Rich Bradley was about to travel to Europe to learn more about his late uncle's heroism during World War II when he suddenly faced a battle of his own — a severe form of Guillain-Barre syndrome that required specialized care at Mayo Clinic.

In September 2018, Rich Bradley was about to embark on the adventure of a lifetime. He had traveled to Jacksonville, Florida, to meet up with his cousin, Kenny. They were flying to Normandy, France, two days later to retrace the steps of their uncle, a decorated World War II hero.

"He was awarded three Silver Stars, two Bronze Stars and a Purple Heart," Rich says. "I wanted to write a memorial biography about him."

But once Rich arrived in Jacksonville, a pain in his right arm that he'd felt a few days earlier became sharp. His cousin took him to a local emergency department. After staying overnight for observation, Rich returned to his cousin's home. That afternoon, the pain continued to get worse, and it radiated to his chest. Rich returned to the same emergency department, but he was discharged again.

"Kenny drove me back to his place, and when I tried to get out of his truck, I collapsed," Rich says. "I couldn't stand up."

Still in considerable pain the next morning, Rich began to suspect his symptoms were neurological. He got on the internet and Mayo Clinic appeared at the top of his search results.

Rich had been a patient at Mayo Clinic's Rochester campus for 15 years for a congenital heart defect, and his family had a long history of receiving care there. He knew Mayo Clinic was where he wanted to be evaluated. After collapsing again, he was taken to Mayo Clinic's Florida campus by ambulance.

A severe form of a rare disease

"I felt my life slipping away on the way to Mayo. I lost hope," Rich says. "But when they opened the doors to the ambulance, and I saw about 30 people standing there, I began feeling hopeful because somebody was taking this seriously."

Rich remembers being in a room surrounded by several doctors. "I'm looking around, and I see this man with white hair, a white beard and a red vest. He says it's Guillain-Barre,'" Rich recalls. "I later found out he was neurologist Benjamin Eidelman, M.D."

Guillain-Barre syndrome is a rare disorder in which the body's immune system attacks the nerves. In severe cases, it can result in complete paralysis.

"You start getting tingling and pain in your extremities. It usually starts in the toes and moves up. Over the course of a few days, it migrates up the legs, fingers and arms," says Jason Siegel, M.D., a neuro-critical care physician who was a member of Rich's Mayo Clinic team. "The most worrisome symptoms are when you can't swallow and your diaphragm stops working."

"The care I got at Mayo was the best I've ever experienced in my life. This is the most phenomenal hospital in the world."

Rich Bradley

Rich's was a severe case, affecting his ability to swallow, cough and breathe. At Mayo Clinic hospital, he was placed on a ventilator and required a feeding tube. During 2½ weeks in the ICU, Rich underwent five days of plasma exchange to remove antibodies that were contributing to his immune system's attack on the peripheral nerves.

"The care I got at Mayo was the best I've ever experienced in my life," Rich says. "This is the most phenomenal hospital in the world. There was someone checking up on me constantly."

Rich was transferred from the ICU to inpatient rehabilitation. But four days later, he had a relapse and returned to the ICU. Rich underwent another course of plasma exchange and was released two weeks later.

"Dr. Siegel always came in with the other doctors to see how I was progressing," Rich says. "He was so nice and encouraging, and answered all of my and my wife's questions."

That clear communication is crucial, according to Dr. Siegal. "The time we take to explain a patient's condition, that's a big part of why we're different," he says.

After a third relapse, Rich was hospitalized again and received intravenous immunoglobin therapy, or IVig, and steroids. He also began physical and occupational therapy.

"Immunoglobulin containing healthy antibodies from blood donors can block the activity of damaging antibodies which are causing Guillain-Barre syndrome," Dr. Siegel says. "After we discharged him, Mr. Bradley got weekly infusions of IVig for six weeks, along with steroids."

The road to a full recovery

Rich returned to his home in Wheaton, Illinois, and did inpatient rehabilitation for six weeks, followed by outpatient physical therapy. He's been walking with a walker and expects to transition to a cane by the end of May.

"There are many presentations of Guillain-Barre," Dr. Siegel says. "In the most severe cases, like Mr. Bradley's, the immune system not only attacks the myelin sheath that covers the nerves, it attacks and damages the nerves themselves, and those regenerate slowly — about 1 millimeter a day."

"The care and compassion at Mayo were overwhelming."

Rich Bradley

Rich is excited about the progress he's made after battling such an aggressive form of Guillain-Barre. "I can walk and talk again. I can feed myself," Rich says. "I can do all the regular things I need to do. I'm very grateful for the care I received at Mayo."

Rich's eating habits changed drastically while he was in the hospital, and he's taking advantage of his second chance to adopt a healthier diet. Diagnosed with diabetes 10 years ago, Rich has been off his diabetes medication for two months thanks to his new diet. His care team plans to reassess whether he can continue to stay off the medicine.

"The care and compassion at Mayo were overwhelming. The physical and occupational therapists were enthusiastic and got me to do things I never thought I could have done," Rich says. "The nursing staff was awesome. I can't say enough about them. I felt loved and cared for."

HELPFUL LINKS

• Learn more about Guillain-Barre syndrome.
• Read about the Department of Neurology.
• Connect with others talking about Guillian-Barre Syndrome on Mayo Clinic Connect.
• Explore Mayo Clinic's Florida campus.
• Request an appointment.

The post Prompt Diagnosis and Expert Care for Guillain-Barre Syndrome Save Rich Bradley’s Life appeared first on Mayo Clinic News Network.

On the Mayo Clinic Radio podcast, Dr. Michael Joyner, an anesthesiologist and human performance expert at Mayo Clinic, discusses the most recent exercise guidelines and ways to get people moving. Dr. Joyner also discuss elite athlete performance and the possibility of someone running a marathon in under two hours. Also on the podcast, Dr. Minetta Liu, an oncologist at Mayo Clinic, explains how liquid biopsy may individualize cancer treatments. And Dr. P James Dyck, a neurologist at Mayo Clinic, discusses Guillain-Barré syndrome.

The post #MayoClinicRadio podcast: 12/15/18 appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Michael Joyner, an anesthesiologist and human performance expert at Mayo Clinic, will discuss the exercise guidelines and ways to get people moving. Dr. Joyner also will discuss elite athlete performance and the possibility of someone running a marathon in under two hours. Also on the program, Dr. Minetta Liu, an oncologist at Mayo Clinic, will explain how liquid biopsy may individualize cancer treatments. And Dr. P James Dyck, a neurologist at Mayo Clinic, will discuss Guillain-Barré syndrome.

Here's your Mayo Clinic Radio podcast

The post Exercise guidelines / elite athletes / liquid biopsy / Guillain-Barré syndrome: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

According to updated physical fitness guidelines issued recently by the Department of Health and Human Services, less than one-third of Americans — and only 1 in 5 teenagers — are getting the recommended amount of exercise each week. The current recommendation for adults is to get 150 minutes of moderate aerobic activity and two sessions of muscle strengthening per week. For children ages 6–17, 60 minutes per day of moderate aerobic activity and two sessions of muscle strengthening per week is recommended. While the updated guidelines recommend the same amount of exercise as the original standards released in 2008, they don’t require the physical activity to occur in at least 10-minute blocks. The message is every little bit helps.

On the next Mayo Clinic Radio program, Dr. Michael Joyner, an anesthesiologist and human performance expert at Mayo Clinic, will discuss the exercise guidelines and ways to get people moving. Dr. Joyner also will discuss elite athlete performance and the possibility of someone running a marathon in under two hours. Also on the program, Dr. Minetta Liu, an oncologist at Mayo Clinic, will explain how liquid biopsy may individualize cancer treatments. And Dr. P James Dyck, a neurologist at Mayo Clinic, will discuss Guillain-Barré syndrome.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: When it comes to exercise, every little bit helps appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Michael Joyner, an anesthesiologist and human performance expert at Mayo Clinic, will discuss the exercise guidelines and ways to get people moving. Dr. Joyner also will discuss elite athlete performance and the possibility of someone running a marathon in under two hours. Also on the program, Dr. Minetta Liu, an oncologist at Mayo Clinic, will explain how liquid biopsy may individualize cancer treatments. And Dr. P James Dyck, a neurologist at Mayo Clinic, will discuss Guillain-Barré syndrome.

To hear the program, find an affiliate in your area.

Miss the show?  Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Exercise guidelines / elite athletes / liquid biopsy / Guillain-Barré syndrome appeared first on Mayo Clinic News Network.

The first study providing evidence for Zika virus infection causing Guillain-Barré syndrome has been released in The Lancet. Researchers looked at a Zika outbreak in French Polynesia between October, 2013 and April, 2014 and found an increase in Guillain-Barré syndrome in that area during that same time period.

Mayo Clinic infectious diseases specialist Dr. Pritish Tosh says, "The risk is very small however, there can be some association between Zika infection and subsequent development of Guillain-Barré syndrome and further evidence suggests there may be a link. It needs to be investigated further."

Watch Dr. Pritish Tosh discuss Zika:
https://youtu.be/mq1Y_Syi79M
"With the new data suggesting a possible link between Zika virus infection and Guillain-Barré syndrome, it is important to realize Guillain-Barré syndrome is still  very rare — even after an infection that could lead to it," says Dr. Tosh. "We need to continue putting our focus with Zika virus on pregnant women and their unborn children."

Zika virus, which also has been linked to the birth defect microcephaly, is primarily transmitted by the bite of an infected Aedes species mosquito (Aedes aegypti and Aedes albopictus), which are also responsible for spreading dengue and chikungunya viruses.

Dr. Tosh says it is important to find ways to control the mosquito population. Such ways which include cleaning up garbage, removing stagnant water sources and use of insecticides.

Most people who are infected with Zika virus — 80 percent — show no symptoms, and 20 percent have mild symptoms that can include fever, rash, joint pain and conjunctivitis.

Related stories.

• Zika Virus and Microcephaly: Need for More Research (Feb. 22, 2016)
• Guillain-Barre Syndrome and Zika: Is There a Connection?  (Feb. 17, 2016)
• Zika Virus Impacts Blood Donations  (Feb. 5, 2016)
• Transmission of Zika Virus and Dangers of Mosquitoes  (Feb. 4, 2016)
• WHO Says Microcephaly-Zika Virus Link International Emergency   (Feb. 1, 2016)
• Mayo Clinic Minute: Zika Virus   (Jan.21, 2016)

The post Further Investigation Needed on Zika Link to Guillain-Barré Syndrome appeared first on Mayo Clinic News Network.

As world health leaders continue to meet and seek ways to fight the Zika virus pandemic, the World Health Organization (WHO) has put together a $56 million Zika virus strategic response plan that includes 

Currently, there is no vaccine for the mosquito-borne Zika virus which has now been found in 39 countries. Mayo Clinic infectious diseases specialist Dr. Pritish Tosh says, "A lot more work needs to be done for Zika virus vaccine development, and in part, because of the amount of money being put towards it domestically and internationally, I certainly hope that there is going to be a lot more research and development into developing a Zika virus vaccine."

Watch Dr. Pritish Tosh discuss Zika Virus 
https://www.youtube.com/watch?v=7_fNpD7Rg2o
 

Most people who are infected with Zika virus — 80 percent — show no symptoms, and 20 percent have mild symptoms which may include fever, rash, joint pain and conjunctivitis. Dr. Tosh says, "The reasons we are concerned about Zika is because there is now an association with Zika virus infection and a certain birth defect, micocephaly, and we are learning a little bit more that there are cases of microcephaly that seem pretty convincingly that Zika virus is involved."

According to WHO, Brazil has reported 4180 suspected cases of microcephaly, 270 were confirmed and six of the 270 confirmed cases of microcephaly had evidence of Zika infection. Dr. Pritish Tosh says, "We don't know the percentage of microcephaly that is occurring in Brazil because of Zika virus. And, that needs to be elucidated further. We also don't know what percentage of pregnant women who are infected with Zika virus end up developing microcephaly in their child because of the Zika virus. These are all very important questions that epidemiologically need to be addressed before we can really understand the risk of Zika virus infection in pregnant women."

Officials with the World Health Organization (WHO) are also exploring a possible link between Zika virus and a rare neurological disorder called Guillain-Barre syndrome (GBS).

Journalists: Broadcast quality video is available in the downloads.

For more on Zika virus:

Guillain-Barre Syndrome and Zika: Is There a Connection?  (2/17/2016)
Zika Virus Impacts Blood Donations  (2/5/2016)
Transmission of Zika Virus and Dangers of Mosquitoes  (2/4/2016)
WHO Says Microcephaly-Zika Virus Link International Emergency   (2/1/2016)
Mayo Clinic Minute: Zika Virus   (1/21/2016)

The post Zika Virus and Microcephaly: Need for More Research appeared first on Mayo Clinic News Network.

Mayo Clinic neurologist Dr. P James B. Dyck says, "While there is not yet data to prove the link, there seems to be an increase in GBS cases in areas where Zika virus is active. If you've had a viral illness or have been in one of these areas and begin to develop numbness or weaknesses, it is reasonable to go to your local doctor or Emergency Department. But also keep in mind that GBS is rare."

The exact cause of Guillain-Barre syndrome is unknown, but the condition is often preceded by an infectious illness. Guillain-Barre syndrome usually begins with a tingling and weakness in the feet and legs that spreads to the upper body and arms. A small percentage of people experience the numbness and tingling in the face or arms first. In some cases, the condition progresses very rapidly.

Guillain-Barre syndrome symptoms may include:

• Prickling, "pins and needles" sensations in the fingers, toes, ankles or wrists
• Weakness in your legs that spreads to the upper body
• Unsteady walking or inability to walk or climb stairs
• Difficulty with eye or facial movements, including speaking, chewing or swallowing
• Severe pain that may feel achy or cramp-like and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing

Doctors who see suspected cases of GBS can confirm the diagnosis with tests such as spinal taps, to look for elevated levels of a certain protein, and nerve condition studies, during which electrodes are taped to the skin near a nerve and a small shock is passed through the nerve to measure the speed of nerve signals.

There's no cure for Guillain-Barre syndrome. But two types of treatments can speed recovery and reduce the severity of the illness:

• Plasma exchange (plasmapheresis). The liquid portion of part of the blood (plasma) is removed and separated from the blood cells. The blood cells are then put back into the body, where they manufacture more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.
• Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.

Dr. Dyck says Guillain-Barre syndrome can be very scary, but with treatment, most cases resolve.

Listen to Dr. Dyck discuss Guillain-Barre syndrome

Journalists: Broadcast quality sound bites with Dr. Dyck and b-roll can be found in the downloads. 

The post Guillain-Barre Syndrome and Zika: Is There a Connection? appeared first on Mayo Clinic News Network.

Mayo Clinic infectious diseases specialist Dr. Pritish Tosh says, "It is important to remember the primary mode of transmission is from an infected mosquito in an endemic area. This is not the first case of suspected sexual transmission of Zika virus. The CDC is developing guidance to prevent transmission to pregnant women."  Dr. Tosh adds, "The general public is not at risk of complications from the virus. Eighty percent of those who develop Zika virus are completely asymptomatic, and the infection does not cause problems for those who are not pregnant."

Watch interview with Dr. Tosh

The birth defect microcephaly has been linked to Zika virus.  Microcephaly is a birth defect that may result in serious defects and fetal demise. There may also be a link to Guillain-Barré syndrome (GBS), a rare disorder in which the body's immune system attacks the  nerves. The CDC continues to work on this to determine if Zika and GBS are related.

Dr. Tosh says, "Zika infection continues to be a public health concern, mainly due to the risk it poses to pregnant women and their unborn children if the mother is infected during pregnancy. Pregnant women should take precaution to avoid infection by avoiding travel to endemic areas and using mosquito repellant if they must travel to those areas that are affected by the mosquito-borne illness."

The CDC has issued a travel health notice and asks pregnant women to consider postponing travel to any area where Zika virus transmission is ongoing.

See earlier posts with sound bites with Dr. Pritish Tosh:

WHO Says Microcephaly-Zika Virus Link International Emergency   (2/1/2016)

Mayo Clinic Minute: Zika Virus   (1/21/2016)

The post Transmission of Zika Virus and Dangers of Mosquitoes appeared first on Mayo Clinic News Network.

The post Guillain-Barre Syndrome appeared first on Mayo Clinic News Network.