By Kay Nguyen, firstname.lastname@example.org
12:30 AM EDT, April 28, 2013
The Rev. Tim Brown is beginning to take baby steps again.
The pastor of Church of the Nazarene in Ellendale, N.D., and avid outdoorsman is recovering after being infected with the West Nile virus last summer.
"I'm learning how to walk again, and it's just like a baby," he said. "It's been about 10 months, and you have to learn to sit up by yourself. Then, you have the help of someone."
He took his first unaided steps April 18.
He doesn't remember being bitten by a mosquito in June. He only knows he was because tests showed the virus affected his central nervous system.
Brown, 59, had open-heart surgery at the Mayo Clinic in Rochester, Minn., in June to replace a valve in his heart that had been affected by a bacterial infection in his heart in 2001.
When he was rushed to the emergency room of Avera St. Luke's Hospital on July 8 with a fever of 103 and his heart racing at 250 beats per minute, it was thought to be another bacterial infection.
He was airlifted to the Mayo Clinic. There, it took doctors three weeks to figure out it was West Nile. A spinal tap found the virus in Brown's spinal fluid, meaning that it had reached the spinal cord and was neuroinvasive.
"We couldn't do anything about it," he said. "It's a virus, so it has to run its course."
In the following weeks, he became paralyzed from the neck down. One day, his legs buckled and completely gave out, he said.
Then, his wife, Cheryl, noticed that he was using his right hand to move his left arm.
"It was dead," he said.
His upper diaphragm was also affected by the paralysis and his breathing became shallow. During the two months he was bedridden, Brown lost more than 50 pounds and some of his muscles atrophied, particularly the left shoulder.
He began to regain strength through therapy, though. His cognitive abilities came back first.
The first challenge was to stay awake for the three-hour therapy sessions at the Mayo Clinic.
He remained at the clinic for two more months while doing therapy, since he had to be lifted out of bed. Then, once he showed enough improvement, Brown was able to live in an apartment in Rochester with his wife while continuing two more months of therapy.
When he came home to Ellendale in January, he was using a motorized wheelchair. He began therapy sessions at Avera Therapy Center in Aberdeen on Jan. 22.
He comes to Aberdeen three days a week. On other days, he works out at an Ellendale fitness center.
Buck Norris, an occupational therapist at the Avera Therapy Center, said he has been seeing more cases of people affected by West Nile.
"We're kind of a West Nile capital around here," he said. "Symptoms can range from getting a little sick to a spinal cord injury like Tim's — it ranges from mild illness to death."
South Dakota is one of the states that is hit the hardest by the virus. Preliminary data from the Centers for Disease Control show that 2012 saw the highest number of West Nile virus cases reported since 2003.
The amount of therapy needed depends on the severity of the infection.
Brown said being able to use a harness system at the Mayo Clinic allowed him to simulate walking and help with muscle memory even when he couldn't walk at the time.
"It gives you confidence because you know you're not going to fall down," he said.
He said he's looking forward to pool therapy sessions at the Avera Therapy Center, which will give him the same feeling.
Brown said he never felt angry or upset during the process. A psychiatrist at the Mayo Clinic explained to him that many Christians lose faith when going through similar tribulations.
"I've been a pastor for almost 30 years, and I've seen good people endure a lot of harship," he said. "Who am I to think I can get through life without any difficulties?"
He said it was humbling when he was unable to move and had only a little mobility in his fingers, not even enough to pull a tissue out of a box.
It was also humbling to see the amount of support that came from the Ellendale community, where he has lived with his wife for 28 years, Brown said.
More than $29,000 was raised by the community, which went to living and travel expenses; medical costs; and the cost of equipment, such as a four-wheel walker and manual wheelchair.
Brown estimates his insurance company has already paid hundreds of thousands of dollars for his care, though he hasn't received a final medical bill.
Brown enjoys hunting, riding horses and dirtbikes and backpacking with his wife in Wyoming, where they are originally from.
Brown returned to preach at Church of the Nazarene in Ellendale in February. There's no rail to help him get to the platform, so he delivered his message from the church floor, where he had to sit on a four-wheel walker due to fatigue.
His goal is to be walking unaided by July. Most days, he can use just a cane to get around.
"This is a challenge," he said. "This is a mountain that has to be climbed."
A runner, he wants to increase from there until he can jog again.
"I'll get there if it's possible," he said.
His advice for others is to take the correct precautions when mosquitoes are present. He said being around a lot of other patients taught him to go into therapy with a positive attitude.
"You can't give up and quit," he said. "I don't have time for a pity party. I've got work to do."