Medical Mystery: Doctors told this 20-year-old his back pain wasn't serious. Then he couldn't walk

The dull pain near James Weitzel's right shoulder blade started in the spring of 2016.

After a few weeks, he consulted his family doctor. She told Weitzel it should improve with rest and the nonnarcotic anti-inflammatory drug she prescribed.

"It did a good job of dulling the pain," said Weitzel, who took the medicine for six weeks. Although diminished, the pain persisted.

In late June, the 20-year-old visited a chiropractor, who performed an adjustment to his back, manipulating his spine, but it didn't help at all.

By a Saturday night in July, he could feel the pain radiating from his shoulder blade to his chest. His parents took him to an urgent-care center near their home in Springfield, Ill. An X-ray of his back revealed nothing amiss. He was given a prescription for another ­anti-inflammatory and a potent muscle relaxant. If the pain continued, he was told, he should get an MRI scan.

That night, Weitzel, who had attended a semester of college on a music scholarship, played the drums with a group at an annual party given by his neighbor. His mother, Lisa Weitzel, remembers telling her husband that their son's playing sounded uncharacteristically "off."

The next morning, Weitzel headed to his job at a pizza shop for an eight-hour shift. He remembers feeling odd. His knees felt numb and his right foot felt as though it had fallen asleep. Weitzel managed to shuffle around the shop, but when he got out of his car at home, his father was struck by his odd gait.

"How many of those muscle relaxants did you take?" his father asked. Only one, he said.

When Weitzel awoke at 6 a.m., he couldn't walk.  His mother called the doctor's office and was told to take him straight to the emergency room.

"My dad had to carry me in," Weitzel recalled.

Doctors in the ER sought, with little success, to determine the cause of Weitzel's sudden paralysis. Twice they trooped to his bedside, had his parents leave, and asked him whether he had used IV drugs. A needle-borne infection might explain his paralysis. Weitzel assured them he had not.

"The third time they started to do it, I told my parents, 'No, you don't have to leave,' " he recalled. " 'I'm not shooting smack — or anything.' "

As the day progressed, so did his paralysis. Weitzel's feet began to curl inward — Lisa Weitzel remembers medical students coming in to photograph the unusual sight. He became unable to urinate and he grew agitated. He told his parents he worried that the paralysis might affect his ability to breathe.

At around 4 p.m., he was taken for an MRI.

The MRI revealed that a large mass, roughly the size and shape of a man's thumb, was pressing on his spinal cord. The X-ray taken two days earlier hadn't detected it because the mass was located inside the spinal cord. Weitzel needed emergency surgery to remove the mass and, doctors hoped, reverse the paralysis.

The nature of the mass wasn't clear; it would be analyzed by pathologists.

"At first I was just happy to have an answer," said Weitzel, who had been given morphine to lessen his pain.

Lisa Weitzel was terrified that her athletic son who loved barefoot water skiing might emerge from surgery as a paraplegic.

Spine surgeon Venkat Ganapathy was on call at Springfield's Memorial Medical Center when he received a call from the ER about Weitzel.

Weitzel's situation was dire. "Time is of the essence for somebody who has lost the function of their spinal cord," Ganapathy said. "If the mass wasn't removed as soon as possible, James could be left permanently paralyzed."

His age also made his case also unusual: Spinal-cord problems in young people are typically the result of trauma, such as motor-vehicle accidents. The cause of Weitzel's problem was unknown.

The three-hour surgery, Ganapathy said, involved painstakingly peeling off and removing layers of a gelatinous tumor shaped like multiple florets on a head of cauliflower, without disturbing the spinal cord.

The spinal cord, he noted, "is a very unforgiving structure . . . the sheer act of trying to peel away a tumor can be dangerous," resulting in bleeding, nerve injury or permanent paralysis.

Ganapathy said that the operation went well. All signs of the tumor were removed. While the family waited anxiously for the pa­thol­ogy report that would tell them what it was, Weitzel began physical therapy to try to regain his ability to walk.

Three days later, pathologists reported that the tumor was an aggressive and fast-growing form of cancer: diffuse large B-cell lymphoma. The malignancy typically affects men older than 50, not 20-year-olds.

"I was told I was the youngest patient the hospital had seen," Weitzel said.

One of the most common forms of lymphoma, a cancer of the white blood cells, B-cell lymphoma is generally found in the lymph nodes or spleen. B-cell lymphoma affects about 7 in 100,000 Americans annually and is fatal if not treated.

Weitzel's cancer was classified as Stage 1E — it had been found early and not in a lymph node. Adding to the diagnosis problem: Weitzel did not have the typical symptoms of the disease, which include fever, night sweats and weight loss.

Treatment of B-cell lymphoma typically consists of chemotherapy and radiation. Following the surgery, Weitzel underwent several rounds of inpatient chemotherapy, followed by 24 radiation treatments. He has been in remission since February 2017.

Weitzel is working full time at a new job — as a clerk in state court — and trying to put his experience in perspective.

He finds comfort in what one of his doctors told him: "This is a flip of a coin. There is nothing you did to cause it and there is nothing you could have done to prevent it."