Augie In Action! Augie In Action! - Ihrsa

Augie Ongoing
Augie’s Quest: An Excerpt
60 Club Business International | MARCH 2008 | www.ihrsa.org
The trouble began with a sharp twinge in the summer of 2004. Forty-six-yearold
Augie Nieto had endured bouts of lumbar pain before, but this one was
different, more tenacious and acute. The discomfort lasted for weeks and only
ebbed after a full course of prednisone and three epidural injections. Augie
attributed the ordeal to overexertion and middle age, but what seemed at the
time an isolated episode would soon take on grimmer significance. That
twinge would prove to be the opening salvo in a cascading calamity.
Over the course of the following months, Augie noticed a gradual erosion
in his strength and endurance. A lifelong weight lifter, marathoner, and
evangelical fitness fanatic, Augie was soon incapable of training with his
customary hundred-pound weights. Then ninety pounds proved too much.
Then eighty. And seventy. At length, he was reduced to working out with forty-pound weights,
which he blamed largely on his weak back but also on the curious state of his right arm.
The muscles had begun to twitch. The entire limb was alive, day and night, with rapid-fire,
involuntary contractions. The condition was painless but maddening.
By early 2005, Augie’s speech had slowed perceptibly, and he was having difficulty reaching
across his body with his right hand to spread shaving cream on his left cheek. A January trip
to Vietnam found Augie waterskiing on the Mekong River, where the towrope pulled out of his
hands, a novel experience for this veteran outdoorsman. “I’d never had that happen to me
before,” Augie confessed. “I came home and told my wife, ‘We’ve got to check this out.’ ”
At the time Augie had no personal physician, but through the years he’d undergone numerous
biannual executive physicals at the Mayo Clinic’s Scottsdale facility. When he called for an
appointment, the staff was quick to accommodate him,
“
and Augie and Lynne Nieto flew from their Southern
That twinge would prove California home to Arizona on the evening of March 23.
to be the opening salvo in a The following morning, Augie met with the physician who
cascading calamity.
”
would serve as coordinator and quarterback for the
battery of tests he would undergo in the ensuing two days.
The Mayo Clinic prefers to start cold with its patients.
Its doctors consult no past histories but begin anew with every evaluation. Augie merely
provided a description of his symptoms, and a team of physicians—specialists in far-ranging
fields—began quizzing and prodding him as they set about working with exhaustive
deliberation toward a diagnosis. They analyzed Augie’s blood chemistry, subjected him
to thoroughgoing motor reflex tests, and performed both a CT scan and an MRI in a bid to
pinpoint the cause of his degenerating strength.
Everyone hoped that the trouble would prove to be relatively benign, a case of heightened
stress and overexertion or, possibly, chronic Lyme disease. But by Friday afternoon, Augie’s
team had only succeeded in eliminating potential culprits, not identifying a cause.
In a final meeting that day, a clinic neurologist asked Augie to stick out his tongue. “Thank
God it’s not vibrating,” the doctor told him. “That’s a symptom of ALS”— amyotrophic lateral
sclerosis, otherwise known as Lou Gehrig’s disease. ALS remains incurable and is invariably
fatal, typically within three to five years.
Augie passed along the news to his wife as they drove to the airport for their flight home.
“They don’t know what it is,” he told her, “but at least it’s not ALS.”
Augie’s lead physician had requested that he return to Scottsdale the following Monday.
“You never,” Augie quips these days, “want to get called back to the Mayo Clinic.” Augie’s