Gordie’s comeback
The remarkable revival of Mr. Hockey
LUBBOCK, TEXAS— By all accounts, Mr. Hockey is doing well. Gordie Howe is 87 and yet here he is, catching balls, climbing stairs and even dancing with his therapist. And he keeps up the pace for more than an hour.
It’s a far cry from the hockey legend’s condition a few months ago, when he suffered a devastating stroke. His family didn’t think he would survive.
On Oct. 26, the family announced the bad news: “(Gordie) suffered a significant stroke on Sunday morning while at his daughter’s home in Lubbock, Texas. His condition remains guarded although he is showing some signs of improvement. We acknowledge that there is a long road to recovery ahead, but Dad’s spirits are good and his competitive attitude remains strong.”
“He had an acute hemorrhagic, left thalamus stroke,” recalled his son, Murray Howe, a radiologist in Toledo, Ohio. He and other members of the family spoke to W5 in exclusive interviews.
“He couldn’t talk. He really couldn’t use his right leg and his right arm at all.”
A U.S. expert, invited to examine the hockey legend, says stem cell treatment may have helped his recovery from a stroke. He remains cautious but calls the case a wake-up call for more research
A blood vessel had burst in his brain, killing cells in a region of the thalamus that controls motor function. As his condition deteriorated over the next few weeks, doctors told the family to prepare for the worst.
Video provided to W5 shows Gordie, paralyzed on his right side, struggling to move his wheelchair.
It was a long way from the man who dominated the National Hockey League for 26 seasons, beginning in 1946-47, all but one year with the Detroit Red Wings. He played six more years in the World Hockey Association, retiring in 1980 at the age of 52.
Howe set many NHL records, and is the only player to have played in the league in five different decades.
After the stroke, “he was laying in bed, pretty much comatose, not doing anything,” said his son Marty Howe, a former hockey player and the family’s business manager.
“They just recommended hospice care at that point,” said Murray. “They just said, ‘He’s not going to last long, maybe two, maybe three weeks.’”
Then came the offer from Stemedica, a company on the leading edge of producing stem cells, that the family could not refuse: an experimental treatment that the Howe family says provided a miracle — but is not without controversy.
Stem cells are the body’s building blocks, which circulate in blood and live in tissue. When our bodies are injured, stem cells repair the damage. Scientists believe they may be useful in treating disease such as diabetes, heart failure, Parkinson’s and stroke, but the research is very preliminary.
“Stem cells can actually regenerate damaged tissue and respond to major conditions for which there are no cures,” said Dr. Maynard Howe, the CEO of Stemedica, who is not related to Gordie’s family.
When Stemedica learned of Gordie’s condition, the company called and offered to enrol him in one of their studies. When Murray Howe read the literature, he was sold.
“I was amazed by the safety profile that basically their stem cells over the last 10 years had no significant adverse reactions,” said Murray. “So we talked about it as a family and said we basically have nothing to lose here and we potentially have a lot to gain.”
They took Gordie to the Santa Clarita clinic in Tijuana, Mexico, to participate in the study that would use Stemedica-produced stem cells.
Gordie received his treatment for free but others pay $30,000 to participate. The clinic offers no guarantees and doesn’t use the word “cure.”
Anesthesiologist Dr. Cesar Amescua injected neural stem cells derived from fetal tissue into Gordie’s spine.
During a visit to the clinic, Amescua showed W5 how he administered the treatment. The injected stem cells travel through the cerebrospinal fluid to the regions of the brain damaged by stroke, he explained.
Within hours of that first injection the family noticed improvement.
“He literally sat up and put his feet on the floor,” said Murray. “I was afraid he would fall over. He walked about 10 steps to the bathroom and then, with my assistance, walked right back.
“Absolutely mind-blowing. I have been doing medicine for 28 years and I have never seen that in a stroke patient, especially someone going downhill like my dad was.”
The next day, Gordie received an infusion of between 60 million and 90 million mesenchymal stem cells, grown from the bone marrow of a healthy donor.
“These ones are designed to go to the bloodstream,” Amescua said.
Again, Gordie showed improvement. At the hotel he began making his bed. And a video taken a few days later shows Gordie home in Lubbock, on his feet, walking, even sweeping and vacuuming.
News of Gordie’s recovery captivated sports fans and scientists. His Lazarus-like recovery was dubbed “the miracle in Mexico” by some, but criticized by others who called stem-cell treatments “snake oil.” Critics also feared that desperate patients would seek out treatment at clinics around the world — a practice known as “stem cell tourism.”
There are more than 700 clinics worldwide, mostly in developing countries, offering stem-cell therapies to cure a variety of ailments and charging $20,000 to $50,000. In some cases patients have returned with infections, other complications and without improvement.
“One danger is that people will jump to conclusions this is a cure,” said Dr. Duncan Stewart, the scientific director of regenerative medicine at the Ottawa Hospital Research Institute and a top researcher into stem cells. “This could be wasting money, could be not safe.”
Faced with controversy and questions, Stemedica invited W5 and Stewart to visit the company in San Diego and the clinic in Tijuana.
In San Diego, Stewart met Stemedica’s scientists, reviewed their research and toured the Food and Drug Administration-approved facility, which has products licensed to be sold for research.
“The company has put a lot of effort and resources into their manufac- turing procedures,” said Stewart. “And I think they’re producing a high-quality stem-cell product. So that part I think is quite strong.”
Stewart and W5 visited Santa Clarita in Tijuana, a clinic operated by Novastem, licensed to use the Stemedica stem cells. “My sense is they’re well-intentioned,” said Stewart. “I don’t think they’re very experienced or well trained in the principle of clinical trials.
“In Mexico, there’s much less regulation for stem-cell delivery and I was told in the clinic it’s allowed by Mexican law to give stem cells as a therapeutic product if the doctor feels it’s warranted.”
Such treatment is not allowed in Canada or the United States.
The clinic says it is conducting a “clinical trial,” but according to Stewart the study lacks proper follow-up to provide the data required in Canada and the U.S.
“I don’t have confidence that these trials are going to actually collect sufficient data for us to have any real good idea whether the therapy works or not,” said Stewart.
Despite the questions, Stewart sees Gordie Howe’s story as an opportunity to ignite public interest and funding for stem-cell research.
The Howe family says it isn’t promoting stem-cell tourism and only went public after numerous media requests.
“We felt we had to tell everybody because the last press release (Dec. 19), we said Mr. Hockey isn’t doing well, he is back in the hospital. We don’t know how much longer he is going to be with us,” said Murray. “Then, suddenly, he is raking and sweeping and goofing around in the back yard.”
W5 was given unprecedented access in Lubbock, where Gordie is undergoing rehabilitation, and the program was allowed to bring a U.S. stroke expert to assess him: Dr. Steven Cramer, a neurologist at University of California Irvine.
Cramer examined Gordie after a therapy session. Gordie’s grip is strong and his ability to move his feet near normal, he said. Gordie signed an autograph with his right hand, paralyzed only months earlier. He wrote slowly but the famous name is legible. Cramer’s conclusion: the recovery is “impressive.”
“It is a remarkable degree of motor improvement for anybody with that severe a stroke and when you mix in the fact that it was toward the end of his ninth decade, it’s all the more remarkable,” he said.
Cramer says physical and occupational therapy could have played a role or there may have been a spontaneous improvement, which happens sometimes during the first three to six months. But Gordie’s recovery may be due to the so-called “piss-and-vinegar gene” — a fighting spirit or drive that Gordie has in abundance, Cramer said.
It’s also possible stem cells could have helped. The fact Gordie’s recovery came so soon after the stem-cell treatment is an interesting “coincidence,” but Cramer is cautious.
“You have to be very careful about drawing any firm conclusions from what we see here. However, what we see here has some exciting potential,” said Cramer. “If his improvement is in anyway attributable to these stem cells, it’s very exciting. It raises hope.”
“Absolutely mind-blowing. I have been doing medicine for 28 years and I have never seen that in a stroke patient, especially someone going downhill like my dad was.” MURRAY HOWE GORDIE’S SON
In San Diego, Stemedica is sponsoring research with four studies underway to treat sun-damaged skin, heart attack, heart failure and stroke. It also plans additional studies into stem-cell use in treatment for Alzheimer’s, type 2 diabetes and traumatic brain injury.
The bottom line: Gordie Howe’s case is intriguing but inconclusive.
“In medicine we know that the strangest things can happen,” said Stewart, the Canadian researcher. “And one case is an anecdote, that’s all it is. It can never prove anything.”
Cramer believes Gordie’s story is a wake-up call for accelerated research and well-designed studies to answer urgent questions.
“We don’t know the risk and we don’t know the benefits yet,” said Cramer, who plans a study using Stemedica cells. “Write your senator or whatever the Canada thing is and get these trials funded,” said Cramer, adding: “I do not suggest to my patients to go outside of the U.S. and do what was done here.”
Stewart agreed. “I hope the reaction would be: this is an area that is ripe for doing clinical trials. We need to step up to the plate and find ways of doing that here in Canada.”
Aware of the growing demand for new therapies, Canada’s Stem Cell Foundation recently launched a campaign on behalf of scientists across the country, seeking $1.5 billion in corporate and government funding over the next decade.
The Howe family is also convinced that more research is needed.
“We get calls all the time from stroke victims,” said Marty Howe. “If we can get the trials we can get the research done, I am positive it is going to show that this is a great help.”
Following Gordie’s amazing recovery they have invested in Stemedica, and Murray Howe is hoping to begin studies of stem-cell treatment for brain injuries at his hospital in Ohio.
“Based on what we have seen, preliminary research I’ve read, stem cells are the most promising thing in medicine since antibiotics,” said Murray. “To me it is clear-cut: you have a man on his deathbed and he has a treatment and eight hours later he can walk and talk. You put two and two together.” W5’s exclusive documentary, Gordie’s Comeback, will be broadcast on CTV Saturday at 7 p.m.
“One danger is that people will jump to conclusions this is a cure. This could be wasting money, could be not safe.” DR. DUNCAN STEWART OTTAWA HOSPITAL RESEARCH INSTITUTE