After recovery from spinal surgery, sky's the limit for rider
DeLAND – On Halloween 2006, a day when most people her age were wondering what costumes to wear, 17-year-old Ashley Scott underwent major surgery to correct curvature of the spine.
The four-hour surgery – and six-month recovery period – were not only painful and uncomfortable but also kept the prize-winning equestrienne from doing what she loves best: riding a Tennessee walking horse named Stormy.
"I'm glad it's all over. It was very hard," she said. "I'm really excited to get back in the saddle. I can't wait to run him again. That's what I really want to do."
Ashley received permission to ride again in late April from her physician, Dr. James Harms, an orthopedic spine surgeon at Carle. For a while, though, she has to refrain from more rigorous activities with Stormy. But she won six blue ribbons in her first competition after surgery and several more in subsequent contests.
A nationally ranked rider in the youth division of the Tennessee Walking Horse Breeders' and Exhibitors' Association, Ashley seems more interested in talking about Stormy, horses and riding than her recent physical ordeal.
She said she didn't like the pain medications she took; they often caused her to hallucinate, and they resulted in ulcers. She weaned herself off them as soon as she was able and no longer takes any medication, even though she sometimes has muscle pain.
During recovery, she had to wear a brace. She could not sit long enough for the 30-minute car ride from her Champaign home to grandparents Karl and Loveta Borton's farm near DeLand, where Stormy is stabled.
Ashley also missed nearly three months of her senior year at Centennial High. She graduated with honors, though. She earned A's and B's her last year even though she had taken mostly advanced placement courses, including AP chemistry, which she aced.
Ashley, who turns 18 on Aug. 31, had idiopathic scoliosis, which is genetic, perhaps with an environmental trigger, according to Harms. About 4 percent of the general population has scoliosis; it affects males and females in equal numbers. However, noticeable curves in the spine occur 10 times more often in females.
Despite beginning brace treatment when she was 12, Ashley's curvature progressed to 53 degrees, with a large curve on her left flank. Harms, Ashley and her parents, John and Robin, decided last fall that it was time for surgery, as Ashley was planning to enter the University of Illinois this year. Without surgery, the curvature likely would have progressed throughout her life.
The operation itself began with Harms making an entry incision in her left side. That is less painful that going in through the back, the more common technique.
"This front approach preserves more back motion as fewer bones need to be included in the fusion, as compared to the more traditional posterior surgery," Harms said.
After removing most of her 10th left rib, he spread ribs 9 and 11 vertically and reserved the removed portion of the 10th rib for a bone graft. To approach her spine, he moved her intestines and other organs out of the way and then dissected a group of the muscles.
He removed three disks in the curvature. Harms then caused small fractures in four of Ashley's vertebrae to create an environment in which her body would grow the affected bones into one solid piece, hence locking the previously curved spine into the corrected position.
The graft was broken into bone chips, which were inserted into the spine where the disks had been removed. The surgeon put screws and rods into the four vertebrae and manipulated the rods to straighten the curved part of the spine.
"The correction takes place immediately," Harms said, "but it takes a body about six months to consolidate the bone graft into the adjacent vertebrae bones. So restriction of activities and/or bracing is needed for this period."
After the surgery, Ashley remained at Carle Foundation Hospital for a week. Her mother, who stayed by her only child's side 24/7, said that when Ashley left the operating room there were seven tubes in her body.
"I don't remember all the pain," Ashley said. "I remember going into shock when they told me they were going to take my chest tube out and that it would hurt."
The day after surgery, Scott sat on the side of her hospital bed, saying she was going to be sick. Nurses offer to help her get up.
"I said, 'No, I'm going to walk,' " she said. She eventually walked to a chair and sat for 30 minutes. "The pain was intense."
Ashley could not eat for three days.
"I remember wanting a doughnut with white icing and sprinkles," she said.
Before surgery, Harms warned Ashley and her parents of the possibilities of infection, nerve damage, blood clots and the failure of the bone chips to heal with possible loss of correction or rod breakage, as well as other potential problems associated with major surgery.
"Fortunately, none of these happened," the surgeon said. "Her latest X-rays looked wonderful."
Ashley remembers being impatient to ride again, particularly at the April 27 meeting with Harms, when he would check her and possibly give the go-ahead.
"I said, 'Can we rush this right along? I have a 3 o'clock riding appointment,' " Ashley recalled. "I was out of the door so quick. I had my boots and 'jods' in the car.' "
Harms realized his patient's determination to get back on Stormy – and to compete.
"I think she's going places in life," he said. "Anyone as determined as Ashley Scott will get whatever she wants out of life."
For now, Ashley is keeping her career options open. She plans to major in animal science and become an equine veterinarian and then the horse protection coordinator for the U.S. Department of Agriculture.
Since she began riding again, she has competed in four competitions. She is among the top five nationally in seven categories of horse-showing events in the youth division of the Tennessee Walking Horse Breeders' and Exhibitors' Association. And she built up enough cumulative points since she began competing four years ago to receive a certificate of merit from the Walking Horse Owners' Association.
Most of those points came in the 2006 season.
"Only 45 people nationwide have that certificate," Robin Scott said. "None of them got it in a year. She did a lot of shows last season. She's now starting to get back into canter and patterned riding, the more demanding events."
As a result of her spine being straightened, Ashley had to learn to ride all over again. And 6-year-old Stormy had to become accustomed to a new rider.
"He was used to her balance being a certain way and feeling her a certain way," Robin Scott said. "Now it's different. She had to relearn how to do that. I think she's eventually going to be a lot better. She's still getting used to a new center of balance.
"She has a new body, as Dr. Harms would say."