Courtesy Photo | Petty Officer 1st Class Michael Molnar poses with his wife Heather and their two sons...... read more read more
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ELIZABETH CITY, N.C. - Coast Guard maritime enforcement specialists are a cadre of professionals with knowledge and skills in law enforcement and security. Members of this rating are assigned challenging duties including maritime law enforcement, anti-terrorism force protection, port security and safety. Among the desirable traits of an ME is strong leadership skills and physical fitness. For Coast Guard Petty Officer Michael Molnar, his wife Heather and their two children, Sullivan, 4; and Dominic, 1, those traits would be put to the test in the fight of his life.
Today Molnar slowly and purposefully shuffles around a room. It’s hard to believe that six months ago he weighed a solid, muscular 202 pounds capable of working long hours while underway aboard the Portsmouth, Va., based Coast Guard Cutter Forward interdicting drugs off the coast of South America.
During one such patrol in early 2011, the wheels were set in motion for “his ride” as he was diagnosed with, and continues to battle the lingering effects of Guillain-Barré [Gheen-yan Bah-ra´y] Syndrome nearly four and half months later.
Guillain-Barré Syndrome is an inflammatory disorder of the peripheral nerves outside the brain and spinal cord occurring when the body’s immune system attacks the nervous system. The syndrome is characterized by rapid onset weakness and paralysis of the legs, arms, breathing muscles and face. The syndrome may occur at any age, but is most common in people of both sexes between the ages of 30-50, and often follows a minor infection such as a lung or gastrointestinal infection. Most of the time signs of the original infection have disappeared before Guillain-Barré symptoms begin.
Guillain-Barré is a syndrome rather than a disease because doctors do not know who will get it and who will not as it only affects one to two people in every 100,000. The syndrome has no boundaries even affecting the 1996 Heisman Trophy Winner and former NFL quarterback Danny Wuerffel who was diagnosed in June 2011.
For Molnar it began in early 2011.
“I caught a nasty strain of bronchitis in South America, probably off one of the boats we were boarding or one of the people we came in contact with down there,” said Molnar.
He went to the Coast Guard clinic about the bronchitis symptoms but he wasn’t given antibiotics due to the possibility of antibiotic immunity. Molnar continued to fight the bronchitis then one night everything began to change.
“The process begins with the antibodies going crazy and attacking everything; the myelin coating on your nerves, everything,” reminisced Molnar, “The antibodies think they are doing what they are supposed to but they are really attacking your nervous system and everything starts shutting down.”
“I woke up in the middle of the night with my hands and feet tingling,” said Molnar. “I thought I had just slept in a bad position.”
That week while Molnar was at the range renewing his weapons qualifications the numbness in his hands and feet persisted. He and his wife Heather went to the local emergency room that night.
“I was told I had bronchitis and pleueritis, and dismissed. When I asked about the tingling and numbness, I was told that because I had been out of the country I needed to see an infectious disease specialist,” said Molnar.
The next morning the tingling and numbness continued causing him to take longer than usual to get his uniform on.
“I couldn’t even pull the zippers up on my boots,” Molnar recalled
Molnar went to work; where things got noticeably worse.
“A three-and-a-half pound shotgun felt like a 9,000 pound anchor, I couldn’t lift it off the table,” Molnar said.
He went to the Coast Guard clinic again. After running some tests he was advised to drive to the ER at Portsmouth Naval Medical Center because they have a neurologist on call. Then everything changed again.
“I was tripping and stumbling down the hall when my legs stopped working and I fell down,” Molnar said. “They called an ambulance to take me to the ER.”
At first the ER doctors didn’t think he was in immediate danger and started to discharge him, but then Molnar demonstrated that he couldn’t lift a chair.
The doctor tested his neurological function checking the strength in his arms and legs. “I held my hands up and he pushed them back down with the light touch of a single finger. I fought with every ounce of strength I could muster to keep my hands up.” Molnar said.
The ER doctor called the neurologist who conducted more tests on him.
Within five minutes of the neurologist seeing him, Molnar was being admitted to the hospital. “He said, ‘you have Guillain-Barré,’” said Molnar. “I asked what that was and as he was leaving the room he placed his hand on my shoulder and said, ‘You’re going to go for a ride.’”
THE JOURNEY BEGINS
For most patients diagnosed with GBS there is hospitalization to monitor the symptoms which in many cases requires the patient to be intubated and placed on artificial breathing support. There is no cure for GBS so much of the treatment is to reduce the symptoms and speed up recovery.
One effective treatment is to block the antibodies attacking the nervous system through high-dose immunoglobulin therapy (IVIG). In this treatment, immunoglobulin is added to the blood in large quantities to block the antibodies causing the inflammation.
Molnar started IVIG therapy the first night. The therapy is an effort to recoat the nerves and protect what is left of the myelin sheath surrounding the nerves.
“It is ridiculously expensive; there are three bottles a day for five days, at a cost of $10,000 per bottle,” said Molnar. “I received two rounds of that therapy.”
As the syndrome continued to attack his body Molnar went through several more stages beginning with the onset of ascending paralysis starting at the bottom and working its way up and in.
Within one week of his diagnosis, Molnar was unable to stand up and was non-weight bearing. Within two weeks, he was placed in a medically induced coma, intubated through a tracheotomy and placed on a ventilator.
“I don’t remember a whole lot about that time, I would get flashes of faces as they would take me in and out of sedation,” Molnar said.
“The progression was extremely hard to watch, given his previous level of health and the new level GBS had reduced him to,” said Cmdr. Michael Stewart, commanding officer, Coast Guard Cutter Forward. “Almost every member of the crew visited him while he was in the hospital, it was rare to walk into his room and find an open seat.”
Molnar started improving after three weeks of going in-and-out of sedation. By mid-April he was able to come out of sedation more frequently and start a second round of IVIG. Toward the end of April he was moved to a rehabilitation hospital where he remained on the ventilator until the end of May. In early June his tracheotomy was removed.
IT’S A TOUGH PLACE TO BE
Throughout this process, Molnar kept asking himself some very real questions.
“Am I going to be stuck here; am I going to be normal again; am I going to ever come out of this bed; am I going to hug my wife, pick up my kids; be able to be a husband, be a dad?” Molnar said, “I wasn’t sure if I was ever going to be able to do all that again.”
He didn’t believe he was making any progress, so Heather plotted his milestones on graph paper and said, “This is where you were, and this is where you are now in terms of ventilator settings and ability to do things.”
“I wrote to my aunt who was a physical therapist and said, Michael sat today unassisted for two minutes and the response I got from her was ‘incredible, he’s sitting up already.’”
Sitting up for two minutes unassisted may seem like no big deal, but it was an amazing feat for someone who just spent two months in bed.
ON THE HOMEFRONT
While her husband made milestones albeit small in his recovery, Heather had to balance visits to Michael, work, caring for the boys and the household.
“I worked in the medical profession for a long time and knew about Guillain-Barré, but had never seen it from the rehabilitation side,” Heather said. “I knew that I had to be there for Michael every chance I could get.”
The balance would prove to be too much when her employer gave her a choice to be with her husband or be at work.
Heather was terminated and that was when family and community began rallying together, and started donating money to help them pay bills.
Molnar’s Coast Guard family was involved from the beginning, stepping up to raise money to help and support their respected shipmate.
“The Chief’s Mess and the Wardroom donated gas money, so Heather could make the daily drive to be with Michael,” said Cmdr. Stewart.
Donations weren’t limited to their current community, Molnar had been a fireman before joining the Coast Guard, and volunteered in a firehouse everywhere he’s been stationed.
“Every firehouse I had been in from Maine, to Connecticut to Elizabeth City did something, from benefit breakfasts, and bingo nights to simply giving us money,” Molnar said.
The Molnars are forever grateful for everything people have done for them, even making road trips out of state as Michael’s condition allows appearing at some benefits and personally thanking those who continue to help.
RECOVERY
The recovery from Guillain-Barré can take years. Most people survive and recover completely. According to the National Institute of Neurological Disorders and Stroke about 30 percent of patients still have some weakness after three years.
During his stay at the rehabilitation hospital and within a few weeks from finally going home, Molnar suffered a setback. He had kidney stones, gastritis and sepsis all at the same time.
This meant making another trip to Portsmouth Naval Medical Center.
“I was back,” Molnar said, “Where I almost died.”
The five days Molnar spent in the ICU sent him down a path of depression, but at the same time strengthened his will to get out of the hospital and start making real progress toward recovery.
“When I got back to the rehab hospital I said, ‘this is it, I’m going to get out of here, I can’t stay here,’” Molnar recalled. “I got into the mindset that nothing good could come of me being there, the only place that would help was going home.”
Ten days later he was discharged from the rehab hospital and has been home for about one month.
“When he first came home from the rehabilitation hospital he relied on the roller-walker, he had difficulty getting dressed, and feeding himself,” said Heather. “Now he walks without a cane, and he helps get the kids dressed. We’re slowly getting back to normal.”
As the Molnars adjust to this new normal, Michael views his life through a different lens.
“My life was going to work; going to the range; teaching; running up and down the ladders of the ship like a monkey; working out; playing and tussling with the kids; going to bed and doing it all again the next day.”
“Now everything hurts; my legs; my knees; my back and I get up a little slower,” Molnar said, “But, he added with emphasis, I’m not in a hospital bed, I’m home.”
While Molnar admits that he misses being able to play with his two kids the way he used to, being home has been the best therapy.
“I play with the kids on the couch or the floor but no more tumbling, we play the Wii, which also is good therapy,” said Molnar. “The doctors said that playing Wii is probably one of the best therapies around.”
“My prognosis is good, it just takes time – if I can get back to 80-100 percent of where I was, I can return to duty, it may just take a year or more,” Molnar said.
THERAPY
Molnar goes to physical and occupational therapy three times a week focusing on improving his grip strength by using putty, exercise bands and other devices. In addition, he works extensively on leg strength, because he spent so much time in bed.
“If you could have seen him when he first started coming in, you’d be even more amazed at where he is today,” said Jason Spruill, Molnar’s occupational therapist.
Molnar’s recovery is continuing with rehabilitation appointments and regular check-ups, but there is the constant knowledge that even with all the gains the possibility of a relapse is never far away. Through all of the difficulties Molnar remains a committed family man drawing strength from his family and looks forward to returning to the Coast Guard job that he really enjoys.
“I have good days and bad days, lately it’s been more good than bad, I’ll be back,” Molnar said.
| Date Taken: | 09.08.2011 |
| Date Posted: | 09.08.2011 15:05 |
| Story ID: | 76673 |
| Location: | ELIZABETH CITY, NC, US |
| Web Views: | 579 |
| Downloads: | 0 |
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