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Doctor (and Patient): Adam J. Messenger, 44, MD, Internist and Diagnostician, Greenwich Hospital, and Autoimmune Disease Patient From Greenwich
Second Doctor: Frederick Nahm, MD, PhD, Neurologist, Greenwich Hospital
Diagnosis: Guillain-Barré Syndrome
THE PRESENTATION
Diagnostician Adam J. Messenger, MD, says his toughest case was actually his own — that is, he was both doctor and patient. Back in 2010, as an internist at Greenwich Hospital, Dr. Messenger was a self-professed workaholic, happily spending 80-plus hours a week at the hospital. But his grueling schedule came to an abrupt halt in November of that year, when the 44-year-old was hit by a mysterious, debilitating illness that left him bedridden and unable to control his involuntary nervous system (i.e., heart rate, blood pressure, temperature, etc). When no doctor he consulted could give him a diagnosis, and even a trip to an internationally recognized clinic in the Midwest was fruitless, he turned to self-diagnosis.
THE JOURNEY
Stuck in bed with nothing to do but research and document his own case, Dr. Messenger jokes, “I was either going to become my own diagnostician or an alcoholic.” He chose the former, and in January 2011, a trip to the Greenwich Hospital ER led him to become a patient of neurologist Frederick Nahm, MD, PhD. “Apart from being a patient, I was instrumental in making my own diagnosis, by writing up a massive case report of all my symptoms, the timeline, the lab and radiology studies, et cetera. So when Dr. Nahm came into my room and asked me several questions, within five minutes the diagnosis was made,” he recalls. He was afflicted with a rare variant of an uncommon autoimmune disease known as Guillain-Barré syndrome.
“What Dr. Messenger has is pretty rare,” says Dr. Nahm, who did his fellowship on the autonomic nervous system and has experience with similar cases. Eventually, Drs. Messenger and Nahm traced the origin of his Guillain-Barré back to a virus he’d contracted in October 2010. “I caught a virus called parvovirus, which is normally found in children and gives them a fever for a few days,” he says. “In adults, it’s a lot worse. It decimated my bone marrow. And that’s what triggered my autoimmune disease.”
Once the diagnosis was made, Dr. Nahm had to figure out how to treat this rare disease so that Dr. Messenger could regain some level of normality. “Adam’s disorder is a systemic disorder, so it affects multiple systems: cardiovascular, hormonal, et cetera. Where do you start with a set of systems that affects multiple organs? That was the challenge,” Dr. Nahm says. Ultimately, they decided on a treatment of antibodies called gamma globulin. With infusions of gamma globulin, things slowly started to turn around. Seven years later, Dr. Messenger still visits Dr. Nahm every three weeks for treatments. “My treatments will most likely be lifelong,” he says.
THE OUTCOME
Dr. Messenger says he is still fighting to gain back his strength and stamina, and, while he no longer is able to work those long hospital shifts, he has branched out into other areas. For example, he recently penned a book about his experience, titled, Unconventional Medicine. And locally, he’s developed a reputation as one of the best diagnosticians around. “The sheer volume of reading up on strange cases made me an expert diagnostician in the Greenwich community. Fellow physicians often send their patients to me when they are having difficulty finding a diagnosis, and they often come to me when they are seeking their own diagnoses. It’s nice to be the doctor to other doctors when they are ill,” he says.