Author: Jamie

The Neurologist in Fredericton is requesting plasma exchange treatment to help with my recovery from Guillain Barre Syndrome. During the week he was waiting for my answer for the go ahead to begin treatment. This is a treatment that I wasn’t crazy on doing but later decided this was my best option.

The reason the neurologist wanted to do this was because on the last nerve conduction test that was done there was no response and poor results. I also haven’t been making much progress so the doctor thought this was the best option. He told me he’s done plasma exchange for some patients in the past who had Guillain Barre Syndrome as well. Each of the patients had great success and improvements afterwords.

After debating about this further I decided to go ahead with the treatment and signed the authorization form. Lots of people, doctors, nurses all said what do you have to lose, and everything to gain. I just wasn’t crazy on having this procedure done on top of introducing blood products from other people into my body. It took me a few days before I made my decision. In the end I just want to get better and had to take the chance and do everything I could to improve my chances at recovery from Guillain Barre. I leave for the Saint John Hospital on Friday and my first round of plasma exchange is on Saturday October 26th.

EMG Nerve Conduction Study Test Results Jamie Boyle Guillain Barre Syndrome

I saw Jamie Boyle, a 41 year old gentleman, in the Electrodiagnostic Lab at the Dr. Everett Chalmers Regional Hospital on October 23, 2019 for an EMG nerve conduction study. As you know, he had progressive rapid muscle weakness in his extremities which started on August 2nd, 2019. He reported having an episode of gastroenteritis with acute diarrhea which lasted around one week before his muscle weakness. He was admitted to the Dr. Georges Dumont Hospital and since the muscle weakness rapidly progressed, he was intubated and transferred to the ICU. He was put on mechanical ventilation on August 3rd, 2019. Guillain Barre Syndrome was diagnosed by neurology there and he received intravenous immunoglobulin to treat this condition.

Subsequently, he did develop a few nosocomial complications such as urosepsis, ileus, acute renal failure, pneumonia, bronchitis and tracheitis. He was eventually transferred to The Stan Cassidy Rehabilitation Centre for rehabilitation. He received two more IVIG courses of treatment, 5 days each time. He says he improved some.

His past medical history is positive for hypertension. Otherwise, he was a fairly healthy man.

PHYSICAL EXAMINATION

Mental status was unremarkable in routine interview. Language was normal. Extraocular movement was normal. No ptosis. No facial palsy. Tongue protruded in the midline without fasciculation or atrophy. He had severe flaccid quadriplegia. In the upper extremity, proximal muscle strength was 1-2/5 and distal was 1/5. In the lower extremities, proximal muscle strength was 2/5 and distal was 1/5. Deep tendon reflexes were absent. He had mild interosseous muscle atrophy.

Electrophysiologic study was requested for further evaluation. EMG nerve conduction study.

NERVE CONDUCTION STUDIES:

In the right upper extremity, median motor distal latency was 4.5 msec with amplitude reduced significantly at 0.4 millivolts. Conduction velocity was reduced at 34 m/s. The amplitude of the median nerve in distal stimuli was 0.4 millivolts and in proximal stimuli was 0.2 millivolts. Although as a definition there is 50% reduction in the amplitude of motor nerves in the proximal stimuli, it could be impacted by very low amplitude and we cannot determine the typical conduction block in the median nerve. Ulnar motor evaluation was nonresponsive. Median sensory peak latency was 3 msec, ulnar was 3.3 and radial was 2.2 msec with normal amplitude.

In the right lower extremity, peroneal motor and tibial were not obtainable. Superficial peroneal sensory was not obtainable. Sural sensory peak latency was 4 msec with amplitude at 10 microvolts.

EMG STUDIES:

A concentric needle EMG was performed on the right anterior tibialis, vastus medialis, first dorsal interosseous and deltoid muscles. Insertion activity was increased in all the muscles in the exam. There were 3-4+ sharp waves. Only on the deltoid muscle, there was small motor unit involuntary contraction. No motor units were obtained in the other muscles.

IMPRESSION AND RECOMMENDATION:

This is an abnormal Electromyography/nerve conduction study and would be consistent with severe motor demyelinating and axonal type polyneuropathy. Guillain Barre Syndrome should be considered as a cause.

With respect to treatment, he received three courses of IVIG. There is no straight forward and well-known recommendations for such condition. He did not have significant improvement with three courses of IVIG. He has severe weakness in all muscles in the upper and lower extremities. He also has significant denervation pattern in the muscles in the exam. With this respect, I recommended we try plasma exchange, five courses, and after plasma exchange, we give him another course of IVIG. After explaining this approach, he agreed to try. Plasma exchange is available in Saint John and the patient likely needs to be transferred to Saint John Regional Hospital for five courses of plasma exchange.

Shahram Abootalebi, MD Neurologist

Words alone cannot express the gratitude we feel for the excellent care Jamie received during his 60 days stay in the ICU battling Guillain Barre Syndrome.

We would like to say thank you to all the doctors, nurses, respiratory therapists, physiotherapist, occupational therapist, technicians, Louise (spiritual care worker), Sylvie (nurse manager), nurses station staff, Rheal, Eric and anyone we may have forgotten at the Dr. Georges L. Dumont Hospital who have helped in any way.

We thank you all from the bottom of our hearts. Thank you also for your patience, your kindness & understanding as we went through this very difficult time in our lives, not knowing what the outcome would be. You made us feel at ease with your kind words.

We hope you enjoy this basket of treats as a token of our appreciation that will never be forgotten. We appreciate each and everyone of you!

Thank you, Brenda, Danny, Jamie Boyle & family

On Thanksgiving weekend my parents came up and I went outside for some fresh air. This is my first time going outside at the Stan Cassidy Rehabilitation Centre since arriving here in Fredericton on October 1st. It felt good getting some fresh air. This is one of my first few times being outside since getting Guillain Barre Syndrome as I was in the ICU in Moncton for 60 days from August 1st till the end of September.

I have to admit being outside is quite depressing as there’s so much I would like to do from gardening, driving my car, playing basketball with the kids and just being able to do anything I choose. No idea when that day will happen but it was definitely nice just getting outside. Someday I’ll hopefully get out of the hospital and get my life back. I’m going to work my butt off up here and so hopefully sooner then later

Since arriving a week ago at the Stan Cassidy Rehabilitation Centre in Fredericton on October 1st I have seen some progress made with my recovery from Guillain Barre Syndrome. I have seen a little movement of the right thumb, a slight movement in my left arm and I am getting more strength in my neck and back. This is all a great sign for my recovery from Guillain Barre.

Although the movements may be small for some this is good news as it’s sign that the nerves are healing. This means signal is getting there which I’m happy to see. I’ll take the small victories as I work towards the bigger goals.

Any progress is better then no progress. I look forward to more changes as I continue with my recovery and rehabilitation from Guillain Barre Syndrome.

Today’s is the day my Rehabilitation from Guillain Barre Syndrome will continue at the Stan Cassidy Rehabilitation Centre in Fredericton. It’s now 7am and my ambulance ride is now here. All of the nurses came to see me before I left. They made sure I had everything packed up as they wish me best of luck with my recovery. There was lots of smiles all around but tears as well. These are the people who kept me alive and took care of me. They seen me at my worst, they seen my progress and now they see the opportunity I have in hopefully getting my life back. These people were more than just nurses to me, they were like friends. I am sad to say goodbye but happy to perhaps getting my life back.

I’m disappointed I wasn’t able to see everyone before I left with one in particular being Rheal one of the orderlies there. He helped me out more then he’ll ever know. On my bad days he was there listening to me and encouraging me to go on. We had many talks and he was always there for me. He brought in his laptop for me, putting movies on for me, downloading more movies so that I wouldn’t be bored. He’s an amazing guy and he helped me so much during this difficult time. A family member had passed away a week before and I wasn’t able to see him before I left. He was coming in this morning but only at 7:30am. He always told me that once I’m better and walking around to come back and visit everyone. I know I definitely will.

Well it was time and all of the nurses that was there Sue, Joanni, Stephanie, Audrey and a few others all said good bye. It was nice and I will miss them all. They were all simply amazing during the most difficult time in my life as I battled against Guillain Barre Syndrome. I will never forget them.

Well after a 2 hour drive I have now arrived at the Stan Cassidy Rehabilitation Centre in Fredericton. My new home for the next little while. Upon arriving I was quickly greeted by the nurse manager Louise who directed us to my room. I’m glad I’m here and I look forward to my recovery program which starts tomorrow.

After 60 days in the ICU at the Dr. George L. Dumont Hospital in Moncton I must say good bye as my journey as I recover from Guillain Barre Syndrome is now headed to Fredericton. Tomorrow I am heading to the Stan Cassidy Rehabilitation Centre where I will continue my recovery from GBS.

I have to say after 60 days of being here in the ICU I will miss everyone. Despite all the challenges I have faced and the condition I was in there’s a lot of good moments and laughs along the way. There was also a lot of tears and emotions as well. The nursing staff and the doctors in the ICU we’re amazing. They treated me like I was family as I was literally there for what seemed like a lifetime. I was even treated with lobster by one of the doctors there. I always joked with him saying where is my lobster and that’s all I wanted when I started eating for the first time again. Every time the hospital food came around it wasn’t lobster. To my surprise the doctor one day brought in lobster for me.

I’m really going to miss the nurses and everyone that took care of me in my time of need. They were amazing! I’m just sad to say goodbye but at the same time I am looking forward to the possibility of regaining my life back as I had to Fredericton.

Today is tough I have to say goodbye to Cheyenne, my kids and my family. My kids came in to see me as I will be heading to Fredericton first thing in the morning at 7am. It was the time that I didn’t want to end as I knew the moment I left Moncton I wasn’t going to see my children for a while. With the long drive and the kids schedule with all their activities it would be too hard to come up and visit. For the rest of the day I just concentrated on spending some time with them and enjoying every moment. It was a great day but a sad day at the same time. Tomorrow my recovery from Guillain Barre Syndrome continues in Fredericton.

Great day, I’m eating pizza for the first time since Guillain Barre Syndrome all started. Let’s put it this way I’ve been craving it. Pizza and water really. My parents always said that once I could eat they would treat me to pizza. Well today’s that day!

We got Pizza from Pizza Hut in Moncton, a large Canadian Pizza with stuffed crust. Talk about good!!! It tasted as good as I imagined. Lol. The only thing I had to wait for bites as I couldn’t feed myself. I have a bite, my dad has a bite of his, lol.

After that great Pizza, my dad gave me a shave. This whole not being able to do anything yourself is something I’ll never get used to. It’s so weird having people do everything. You lose all dignity when you go in the hospital.

Today the family came to visit me at the hospital. My parents, my sister and my nephew. It won’t be long now till I’m headed to Fredericton at The Stan Cassidy Rehabilitation Centre to start my recovery from Guillain Barre.

I wasn’t sure how my nephew was going to take it seeing me in the hospital but he was good.

While they were here my dad cut my finger nails as they were getting long. The things you can’t do after becoming paralyzed with Guillain Barre Syndrome on August 1st, 2019. In any bad situation you need to try and have a laugh every once in a while. It was kind of funny, dad doing this. There was a laugh or two.

In a little over a week my recovery from Guillain Barre will be heading to Fredericton. I’m anxious to get my life back just sad to leave Moncton where all my family is, my kids. It’s something I have to do, best Rehabilitation Centre around, just going to miss home. It’s too bad Moncton doesn’t have a Rehabilitation Centre as well equipped as Stan Cassidy. I’m just going to enjoy my time with family till I go. Happy day coming but sad as well.

I can’t believe it, today is my first time outside in 50 days. Yes! Jamie Boyle first time outside in 50 days since becoming ill with GBS…. It’s been a while. It felt great to get out of the hospital. Does it ever feel good to get outside and get some fresh air. It wasn’t too hot, it was just perfect, even had a slight breeze. I finally got everything unhooked from me even my trach. Unfortunately I missed out on the rest of the summer as a result of Guillain Barre Syndrome. Being outside makes me think of gardening and playing basketball with the kids. Hopefully next summer I’ll be back at it and recovered from GBS.