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Australian surgeons rebuild girl’s spine

Grant McArthur, December 14, 2020 7:00PM Herald Sun

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Orthopaedic Surgeon Dr Yi Yang with Nichole after surgery. Picture: Alex Coppel media_cameraOrthopaedic Surgeon Dr Yi Yang with Nichole after surgery. Picture: Alex Coppel

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Standing straight and walking tall for the first time in her life, Nichole Jamelo can’t wait to take on the world.

With two 90-degree bends in her spine, the shy 11-year-old Filipina’s* deformities were more extreme than anything her Australian surgeons had seen.

But just days after major surgery at the Epworth Hospital in Melbourne to rebuild her spine, Nichole has amazed everyone by not only standing, but proudly walking as she turned her back on the physical and psychological injuries that had shaped her life.

“I will have the courage to face the future,” Nichole said. “It will give me self-confidence, and self-worth as a child going back to a normal life without being bullied and being helpless.”

Nichole Jamelo media_cameraNichole after the surgery. Picture: Alex Coppel

Even when Nichole was brought to Australia by Children First Foundation in February, nobody realised just how severe her condition was, nor the efforts it would take to help her.

In 2018, Australian Judy Bell was in the Philippines undertaking missionary* work when her church group became involved with Nichole’s family church in Bago City.

Nobody in the Philippines could help Nichole, the youngest of six daughters in a very poor family, so Ms Bell called the Melbourne-based CFF charity.

media_cameraAn X-ray of Nichole Jamelo’s spine before her surgery. Picture: supplied

While surgery to repair scoliosis* is usually not undertaken until a child has fully developed, it was decided to bring Nichole to Melbourne so she could be fitted with a brace to prevent her condition worsening, then possibly bring her back to Australia for an operation in a few years.

However, CFF chief executive officer Elizabeth Lodge said specialists were so shocked when they saw how badly the 11-year-old’s spine had deteriorated*, they had to act as soon as possible. Then COVID-19 hit and forced the closure of Victoria’s operating theatres.

“Originally she was just coming for a brace and then going home,” Ms Lodge said.

“But it was so severe, we couldn’t send her home, she had to have the surgery because it was just so bad.

“They were just so understanding and respectful that they just had to wait their turn. They were gracious and so thankful I knew that eventually she would have her surgery.”

Despite devoting a career to helping scoliosis patients, spinal surgeon Associate Professor Yi Yang had never seen a patient in as desperate a situation as Nichole and stepped up to offer the surgery for free, supported by the Epworth.

In most cases, idiopathic* scoliosis causes a mild curvature* of the spine — less than 25 degrees — which does not require intervention*.

Radical* operations are considered for moderate cases, where a curve extends to 40 degrees. But Nichole had two different curves and each twisted her at a right angle*.

“Nichole’s spine was 90 degrees in both curves, so she was very severe and, on top of that, her spinal curvature was very stiff as well,” Prof Yang said. “This was taking a toll* on her physically, because it was affecting her walking.

“It was causing her right shoulder to be much higher than what it was, and it was also tilting her off to the left-hand side, and it was also starting to compress on her organs and restrict her lungs’ function. She was having trouble walking because of the shape of her spine.

“Nichole was quite self-conscious because of the shape of her body and her spine, so it was having both a physical and a psychological impact.”

The first and essential stage of Nichole’s treatment was undertaken by the staff and volunteers at Children First Foundation’s Kilmore East retreat in country Victoria.

Weighing just 22kg, efforts were made to improve Nichole’s overall health before surgery. Accompanied by her cousin Phoebe Chavez, 30, Nichole was also surrounded by other children from all over the world who were in Australia for their own life-transforming surgeries.

Their company gave her a chance to heal emotional scars at the same time.

“She is a bit shy and she gets bullied at school, so just keeps concentrating on her studies,” Phoebe said. “She excels in her class. She is really smart.”

In a quirk of COVID-19 fate*, Nichole barely skipped a beat in her year 6 studies this year. Like Australia, schools in the Philippines were all moved to remote learning, so Nichole has attended the same virtual lessons as her classmates at home — but from much further away.

By November 28 good nutrition and physiotherapy built Nichole up to a healthy 30kg and Victoria’s operating theatres had been allowed to reopen.

media_cameraThe surgical team at Epworth Hospital in Richmond, Victoria during Nichole’s operation. Picture: supplied

In the first stage of a five-hour operation, Prof Yang first made controlled cuts into the bones making up Nichole’s spine, allowing it to flex. The second step saw computerised navigation used to guide screws being placed into Nichole’s vertebrae — millimetres from her spinal cord — to act as anchors.

During the final stage of the surgery, the anchors are attached to rods so they line up straight, forcing Nichole’s spine to be held in its new, upright, place.

During the operation Nichole lost almost a litre of blood — about half of her body’s volume. But she still sailed through it so well she has stunned her carers.

“Nichole is a very tough girl,” Prof Yang said. “She has done amazingly in her recovery — she got out of bed on day one after her surgery and has been walking every day since.

“She is walking by herself on day five after major spinal surgery, so it is amazing and incredible, and I am very happy with her progress. It is my hope that now Nichole will get the confidence and comfort to be able to go on and achieve whatever she wants to in life.”

Nichole Jamelo media_cameraOrthopaedic Surgeon Dr Yi Yang holds Nichole’s X-ray after surgery. Picture: Alex Coppel.

While follow-up appointments and therapy to help her adapt to her new upright spine will see Nichole remain in Australia for another three months, she cannot wait for the chance to return home to a new life.

“I am extremely tired and weak. I also feel quite a bit of pain,” she said. “But I look forward to walking straight, doing activities like playing badminton and volleyball.

“Having surgery has given me self-confidence, self-worth, and great testimony* to tell the world.”

GLOSSARY

  • Filipina: female from the Philippines
  • missionary: person who works on behalf of a church
  • scoliosis: medical condition in which the spine is curved
  • deteriorated: got worse
  • idiopathic: without a known cause
  • curvature: describing the curve of something
  • intervention: stepping in to change something
  • radical: big, serious or extreme
  • right angle: 90 degrees, like the corner of a square
  • toll: cost or impact
  • quirk of fate: strange and unexpected event
  • testimony: account of something that happened

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QUICK QUIZ

  1. How old is Nichole and what grade is she in?
  2. Where is she from? Why did she come to Australia for surgery?
  3. What happens next to help Nichole’s recovery?
  4. What did Dr Yi Yang do?
  5. What is the name of the spinal condition Nichole was born with?

LISTEN TO THIS STORY

CLASSROOM ACTIVITIES
1. Draw a Flow Chart
It is so uplifting to hear how so many people and organisations have worked together to help change the life of Nichole Jamelo for the better.

Read through the article carefully and create a flow chart that shows all the things people and organisations did that helped take Nichole from an underweight girl with major spinal deformities into surgery and well on the road to recovery with the ability to achieve whatever she wishes in life.

Include the name/s of people or organisations and what role they played on each step of the flow chart.

Time: allow 30 minutes to complete this activity
Curriculum Links: English, Personal and Social Capability, Critical and Creative thinking

2. Extension
Write a Letter
Choose one of the above people or organisations and write a letter on behalf of Nichole Jamelo, thanking them for the part they played in helping her get the surgery she needed. Address your letter to a person or to the organisation. Include what role they played and how their part in the process was important to achieving the overall goal of spinal surgery.

Time: allow 20 minutes to complete this activity
Curriculum Links: English, Personal and Social Capability, Critical and Creative thinkin g

VCOP ACTIVITY
Opener Up-Level It
Make a list of all the openers in the article. Pick three that repeat and see if you can replace them with another word, or shuffle the order of the sentence to bring a new opener to the front.

Don’t forget to re-read the sentence to make sure it still makes sense, and that it actually sounds better.

HAVE YOUR SAY: How did Nichole’s story make you feel?
No one-word answers. Use full sentences to explain your thinking. No comments will be published until approved by editors.

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