Age: 48.0
Sex: F
Vaccine: FLU4
Symptoms: Nuclear magnetic resonance imaging, Oxygen saturation decreased, Pain, Pallor, Paraesthesia
Clinical narrative: Diagnosis - Guillain-Barre. On November 24, 2016, I woke up with the tips of my thumb, pointer, and middle finger on my left hand tingling. As the day went by, the "pins and needles" feeling moved over my entire left hand, except my ring finger and pinkie. By evening, my right hand mirrored the feelings on my left hand. By this time, my left big toe had the "pins and needles" feeling as well. Friday, 11/25, the symptoms were the same and also moving my hand felt like it was through thick rubber gloves: strength was there, but fine motor skills seemed affected. Now all the toes on my left foot were numb. Saturday, 11/26, my right foot began to have a feeling similar to my left - "pins and needles" on the toes. Between Friday and Saturday, I also began to have tingling in my tongue and lower lip. Also on Saturday, I began to experience a headache - a "cap"-like dull pain over my head. By Saturday afternoon, I began having shooting pain over my right eye. Sunday and Monday, all these symptoms remained consistent. Monday morning I went to urgent care. My husband was with me. We met with the Dr., and after careful review he determined I may be having an allergic reaction to my blood pressure medication, and encouraged me to go to the Emergency Room. We elected to go to Hospital. When I first saw the triage nurse, she took my blood pressure and it was around 212/107. She spoke with my physician about my medications, said it was OK to take them to get my blood pressure down, and hours later I was seen in the Emergency Room. Tuesday, all the symptoms remained. That evening, I felt for the first time my top lip being affected - as it slipped sideways while I was trying to speak. On Wednesday morning, my entire lip and more of my tongue were affected. I called my clinic because the swelling of my mouth and tongue was getting gradually worse. They said to go directly to the Emergency Room. Then, the ER professionals triaged the situation by using an EKG and CT scan to rule out possible stroke. I was sent home that evening with no diagnosis. Not having eaten all day because of the testing, I put some food in my mouth and found that I was unable to chew it because facial paralysis was setting in. On Thursday, my primary doctor from the clinic again sent me to the ER because the results of the prior day's tests were inconclusive. In the meantime all the symptoms had been worsening. The doctors at the Hospital conducted an MRI and sent me home again, still with no diagnosis. On Friday, at the ER's suggestion, I had an appointment with a vascular surgeon at a Clinic, to rule out temporal arteritis. That evening, symptoms persisted. Saturday morning, I could not walk upstairs but had to crawl. I had difficulty getting into our van and could not smile; my paralysis was worsening. This evening, upon seeing and talking with me, a family friend told me about Guillain-Barre and directed me to the Clinic website. I identified with nearly all the symptoms listed except for breathing difficulties. On Sunday I was also feeling extreme muscle fatigue and my lower extremities were impaired. That afternoon, I called the nurse line, and based on my description of the symptoms the nurse urged me to return to the ER, which I did. I waited for several hours in the waiting room, where I passed out in a wheelchair after my blood pressure was found to have dropped around 30 points within ten minutes. My husband reports that at this time my face appeared greenish and whitish. We asked about Guillain-Barre and the doctor emphatically disagreed that it was a possibility, based on her description of the condition's presenting symptoms - which she said always start low and spread up the body. I specifically recall the doctor saying: "It's Sunday. You have an outpatient appointment set for Tuesday afternoon with the neurologist. What's two days going to buy you?" We insisted on staying, because I'd been to the ER four times that week, and other doctors agreed to perform further tests and continue observation. We agreed to this. Monday afternoon, the neurologist suggested that in fact my condition could be Guillain-Barre, and did a lumbar puncture to determine if that was the case. The diagnosis was confirmed. Tuesday morning, a nerve stimulation test was administered to me, and immune-globulin IV treatment was started. At this time I became emotional, as it was exactly two days from when the ER doctor had asked what two days would get me - and I wondered where I would have been without the treatments that had occurred in the meantime. Those IV treatments lasted five days, for several hours each day. The hospital kept me for one more day for observation, as I had some nighttime oxygenation desaturation. I was ultimately discharged on Sunday, December 11. Paralyzation and walking have greatly improved, but symptoms in my hands, feet and legs, as well as headache, generally persist to this day.