Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, November 24, 1994 TAG: 9501180014
SECTION: NEIGHBORS PAGE: S2 EDITION: METRO
SOURCE: LISA APPLEGATE STAFF WRITER
DATELINE: LENGTH: Long
But if a "Power Rangers" baseball hat accidentally slips off, a shiny head - bald from months of chemotherapy - reveals just how unique they are.
Both suffer from acute myelogenous leukemia, a cancer of the blood-forming organs. They've spent a good portion of the past year at University of Virginia's Medical Center, enduring treatments and battling infection.
Both have had the cancer temporarily eradicated and are in remission. They've been approved by Duke University Medical Center in North Carolina for a procedure that, while life-threatening, is the only chance to permanently heal their medically battered little bodies: a bone marrow transplant.
Nathan was scheduled to make the second of several trips to Duke this week for testing. Andrew should make his first trip within the next few days.
Their anxious parents say they don't mind spending Thanksgiving - or Christmas, for that matter - away from home.
"As long as I've got my family with me, I don't care where I am," said Denise Brown, Nathan's mother.
Lori Braford agreed. "We've been preparing for this ever since Andrew was diagnosed. We're just so thankful to have the chance to get rid of" the leukemia, she said.
The boys will undergo two different types of transplants. Andrew will have an anonymous donor's marrow; Nathan will receive his own, treated marrow.
Ideally, after a few weeks the new marrow will begin producing the proper amounts of red and white blood cells. The weakened immune systems should again be able to fight off most infections.
But with each procedure comes dangerous risks.
Dr. Michael Graham, with Duke's pediatric bone marrow transplant unit, said the crucial time in Andrew's transplant begins just after he is injected intravenously with the donor marrow.
Andrew's body could simply reject the new marrow, leaving him without enough blood-making cells. Or the donor marrow could recognize its host as foreign and begin attacking Andrew's cells - a condition called graft-vs.-host disease.
"The chance of complication in Andrew's case is as high as 30 to 40 percent," Graham said. But if Andrew gets through the initial stages, he'll have the same chance - almost 40 percent - of full recovery and an end to the leukemia.
Nathan faces just the opposite challenge: keeping the cancer from coming back.
For him, using an anonymous donor would have meant up to six more months of toxic chemotherapy to keep him in remission while doctors continued the difficult search for a match.
Instead, they opted to harvest Nathan's own marrow. They will treat it with a drug to eradicate what little leukemia is left, then send the healthy marrow back in intravenously.
"Nathan's got a better than 95 percent survival rate," Graham said, "but there's a fairly high chance - 40 to 70 percent - that the leukemia will come back."
But it's the slim success rate, Denise Brown said, that she and her husband, Gene, hold onto.
Nathan was diagnosed two weeks before his third birthday. He has had more than 20 spinal taps - one before each round of chemo - and survived pneumonia. He knows the UVa nurses about as well as his own relatives.
"Oh, he loves the hospital. At UVa they've got a preschool and an activity terrace. ... He could watch the Pegasus [UVa's medical transport helicopter] take off and land all day," Denise Brown said.
That's where he met Andrew several months ago.
Andrew was just beginning to recover from the intense chemo treatments he'd been receiving since the diagnosis in June.
"He lost all motion on his right side - couldn't walk, couldn't talk. ... But look at him now - he's making up for lost time," said his father, Dick Braford.
Both couples say they couldn't have made it through this trying time - both financially and emotionally - without their families, friends and co-workers.
Since Denise Brown frequently took Nathan from their Roanoke County home to UVa at a moment's notice, Denise's sister quit her job to help take care of Megan, the Browns' 18-month-old daughter.
The Parkway Weslyen Church provided food all summer for the Braford's 10-year-old daughter, Rachel, and 12-year-old son, Ricky. Several of Dick Braford's co-workers at the Roanoke County Police Department came to his Troutville home to clean the house and chop firewood.
"I haven't mowed the yard but twice all summer, thanks to them," he said.
While most of their medical expenses are covered by insurance, family and friends have tried to cushion the financial blow of travel costs to and from the hospitals.
"Everybody's been wonderful," Denise Brown said. "Gene's company [State Farm Insurance] has held bake sales, we've had three flea markets, a car wash..." There's even a billboard, donated by Lamar Advertising on U.S. 460 East, seeking donations for Nathan.
The Ruritan Club and the fire department in Natural Bridge, home of Dick Braford's parents, held a cake walk to raise money for Andrew.
"The entire community of the Roanoke Valley have been supportive," Dick Braford said. "People we've never heard of before call us and offer their help."
The Brafords and Gene Brown say their co-workers, who have switched shifts at a moment's notice, have been a source of comfort. Denise Brown quit her job once Nathan was diagnosed.
Lori Braford said the people she works with in Community Hospital's obstetrical operating room "have always had time to listen and had a shoulder to cry on. ... Many have very wet shoulders now."
Both sets of parents say they will try to keep their families together as much as possible while Nathan and Andrew are at Duke. They might even rent a furnished apartment together for the month or two it will take for the boys to recover.
As long as there's a chance at full recovery, said Denise Brown, these families will do whatever it takes.
The procedure at Duke "will either work or it won't," Dick Braford said. "We feel real confident that he will get through this, though."
Donations for Andrew and Nathan can be deposited at the N&W Credit Union on 4th Street in Roanoke.
by CNB