You wouldn't know it by looking at her, but Josalyn Kaldenberg has a bionic arm.
Even if you looked hard at her right arm, you'd only see a small scar, a barely noticeable, faint line that starts around her elbow and then runs up her arm. It looks like it could be the result of an injury any 11-year-old like Josalyn would have - maybe she fell off a swing or got injured rough-housing with her four younger siblings back home in Woodward, Iowa.
But that scar is actually historic. You see, under that scar, Josalyn Kaldenberg has an expandable, prosthetic upper arm bone - the first of its kind in a child in the United States.
The story begins in 2010, when Josalyn was just days away from having her right arm amputated due to a malignant tumor that developed inside the humerus and then spread to cover the bone as well as the muscles and nerves that surrounded it.
“That was the most devastating part when we thought she would lose her arm and you just think of all the things she won’t be able to do in her life, you know, even just tying your shoes,” her mother Heidi said at the time.
Heidi was looking for an alternative treatment online when she found an article that indicated that Dr. G. Douglas Letson, chair of the Moffitt Cancer Center Sarcoma Department, might be able to help them. In interest of disclosure, Moffitt provides underwriting support for University Beat.
Letson had replaced lower arm bones in children before with prosthetic replacements, and had also done similar replacements of upper arms in adults, where future growth isn't a concern. But until then, no child had had the procedure done in the U.S.
With financial assistance from Shriners Hospital for Children, Kaldenberg and her family made their way to USF's Tampa campus. In April 2011, Letson removed the tumor and then the humerus. He installed the expandable "bionic" prosthesis, along with an artificial elbow and a partial artificial shoulder.
"The prosthesis is made out of a variety of different metals, between titanium and cobalt chrome. What it is, it's a telescoping prosthesis or metal, so that there's a tube in a tube," Letson explained at a 2011 press conference. "As we want to lengthen the child's arm, there's gears and so we actually either use a screwdriver or a magnet to turn the gears so as we turn the gears, the two telescoping pieces expand upon each other."
Flash forward to last week, where Josalyn, Heidi and Dr. Letson again sat in front of reporters at Moffitt.
But this time, the nervous 8-year-old who had lost all her hair due to chemotherapy was gone. In her place was a smiling 11- year old, free of cancer, with a head full of gorgeous curly hair and that barely noticeable scar.
"Yeah, some people will ask me “What is that scar there for?” so I just have to explain it," Josalyn said.
Again with financial assistance from Shriners, the Kaldenberg's were back in Tampa for the first adjustment.
"We’ll probably lengthen her about a centimeter at this time," said Letson, now Moffitt's Executive Vice President and Physician-in-Chief. "She’s several centimeters short, but we wanted to get her as old as we could before we start lengthening, so her body could tolerate the lengthening better."
Heidi said the last three years have been tough at times, as they've had to keep Josalyn from riding a bicycle or jumping on a trampoline with her friends, but the things she can do outnumber what she can't do.
"I’m pretty proud of her, she’s a tough little cookie," Heidi said. "We’re putting more of this behind us and life is just getting more normal, even coming back down here, it brought back a lot of memories and a lot of emotions about that time in our lives, and it seems so far away now that we’ve just moved back into a ‘new normal,’ and you know, just very blessed of where the Lord has brought us and the healing that He’s done in her life and all the people that have worked together to help with that, so I guess we’ll just keep moving forward with that."
Josalyn agrees with her mom that she’s been blessed.
"It’s taught me to be thankful for what I have and I’m really grateful that I still have it," she said.
Josalyn had the lengthening procedure this past Friday, and made it through with flying colors. Letson says she’ll undergo one or two more procedures a year for the next five years or until she reaches full growth - a day that Josalyn, her family, and her doctor look forward to.
"It’s just looking at her and the outcome is what makes it all worth it," Letson said. "That’s the most important thing. How well Josalyn’s doing, that’s what makes it so, so important."
