College Student’s Determination Key to His Recovery from Rare Neurological Disorder
June 01, 2022
In October 2021, David Yanovsky, a 21-year-old nursing student at Ramapo College, started feeling run down — especially after his swim team practices. He initially attributed it to stress. After all, he was a busy college student.
But on October 6, shortly before he was due in class to take an exam, he suddenly couldn’t lift his arms.
“It was hard to walk, and I can’t believe I made it to class,” David says. “After I finished my exam, I lost the ability to hold myself up and fell to my knees in class. My professor called 911 and an ambulance took me to [Hackensack Meridian Pascack Valley Medical Center].”
A Rare Neurological Diagnosis
When David arrived at the Emergency Department, physicians ran a battery of tests and diagnosed David with a rare neurological disorder called Guillain-Barré syndrome (GBS).
GBS occurs when the body’s immune system mistakenly attacks healthy nerves, causing weakness and paralysis that can range from mild to severe. Researchers aren’t sure exactly what causes GBS, but the effects can be devastating. In severe cases like David’s, nerve damage can prevent a person from breathing independently.
“By the time I was admitted to the intensive care unit, I wasn’t able to get out of bed and it was tough to take a full breath,” says David. “However, I was mentally alert and very scared — I didn’t know what GBS was until that point.”
Eric Mittelmann, M.D., a neurologist who specializes in neuromuscular disorders, confirmed David’s diagnosis and began a treatment called high-dose immunoglobulin therapy (IVIg). The next day, David’s condition continued to get worse, and he was placed on a ventilator to help him breathe.
But because David’s case of GBS was severe and rapidly getting worse, Dr. Mittelmann transferred David to the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, where he would have access to a treatment called plasmapheresis.
Plasmapheresis involved removing David’s own blood, extracting the plasma and removing a portion of the abnormal proteins called antibodies that were causing nerve damage before giving the plasma back to David.
“David received daily plasmapheresis treatments, and at first, he was intubated and had very little ability to move,” says Dr. Mittelmann.
By October 13, after David’s fifth plasmapheresis treatment, his condition had improved significantly.
“He could bend his neck forward, lift his arms slightly, open his fingers and make a fist,” says Dr. Mittelmann. “Each time we do plasmapheresis, we remove about half of the antibodies that are causing damage. By David’s fifth treatment, we had removed well over 90 percent of the antibodies, which gave his body a chance to heal.”
Rooting for His Recovery
After 11 days on a ventilator, six plasmapheresis treatments, two IVIg treatments, and additional time to stabilize his condition, David was discharged to inpatient rehabilitation at Johnson Rehabilitation Institute at Ocean University Medical Center.
“When David came to us, he was severely weak and understandably overwhelmed and scared,” says Robin Bash, M.D., physiatrist at Johnson Rehabilitation Institute. “He couldn’t hold utensils to feed himself or push buttons on his cell phone.”
“I was like a sack of potatoes,” says David.
Under the supervision of Dr. Bash, David received physical, occupational and speech therapy. His care team used innovative technology, including electric stimulation to “re-educate” his muscles and a harness system called ZeroG to provide body weight support as he learned to walk again.
And thanks to David’s determination to get better, the encouragement of everyone on his care team, and the outstanding care he received throughout his journey, he made rapid progress.
“David was our youngest patient, but also our weakest, and he needed our extra support,” said Dr. Bash. “Everyone — from the aides to the therapists to the physicians to the other patients to his family — was rooting for David, and I think it helped to expedite his recovery.”
In early December, David was cheered on by patients and staff as he was discharged from inpatient rehabilitation after making a remarkable, near-complete recovery during his seven-week stay.
“David’s form of GBS actually attacked the nerves themselves, not just the insulation that covers the nerve, so he had a more severe case and a poorer prognosis,” says Dr. Bash. “People in David’s condition don’t always recover completely, which makes his recovery even more remarkable.”
“My care team helped me surpass every challenge — both physical and mental,” says David. “I am beyond grateful that they got me back to the same quality of life that I had before.”
Planning for His Future
David completed outpatient rehabilitation close to home, but continues to go to physical therapy conditioning sessions twice a week to help him prepare to return to his summer job as a beach lifeguard.
He plans to resume nursing school at Ramapo College in fall 2022 — where, coincidentally, Dr. Mittelmann and his wife, a nurse, are alumni — and he can’t wait to put his gratitude for the care he received to work in his own career.
“Having this story to tell will help me care for my patients with empathy and compassion, and make my nursing journey that much more fulfilling,” says David.
Next Steps & Resources:
- Meet our Experts: Eric Mittelmann, M.D. and Robin Bash, M.D.
- To make an appointment with Dr. Mittelmann, a physiatrist, or a doctor near you, call 800-822-8905 or visit our website.
- Learn about rehabilitation and neurology at Hackensack Meridian Health.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
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