Possible diagnosis while in the ICU

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CaityCakes

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Feb 18, 2024
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Lost a loved one
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2/2024
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US
Hi everybody. This will be long, rambling, and possibly confusing post. Many thanks to anyone who reads it ❤️

My father in law was a relatively healthy man in his mid 70's before this began. He had been complaining of arm weakness during the last six months, even brought it up to his PCP, but was told this was a part of aging. He was still able to do everything he wanted, but needed to put in more effort. His legs were not affected.

2-3 weeks ago, he came down with what we thought was a cold. It eventually progressed and he was admitted to the ICU, placed on a ventilator, and diagnosed with septic shock and respiratory failure due to this viral illness. The days passed by and his pneumonia cleared nicely based on blood work and x-rays.

He "should" have been turning the corner, but it became obvious that he was profoundly weak. Weaker than you would expect him to be after an ICU admission. Too weak to lift his arms or legs. Too weak to support his own breathing and come off of the ventilator. He was able to move his head independently, but that was it.

Finally, a neurologist came to the ICU and examined him. He had 0/5 strength in all extremities, and diffuse atrophy in his upper and lower extremities. Preserved reflexes and positive babinski. No fasciculations noted. TONS of blood work was sent out, everything was normal. Normal neck MRI.

Neuro believes this could be MND that wasn't diagnosed yet. Looking back, symptoms started 6 months ago.

We have transitioned my sweet father in law to hospice care, as he was adamant that he never wanted a trach, and never wanted to live a life where he could not care for himself. He has lived a good, long life. We are thankful.

All that to say----what. just. happened. Has anyone heard of MND going from early stage to profound weakness during the course of a different major illness? He was walking one day and was basically paralyzed 8 days later. Woah. Thoughts? Ideas? This is just so strange to me. Obviously, we will not do an EMG while in hospice care.

Love to you all.
 
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I'm very sorry to hear about your FIL but glad to hear that you all are with him and abiding by his wishes.

I am assuming that severe Covid, acute GBS, stroke, etc., alone or in combination, were ruled out, since I would have considered those higher likelihood than undiagnosed ALS.

To answer your question, I can't say I've heard of a decline this complete and this fast, that was diagnosed as ALS. While I understand not worrying about an EMG on hospice, I hope that he/you will consider a brain donation for research that could help others.
 
I am so sorry this happened to your father in law and family. Take care of each other. ❤️
 
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