Eight months ago, the biggest problem facing genial, hard-working George Mercado was getting ready for the holiday business rush that annually swamps his Severna Park jewelry store.
But overnight, he came face to face with one of life's most terrifying possibilities: debilitating illness. Now he is recuperating from one of medicine's strangest maladies, Guillain-Barre syndrome.
Mr. Mercado and his wife, Maria, natives of Buenos Aires, had just returned to Maryland last November from a trip to Spain. He was back at work when he noticed a peculiar feeling in his legs that was more distracting than painful.
At first, the jeweler joked it, saying, "Age doesn't come alone, but with pain."
The discomfort grew worse, however, and one rainy night, as he tried to mount the three steps to his front door, his legs collapsed beneath him.
Instead of worrying about his physical condition, Mr. Mercado's first concern was that his "neighbor would think I am drunk."
The next morning, after a barrage of blood tests ordered by his family doctor, he was sent to Annapolis neurologist Dr. Larry W. Blum.
In less than an hour, Dr. Blum told him, "You have Guillain-Barre syndrome."
An illness so rare that its correct pronunciation is not well known, Guillain-Barre (GHEE-lan bah-RAY) affects the peripheral nerves in the arms, legs and spinal column in ascending fashion.
According to the Guillain-Barre Syndrome Foundation International, it is difficult to describe the "average" GBS patient because the syndrome is so variable. Scientists believe it is caused by a minor infection, which triggers the body's immune system to attack the peripheral nerves.
The syndrome strikes people at any age, first in the legs, then the arms, and sometimes the head, heart and respiratory system. Five percent of those who develop the disease die within weeks due to breathing or heart problems.
The good news is that up to 70 percent eventually reach complete or nearly complete recovery, although as many as 15 )) percent will have significant long-term disability.
Mr. Mercado was one of the lucky ones. His case was discovered early, and treatment began quickly. He was immediately admitted to Anne Arundel Medical Center, where Dr. Blum ordered a spinal tap, which revealed further clues to the disease. The next morning, he was transferred to Johns Hopkins Hospital, where he spent the next three weeks under the care of Dr. Kevin Flannigan.
"There has been a major advance in the past 10 years in this disease, which is the most common form of sporadic paralysis in this country, now that polio has been conquered," said Dr. Blum.
The advance he refers to is plasmapheresis, a procedure in which blood is drawn from one arm, processed through a machine to separate the plasma from the red and white cells, and returned to the patient's other arm. This has become the accepted mode of treatment in the last seven years.
Mr. Mercado's blood was processed five times, but before it reversed the course of his illness, he was totally paralyzed.
"Until that day, I was never sick," he says. "I never considered the possibility [of severe illness]. At the beginning, I was very depressed."
The pain escalated to a level that Mr. Mercado doesn't like to remember, and he was given the strongest pain killers. When he returned home, he reduced the prescribed eight pills a day by 50 percent, then by 25 percent. Now, he only takes over-the-counter medication occasionally.
"My wife handled this like a tiger," he says with pride.
At the same time he was ill, his wife's mother had to have her leg amputated. Within two months, the other leg was removed.
Up to 10 cases of GBS are diagnosed every year in the county, many more in large urban areas, Dr. Blum said.
Mr. Mercado recalled that his hospital room often filled with doctors and interns, eager to see a case of this rare illness. One day, 27 eager observers crammed themselves into his room. Several had to stand in the bathroom.
Three people helped Mercado during his four-month absence from the store: his daughter, Marisa Dolbey, a trained gemologist; jeweler Richard Phisterer, who has been with him for 20 years; and his long-time assistant, Bert Braland, who came out of retirement to help run the shop.
Mr. Mercado is quick to praise his doctors and especially the hard-working nurses. And he doesn't miss an opportunity to give an encouraging word to new victims and pass along the address of the GBS Foundation: P.O. Box 262, Wynnewood, Pa. 19096.
Doctors say he is recuperating on schedule, although he sometimes walks with the aid of a cane. But Mr. Mercado is back at work after four months and expects a complete recovery.
* Medical assisting is the top career on the federal government's list of the 20 fastest-growing occupations, offering employment in physicians' offices, health maintenance organizations, clinics and hospitals.