Like a lot of us, I suspect, I was hoping that since there are so few neurosurgeons as compared to the population in general, no neurosurgeon I know would get a real case of COVID-19. CANS President Mark Linskey has been asking for over a year to have any member of CANS report getting COVID-19 or hearing of someone who did—with no response.
Well, the second shoe dropped when Jay Levy from Napa let us know about his saga with the virus plus a bout of Guillain-Barre. Here is his story:
Jay Levy here.
I had Covid, and because it was complicated by a neurological disease I’ll tell the whole long story for the interest of CANS members.
I’m 86 years old, in good health, and did not retire from neurosurgery until I was 81 years old. I did my last surgery working as a locum’s in North Dakota and retired in 2017 just before my house and property burned in the wild fire.
I’m now 86 , and considered myself to be in fine health before any symptoms began.
On September 11 I had my annual influenza vaccination.
Two weeks later I began to notice weakness in my hamstrings and quadriceps on both sides.
The last week in September I had to walk off the golf course in the middle of a round because my legs were weak and I simply couldn’t hit the ball.
In July 2019 I had a decompressive laminectomy at L3 for spinal stenosis with symptoms that were mostly weakness of the L4 and L5 innervated leg muscles and little of the usual pain.
For this reason I contacted my surgeon and a lumbar MRI was done the following week with no evidence of recurrent stenosis.
This was during the Covid epidemic and no one had seen me to examine me.
The second week of October I saw my family practitioner and we decided that I could very well have Guillain Barre syndrome with symptoms of ascending weakness with minimal sensory loss.
An EMG was scheduled for the next week for 21 October.
At that time I could still ambulate and could climb two flights of stairs but with severe muscle fatigue
On Sunday the 18th I happen to use my pulse oximeter and it read 90 instead of the usual 97.
As usually happens when physicians are trying to treat themselves I thought this was a mechanical failure and not pertinent.
Monday I was confused and Tuesday I really could not think straight, but with no fever, no pulmonary symptoms of any sort and on Wednesday the 21st the day my EMG had been scheduled I had to go to the hospital for confusion and increasing weakness.
When they examined my lungs prior to admission there were abnormal findings and I was taken to the emergency room for a chest x-ray which revealed a Covid type pneumonia.
I saw this x-ray and it looked pretty serious to me.
That is the last thing I remember the five weeks.
Because I had Covid the thought of Guillain Barre was ignored and I was sent home.
By the time I got home, a 15 minute ride, I was unable to walk and it was necessary to get help and carry me into my home in a chair.
An ambulance was called and I was returned to the hospital and placed in ICU.
During five weeks in the acute-care hospital including ICU time, I was intubated for a week and subsequently had a tracheostomy placed.
It’s difficult to say how much Covid symptoms were involved in my treatment but clearly the tracheostomy was required because of ascending paralysis.
I did have the usual prescribed treatment for Guillain Barre.
The first memory I have after seeing my chest x-ray on 21 October was being wheeled into the acute rehabilitation units on the last day of November.
At that time I had marked atrophy of my hand muscles but had recovered reasonable strength in my upper extremities and the tracheostomy had been removed.
At that time, however, I was unable to move my lower extremities.
I was in the hospital rehabilitation for a month, and then skilled nursing rehabilitation for two months
Now, with April Fools Day approaching, over five months after Guillain Barre onset, and over four months after exacerbation by Covid I have had gradual improvement every day and am now able to ambulate short distances with ski poles.
My grip strength is now 91 pounds, up from 51 pounds when I first left the acute hospital and though I sometimes use a wheelchair or a walker I am totally independent in all of my dressing and bathroom needs.
I intend to recover and go back to the golf course, but will just have to be patient and see how long that takes.
A friend of mine from Arkansas told me he knew I would get well because he described me as being “tough as woodpecker lips”.
I offer this long story because the rapid exacerbation of my weakness related to the onset of the Covid virus infection might be of interest to neurological surgeons.
Also, my ultimate good recovery, particularly at my age, is encouraging.
Jay’s long suffering wife Jodi had a miserable 5 months as one might imagine and was unable to visit Jay or even communicate with him during his extensive ICU stay. She was alone at their home for 4 months but like most neurosurgeon’s wives, she toughed it out and kept the home fires burning until her man came home.