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.

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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.

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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.

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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