Update on Betty Montgomery

Betty Montgomery still in hospital

From WTVG-TV Toledo website

May 31, 2006 - COLUMBUS, Ohio (AP) - State Auditor Betty Montgomery has been moved out of intensive care and into a standard patient room for treatment of inflammation of the nerves.

Her office says Montgomery -- also the Republican nominee for attorney general -- is being treated for Guillain-Barre syndrome. She entered Ohio State University Medical Center on May 17 after a weeklong chest cold and cough. She spent two weeks in intensive care.

In a statement released by her office, Montgomery says her doctors tell her she is making great progress and she'll resume her work schedule as soon as they allow it. Neither the auditor's office or the hospital would release her condition.

The 58-year-old Montgomery entered the governor's race last year but dropped out in January to pursue her former position of attorney general. She faces Democratic state Senator Marc Dann in the November election.

http://abclocal.go.com/wtvg/story?section=state&id=4222269

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http://www.ohio.com/mld/ohio/living/health/14687867.htm

Posted on Sun, May. 28, 2006

Board wants disease in spotlight

Group hopeful state auditor's illness teaches more about Guillain-Barre

By Elizabeth Suh

Beacon Journal medical writer

While Barbara Katzman never wishes that anyone falls ill, she said she hopes the recent diagnosis of Ohio Auditor Betty Montgomery with a rare nerve disorder will help people learn more about the disease.

Katzman is the associate director of the GBS/CIDP Foundation International, which supports patients with Guillain-Barre (ghee-YAN bah-RAY) syndrome.

The disease often causes temporary paralysis and strikes 1 or 2 in 100,000 people in the United States.

Montgomery, who is the Republican candidate for state attorney general, was admitted for treatment of the disease on May 17 to the Ohio State University Medical Center, where she remained in the intensive care unit through Friday afternoon.

Jennifer Detwiler, Montgomery's spokeswoman, said she could not comment on Montgomery's health status but staffers at the auditor's office have no reason to expect anything other than a full recovery for Montgomery, 58.

Detwiler could not say whether Montgomery has been placed on a ventilator or when she would be discharged.

Montgomery has been in contact with senior staff members every day since being hospitalized, Detwiler said, and plans to forge ahead in her campaign for attorney general.

Signs of symptoms

With Guillain-Barre syndrome, the body's immune system goes awry, attacking nerves outside of the brain and spinal cord. The first symptoms usually are weakness or tingling in the legs and arms.

In the most common form of the disease, antibodies in the immune system attack insulation around the nerves, causing weakness and altered sensation.

Virtually all who get the disease are hospitalized, as the disease can rapidly affect nerves leading to the heart and lungs. Yet even in the most severe cases, most patients fully recover. However, many patients continue to have residual effects such as fatigue.

Only 5 percent of patients die from the disease, and those cases usually occur in the elderly as a result of complications such as blood clots or pneumonia, said Dr. Gareth Parry, a neurology professor at the University of Minnesota who serves on the GBS foundation's medical advisory board.

The disease's course ranges widely among patients, but it usually lasts two to three weeks from onset to its worst point, said Dr. Richard Lewis, associate chair of neurology at Wayne State University in Detroit, who also serves on the GBS foundation's medical advisory board. Then there's a period of plateau, then recovery that can take weeks or years.

About one-third of patients are fully paralyzed, Lewis said, and the rest usually have some kind of paralysis.

It's unknown what causes Guillain-Barre syndrome, but it's usually preceded by a bacterial or viral infection. Montgomery had been suffering from a cold and cough for about a week before being hospitalized.

Some may have heard of Guillain-Barre syndrome after a spike in cases of the disease was linked to U.S. vaccines during the ``swine flu'' epidemic of 1976, prompting a halt to vaccinations. No other vaccine has been conclusively associated with the syndrome, Parry said.

Time in intensive care

About 30 to 40 percent of Guillain-Barre syndrome patients go into the ICU, usually for life support, such as use of a ventilator, Parry said. Patients are kept in the ICU as long as there is danger that vital functions like breathing, swallowing and heart rhythm might drastically change.

Doctors might be more likely to keep a ``VIP'' like Montgomery in the ICU for less serious reasons, Lewis said.

The disease doesn't seem to strike certain people more frequently, except it does occur more often in older people, Parry said.

Although it probably would take Montgomery longer to recover if she required use of a ventilator, Parry said, the disease wouldn't necessarily have to impact her campaign much.

Once patients begin improving, they can improve rapidly, he said. He's seen patients who had been on a ventilator walking a week later.

Two treatments help shorten the severity and duration of Guillain-Barre syndrome. In plasma exchange, the patient's blood is flushed of misbehaving antibodies and returned to the body with replacement fluids.

In the other treatment, called immunoglobulin therapy, the patient is injected with healthy antibodies that block the misbehaving antibodies.

Lasting effects

Kassandra Ulrich, the GBS foundation's regional director of the Midwest, said she thought she would never walk again when she got Guillain-Barre syndrome 25 years ago, a few days before her son was born.

Ulrich, an Akron resident, was almost completely paralyzed and was in the ICU for three weeks.

But she set the goal of walking again before her newborn son learned to walk. It took her eight months, but she won that race. Now, the main leftover from her disease is the fatigue that makes it hard for her to move her body steadily when she overworks herself.

Despite the disease's unpredictability, Ulrich, who has spoken with at least 1,000 people who've had Guillain-Barre syndrome, said she's confident Montgomery will be able to handle campaigning with the physical manpower of her staff.

Montgomery can withdraw from the race at any time before November's elections, but she would have to withdraw by Aug. 23 for the Republican Party to name a replacement at that time.

Hopefully, Montgomery can find some positive aspects to the hardships she now faces, Ulrich said.

``It slowed me down,'' Ulrich said of the disease. ``I got to enjoy life more.''

For more information on Guillain-Barre syndrome, visit www.gbsfi.com or call 610-667-0131.

Elizabeth Suh can be reached at 330-996-3748 or esuh@thebeaconjournal.com.

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Toledo Blade; Article published Saturday, May 20, 2006

Montgomery's prognosis is hard to pinpoint

By LUKE SHOCKMAN
BLADE STAFF WRITER

Ohio Auditor Betty Montgomery's office says she'll remain in her race for attorney general despite a neurological disorder.

The disclosure this week that Ohio Auditor Betty Montgomery has developed a rare neurological disorder called Guillain-Barre syndrome likely had many saying, "Guillain what?"

First described in the 1800s, it was later named after two French physicians, Drs. Guillain and Barre, who during World War I described a peculiar disease that resembled polio. Those with the disorder developed, often suddenly, tingling in the limbs of the body, trouble breathing, and difficulty moving, even paralysis.

Those of a certain age may remember Guillain-Barre - pronounced (ghee-yan bah-ray) - from more recent times when it was linked in the United States with flu vaccinations during the "Swine Flu" epidemic of 1976. Federal officials feared the Swine Flu might be a repeat of the deadly Spanish Flu of 1918 so they began vaccinating millions of Americans. They stopped in late 1976 after more than 500 cases of Guillain-Barre syndrome appeared. Whether the vaccine actually sparked some cases of the syndrome is debated and controversial.

Even today, the causes of Guillain-Barre are unclear. However, it's thought that the syndrome is triggered by infections in the body, from a cold or some other infection, according to Dr. Robert Lisak, chairman of the department of neurology at Wayne State University School of Medicine in Detroit.

Ms. Montgomery's staff said she had been suffering from a chest cold for about a week before being admitted Thursday to Ohio State University Medical Center, where she remained yesterday, according to spokesman Jen Detwiler. Ms. Montgomery, 58, is the Republican nominee for attorney general and she has no plans on leaving the race because of this illness, Ms. Detwiler said.

Whatever the trigger for Guillain-Barre, the result is the body's own immune system begins to attack nerves in the "periphery" of the body, such as the arms or legs. In the most common form of the syndrome - there are thought to be up to four forms - antibodies eat away at the myelin, or coverings of the nerves. Think of myelin as similar to the sheathing around electrical wires; it insulates the nerves and prevents nerve signals from being interrupted.

The syndrome afflicts about one to three people per 100,000 annually in the United States.

Dr. Lisak said the prognosis for someone with Guillain-Barre is difficult to say, as the affliction affects each person differently. In general, about 80 percent of those afflicted recover with no problems or have only minor complications. However, it can take from days to months, even several years, for recovery.

In 10 to 15 percent of patients, those who recover are left with some form of complication, such as trouble walking. The syndrome is rarely fatal; only 1 percent to 2 percent of cases result in death.

It was unclear yesterday whether Ms. Montgomery was on a respirator. Ms. Detwiler said she didn't know.

Respirator care happens in up to 40 percent of all cases, said Dr. Lisak, who's treated many Guillain-Barre cases. Being on a respirator, however, doesn't mean the person won't make a full recovery, he said.

"The more serious cases are those that need a respirator, but we've seen lots of respirator cases do very well, very rapidly," he said.

The syndrome does not affect the brain's ability to think or reason, he said. While it can be painful early on, the pain usually subsides with the most common side effect being some muscle weakness or paralysis. Those problems often disappear, said Dr. Lisak, who's on the medical advisory board for the Guillain-Barre Syndrome Foundation International (www.gbsfi.com).

Estelle Benson, executive director of the Pennsylvania-based foundation, said the public "shouldn't jump to conclusions" about the disorder. It's unpredictable how bad a person will be, how much paralysis they might have, how long it will take to get better, and if they will be left with any residual [complications]," she said.

Others who've had the syndrome include Catch-22 author Joseph Heller and TV star Andy Griffith. For more information, visit the National Institute of Neurological Disorders and Stroke Web site, http://www.ninds.nih.gov/disorders/gbs/gbs.htm.

Contact Luke Shockman at: lshockman@theblade.com or 419-724-6084.