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Gabrielle continues to spike daily fevers up in the 103-104F range. We are now medicating her around the clock with Motrin which has helped keep her more comfortable. Her blood counts look good and continue to improve. All of her cultures remain negative at this point. We are expecting the fevers will begin to disappear as her immune system settles down. We are so thankful there are no other signs of infection. Gabrielle was able to participate in a full day of therapy today. She is making progress in her sitting and standing. She is smiling more and beginning to trust the therapists.
We are working on the logistics of getting out of the apartment, getting Duff and the kids to NH, and setting Gabby and myself up for several weeks in the hospital on our own.
I’ll post more later!
Kelly

Sorry it has been awhile since my last post. We had to wait a couple of days for BCBS to approve rehab services and in the meantime Gabrielle’s fever returned. We moved over to rehab late Thursday and the doctors over here have been very concerned about the fever. They have done more blood cultures, urine cultures, Chest x-rays, strep tests, and now a CT scan and a lumbar puncture. The good news is that so far all of the cultures are negative. Dr. Weiner believes it is aseptic meningitis which is basically an intense immune response triggered by the brain surgery itself. We continue to pray the cultures will remain negative and that the fever would disappear. The best news is that we haven’t seen any seizures and the follow-up EEG they did last week did not show any abnormal spiking or seizure activity. Praise God!
Despite the fever, which gets pretty high at times, Gabrielle has still been able to make some progress in therapy. She is able to sit-up unassisted for a good while now and she is beginning to move her left arm a little more. They have begun trying to stand her up which she seems to tolerate a little better every day. The fever definitely saps her energy and interferes with her ability to participate in therapy sessions at times so once that improves she should be able to work a little harder.
I have been out of commission for the past 1 1/2 days with a stomach bug so I quarantined myself to the apartment so as not to infect Gabrielle and to give myself a chance to recover. We have been trying to come up with a plan for the next few weeks. As it stands right now, Duff and the 4 other kiddos are going to head up to the “Bradford House” in NH (courtesy of the Eglintine family) while Gabrielle and myself stay in NYC and continue rehab for a few more weeks. Then, God willing, we can all head back home to NC together!
Thank you for continuing to check-in on us, think of us, and pray for us!
Love,
Kelly
Gabrielle is slowly improving bit by bit. She is growing more interactive and has been blowing kisses, waving bye-bye, and giving out high-fives. Her fever seems to be gone and the diarrhea has improved tremendously. She has been sleeping very poorly at night and is quite irritable in the wee hours of the morning. We’re not sure if her sleep cycles are just off or if it’s something else.
We were planning to come home to NC to begin rehab but what we learned yesterday is that once a person is discharged from the hospital it is almost impossible to get them readmitted for inpatient rehab. Therefore we have decided to have Gabrielle transferred to the rehab floor here at NYU for the next week while we work on lining up inpatient rehab somewhere closer to home. As of now, we know that ECU and Charlotte offer peds rehab for little people like Gabrielle. We are also looking into the Kennedy Krieger Institute in Baltimore which provides rehab for children recovering from hemispherectomies performed at Johns Hopkins. Once we settle on a facility we will then have Gabby “transferred” to avoid insurance glitches.
It will be difficult to move right into rehab without any break from the hospital way of life but I think it is definitely the best thing for Gabby. She needs at least 4 weeks of intensive rehab so she can begin to recover from one of the most aggressive brain surgeries performed. We continue to pray that God will lay out a plan for this next stage of recovery. We pray that Gabrielle will continue to move forward and make daily progress in the rehabilitation of her motor skills. We pray that God would continue to watch over our family as we work out the logistics of inpatient rehab, income, and the care of our 4 other children. God has already provided in so many amazing ways. Our families have been taking the very best care of Maddie, Gavin, Keagan, and Luke. They sound like they are happy and having so much fun we often wonder if they miss us.:) The apartment has been the perfect sanctuary to get a good night’s sleep and a refreshing shower. The doctors and nurses have been wonderful. Our friends and family have been so supportive. It really just amazes me how God has worked things out thus far.
For anyone wanting to learn more about hemispherectomy I came across the following blog http://jessiekelley.blogspot.com/ about a girl named Jessie who recently had the same surgery as Gabby. Her parents just started the Hemispherectomy Foundation which has been in the news. There are also links to several other blogs that share the amazing stories of other children who have undergone hemispherectomy.
I hope to post some pictures of Ms. Gabby soon!
Love,
Kelly
We moved out of the PICU yesterday late afternoon. We will miss the nurses there but we’re glad to be in a quieter environment with our own bathroom. Gabrielle’s fever is gone and the vomiting has ceased. She’s had a very bad case of diarrhea for the past 48 hours which is hopefully beginning to resolve. She is still extremely irritable and a bit withdrawn. Her left side has been pretty still. She moves the toes of her left foot in response to stimulation. We’re beginning to think outpatient PT, OT, and ST might b a better option so our family doesn’t have to split up again upon returning to NC.
Thanks for everything you have done to sustain us on this journey!
Love,
Kelly
Gabrielle has been struggling with a high fever again and is having trouble keeping fluids and food down. She has not been very interactive thus far and scared us a bit this morning with some funny eye movements called nystagmus. She seems to be a bit more alert this afternoon and able to make eye contact. They sent blood cultures and a urine culture to rule out any infection. We are still in the PICU where they take very good care of us but may be moving to a regular pediatric bed soon.
We have begun the process of looking into rehab. The doctors have recommended beginning with inpatient rehab and then carrying over into outpatient rehab. We are trying to find a good facility in the triangle area that offers acute inpatient pediatric rehab. If anyone has a recommendation we would love to hear from you.
We continue to pray Gabrielle will pull through the fever and that she will grow more alert and interactive.
I’ll update again soon!
Kelly
Dr. Weiner just came out of the OR and let us know that everything went very smoothly. Gabrielle remained stable throughout the surgery and lost very little blood. He feels confident that all connections were severed and is hopeful that this will stop the seizures for good. Gabby just went down for a CT of the head to rule out bleeding which is standard after a big surgery. She is still intubated and will arrive back in the PICU in the next half hour.
We will update as we know more and greatly appreciate your continued prayer.
Love,
Kelly
Moments after I posted the last blog entry I returned to the PICU and found we had our answer. Gabrielle had 3 seizures in the time I was gone and has had 11 more since then. The seizures originated from the temporal and parietal lobes. All of the doctors, without reservation, have recommended functional hemispherectomy. Gabrielle will go down to the OR about 11am this morning to have the right hemisphere of her brain disconnected from the remaining structures. The doctors estimate it will be a 4-8 hour surgery. They predict about a 90% likelihood that she will be seizure free. The surgery will affect the motor and sensory function of the left side of the body and will also cause loss of half of the visual field in each eye. It can cause hydrocephalus which would require the placement of a shunt so we will be praying Gabrielle does not experience this complication.
The peace we have going into this surgery is amazing. God has faithfully answered our prayers and has lead us through this entire process. We know without a doubt that this is God’s will. Gabrielle was supposed to have the final stage of her surgery on Monday. It was rescheduled for today so we could monitor the spiking for a couple more days. Monday we hadn’t seen any seizures so we would have closed her without further resection. Can you imagine the devestation we would have experienced if the seizures had returned days after surgery was complete? I am so thankful that God has orchestrated all of this and that He continues to lead us through this storm.
I will post with an update later today.
Love,
Kelly

Gabrielle has definitely improved since I last posted. Thanks so much for all of your prayers and words of support. Her blood pressure and temperature have returned to normal and she is again taking in fluids and food. She has grown much more irritable over the last few days and is having trouble sleeping at night. She really just looks pathetic at times and I am so glad tomorrow is the final stage.
The plan for tomorrow’s surgery is still up in the air. We have not seen any seizures since the resection a week ago. Gabrielle has been taken off all of her anti-convulsants to see how the spiking over her motor-sensory area responds. The doctors are hesitant to remove such an important area if the seizures have stopped. The concern is that spiking could lead to the return of seizure activity in the future. If we see seizures in the next 24 hours we will proceed with further resection if we do not then we will proceed conservatively and remove all the grids and close her up.
This decision is obviously in God’s hands. So many bible verses have flooded my mind over the last several days. Among these:
Proverbs 3:5
“Trust in the LORD with all your heart
and lean not on your own understanding;
in all your ways acknowledge him,
and he will make your paths straight.”
Matthew 6:34
“Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.”
Philippians 4:6
“Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.”
Psalm 46:10
“Be still, and know that I am God;
I will be exalted among the nations,
I will be exalted in the earth.”
And so I am constantly reminded to seek God, trust God, and worry not because He is Lord and He knows the path we should take. So we will sit in our room the next 24 hours continuing to wait on God. Waiting for Him to reveal His decision to us and praying the peace that passes all understanding will be ours.
I will update tomorrow.
Love,
Kelly
Gabrielle has had a rough day today. Her blood pressure has been running high, she has a fever, she is vomiting up all fluids, and she is pretty withdrawn and sleepy. Gabby’s left side has recovered amazingly well from the surgery. She was trying to pull a splint off using her left hand. Dr. Weiner was impressed! She is currently having another MRI completed to check for placement of the grids and electrodes.
We have not seen any seizures but the neurologist reported fairly regular spiking in the motor area and parietal lobe. He said he would proceed with hemispherectomy at this point if Gabby was his child. It was hard to hear about the continued spiking but at the same time we’re relieved to hear about it now while her skull is still open rather than a month from now. Still, it is so difficult to sign your child up for a surgery knowing it will result in new deficits. We have much to discuss with the doctors as we begin to make this next decision. We pray that God would direct our path and that Gabby would begin to feel better.
Thank you for your continued thoughts and prayer.
Love,
Kelly

Surgery is over! Dr. Weiner just came out to let us know that everything went as planned. He was able to map motor responses which was an unanticipated bonus. He removed the remainder of Gabrielle’s frontal lobe, all the way up to the primary motor cortex, and about half of the right temporal lobe. We should expect at least temporary left-sided weakness. He moved the grids and electrodes over the remaining right hemisphere to monitor for any further seizure activity. If these areas continue to produce aberrant electrical activity then the final stage may require a complete disconnection of the right hemisphere (hemispherectomy). So now the waiting begins. I’m praying that regardless of the outcome we would remain strong knowing God’s perfect character. Knowing He is all good and His plan truly is what is best for each of us.
Thank you for praying today and for the messages of support you have sent. It means so much knowing we are surrounded by so many loving and caring individuals!
Love,
Kelly
Tomorrow Gabrielle will have the next stage of surgery completed. We are going to proceed conservatively at this point. The data shows activity in the anterior temporal lobe, remaining frontal lobe, and the motor strip leading into the sensory area of the parietal lobe. Dr. Weiner and Dr. Devinsky have recommended that we resect non-eloquent cortex initially and only go back for the motor/sensory area if the seizures continue. Consequently Dr. Weiner plans to remove the remaining right frontal lobe and the anterior portion of Gabby’s temporal lobe. He will remove the tissue all the way up to the motor cortex including the supplementary cortex which means we may see paralysis of the left side but it should be temporary and movement usually returns in 1-4 weeks. Mapping out the area that does control motor movements in a child under five is normally difficult and the doctors often have to use anatomical landmarks to guide the resection. This just means there is a little higher risk of accidentally resecting a motor area which could result in a deficit.
It is our prayer that the resection tomorrow will control Gabrielle’s seizures and that she wouldn’t have any lingering paralysis or weakness. It is our prayer that any resection after tomorrow would prove unnecessary as it could result in long-term motor and sensory deficits of Gabby’s left side. We pray for God’s continued strength and guidance. Thanks for all of the amazing support you have provided through emails, messages, phone calls, etc.
Thanks for remembering to lift our little girl up to the Father.
I’ll update tomorrow.
Love,
Kelly


