A lasting gift
When a Silver Spring dad was diagnosed with an aggressive form of leukemia, his teenage son was his best hope for survival
After several days of chemo, Paul began experiencing chest pain. Doctors gave him antacids, which didn’t help. “There was pressure in my chest, down my arms. Deep within,” he says. “I’d never experienced it before. It was day seven of chemo, Julie was there as she always was, holding my hand. I was in a lot of pain, and the cardiologists were checking on me all the time. They knew something wasn’t right. Then at one moment in the middle of the afternoon my eyes rolled back and I went into cardiac arrest. I was unconscious.”
At this point, only Julie can tell the story.
“When it happened, I yelled for the nurse and she came running,” Julie recalls. “He was down for like 35 minutes, and they couldn’t resuscitate him, so they sent the chaplain and the social worker to me. We were outside in the hall because I didn’t want to watch.”
Paul had suffered chemotherapy-induced cardiac arrest, which Webster calls “exceedingly rare.”
A nurse told Julie later that a doctor working on Paul insisted on trying to revive him by shocking his heart one last time. Somehow it worked, but Paul did not regain consciousness for a few hours. “I called my family because they said he was going to be brain damaged and wouldn’t be able to come back from it,” Julie says, her voice wavering. “I didn’t tell the boys that. When they came to the hospital, I just said, ‘Daddy wants to see you.’ He was intubated and couldn’t talk, but the boys talked to him. They told him they loved him and they hugged him. We were all in tears. I thought it was the last time they would see him alive.”
Paul was heavily drugged (he remembers looking at an IV bag and hallucinating that it was filled with ramen noodles), but he could communicate with Julie by squeezing her hand in response to questions she asked about his well-being. One squeeze for yes, two for no.
The next morning, she got him a notebook. His first written message was a plea to remove a catheter. Slowly his heart began to regain strength. He had dodged a bullet, but he still had leukemia. “The day they thought I was good enough to go back to the leukemia section—that was a real positive day,” he says.
Because Paul’s cardiac arrest was caused by a toxic reaction to chemo, his best hope for recovery was a bone marrow transplant.
“The big concern in Mr. Tewksbury’s case was he had this horrible complication from the chemotherapy, and so one of the questions was, are we willing to go back and use those same chemotherapy drugs again knowing what had already happened with his heart problem?” Webster says. “It’s conceivable that he would not have died without the transplant, but I think in all likelihood, without some sort of additional therapy for his leukemia, it eventually would have come back.”
Historically, doctors have preferred that bone marrow donors be full matches to recipients, Webster says. Essentially, a recipient’s siblings have a 25% chance of being a full match, a 50% chance of being a half-match, and a 25% chance of not matching, he explains. Paul has one older brother, but he was considered a less-than-ideal candidate because he was over 40 years old.
Hopkins was a pioneer in the area of bone marrow transplants using half-matches—children are a half-match for their parents—and started performing the procedure in the late 1990s. Today, Hopkins’ Sidney Kimmel Comprehensive Cancer Center does more than 100 a year, according to Webster. Donors need to be at least 13 or 14 years old, and generally at least 130 pounds. In Paul’s case, fortunately, there was one person who fit that profile: his son Stew.
“Initially, I felt very scared and very worried, but then I did all of my research and I found out that it was safe for Stewart to do,” says Julie, 49. “We spoke to pediatricians, we spoke to oncologists at Johns Hopkins, we spoke to a psychologist. Everyone reassured us that the biggest risk was the anesthesia.”