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GREAT FALLS – It has been six months since Ashley Whittle was seriously injured in an industrial accident, and for 24-year-old Whittle, it’s a day she’ll never forget.
Whittle had worked at Morcon, a manufacturer of paper products, for almost four months when the unexpected happened. She was still in training and her job was to pack and box products made at the facility.
Whittle’s long, dark hair fell to the middle of her back so she kept it pulled up in a ponytail at work.
“I was facing the machine,” Whittle said. “All I remember is being pulled into the machine. It was so quick that I didn’t realize what had happened. I didn’t know what was fully going on until the doctors and my dad told me what happened.”
A section of Whittle’s scalp and forehead was torn off. Part of her scalp was still attached but a portion was totally detached.
“It started at my eye, went around the side and up to the back of my head,” she said. “The next thing I knew, I was in the back of an ambulance. They said I never passed out. I knew something happened but I really didn’t know what,” she said.
A medical helicopter first airlifted Whittle to Palmetto Health Richland in Columbia after the accident on Jan. 30. She doesn’t remember the flight to Columbia.
Because of the seriousness of her injury, Whittle was loaded on to another air ambulance and transferred to the Medical University of South Carolina in Charleston. She remembers the second flight.
“I was scared because I don’t like heights,” she said.
Dr. Kevin Delaney was the plastic and reconstructive surgeon who got the call when doctors at the Columbia hospital were looking for a hospital who could handle Whittle’s case. After getting the call, Delaney hurriedly assembled two surgery teams and had Whittle airlifted for the second time that day.
Delaney said a successful scalp replantation happens only a few times yearly nationwide.
“It’s difficult to treat because we have to take the tiny microscopic blood vessels that are still attached to the amputated scalp and, using a high-powered microscope, we have to attach those tiny arteries and veins to the surrounding arteries and veins still on her head to get adequate blood flow,” Delaney said.
The vessels are one to three millimeters in size so it is delicate, painstaking work, Delaney said.
Whittle’s scalp amputation included a portion of her right eyebrow, which meant the piece of tissue that had to be sewn on was larger than usual and the vessels in the brow area were smaller, which made it even trickier.
“It was one of the most complex cases that we’ve ever had,” Delaney said.
The surgery took two plastic surgery teams and lasted about 10 hours. One group prepped Whittle and the other cleaned the scalp that fortunately had been preserved by the first responders.
“I was on both teams,” Delaney said. “I was orchestrating the entire process until we did the microsurgery to hook the scalp up, and then I was involved with that whole process.”
Doctors properly positioned Whittle’s scalp back onto her head, temporarily securing it in place with sutures. Arteries and veins on the amputated scalp that were identified and marked were unclamped and irrigated with an anti-clotting solution. Using the microscope, two microsurgeons worked together to hook up the ends of two to three veins between the amputated scalp and Whittle. Once the veins were hooked up, the plastic and reconstructive microsurgeons began work on the arteries. Once completed, the blood vessel micro-clamps were removed and the blood flow was restored to the amputated scalp. Whittle’s scalp immediately regained its color.
The blood vessels that were joined were then evaluated using a Doppler machine that helps monitor the continued blood flow where the vessels had been joined. Monitoring was critical.
Whittle was placed in the surgical intensive care unit where her scalp was monitored on an hourly basis.
“I was very talkative and asking a lot of question when I woke up,” Whittle said.
Medicinal leeches were used to better control the blood draining properly. Whittle said she was not aware of the leech therapy at first.
She has intermittent memories of the whole ordeal but was awake for part of the leech treatment. She said it took some adjustment on her part.
Leeches “drink” the excess blood and produce hirudin, a natural anti-coagulant in their saliva that improves blood flow in the scalp. Whittle said it was tough, but she understands how it helped.
Delaney said he is thrilled with Whittle’s progress.
“When you have a patient who has a good attitude and who is willing to do what you ask during the recovery, then that helps to bring a good outcome,” Delaney said.
Delaney also praised the teamwork of doctors and nurses involved with Whittle’s case. In Whittle’s case, if doctors had tried to just cover her wound, she would have been left with a very, severe defect of her scalp.
“She would have never had her own hair,” Delaney said. “She would have required multiple, additional operations just to close the wound and get the bone of her scalp covered and closed. She would have never been able to grow her own hair in that area.”
Whittle’s long hair had to be shaved off prior to the intense surgery.
“It’s amazing how quick my hair is growing and that I actually have a head full of hair now. I had a great team and if it weren’t for them I wouldn’t be here now, and I wouldn’t look as beautiful as I do right now,” Whittle said.
Whittle admits she misses her long hair. She said she still has pain in the scars where her scalp was reattached. She can’t move her right eyebrow, but she’s grateful she has no visual or hearing loss.
She said there is some nerve damage and the feeling is slowly coming back. She takes Advil or Ibuprofen for the pain.
“I don’t like taking meds. If I don’t have to, I don’t take it,” she said.
Whittle spent 14 days at MUSC. She said her father and step-mother, Chris and Shellie Whittle, and her mother, Tammy Wallace, spent a lot of time at the Charleston hospital. Her aunt and uncle,Virgil and Joyce Wright, were also part of her support system.
Whittle said the accident marked a turning point in her life. She decided she wants to get her GED and walks to the nearby library to study.
Whittle is scheduled to return to MUSC on Aug. 22 to visit with her plastic and reconstructive surgeons.
“I love to see all of my doctors and nurses,” she said. “I light up. My doctor is so amazed each time he sees me how I look so different.”
She said she gets up early on the mornings she has doctor appointments in Charleston so she has time to visit the nurses also.
Tammy Whittle said part of the new confidence her daughter shows now comes from the support she’s gotten from Delaney, the surgeon who took control and watched over every aspect of Whittle’s recovery.
“I love the look of total amazement when he sees her. He didn’t expect her hair to be anything like it is. He boosts her confidence in herself and lets her see how life goes on. She’s able to look at herself and say ‘I am beautiful,’” Tammy Whittle said.
Ashley said her dad and step-mother have been by her side from the time the accident happened to her return home.
“[My dad] still takes care of me,” she laughed.
Whittle also sees a physical therapist for her shoulder and neck injuries. She said the muscles tighten, so she does exercises to stretch and relax them.
Whittle said she tries not to think about the accident, but the memories of that horrific day are forever etched in her brain.
“I can be reading or watching TV and I get flashbacks. It’s never going to go away. I’m just trying to get to where I can cope with it,” Whittle said.
She was having nightmares about the accident but she said the dreams are not as frequent now. She still has “down” days but is determined to get past those and move on to happier times.
Whittle has been seeing a psychologist in Rock Hill to aid her emotional trauma.
“I don’t cry like I did at first, but I still tear up,” she said. “I’m tough in spirit and it helps pull me through.”
Whittle is drawing Workmen’s Compensation. She said she would like to go back to work but she isn’t sure what type work she can do. She claims to be a hard worker and said she often made production at the manufacturing facility.
She has proven she is not only tough in spirit, but she is physically tough. She worked with her father’s construction business for about six years. She carried shingles up the ladder and on to the roof, painted and did other carpentry work. Whittle said she would love to work with her father again, but she has to be careful about being out in the sunlight because of her scarring.
“My life changed in a lot of ways,” Whittle said. “I don’t take life for granted any more. My personality is the same, and I walk around with a smile on my face. I don’t let the scar bother me anymore. It’s unbelievable. I’m grateful and thankful I’m here, and I’m thankful to have my hair back.”
“I had a guardian angel with me,” she added.
Dawn Brazell, public relations with The Catalyst, a publication for the Medical University of South Carolina, contributed to this article.
The MUSC has a video available including interviews with Whittle, her mother and Dr. Delaney.
To watch the video, go to http://bit.ly/MicroSurgery.