‘Feeling blessed that I’m here’

As a patient recovers from a life-threatening brain infection, a doctor reminds residents, ‘West Nile virus is in our backyard.’

Bob Tonning never bothered with bug spray because mosquito bites never bothered him.

But after surviving a life-threatening bout with West Nile virus, he has a new appreciation for mosquito repellents. And a renewed appreciation for life.

“I’m feeling blessed that I’m here, believe me,” he said.

He spent nearly a month in the hospital after contracting the virus, which is carried by birds and transferred to new hosts by mosquitoes.

“My husband is a Vietnam veteran,” said his wife, Colleen. “He served in Vietnam and went through all kinds of difficult things. I can’t believe a mosquito would take him down.”

His experience should be a wake-up call for people to take precautions against mosquito bites at home or when away, said Jorgelina de Sanctis, MD, an infectious disease specialist with Spectrum Health Medical Group.

“West Nile virus is in our backyard,” she said. “We should remember to never let our guard down.”

Although Tonning, 70, doesn’t know when he received the virus-carrying bite, he and Colleen suspect it happened after their house was flooded in June. The couple lives on Second Lake in the community of Six Lakes in central Michigan.

“We lost the bottom level of our house, and the mosquitoes were really bad,” Colleen said. “There was so much standing water.”

In early August, he felt sluggish for a couple of days. And early in the morning of Aug. 9, he woke up and realized he couldn’t feel his legs. He tried to stand but fell back into bed.

Colleen took him to the emergency department at Spectrum Health Kelsey Hospital. He underwent tests and was transferred to Spectrum Health United Hospital in Greenville.

As Tonning’s condition deteriorated, he experienced tremors and garbled speech. When he developed trouble breathing, he was put on a ventilator.

Colleen and the medical team in Greenville consulted with an infectious disease specialist at Spectrum Health Butterworth Hospital through the telemedicine service, MedNow. They decided to transfer him to the neuro intensive care unit at Butterworth in Grand Rapids.

Five days after Tonning became ill, the results of the blood tests came in, pinpointing West Nile virus as the culprit behind his illness.

Four cases in Michigan

His illness was one of the first human cases of West Nile reported in Michigan in 2017, according to the Michigan Department of Health and Human Services.

In most people, West Nile virus causes no symptoms. About 20 percent develop a mild flu-like illness, according to the health department. One in 150 people develop severe illness, associated with encephalitis or meningitis.

Tonning became one of the few to get encephalitis.

“With West Nile encephalitis, it causes irritation and inflammation in the brain,” said Patrick Mullan, DO, the interim director of the Inpatient Rehabilitation Center at Blodgett Hospital.

Once symptoms appear, encephalitis progresses quickly.

If a patient has a worsening fever, severe neck pain or signs of confused thinking, Dr. Mullan recommends seeking medical care quickly, as the Tonnings did.

It’s also important to get treatment because other serious conditions―such as strokes or bacterial meningitis―can cause similar symptoms as encephalitis.

Beginning rehab

Ten days after he fell ill, Tonning rebounded enough to leave Butterworth Hospital. But his battle with encephalitis had taken a toll on his body.

He transferred on Aug. 18 to the Inpatient Rehabilitation Center at Blodgett Hospital.

When Tonning arrived, he lacked the muscle strength to overcome gravity, Dr. Mullan said. He couldn’t raise his arms or legs by himself and needed help with the most basic activities of daily living.

The irritation and inflammation in his brain also slowed his ability to process information and respond when asked a question. And his ability to swallow was impaired, so he received nourishment through a feeding tube.

He began therapy three hours a day, working with physical, occupational and speech therapists.

At first, he had a hard time understanding why he had to do therapy. But as his health improved, Colleen could see his motivation kick in.

His willingness to work hard didn’t surprise her.

A former Army sergeant and U.S. Postal Service worker, Tonning has always been physically active. Before his illness, he golfed and fished. And he recently built an addition to their home.

“He was very calm. He has been remarkably cool with this, which has been impressive,” Colleen said. “Every couple of days, he would make greater gains.”

Tonning’s abilities improved with a speed that impressed his caregivers, Dr. Mullan said.

Nineteen days after he began rehab, he was ready to move home. By then, he had relearned to feed and care of himself.

“I could throw the walker away and walk by myself,” he said. “That’s amazing.”

As he continues therapy at home, he has his sights set on a full recovery. He hopes to golf before the snow flies this year.

And he wants to be active enough to enjoy fun times with his family, which includes nine children, 10 grandchildren and one great grandchild.

“I’m thinking in the next 30 days, I should be able to make a really good recovery,” he said. “That’s wishful thinking, but that’s the way I am.”

He credits his medical team, his wife, family and faith with his recovery.

“Definitely our God had something to do with it,” he said. “Believe me, we did a lot of praying.”

West Nile prevention

The Michigan Department of Health and Human Services advises the following steps to avoid West Nile virus and other mosquito-borne diseases:

  • Maintain window and door screening to help keep mosquitoes outside.
  • Empty water from mosquito breeding sites around the home, such as buckets, unused kiddie pools, old tires or similar sites where mosquitoes lay eggs.
  • Use nets and/or fans over outdoor eating areas.
  • Apply insect repellents that contain the active ingredient DEET, or other EPA-approved product to exposed skin or clothing, and always following the manufacturer’s directions for use.
  • Wear light-colored, long-sleeved shirts and long pants when outdoors. Apply insect repellent to clothing to help prevent bites.

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