The Finish Line is the Starting Line in Disguise

Well, I've been dealt a new low in my horse life. Flora came out of her stall lame on her left front hoof one day in March after a nonchalant week of flat work. It was sudden and acute so we thought it was an abscess. After two weeks we were seeing some improvement but not as much as expected. Waylon took her to UGA for x-rays which looked normal. We started tack walking under saddle and the lameness got worse again. She went back to UGA on April 25th for a MRI. The MRI showed an acute traumatic injury to her coffin joint resulting in a cartilage contusion and 25% cartilage loss. 

What does that mean? According to the official MRI report, it means her "prognosis for longterm serviceable soundness is poor." Translation: This is most likely a career ending injury. 

How did it happen? We have zero idea. 

We've consulted with half a dozen vets all of which are aligned on the seriousness of the injury. Most give her favorable odds for pasture soundness as a broodmare. There is less consensus on if she will return to competition. The first set of vets at UGA said if she jumps again, they would be backflips across the campus. Most of the non-UGA vets we consulted agree - they don't think the joint will hold up or heal enough to be able to take the impact of galloping and jumping. But it's an injury most vets haven't seen and can only be detected with an MRI. 

The first set of UGA doctors did socialize her MRI around with the other doctors at UGA and they came back a few days later with a less dire prognosis. A couple of the doctors have seen horses come back to competition after this injury. Jenny and I consulted with Dr. Peroni at UGA and these are some of the highlights of our conversation:

About the injury itself:

• Even though the MRI shows some wear in other areas of her joint, he believes some sort of concussive force caused her short pastern bone to crush a portion of the cartilage encasing the coffin bone below it. 
• Even though the report says full thickness cartilage loss he says that is only true of the coffin bone - the short pastern still has its cartilage which means this is not a bone-on-bone situation

His thoughts on her recovery:

• Overall, he thinks the joint around the point of trauma is in relatively good condition and shows typical wear for a 13 yr upper level event horse
• Because of the trauma, there is inflammation in her foot. This is a problem that needs to be dealt with quickly because inflammation causes bone to grow where it shouldn't (aka ring bone) and inflammation can cause the joint to deteriorate more quickly.  
• Cartilage will heal itself - it doesn't grow new cartilage. It grows fibrocartilage - which is kind of like a scar tissue. Because cartilage doesn't have a blood supply, its a slow process. 
• He gives her a guarded 50/50 chance of returning to the FEI level if I do everything I can to help the healing process

Treatment options:

1. For the inflammation: Hit it with IRAP. This is a process where they use Flora's own blood to counteract inflammation proteins at the site of the injury. 
2. Regenerative Stem Cell Therapy (harvested from bone marrow) to support the cartilage healing/fibrocartilage development process, OR 
3. A polyacrylamide injection into the joint (brand names Arthramid and Noltrex). This is a plastic based gel used to help lubricate the joint. Studies have shown better levels of cartilage healing when one of these methods is used. Because polyacrylamides are a plastic - you are limited in how many injections you can actually make. 
4. Wooden shoes to help with circulation and shock absorption 
5. Doing nothing will for sure result in joint degeneration. 

I put everything I had into buying Flora. She is a horse of a lifetime. What can I do but do everything possible to try and give our future a chance. We started IRAP last week and harvested cells from her bone marrow to grow stem cells. They should be ready in a few weeks. We won't know for 4-6 months how things are going. Thought its cheaper, I'm going to save the polyacrylamide injection in case I need a future option.

I was very much crushed when the reality of her injury came to light. My last ride on Flora was a magical flat lesson with Waylon where we were working on shoulder-in to halfpass (never done that before in my life) and 3-loop canter serpentines alternating between walk transitions and counter canter and learning proper turn on the haunches. It was so much fun, so rewarding. That was nearly every ride on Flora. She is a dream horse. The consummate professional, so polite, so workman-like. Then nicest horse to be around. She is still is! 

I've been listening to Nike coaches on my runs and their sports psychology really helped me through the initial days of Flora's diagnosis. In sports, you on a quest to be extra-ordinary. To do more than what is ordinary. To do that, you have to take risks and weather huge disappointments. The highs are so high and the lows so low - and everything in between is slow, steady work. Whatever happens is not personal and every athlete is managing those same waves. You have to be willing to lose it all to achieve the greatest success. 

I feel like I'm on the verge of losing it all, but at least it was in pursuit of my greatest passion. Clearly my greatest obsession. 

I always try to have a clear picture of what I want in life and manifest those things. It's so easy to feel defeated and frustrated when everything lines up and then goes to shit. I spent a couple of days crying, mourning the loss of my dreams with Flora. So sad by the reality that my riding would be on hold yet again; so sad to be unable to afford another horse while managing Flora's treatment. But then when I really thought about it, I couldn't help but laugh at the irony. Of course this would happen! Horses are the great unknown and there are no guaranteed outcomes when you choose to have a life with them. 

A long time ago Humans of New York interviewed a woman and she said when a wave comes you have a choice:

“There are three things you can do when life sends a wave at you. You can run from it, but then it’s going to catch up and knock you down. You can also fall back on your ego and try to stand your ground, but then it’s still going to clobber you. Or you can use it as an opportunity to go deep, and transform yourself to match the circumstances. And that’s how you get through the wave.”

Her perspective has always stayed with me. So I'll go deep. There was a thread that brought me to Flora and there is a thread through this wave to something else. I don't have line of sight, but alas that is life. It's slow but, eventually, all is revealed. I think...