It was a warm summer afternoon and Andrew Tucker was running on the track when his legs suddenly felt like they were about to buckle under him.
A few days later, he couldn't unscrew the cap of a toothpaste tube, spray a deodorant can, properly use a knife and fork, or even write.
These are just the mild symptoms of Guillain-Barré syndrome (GBS), which is a rare disorder that can be fatal. There is no known cure for the debilitating disease, nor does anyone know its actual cause.
However, the 18-year-old, from Noordhoek in Cape Town beat the syndrome and became the country’s top matric achiever in the class of 2015. Tucker, who attended the South African College High School (SACS), was lauded by Basic Education Minister Angie Motshekga for his "never-say-die" attitude.
What is GBS?
GBS is an uncommon autoimmune disorder where the body's immune system attacks its own peripheral nerves, explained Dr Andrew Rose-Innes to Health24.
"The peripheral nerves are those that lie outside the brain and spinal cord and control body parts such as the limbs and chest," said the neurologist who is in private practice at The Oregon Clinic, Portland, Oregon, USA.
"GBS often follows a flu-like illness which may activate the body's immune system to damage the nerves. Anyone at any age can get GBS, but children less so and older people more often," said Rose-Innes.
"It often begins with tingling and pain, followed by weakness in the legs, which may spread to the arms and upper body. In severe cases, patients may not be able to walk, swallow or even breathe adequately."
The disorder is typically recognised by a doctor on the basis of characteristic symptoms and signs on examination. The tests may include blood tests, electrical testing of nerve conductions and examination of the fluid around the brain and spinal cord (lumbar puncture).
"In mild cases, nursing and physical therapy may be all that's necessary," Rose-Innes said. "In more severe disease, specialised intravenous therapies, and if necessary, ventilation in an intensive care unit may be needed."
With adequate medical care, there is a good expectation of recovery in most, but not all, patients.
‘My legs started feeling weak’
Tucker told Health24 he experienced the initial onset of GBS when he took to the track for a run.
"I am a track runner and the first symptoms that I had is that my legs started feeling very weak, as if they were going to buckle while I was running around the track.
"That night I was still feeling funny. I thought maybe I was getting a really bad bout of flu, but I suspected that there was something sinister beneath it."
Tucker left school early the next day to consult a doctor. "I had to go home from school early and I normally would never do that. I knew something was wrong and I went straight to a GP."
It was thought that Tucker was dehydrated, especially since he was running and it was a very hot February afternoon. "I was told to go home and drink lots of fluids." However, his condition deteriorated a day later. "I didn't improve and I had become even worse."
He returned to the GP who ran some tests and was then referred to a neurologist who could only see him the next day.
"As soon as I was diagnosed with GBS, I was sent straight to ICU." The risk was that Tucker's muscle weakness could spread to other parts of his body, including his lungs which would require him to be put on a ventilator.
Hitting an emotional low point
Despite being scared, Tucker said that he was relieved when he found out that he had GBS because he had hit an emotional low when he did not know what was happening to him.
"I think not knowing before I was diagnosed with GBS was definitely the worst because it really felt like my whole body was shutting down and I didn't know what was causing it.
"I was very scared. After two or three days passed, I just felt all my energy draining out of my body. I just felt like I was becoming weaker and thought I would deteriorate further."
Some of the worst symptoms that Tucker experienced affected his hands. "I lost my fine motor skills in my left and right hands and I couldn't hold an object like a pen, a knife and fork. I could sort of grip a pen, but I definitely couldn't write my name or anything – and this is just from being absolutely fine a few days earlier."
Tucker continued: "I went from spraying an aerosol can to not being able to decompress the nozzle; I couldn't even unscrew the cap of a toothpaste tube. I couldn't lift my hands above my head to wash my hair. I couldn't open any sweet packets. I couldn't tear open a sachet of sugar for tea or coffee."
It got to a stage where the teen even struggled to walk. "I was able to walk even at my worst, but almost with the help of somebody else and I struggled to walk for more than 50 metres at a time without having to go and lay down again on the hospital bed."
Tucker's condition stabilised in hospital after a week and he was not given any treatment.
The situation was highly traumatic for his parents.
‘Frightening, scary and traumatic’
"I was devastated and frightened," his mom Meghan Tucker said. She added that it was scary to have him admitted to ICU directly from the consulting rooms, but also a relief to have a firm diagnosis.
"The neurologist was very positive that Andrew would ultimately make a complete recovery, although it would be long and slow, so we had to cling to that re-assurance."
Describing how he felt, dad Peter Tucker said: "It was frightening. It was scary. It was traumatic."
He said that he had been worried about how severe the disorder would become. "He was getting weaker and weaker and not able to do basic day-to-day bodily functions. He could no longer tie his shoe laces or tie his buttons. He couldn't write, so it was frightening going from a perfectly healthy kid to someone with this illness just about overnight."
Typically, his father said, one gets the symptoms and then descends into the illness before it levels off. "Andrew was quite fortunate that he reached his plateau early compared to other people suffering from the illness."
His father expressed his gratitude for the strong support network surrounding his son.
"Fortunately, we were surrounded by positive people. The neurologist who was treating him, as well as the occupational therapist and physiotherapist got involved pretty early in the process and they were incredibly positive and helped us to stay positive."
He noted that his son's headmaster, as well as teachers at the school, went above and beyond the call of duty to help him get back on track.
Tucker wasn't able to attend a full school day – because he was too fatigued – until the end of the second term. At times he would arrive at school at 09:30 and then leave again at 12:00.
"I came in and out of school for about an hour or two at a time. During the second term, I stayed for longer sessions at a time. But even when I went back for a full day, by the end of the week, I was so exhausted that I had to take a day off."
He said that it was through hard work and perseverance that he was able to get through the many obstacles he faced.
A doctor’s touch…
While Tucker was in hospital, it dawned on him that he would like to dedicate his life to making a difference to the lives of others by studying medicine.
"At the beginning of the year I was pretty much on the fence between medicine and business science and probably even leaning slightly away from medicine. But after all that had happened, I realised while I was lying in ICU – right there and then – that I want to be able to do what my doctor did for me for somebody else one day by becoming a doctor and following a career in medicine."
His doctor didn't perform a miracle. It was simply his optimism and words like "you are going to be okay, you are going to be fine" that inspired Tucker.
"I can only praise my doctor. I owe a lot to him. He was very positive from the start and that made me positive about the situation."
Having being treated by a neurologist, Tucker said he too would like to specialise in neurology, but added that he might change his mind if something else caught his attention during his studies at the University of Cape Town.