The first diagnosis when Tyler Nicolay began coughing up blood was bronchitis and a chest infection.
He was given an inhaler and a prescription for antibiotics and sent home from Red Deer Regional Hospital Centre’s emergency department on Aug. 10.
Three days later though, the Innisfail-area 18-year-old began throwing up blood and went back to emergency.
This time there would be no going home anytime soon.
While no one knew at the time — and would not for more than a week — was that he was suffering from hantavirus pulmonary syndrome.
It is a rare and potentially fatal disease carried primarily by deer mice and spread to humans through their droppings, urine or saliva. Typical symptoms are similar to the flu — fever, chills, body aches or trouble breathing.
On that second trip to the hospital, tests determined Tyler’s blood oxygen levels were unusually low and within hours he was airlifted by STARS to Calgary’s Peter Lougheed Hospital where one of Canada’s top pulmonary specialists is on staff.
He was soon transported to Foothills Hospital, which was equipped to undertake a procedure to remove Tyler’s plasma and replace it with healthy plasma.
For Tyler, the move to Calgary was worrying, but the transfer to the Foothills Hospital was really scary.
“After they told me I was going to Foothills I started panicking because they didn’t know what was wrong with me.”
Doctors began an exhaustive round of testing to find out what was wrong with their patient, a young man who only a day before had felt well enough to go to work driving heavy equipment at his construction job.
At first, it was thought he had an auto-immune disease, said Tyler’s mother Jamie.
“They tested him for everything. Anything you can imagine; drugs, anthrax and hantavirus, anything that can make you very, very ill.”
For Tyler, much of his treatment remains a blur.
“I don’t remember a lot of it. It felt like a really long nap and I woke up in hospital.”
While he was being treated, he was put into a medically induced coma for more than three weeks to keep him calm and to control his coughing, which caused renewed bleeding.
All the while the family, his mom and father Alvin and older sister Taylar and younger sister Maezie, had an agonizing wait to find out what was afflicting Tyler, who would be on life support for six weeks.
“He went in on (Aug. 13) and we found out on the 22nd of August what he had,” said Jamie. One of the reasons for the delay was that testing for hantavirus required the growing of cultures, which takes days.
Tyler was determined to get out of hospital before his mother’s 40th birthday on Sept. 24. He made it with two days to spare.
“It was the best present anyone could ever ask for,” said Jamie.
The five-foot-11-inch (1.8 metres) teen came out of hospital weighing only 135 pounds (61 kg) having lost 36 pounds (16 kg) and much of his muscle mass during his lengthy stay.
He had received nine units of blood and had his plasma replaced four times during his treatment.
Twice weekly physiotherapy sessions are helping him rebuild his muscle and he’s already put back about 15 pounds (seven kg).
Tyler said he feels good. “Just like I was before.”
His thoughts on his near-fatal brush with hantavirus? “It’s amazing something that small can have that effect.”
Jamie said the ordeal is never far from her mind.
“We’re still trying to wrap our heads around how he got it. “We’re just happy he’s home and healthy.
“We almost lost him a few times in hospital. It’s just like a miracle happened.
“Thank God, he’s young because if he didn’t have youth on his side we’re not sure he would have walked away from this.”
The family can’t give enough credit to the numerous doctors, nurses and other health workers that tended their son, she said.
“Tyler had so many different doctors and nurses while he was in hospital and they were all so good.”
The first hantavirus case was identified in Alberta in 1989, and since then 70 cases have been confirmed, mostly in Western Canada. In June, a Saskatchewan man died from the disease.
Alberta’s previous last confirmed case was in 2012 when an unidentified Central Alberta man was infected.
Alberta Health issued an advisory on Aug. 27 after Tyler’s hantavirus was confirmed, urging those who expect to be around mouse droppings to take precautions, such as wearing rubber gloves and soaking areas littered with droppings with a bleach solution before cleaning up.
How Tyler picked up the disease remains a mystery. Symptoms usually take three to five weeks to show, which meant he picked it up early in the summer.
It’s possible he picked it up somehow at work, but no others at the construction company came down with the disease. He helped clean out a friend’s Bowden home a few weeks before, but again no one else got sick.
The family lives on an acreage but Tyler didn’t spend a lot of time there and had not been cleaning out any sheds or doing anything else likely to bring him in contact with deer mice droppings.
“It’s just odd,” she said.
His symptoms also weren’t typical. Bleeding is not usually associated with hantavirus so it’s possible he had a pulmonary issue on top of the disease, she said.
Tyler thinks he might have picked up hantavirus from the heavy equipment he was driving. Mouse droppings were found on one of the machines later, he said.
He’s back driving his car now, but it will be some time before he is strong enough to work.