Science

A COWBOY’S SPINE

Casey Peterson is happy to be science’s guinea pig if it means he can drive again

BRIAN BERGMAN July 4 2005
Science

A COWBOY’S SPINE

Casey Peterson is happy to be science’s guinea pig if it means he can drive again

BRIAN BERGMAN July 4 2005

A COWBOY’S SPINE

Science

Casey Peterson is happy to be science’s guinea pig if it means he can drive again

BRIAN BERGMAN

ON A COLD, wet spring day three years ago, Casey Peterson was doing what he loves best, working the horses. A champion chuckwagon driver, Casey, then 34, was in the middle of a training run on the quarter-section he owns near rural Kelvington, Sask., when the four horses became entangled. Casey hopped off the wagon to sort them out. But before he could get back on, one horse bolted, dragging Casey, who was still holding the two sets of reins. “I would have been okay,” he recalls with a shake of his head, “if I’d let go of the damn lines.

But I didn’t want the horses to run away or get caught in the fence.”

Casey was hauled for almost half a kilometre before he fell beneath the wagon, and the wheel axle flipped him. “At first, I thought I’d just broken my legs,” he says. “No big deal. I figured I’d drag myself up to the road so someone would see me. But I couldn’t move a thing. Not a finger. Not a hand. Not a muscle. I just lay there.”

Casey says he wasn’t in terrific pain and remained conscious: “I’m not sure what went

through my mind. I was just waiting for help.” Three hours passed before a neighbour noticed two horses caught in the barbed wire fence and called Casey’s father, Ryan Peterson, who lives down the road. Ryan and Casey’s brother, Clint, hurried to the property. The ambulance they called became stuck in the mud at the farm gate. So the paramedics strapped Casey on a stretcher, carried him out and drove him to the local hospital. He was then

Can a highly experimental treatment in China fix a broken back?

driven to Royal University Hospital in Saskatoon, about 200 km to the west, where doctors determined he had damaged two vertebrae in his upper spine. Surgeons fused the two together and inserted a metal rod in his neck. They assessed him as a complete quadriplegic and said he had little hope of recovering movement in his arms or hands. They also told him he would never walk again.

Casey didn’t believe them then. He has no intention of starting now. That’s why he’s signed on to undergo a highly experimental—and potentially dangerous—cell-transplant procedure in China aimed at helping spinal cord victims recover at least some lost mobility. Casey is booked for surgery in Beijing in October 2006—the waiting list for foreigners is long— and his neighbours have begun raising money to help out. Now comes the tough part. “I wish,” he says, “I could leave tomorrow.”

CASEY WHEELS around in his motorized chair, pointing out the exercise and rehab equipment that fills two rooms of his farmhouse. He’s dressed in the ranch garb he’s always worn: blue jeans, jean jacket and a black cowboy hat. Despite being confined to a wheelchair, he looks healthy and surprisingly strong. He’s worked hard for every bit of that strength.

The first thing he shows a visitor is an elongated exercise bike with electric wires streaming from it. These attach to his legs and posterior, shocking the nerves and muscles into action. “It fires your muscles one way and then another and that makes you pedal the bike,” says Casey. “It’s nice to see the legs moving again, even if it’s the electricity doing it.”

Next to it is a kind of adult Jolly Jumper that allows him to be vertical for up to 90 minutes at a time. “It’s supposed to be good to get weight back on your feet,” he says. The device is to help keep bones strong and also to alleviate another common side effect of spinal cord injuries, low blood pressure. “You have no circulation in the bottom extremities,” Casey explains, “so sometimes just going from the bed to the wheelchair, you can pass out. I still have bad days when I can’t see anything. It just turns black.”

He heads down a corridor to an elevator he had built after the accident, one of several renovations paid for by the Saskatchewan Worker’s Compensation Board. One floor below is a specially designed weight machine. He can wheel in backwards, then pull the bars forward with his hands. At first, he could barely make them budge. Now he’s pressing almost 50 kg.

Casey spends up to six hours a day on the exercise machines and various stretches. His perseverance has paid off. Defying doctors’ predictions, he now has the use of his fingers and can feed and dress himself. He figures he has about half his former strength back in his arms, maybe 20 per cent in his hands. With this has come a measure of independence. On his farm, Casey oversees the feeding and care of 100 chuckwagon and saddle horses. He also helps out at his parents’ catde auction business down the road. After the accident, Casey didn’t have the lung capacity to do much auctioneering. But he worked

with a breathing machine and now he’s able to call out the bidding for a few hours at a time, more if he pushes it.

None of this is enough for Casey. He is determined to walk again. More importantly, he wants to drive the chucks—and he’s willing to do whatever it takes to realize his dream. That’s why Casey was excited when

DOCTORS here are

wary of Huang’s surgery: the stem cell-like concept has not been proven in clinical trials

his mother, Della, read on the Internet about the procedure being offered by Chinese surgeon Hongyun Huang, which has reportedly helped hundreds of spinal cord victims. Canadian doctors won’t endorse the operation, saying its efficacy has yet to be proven through the normal course of animal and clinical trials. As a result, Saskatchewan Health will not pay Huang’s $20,000 fee

(travel costs are extra).

The operation is, in its own way, a bit of cowboy medicine, on the edge of what most neurosurgeons deem acceptable practice. It involves taking olfactory ensheathing cells (OECs) from the nasal area of aborted fetuses, cultivating them and then injecting them into sections of the spinal cord near the site of the injury. According to Huang’s website, the OECs act as a catalyst, helping damaged nerve fibres and neurons renew themselves. And while he doesn’t promise to make victims of spinal cord injury walk again, Huang claims the majority of patients benefit through, among other things, improved sensory and motor function, trunk balance and bowel and urine control. Neurosurgeons and cell therapy researchers around the globe are watching the American-trained Huang’s progress closely, but warily. Huang has declined to publish his findings in a peer-reviewed medical journal, making them impossible to verify.

OECs are not fully stem cells, the human body’s primary and most pliable building blocks. But they contain stem cells and other regenerative tissue; and what Huang is attempting is not that different from some of the clinical applications envisioned by many in the field, Canadians prominent among them. More is learned every day from animal experiments about the potential use of adult and embryonic stem cells. The hope is they can help rejuvenate tissue or muscle that has been damaged by spinal cord injuries or such conditions as heart attacks, stroke, Parkinson’s disease and Alzheimer’s.

“There is no problem with Huang’s concept,” says Charles Tator, a professor of neurosurgery at the University of Toronto and one of Canada’s top stem cell researchers. “The difficulty lies in extending the experiments to humans without a firmer base in lab animals. However, society is in a hurry and fame and fortune are beckoning.” Tator, along with others, warns that operations like Huang’s are not only unproven, but potentially dangerous. The risks could include further damage to the spinal cord, and even the possibility of implanted cells growing uncontrollably into cancerous tumours. In the absence of clinical trials, they say, people like Casey are little more than human guinea pigs.

If so, he’s a willing one. Asked if he’s worried about the risks involved in the Chinese surgery, Casey doesn’t miss a beat. “No,” he says in his clipped, to-the-point manner. “No use worrying. You go there with a positive attitude and you come out with positive results.” His mother is not so sanguine. “Yeah, it’s scary,” says Della, a tiny bundle of energy whose fingers tap the tabletop as she speaks. “But it’s a chance Casey wants to take. And when he decides he’s going to do something, he’s going to do it. He’s been like that since he was a kid.”

CASEY PETERSON can’t remember a life without horses. Raised on a farm not far from where he now lives, he took to the saddle as a toddler and was riding on his own by the time he entered school. At 15, Casey drove his first chuckwagon race, an experience that still brings a boyish smile to his face. “It gets in your blood,” he says, “and you don’t get rid of it.”

From then on, Casey spent his weekends, May through September, riding the Prairie rodeo circuit while working at the family auction business during the week. He competed in the pony chuckwagon and chariot races that are a staple of small town rodeos. The animals are smaller and the wagons lighter than the ones used at major events like the Calgary Stampede. But the race itself, around an oval field—affectionately known as the “half mile of hell”—is just as fast and still dangerous. Like many drivers, Casey sounds downright laconic when listing his injuries over the years. “Uh, separated shoulders, broken ankles, broken legs. Small things like that.” In August 1999, he won the world pony chuckwagon championship in Saddle Lake, Alta. He was hoping for another shot at the title when the accident occurred.

During four months of rehab at Royal University Hospital, Casey admits he wasn’t a model patient: “I had a kind of mean attitude.” It took him a while to change his mood, but he did. “You realize there’s a lot of stuff you can still do. You’re not beaten until you’re dead.”

As always, working the horses was the key. His family rigged him up a four-wheel

all-terrain vehicle, which quickly became his legs. He gets to the quad bike from a wheelchair ramp off the back of the house. Once on, he can scoot around the quartersection and tend to the horses. Using hand controls, he also drives a truck; from its cab, he can operate the mechanical arms that heave out the huge bales of hay for the feed. All the same, Saskatchewan’s harsh climate takes a lot out of him. Like many people with a spinal cord injury, Casey has poor

‘EVEN if I could just get the full use of my hands, I could strap myself in the chuckwagon and get back at ’er’

circulation and his body doesn’t regulate extreme temperatures very well. In winter, he often gets a bad case of the shakes when he comes inside and has to huddle under blankets; in summer, family members sometimes have to haul him off the fourwheeler before he passes out from the heat.

There have been other setbacks along the way. When he left hospital, Casey returned to his live-in girlfriend, with whom he has a daughter, Brooke, born just five months after the accident. The couple have since split. (He has three children, ages nine to 13, from a previous marriage.) His mom, who comes over most evenings to help Casey with leg

stretches, marvels, however, at his physical progress. “You should have seen him right after the accident,” she says. “He was like a sack of potatoes, no control whatsoever. If you lifted his arm and let it drop, it would hit him in the head. So he’s come a long way. If he can come that much further again, he’ll walk.” Casey knows the Chinese surgery may not be enough to do the trick. He’s been in touch with a Michigan man who went to Beijing for the procedure: he gained some upper-body mobility but remains wheelchair-bound. “Even if I could get full use of my hands that would help,” says Casey. “I could strap back in the chuckwagon and get back at ’er.” A few days earlier, the people who work on his farm strapped him in a wagon drawn by two horses. “I drove around for about a half hour. It was a nice feeling. Mind you, if the horses had taken a couple of jumps, they probably would have tore away on me.”

CASEY SHOWS videos his mother took of some of his races when he was around 20. There’s also a clip of a fresh-faced Casey in a white shirt and white cowboy hat earnestly explaining to a local TV host why he loves the sport. Does it hurt to watch this stuff? “ft did at the start,” he concedes, “but now it isn’t so bad.” But what if he is never able to walk again? Casey insists he doesn’t think about that. Between the Chinese operation and the research he’s read about, Casey is certain something is going to break his way. “With technology coming on like it is,” he says, “one way or another, I will be walking. It’s not a question of if I walk, it’s when I walk. It’s going to happen.” UH