Reason For Hope For Two Spokane Bone Marrow Transplant Survivors, This Weekend Marks A Very Special Milestone

Last weekend, Rich Watkins went to a family reunion. Next weekend, it’s his 10th high school reunion. And this weekend, he’s at a very special reunion - for people who have had bone marrow transplants at the Fred Hutchinson Cancer Research Center in Seattle.

Watkins and Andrea Balazs are among the more than 100 transplant patients at the gathering who have survived for longer than five years.

Although they live only two blocks apart in southeast Spokane, Balazs and Watkins didn’t know about each other until last week, when they met at a photo session.

There are similarities in their stories. As young adults, both were suddenly stricken with aplastic anemia, a relatively rare disease in which the bone marrow stops making blood cells.

“I thought I was invincible, then, boom!” said Watkins.

But there are big differences. Balazs, 37, had her transplant in 1975, when the procedure was still experimental. Hutchinson doctors did 75 bone marrow transplants that year; only seven patients are alive today.

For Balazs, it was a breeze, partly because she had an identical twin as a donor. That greatly reduces the chances of complications as the body adjusts to the new marrow.

“Mine was really easy,” she said, almost apologetically. “Most transplant patients go through hell.”

Watkins, 28, knows all about that. He was so sick before his transplant in 1988 that doctors didn’t think he would live through it. Although his health has gradually improved, he lost the sight in one eye and has spent his past three birthdays in the hospital.

The only other bone marrow transplant patient he knew was a 15-yearold boy who died.

“The important part is seeing people who are healthy,” Watkins’ wife, Karen, said of the reunion. “He needs to meet people like him who are doing well.”

While bone marrow transplants are still far from a sure thing, the list of success stories is growing.

Almost 6,000 of the procedures have been performed by Hutchinson since Dr. E. Donnall Thomas did the world’s first marrow transplant there in 1969.

Most have involved patients with blood disorders like aplastic anemia, or cancers that affect the blood system such as leukemia and Hodgkin’s disease.

But bone marrow transplants are starting to be used for solid tumors, such as breast cancer, and for other diseases including HIV.

Balazs, the daughter of local artist Harold Balazs, started feeling rundown during the fall of her freshman year at what was then Western Washington College. When she went to the student health center, they thought she had mononucleosis.

After she passed out in her dorm room one Saturday night, Balazs was taken to the Bellingham hospital, where an emergency room doctor noted her low blood count. He called in a specialist who worked with Hutchinson.

By Monday, Balazs was in Seattle’s University Hospital. By Tuesday, her twin sister, Erika, a University of Washington student, was being prepared to donate marrow. On Wednesday, the transplant was performed.

It’s more of a transfusion than a transplant. Marrow is a soft tissue tucked into cavities inside bones, like a honeycomb. It produces red blood cells, which carry nutrients through the body and remove wastes, and white blood cells, which help form the immune system and fight infections.

Marrow is removed from the donor’s hip bones and given to the recipient intravenously. More recent patients, like Watkins, have a catheter implanted in their chest; Balazs received hers through a line in her arm.

Marrow transplant patients are typically hospitalized for a month or more, and aren’t allowed to return to work or school for the better part of a year. Balazs was out of the hospital in two weeks and back to school in two months.

“I had been a jock in high school, so I was still in fairly good shape,” she said. “Some transplant patients have been sick for a long time.

“I was in the right place, at the right time, with the right doctors - and I had an identical twin.”

Because their marrow matches so closely, there’s little risk that the transplant will be rejected in cases involving twins.

“We’ve talked some about it, but not Oprah talk,” Balazs said of her sister, who’s an attorney in Spokane. “I’ve said thank you. I wouldn’t be alive if it wasn’t for her.”

Back in school, Balazs decided she wanted to be a nurse. Her first job out of college was at University Hospital in Seattle, where she worked with marrow transplant patients.

Balazs also lived in Alaska before returning to Spokane. She’s studying at Gonzaga University to become a nurse practitioner, meaning she could practice basic medicine.

“The nurses were the ones who were there in the middle of the night, who really made an impression,” Balazs said. “They made a lot of difference in my life. I thought maybe I could make a difference in someone else’s.”

And as a transplant survivor, she said, “I thought I could be a little bit of hope.” At age 22, Watkins wasn’t sure what he wanted to do with his life. That

summer, he was working on a fishing boat in Alaska, where one of his sisters lived, when he noticed small bruises all over his body.

“I thought maybe I was allergic to fish,” Watkins said. Actually, his blood had stopped clotting and was rising to the surface when his skin was irritated.

When the boat docked in Kenai, Watkins went to the hospital for a check-up - ironically, the same hospital where Balazs once worked. He was supposed to pick up fast food lunches for the crew on his way back. They never got them.

The first doctor he saw thought Watkins had leukemia. He was flown to Anchorage, then to Seattle, where he was diagnosed with aplastic anemia.

Doctors told Watkins’ father they could try drug treatments, which would wear off in a few months, or a marrow transplant, which was risky. Otherwise, he would be dead in three weeks.

Unaware of those odds, Watkins couldn’t believe what was happening. “I felt fine,” he said. “I felt great. It was like, this is ridiculous, can’t we just get something done about these spots?”

Then he caught a cold, and ran a 105-degree fever for almost a week. He felt better by the time a bed opened up at Hutchinson, but X-rays showed a haze in his right lung.

Doctors feared it was a potentially fatal fungal infection, and did biopsy surgery. They found nothing, but warned Watkins’ family that he might not make it through the night.

He did, only to undergo two days of intensive chemotherapy to kill his remaining, diseased marrow. Again, doctors said he might not survive. Again, he did.

Meanwhile, Watkins’ brother and two sisters were tested to see which was the best match for a marrow transplant.

“We were betting on who it was going to be,” said Kathy Horner, his sister from Alaska, who was married just six weeks before. “We figured it was going to be me, because I lived the farthest away.”

After a day of rest following the chemotherapy, doctors did the transplant. The process was harder on Horner; stiff and swollen afterward, all she could wear was sweat pants.

“They joke about the Fred Hutchinson shuffle,” said Horner, now 35, who’s also attending the reunion. “You can tell who the donors are.”

Following the transplant, Watkins was kept inside a sealed tent, in what’s called a laminar-air-flow room, to guard against infection. Everything that went inside was supposed to be sterilized, although they only sprayed his Nintendo game with disinfectant for fear of melting it.

His blood activity needed to reach certain levels for three days in a row before he could be discharged. “One day it would be up, and you’d get excited,” Watkins said. “The next day, it would be down.”

On the 19th day, a doctor walked right into the tent. “Does this mean what I think it means?” Watkins asked. Said the doctor: “You’re out of here.”

But his ordeal was only beginning. Complications soon set in. Watkins’ 23rd birthday present that November was a liver biopsy. He later went blind in his right eye as his body battled the marrow.

“If that’s what it takes to be alive,” he shrugged, “that’s what it takes.”

Watkins suffered a setback last summer when doctors said his new marrow hadn’t fully grafted after five years, as they had originally expected.

Said Watkins: “It was like, I want my money back - you said five years!”

But he hasn’t let his struggles stop him from living.

Always an excellent athlete, Watkins started playing softball again the spring after the transplant. One time he hung his IV bag from a tree so he could administer medication between tournament games.

While Watkins has gained back much of the 60 pounds he lost after the transplant, his home-run power hasn’t returned. “I’m still competitive, but now I realize that if I only get a double, that’s OK,” he said.

Watkins completed college, and works as a sales representative for a chemical company. In 1992, he married Karen, a nurse in Sacred Heart Medical Center’s cardiac unit.

“If I get down, she keeps me in perspective,” he said. Added Karen: “It could be a lot worse.”

They’re hoping things will be better soon. Three weeks ago, Watkins again improved to the point where he could stop taking his medications. Time will tell if it’s for good.

The sixth anniversary of his transplant was Friday, the first day of the reunion. Watkins was hoping to look up two of his favorite nurses from Hutchinson who went to his wedding.

Revisiting the center might also reinforce the philosophy that got Watkins through his transplant in the first place.

“My attitude was, this isn’t going to beat me,” he said. “I’m going to beat it.”