spread quickly, paralyzing the whole body. If it gets to the diaphragm, it can be deadly.<\/p>\n

\"Cameron
Cameron and Jen with their son, Colt, on his first birthday, not long before Cameron’s Guillain-Barre syndrome diagnosis. Photo courtesy of Cameron Armagost.<\/figcaption><\/figure>\n

No one knows what causes GBS, though experts believe a problem in the immune system triggers it. GBS is not passed from one person to another, nor is it inherited.<\/p>\n

Armagost told his doctors that a week before his hospitalization, he had a minor sinus infection while on a company retreat in Arizona and a sore throat after his return flight. He didn\u2019t think anything of it.<\/p>\n

Having a health history from patients helps physicians with their clinical diagnosis, said Dr. Brian Kaiser<\/a>, a hospitalist who treated Armagost at UCHealth Greeley Hospital.<\/p>\n

Research shows a connection between viral and bacterial infections and the onset of Guillain-Barre syndrome. In two-thirds of GBS cases, a patient had an infection, such as food poisoning, flu, or COVID-19, a few days or weeks before their diagnosis.<\/p>\n

\u201cThough we see Guillain-Barre with COVID, any viral illness could cause it, and only about half the time can we identify that trigger in patients,\u201d Kaiser said. \u201cThat story helps support our clinical diagnosis, but by and large, we don\u2019t care how it (GBS) started because the treatment remains the same independent the initial cause.\u201d<\/p>\n

A diagnosis of Guillain-Barre syndrome<\/strong><\/h2>\n

Kaiser and his team of neuro-hospitalists<\/a> treat about one case of GBS per month. When ER doctors suspected (and then confirmed) GBS with Armagost, Kaiser advised the team to immediately start IV immunoglobulin infusions (IVIg), a treatment derived from plasma donated by thousands of whole blood donors.

Donating whole blood saves lives. <\/strong>And now, donating blood is convenient and easy with a new online donor registration portal<\/a> and locations in Greeley, Fort Collins and Loveland, as well as mobile blood drives throughout northern Colorado. <\/div>\n

Immunoglobulins are proteins made naturally by the immune system to attack infecting organisms. IVIg is one of the primary treatments for GBS, and after a five-day course of treatment, patients are often discharged from the hospital to an acute rehab facility.<\/p>\n

The treatment lessens the immune attack on the nervous system. But the damage to Armagost\u2019s nerves was causing him horrendous pain. Doctors put him on pain medications, which added to the complications. Though 60% of patients fully recover from GBS, 15% continue to have severe and debilitating symptoms.<\/p>\n

Sadly, it was not looking good for Armagost.<\/p>\n

\"\"
Cameron and Jen with their sons, Colt and Levi. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

When GBS doesn\u2019t respond to treatment<\/strong><\/h2>\n

By Armagost\u2019s fourth day in the hospital, it was evident that treatments were not helping him enough. The syndrome was progressing, and doctors had to put Armagost on a ventilator.<\/p>\n

\u201cAt this point, he was not getting better. He looked worse,\u201d Kaiser said. \u201cThis was one of the worst cases I\u2019ve seen. Most people retain some movement of their arms and legs, but Cameron couldn\u2019t move his legs or arms, and even his eye movements weren\u2019t aligned with one another.\u201d<\/p>\n

\"Cameron
Cameron remained on a ventilator weeks after symptoms of GBS first presented. Photo courtesy of Cameron Armagost.<\/figcaption><\/figure>\n

Armagost\u2019s condition started to become \u201ctouch and go.\u201d<\/p>\n

\u201cIt went from an autoimmune response to becoming the most progressed it could,\u201d Armagost said. \u201cI couldn\u2019t open or shut my eyes. I couldn\u2019t talk. For the next six weeks, I was only able to communicate with a slight nod to yes or no questions.”<\/p>\n

Almost two years later, Armagost still gets emotional when recalling his condition.<\/p>\n

\u201cI could only hear and shake my head, and I was in a lot of pain,\u201d he said. \u201cI like to talk and not being able to do so made the whole process worse.\u201d<\/p>\n

Armagost remained on a ventilator for almost two months \u2014 three weeks in the ICU at UCHealth Greeley Hospital, three-and-a-half weeks at a long-term acute rehab facility and his first two weeks at Craig Hospital in Denver.<\/p>\n

The mental struggle was a battle of its own.<\/p>\n

\u201cMentally, when you lose most of your senses, your mind takes you to weird places,\u201d he said. \u201cThere were a lot of mind games going on.\u201d<\/p>\n

His wife, Jen, whom he met on the opening day of the 2015 Colorado Rockies season, was his comfort. They married in 2018, and in March 2020, a few days before the pandemic shut down the country, they had their first son.<\/p>\n

In the hospital, Jen had a gift for understanding what her husband needed when he couldn\u2019t communicate it himself.<\/p>\n

\u201cShe could read my mind and ask the right questions to find out my needs,\u201d Armagost said. \u201cImagine being in a lot of pain, but you don\u2019t know where the pain is. You think it is in your left foot, but it is in your right hand.\u201d<\/p>\n

\"Cameron
Cameron and Jen met at a Colorado Rockies game in 2015. They married in 2018 and are raising their two sons in Fort Morgan, Colorado. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

He relied on his nurses to help him improve.<\/p>\n

\u201cI know it had to be difficult,\u201d he said, recalling how the staff took care of him during those weeks. “It took a lot of people and a lot of patience to find the area causing the pain but moving my limbs gave me some relief.<\/p>\n

\u201cThey didn\u2019t just sit there and watch a machine breathe for me. Everyone was very involved.\u201d<\/p>\n

The clinical staff had to frequently clear Armagost\u2019s airway. They moved his limbs for him, to help with pain. They helped him open and shut his eyes, applying ointment to keep them healthy. They held up a screen, so he could see his son.<\/p>\n

During Armagost\u2019s nonverbal outbursts, they calmly comforted him.<\/p>\n

\u201cI can\u2019t express enough the respect I have for nurses,\u201d he said. “I always knew their job to be hard, but you get someone like me who cannot speak. They have to read my mind and try to solve it as I get more and more frustrated. That takes a special person, an angel, who has a special place in heaven. It takes a special human with a heart bigger than anyone could ever imagine.\u201d<\/p>\n

\"Cameron
Cameron holds his son, Colt, now 3, while at an inpatient rehabilitation center in Denver. Photo courtesy of Cameron Armagost.<\/figcaption><\/figure>\n

Not sure if he will ever recover from Guillain-Barre syndrome<\/strong><\/h2>\n

By June 2021, Kaiser transferred Armagost from Greeley Hospital to an acute care hospital about an hour from their home. There, he received rehab and began weaning off the ventilator. Three-and-a-half weeks later, he went to Craig Hospital in Denver.<\/p>\n

Jen\u2019s retired parents moved from Cincinnati, Ohio, to Fort Morgan to help with their son so Jen could be by her husband\u2019s side as much as possible. At Craig, the road to recovery was still long. Armagost was taken off the ventilator within two weeks of arriving at Craig, but it was still unclear if he\u2019d ever regain his mobility.<\/p>\n

\u201cAt that point, I could kind of open and close my eyes,\u201d he said.<\/p>\n

\u201cMy family reminded me regularly if I ever said \u2018I can\u2019t do this,\u2019 the response was always \u2018not yet. But you will,\u2019\u201d Armagost said.<\/p>\n

They were right. At Craig, with plenty of physical therapy, he began to slowly move his limbs, though everyday tasks like feeding himself were difficult. He questioned whether he’d fully recover.<\/p>\n

“Of course, it crossed my mind many times that I wouldn’t be the same guy,” he said.<\/p>\n

Doctors told him it may take upward of three years before he would walk \u2014 that\u2019s if he ever did walk again.<\/p>\n

But after months of grueling work, he managed on Sept. 13, 2021 \u2013 five months after GBS first attacked \u2013 to walk with crutches and braces on his legs into his office at the Bank of Colorado.<\/p>\n

\"Cameron
Cameron Armagost, market president for the Bank of Colorado in Fort Morgan. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n

How long does it take to fully recover from GBS?<\/strong><\/h2>\n

Nearly two years after GBS nearly destroyed him, Armagost said he is thankful for each day. He is happy to be a father, to be around to play with their son Colt, who is nearly 3, and Levi, his second son, who was born this past year.<\/p>\n

But Armagost must remind himself to stay positive because he feels he is only 90% of fully-recovered.<\/p>\n

\"Cameraon
Many people fully recover from a Guillain-Barre syndrome diagnosis, but Armagost\u2019s case of GBS tested every ounce of his strength and sanity. Photo courtesy of Cameron Armagost.<\/figcaption><\/figure>\n

\u201cI don\u2019t know if 90% is right, but I feel like I\u2019m 90% of who I was before,\u201d he said.<\/p>\n

He still gets nerve pain \u201clike someone is taking a blow torch to the bottom of my feet and putting needles through the bones in my hands.\u201d He has weaned himself off most of the medications he had to take, except for the nerve blockers. He also struggles with fatigue.<\/p>\n

\u201cIf I can get 14 hours out of a day, that\u2019s pretty good,\u201d he said.<\/p>\n

Though he has difficulty walking uphill or on uneven surfaces, he managed to run the BOLDERBoulder 10K in 2022 \u2014 \u201csomething pretty momentous in my mission to overcome what GBS had taken away from me,\u201d he said.<\/p>\n

He hopes to return to elk hunting one day soon.<\/p>\n

\u201cResidual symptoms I experience on a daily basis are not debilitating,\u201d Armagost said. \u201cI have a good quality of life and am blessed to be where I am today. I have nothing to complain about, just things to work toward.\u201d<\/p>\n

He remains positive and hopeful that he\u2019ll continue to improve.<\/p>\n

\u201cFrom where I was to here, I was lost and scared and hurt and had so much fear that I\u2019d never be back to where I was,\u201d he said. \u201cI believe God blessed me to recover as much as I have, and I hope to be able to help others someday.<\/p>\n

\u201cI\u2019ve learned there are no two things alike in injury and sickness, but with a positive attitude, faith and drive \u2014 having \u2018grit\u2019 \u2014 you can overcome anything. If you can get to that stage mentally, it\u2019s amazing what you can accomplish.<\/p>\n

\u201cAnd I hope I can instill that in my boys, the power of positivity and faith \u2026 focusing on blessings in times of adversity.\u201d<\/p>\n

\"Cameron
Cameron puts his son, Colt, into his car seat. Colt was only a year old when Cameron was hospitalized with Guillan-Barre syndrome and spent months recovering. Photo by Joel Blocker, for UCHealth.<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

No matter how hard he tried, Cameron Armagost could not rid himself of the pain in his feet and legs. \u201cI thought I had bad boots,\u201d he said. \u201cI even told my wife (Jen) I needed new ones.\u201d The next day, he tried to celebrate Jen\u2019s birthday in their hometown of Fort Morgan, but the […]<\/p>\n","protected":false},"author":2164,"featured_media":68451,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[3329,184,4624,65,130],"class_list":["post-68443","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-inpatient-rehabilitation-and-therapy","tag-neurology","tag-neurosciences-outcomes","tag-pain-care-and-management","tag-rehabilitation"],"acf":[],"yoast_head":"\nGuillain-Barre syndrome diagnosis: an attack on the nerves - 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