Well, one last suggestion that probably would throw too many wrinkles and complications and trauma in but would allow any timing you needed: suicide.
You guys have all given me a lot of great suggestions–thanks! I think there are several different options I can take.
Unfortunately due to the circumstances of her death (rather suddenly after taking a fast downturn, in the hospital) and her personality (she wouldn’t do that to her son even if she was physically capable of it at that point), suicide won’t work.
This just happened to my coworker.
At the beginning of February 2013, she found a lump in her breast which hadn’t been there 3 weeks earlier.
A week later she had a biopsy.
Less than a week later she had a diagnosis of metastatic melanoma.
At this point other than pain in her breast she was still fine.
At the end of February she was out of work on medical leave for surgery, chemo, and radiation.
At the beginning of June she was feeling great and getting ready to come back to work.
About a week into June (and a week before she was due to return to work) she started getting really bad headaches, dizziness, and nausea. She went back to the doctor and found out that the cancer was now in her brain. She was given fewer than 6 months to live.
About 3-4 weeks later she went from home to hospice.
About 2 weeks after that she was dead.
She was under 40 with young kids. When I met her in mid-January she was perfectly healthy and happy.
So, fewer than 7 months after she found out she had metastatic melanoma in her breast she died of brain cancer, which she apparently had had for fewer than 2 months.
Fuck cancer 
The accident one can be made mto worrk quite well, if it isn’t too much exposition for you. Accidents cause prolonged immobility during recovery. Prolonged immobility can trigger clots, related to a genetic predisposition and other factors like obesity, which break off and go to lung which can be fatal (deep venous thrombosis, DVT, causing a pulmonary embolism, PE). So yeah, bad accident then dying from a PE can easily work. (Of course I still like viral cardiomyopathy, especially for the broken heart metaphor … okay, go with accident!)
Not if you’ve been carrying around cancer and not know it. My father went to the doctor with what he thought was pneumonia, and six weeks later he was dead from lung cancer.
In my defense, as I said before the GBS would be for the two week period during which the mother becomes acutely ill, and the month long mildly ill period preceding that would be the viral antecedent.
I don’t really think it’s that much more absurd than a viral cardiomyopathy causing a suddenish death. Both are fairly common conditions that are rarely fatal (I could not find good numbers for the absolute mortality rate of viral myocarditis, because it seems that many people who have it are asymptomatic, but I doubt it’s one of the more common causes of cardiac death in the United States) which would, overall, be too distracting to work properly in the story.
Also, while death from GBS is rare, I have seen GBS require people to be ventilator-dependent for weeks . . . if someone refused to be mechanically ventilated that long, than they could die from GBS.
Just to look at it from another angle, you might want to ask yourself What kinds of care do home health care nurses usually provide? (Since the condition is not supposed to be exotic.) Then the required type of care you choose might dictate the illness/condition and leave room for your needed sudden down-turn.
I am sorry to be so critical but a month long viral illness antecedent would be a) very strange and b) not fit the demands of the plot. The viral antecedent is typically a typical viral bug, such as a typical cold, stomach bug, or flu. Such illnesses are more commonly 5 to 7 days, maybe 10, but not for a month, and are not illness enough to warrant a change in the young man’s plans.
And put simply you are just plain very wrong about the “absurdity” of viral cardiomyopathy causing sudden death along the course of a worsening debilitating illness. For a concise summary of viral cardiomyopathy see here.
(Bolding mine.)
A bit more detail here.
Mean age of onset is 42. Rapid onset of progressive CHF symptoms requiring home health care for daily functioning for a couple of months, then killed by a fatal arrhythmia or clot would be a very realistic course.
Okay fair enough that most viral illnesses are days, not weeks long; however, with viral cardiomyopathy, my point was not that death from dilated viral cardiomyopathy is absurd, but rather death from viral cardiomyopathy is not common. Like I said, I could not find any cites for the mortality rate from viral cardiomyopathy. The BMJ article you cited said that death was 20% for patients who had already progressed to dilated cardiomyopathy.
Whereas the death rate for GBS is 2-3% even in the best ICUs. That is not an insignificant rate of death, and frankly I would be surprised if the rate of death for all cases of viral myocarditis is that high (although I freely admit I could be wrong on that point).
Also, re GBS antecedent infections, c.jejuni is the most common one (which does have a short course), but in this study 13% had CMV, 10% EBV, both of which have more protracted courses.
I concede that the viral illness would probably not be enough to cause a young man to change his travel plans
Yes, asymptomatic cardiomyopathy is pretty common. Clearly the character in question does not have an asymptomatic or extremely mild condition; she has something that has made her ill enough that she has become significantly impaired fairly quickly, needing home helath care and disconcerting enough that her son changed his plans to be around to help out, emotionally if not physically. That puts her in the group that has dilated cardiomyopathy and some significant, perhaps severe degree, of heart failure. (Those are generally the cases that we know about, who get labelled, as the asymptomatic and mild cases are often never diagnosed.) That group is not so tiny as to be exotic and the time course is consistent.
Remember also that the predictor of that uncommon mortality with GBS is older age and pre-existing comorbidities, which do not apply to the character in question. And again the tempo of the illness is off: it gets as bad as it is going to get fairly quickly and then not much worse even if recovery is prolonged. Did not know that association of EBV and CMV with GBS though. Thanks for the link.
You know what, upon further research I will concede your point. There is no way to determine what percentage of people with viral myocarditis develop dilated cardiomyopathy, simply because viral myocarditis is usually asymptomatic. However, http://www.sciencedirect.com/science/article/pii/0735109794907404 this article says that there is an idiopathic etiology for 59% of dilated cardiomyopathy, this website states that the incidence of dilated cardiomyopathy of all causes is 148/100,000. The incidence of GBS from all studies I could find, including this one including this one demonstrate an incidence not greater than 2/100,000.
The fatality rate for dilated cardiomyopathy is also much higher than for GBS, as mentioned in DSeid’s post.
So the incidence of death from viral cardiomyopathy could be as high as 18/100,000 (assuming all cases of idiopathic dilated cardiomyopathy are viral in origin)
The incidence of death from GBS is .08/100,000
So I will agree that an average person, not taking into account gender or age, is much more likely to die of virally-induced cardiomyopathy than GBS.
You, Sir or Madam, are a gentleman or lady and a scholar. 