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PERFECT STRANGERS

Experiencing unusual symptoms, 25-year-old David Ruff visited his doctor who immediately sent him for bloodwork. The results came quickly and were alarming. By that afternoon, David was hospitalized and preparing for chemotherapy the next day.

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Growing up in Quispamsis, New Brunswick, David Ruff enjoyed playing hockey and baseball or just hanging out with his friends.

Watching crime TV shows were also among his passions. He remembers rushing home from school to catch an episode of CSI, dreaming of one day becoming a crime scene investigator. Once he understood the complex cases depicted on television take considerably longer to solve than the 60-minute drama, he abandoned that dream and set his sights on travel. Today, he works for a worldwide hotel chain, supporting his love for adventures locally and abroad.

David works out at the gym with his girlfriend Kayla and plays ball hockey with friends. These activities kept him energized and strong until he began noticing his energy reserves were depleting more quickly than normal for a healthy 25-year-old.

INITIAL SYMPTOMS

"I would walk up a hill and feel like I wanted to sleep or pass out," David said.

More worrisome was the fact the exhaustion was coupled with various other symptoms. He compiled a list that included an infection in his mouth and bruises on the bottoms of his feet.

He saw his family doctor, and she was concerned enough to send David to Horizon's St. Joseph's Hospital for bloodwork, stat. He complied, arriving at the blood clinic early on the morning of Friday March 4, 2016. David then returned to his job at the hotel call centre, expecting results in a few days.

Instead, events unfurled faster than an episode of CSI.

By 10:30 a.m., his blood sample was in the lab at Horizon's Saint John Regional Hospital (SJRH) where it was examined by a technologist.

WE NEED TO REACH DAVID!

When the physician's office could not connect with David, they reached out to other family members listed on his medical file. Christie Ruff, David's mother will never forget the phone call that morning.

"We're trying to reach your son… He needs to come to the hospital!"

Oblivious to the urgency and due to the nature of his call centre job at the time, David could not always take calls. When his mother's name flashed on the caller ID of his cell, he knew something serious was happening and called her back.  

His mother, a Licensed Practical Nurse at SJRH, told him he needed to get to the hospital immediately. David returned to his work while he waited for Kayla to drive him there.

EMOTIONAL FAMILY MEETING

Christie and her husband Larry shivered in the parking lot of the hospital that frigid Friday morning as they awaited the arrival of Kayla and David.

"She didn't tell me until I got to the hospital and was just about to walk in," David recalled.

"We're all standing in the lobby crying," remembered Christie. "We were just overwhelmed."

Within minutes, an oncology manager ushered the distressed family to a room upstairs, while David was given a bed. Minutes later, Oncologist Dr. Terrance Comeau was at David's bedside explaining the results of the bloodwork.

Further confirmation was needed but he believed it was leukemia. In the meantime, David had a Peripherally Inserted Central Catheter (PICC) line inserted into his arm for chemotherapy.

"Evidence never lies," as CSI's TV forensic entomologist Gil Grissom would say.

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DETERMINATION

Despite the shock of his diagnosis, David resolved to be an active, cooperative participant in his care and maintain a positive attitude throughout. That care began in earnest the next morning with the start of chemo treatments.

"He was very determined to fight the disease," said Dr. Comeau. "The key factors that contributed to his success were his compliance with all of his chemotherapy admissions as well as all of the supportive care to treat and minimize toxicity."

For six months, David was in and out of hospital for treatments. They appeared to be successful and in August, the medical team declared him to be in remission.

Relieved, David committed to increase his strength and to go back to work the following January.

SETBACK

David returned to his job in January 2017 as planned and was working out at the YMCA again. He was feeling fine.

By February, just before a dual celebration of his parents' birthdays, some routine bloodwork came back positive. He tried not to dampen the festivities but felt a burden to let them know.

"I said 'We're going to have a good time at the party and that I'm going in next week'," David said. "I reassured them that it might not be anything, even though I knew it had to be something."

TRANSPLANT

It was something.

David was readmitted to the SJRH and needed a bone marrow transplant to survive. These were among David's saddest and most difficult days, the news an admitted blow to his previously optimistic outlook.

At 26-years old, he had sunken to despair and resigned himself to the reality of his own mortality.

"If I'm gonna go at this point, I'm gonna go," he told himself.

Kayla was by David's side to cheer him up and remind him he had what it takes to overcome his illness.

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I CAN DO THIS

"After a day or two I realized, I've already done it once, I can do it again," he said, determination building. "Once I got there I tried to do as much as I could to ensure that I'd be all good to go for it."

Going for it meant following medical advice and remaining active and inquisitive as a patient.

"It is important for the physician and patient to have a very good understanding of the patient's disease and to always look forward to the next step in therapy," said Dr. Comeau.

DONOR SEARCH

For David, having a better future-or any future-meant finding a suitable donor. None of his family members or friends were a match.

The family organized a blood donor clinic to find a suitable donor for David. The turnout was massive.

David made an appearance, smiling at the support and love he felt from family, friends and the community. But still, none matched.

PERFECT STRANGER, PERFECT MATCH

Around the time of the clinic, he received news of a willing donor. Not from family. Not from friends nor close supporters. A perfect stranger; a perfect match.

A 10 out of 10 for genetic markers is like winning the lottery, said Christie.

"This man was his only chance of survival," she said.

In June 2018, a year after the successful transplant, David permitted the organ donation registry to have the donor contact him.

A week later, a 24-year-old man from Nova Scotia reached out.

"Hey man, I donated your marrow!" David remembered him say.

No less casual was how the young man had become a donor. He was a high-schooler in Halifax, when his school hosted a donor registry clinic where he was encouraged to submit a swab test.

"They told him he got to skip class and they'd give him candy if he went out to do it," David said the donor told him. "He didn't even remember he was in the bank as a potential donor until Canadian Blood Services (CBS) called him and asked if he would be willing to help somebody out."

NO HESITATION

Christie takes a moment to summon up her composure when she remembers the kind and humble response of the donor who saved her son's life.

"His response was, 'Absolutely, tell me what I need to do'," Christie recalled. "There was never a hesitation in his mind."

"He said, 'It's the right thing to do'," added David.

A SELFLESS ACT

He was David's only chance of survival.

"Not getting the transplant would have cost him his life, so the donor literally saved his life," said Christie. "When a young person like that is willing to put himself out there without any hesitation, I say he deserves accolades, but he doesn't want any recognition whatsoever."

The donor attends university in Nova Scotia and has met David a few times. David describes him as laidback, and the two as being similar in personalities. To be a perfect match in marrow, one would expect similarities to be genetic.

Christie, who grew up in near Boston, wonders. The donor looks strikingly like her brother who still lives there.  The donor also has family in the area. But that's a riddle to be solved another day.

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For now, David and his family are grateful for his restored health as they anxiously look toward the ever-important five-year milestone of a cancer-free declaration. 

David is back at work. He is back exercising at the YMCA and playing ball hockey with his friends. He and Kayla take as many adventures as they can because of life's uncertainty.

"Every day is a new set of possibilities to go out and explore and I want to take full advantage of that," said David.

He knows that life is complicated and the curve balls it throws change us more deeply than any TV crime drama.

But like last week's episode, David's sees his sickness as part of his past. He looks optimistically toward the next season: five years cancer free.

"I just have everything to look forward to."

If David's story inspired you to want to consider becoming a bone marrow donor, contact Canadian Blood Services to learn about donating stem cells.

 

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