John Warner rolled into Cleveland Clinic’s emergency room in a wheelchair on August 20, 2007. A nurse had to lift the 71-year-old out of his car and into a wheelchair. “I was dead weight,” Mr. Warner says. “And my legs were really in trouble.”
After just four days of treatment, he boarded his daughter’s boat – with some help – and cruised the waters of Lake Erie.
Seeking Shorter Distances to Expert Care
When Mr. Warner arrived at Cleveland Clinic, he had a prior diagnosis and treatment plan, failing nerves in his right foot and leg, and nerve problems spreading through his left leg and arm.
In January 2007, he had been diagnosed by another healthcare provider with chronic inflammatory demyelinating polyneuropathy (CIPD) a rare condition in which nerve signals don’t reach the muscles. This neurological disorder often begins in the fingers and toes and affects skin sensation and movement.
Despite treatment, his condition worsened. He needed to find high-quality medical care that was convenient to his home in Buckhannon, W. Va. He decided to visit Cleveland Clinic because his daughter lives in a suburb of the city, and he already knew about the quality care Cleveland Clinic provides. In 1999, Mr. Warner’s wife, Judy, was diagnosed with breast cancer. Following her doctor’s recommendation, she sought treatment at Cleveland Clinic. Her cancer has been in remission the past eight years. Mr. and Mrs. Warner also have a handful of friends who went to Cleveland Clinic for treatment of heart conditions.
A New Diagnosis Means Good News
John Warner
After Mr. Warner was admitted to the hospital, a neurologist came to speak to him. Rebecca Kuenzler, MD, of Cleveland Clinic’s Neurological Institute, walked into his room and cheerfully declared, “I want to be your neurologist.” Touched by her bright introduction, he gladly accepted her offer.
Dr. Kuenzler knew something was affecting Mr. Warner’s nerves but wasn’t certain about his previous diagnosis. After combing through his files and past diagnoses, she ran tests on Mr. Warner and gave him a new diagnosis: multifocal motor neuropathy with conduction blocks (MMNCB). Like CIDP, MMNCB is a rare nerve disorder characterized by a break in the communication network between nerves and muscles. But unlike its cousin CIDP, which affects sensation and movement, MMNC B affects only movement.
Dr. Kuenzler told Mr. Warner that if he had CIDP , his legs wouldn’t respond to touch. “But I had full tactile feeling,” he says. Doctors put pressure on his legs and touched the bottoms of his feet with metal instruments, causing him to squirm at the tickling sensation. “If I had CIDP, I wouldn’t have felt that,” he says.
“Mr. Warner had experienced some abnormalities with sensation,” Dr. Kuenzler says. “That was from an unrelated condition, which led to the CIDP diagnosis.”
With the new diagnosis came good news: Mr. Warner would walk again.
Encouraging Treatment in More Ways than One
Because the damage in his right leg had accumulated over the course of about one year, it could not be completely reversed. But the damage to his left side had occurred more recently, and it was likely that it could be halted and at least partially reversed.
Dr. Kuenzler continued the previously prescribed gamma globulin treatment – injections intended to boost immunity and ease nerve inflammation. “I have a truly crippling disorder,” Mr. Warner says. “The gamma globulin that they gave me had a huge effect on my body.” Dr. Kuenzler also introduced another treatment, a medicine used in chemotherapy.
During his arrival and treatment, Mr. Warner said the Cleveland Clinic staff made him feel comfortable and genuinely seemed to care. When he entered Cleveland Clinic, a patient service specialist helped him with his stay and in finding his way around. When Dr. Kuenzler would stop in to see him, she would often have a group of interns following her. Mr. Warner, a professor emeritus of West Virginia Wesleyan College, enjoyed talking to the interns, who came from all reaches of the globe. “The first evening, a student from Mexico and one from India were so positive and helpful,” he recalls. “It gave me the feeling that they were going to help me.”
When Mr. Warner returned home, he wrote a column for the Charleston Gazette, which he contributes to regularly. He chronicled his stay at Cleveland Clinic, talking about the people who helped him and how MMNCB has affected his life. “My week in Cleveland Clinic changed my life,” he wrote to his patient services representative. “I can never thank you enough.”
Steps in the Right Direction
Mr. Warner was released from the hospital on August 24, after four days of treatment. The next day he boated on Lake Erie with his family. Two weeks later he began walking regularly with his wife. With one hand poised on her shoulder and one on his cane, or “shillelagh” as he has dubbed it, he strolls a quarter mile and back on the Buckhannon River Walk, a park near his home.
Twice a week, Mr. Warner gets his “gammas” at a hospital near his home in West Virginia. Dr. Kuenzler is working with his local doctor to create a more convenient treatment plan for Mr. Warner.
In the meantime, Mr. Warner regularly walks with his “shillelagh” and only rolls out his wheelchair for long distances.
To make an appointment with a physician in The Cleveland Clinic Neurological Institute, call 800.884.9551. If calling from outside of the United States, call 001.631.439.1578.
