Field is goal

Kenwood's Gregory stuns medical experts by playing football

Varsity

November 05, 2006|By Lem Satterfield and Bill Ordine | Lem Satterfield and Bill Ordine,Sun reporters

Lester Gregory, slender and serious, sat expressionless on a hospital gurney, two long tubes extending into each of the 15-year-old's lean arms.

Where a needle pierced the soft inside of his right elbow, fresh whole blood coursed into Gregory's veins - oxygen-rich blood that would stave off anemia and invigorate him. From his left arm, clumpy, sickle-celled blood flowed into a large bag to be discarded.

"I've been doing this for so long - since I was little - I don't even feel [the needles], really," said Gregory, who was diagnosed with sickle cell disease as a baby. "I've gotten so used to them, it doesn't even affect me anymore."

Blood transfusions, which Gregory has been getting for nearly eight years at Johns Hopkins Children's Center, help thousands of sickle cell sufferers survive. But in the case of the Kenwood High School junior, the monthly two- to four-hour procedure helps him defy the odds of the insidious disease even further.

Less than 24 hours earlier, the 5-foot-6, 130-pound Gregory was playing defensive back, albeit briefly, for the Kenwood football team.

It's an accomplishment that astonishes even medical experts.

Dr. Willarda V. Edwards, who heads the Baltimore-based Sickle Cell Disease Association of America, said she was unaware of a sickle cell disease sufferer playing strenuous athletics at any high level.

"This is my first year being clinically cleared to play football because this sickle cell disease has been holding me back," Gregory said. "I've wanted to play football since elementary school, and the transfusions help me to have that chance."

The ailment is an inherited blood disorder in which hemoglobin clusters and distorts red blood cells from a normal round shape to a sickled one that impedes the free flow of blood. This results in less blood and oxygen reaching organs and tissue.

Sickle cell disease mostly affects people of African descent but also can occur in Hispanics, as well as people from the Middle East, Southeast Asia and the Mediterranean region. More than 70,000 Americans, including about 3,200 in Maryland, have the disorder, experts say.

Although life expectancy for those with sickle cell disease has at least doubled in the past generation - sufferers typically died in their 20s and now live into their 40s and even 60s - complications can be acute. Gregory was near death twice when he was 2 and had a mild stroke when he was 8.

Sufferers can experience severe discomfort, called "pain crisis," and the lack of normal blood flow can cause severe damage to vital organs, including stroke and heart attack.

Cautionary consent

To be able to play, Gregory needed consent from his parents and physicians.

Gregory's family physician initially signed the required paperwork but with restrictions, including that he remain hydrated and take rests when needed (his first practice this past summer was on a sweltering mid-August day).

However, Gregory's doctors at Johns Hopkins were unaware of his football participation. The morning after his first practice, Shirley Reddoch, a pediatric hematologist at the hospital, was alarmed at the teenager's sickle cell count during his monthly transfusion.

Because of exertion in practice, Gregory "showed an unusually high sickle cell count," his father, also named Lester, said. After consulting with Clifford Takemoto, Gregory's pediatric hematologist at Johns Hopkins Hospital, Reddoch agreed to allow Lester to play, the elder Gregory said. The consent came with a cautionary tone.

"Football is not a sport that pediatric hematologists generally encourage for people with sickle cell disease," Reddoch wrote in an e-mail to The Sun. "The risks, as best they are known, as well as the fact that there are always unknown and unpredictable risks, are conveyed. The ultimate decision is between the youth, the parents and the sports coach."

Said Takemoto, who has treated Gregory since 2000: "The transfusions decrease the risk of having sickling complications [as a result of] ... exertional activity, but do not completely eliminate the risks. [Lester's] family was counseled about these potential risks and strategies to further reduce risks."

Lester's mother, Lori, 40, said "despite the risks, it was important to allow Lester to play because we saw how important it was to him.

"He has a passion for football, and if the doctors would allow it, I wanted to allow him to have the experience of being a regular, normal young boy."

Said Takemoto: "You can't absolutely say he should or shouldn't be playing. It's really tough to put a number on the risks. Of course, there can be sickling complications which can result in pain crises."

An obstacle to sports

It is extremely rare for someone with the disorder, especially the severe type that Gregory has, to be able to compete in strenuous organized sports. A characteristic of sickle cell is that a crisis can occur suddenly, causing extreme pain, and that was one of her major concerns, Reddoch said.

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