November 7, 2009

What an experience it has been so far. We arrived at Vanderbilt Children’s Hospital at 7am Friday morning and was joined by Pastor Joe and the Grandparents. After checking in we had time to fellowship as we waited to be called back for preparations. Before going back we had a time of prayer for Gabrielle and her doctors. At 8:45am we were finally called back to begin the preparations for the procedures.

Gabrielle’s vitals were taken then we were taken to a holding room. Once in the holding room doctors and nurses started coming and talking to us about the different things Gabrielle was going to be experiencing. There were times that one person would be talking with Ashley while another was talking with Jeff. At 9:15am after everyone had talked with us and all the consents were signed Gabrielle was taken back to the procedure room and Ashley and I to a small waiting room. Gabrielle had fallen asleep prior to time to go to the procedure room so that was a blessing for us and her.

All of the procedures were done under anesthesia. They planned on starting the anesthesia through a mask. After the mask they could give some through an IV. Gabrielle was also hooked up to a standard IV in her leg to provide her fluids during the procedures.

The first procedure was a bronchoscopy. This is where a camera is sent into her lungs to examine them. They also sprayed a small amount of saline solution in to wash some mucus off of the lungs and then they sucked it back up to collect a sample. This procedure took 10-15 minutes to complete. The doctors told us visually everything looked good. We are waiting for the results of the bacteria cultures so we know the different types of bacteria in her lungs. Once this is known the doctors can finalize her treatment regime.

The second procedure was an Esophagogastroduodenoscopy (EGD) with biopsy. An EGD is an examination of the lining of the esophagus, stomach, and upper duodenum with a small camera which is inserted down the throat. Biopsies were taken so they linings could be examined under a microscope for inflammation and to determine how the reflux medicines are working and if Gabrielle is having any allergic reactions to her formula. This procedure also took 10-15 minutes to complete. The GI Doctor told us the visually everything looked good. We are waiting for the results of the biopsies which we should get Monday or Tuesday.

The third procedure was to insert a peripherally inserted central catheter or PICC Line. A PICC Line is a long, slender, small, flexible tube that is inserted into a peripheral vein in the upper arm and sent through the vein until it reaches a large vein in the chest near the heart. Ashley and I decided to have the PICC Line placed in Gabrielle to reduce the number of times she would be stuck with a needle. The PICC Line takes the place of an standard IV and will last 2-3 weeks verses the 3-4 days a standard IV would last. Since Gabrielle’s IV antibiotic will run for 14 days the PICC Line was the best way to go. The PICC Line took 30-60 minutes to place and required a chest x-ray to verify its position. The PICC Line was verified and approved for use.

The forth procedure was the Chest X-ray to verify the position of the PICC Line. This was done after she had woke up from the anesthesia. The doctors also used this opportunity to use the Chest X-ray to examine her lungs for blockages so an extra view was taken with the Chest X-ray. The Chest X-rays looked good both in regards to the PICC Line and looking at her lungs.

Ashley and I were taken back to the recovery at 11:30am. When we arrived Gabrielle had just woke up and was scared and crying. We were able to get her calmed down and she fell back asleep. Ashley and I stayed with Gabrielle from that point on. About 2:30pm we were able to go and have the Chest X-rays done and then returned to recovery to wait on a room. At 4:30pm we were finally taken to a room where Gabrielle will remain for the next 7-14 days. The IV antibiotics last for 14 days but there is a chance we can finish the last week of treatment at home.

The IV antibiotics currently consist of two different antibiotics. The first antibiotic, Cefepime, is given every 8 hours and the second, Tobramycin, is given once a day. It takes about an hour for each antibiotic. Blood is drawn each day to check her kidneys and to check the level of Tobramycin in her blood stream.

Another part of her treatment is her Respiratory Therapy. Her Respiratory Therapy consist of Chest Percussions and Aerosol inhalants. The chest percussions are the same as we have been doing at home. The only difference is they are being done 4 times per day, where at home it was only twice. A new part of her Respiratory Therapy are the Aerosol inhalants during the 14 days of antibiotics she is receiving Albuterol prior to the chest percussions 4 times per day and then twice a day she is receiving Pulmozyme after her chest percussions. The Albuterol opens her airways up so the mucus can flow out easier. The Pulmozyme actually breaks down the mucus at the cellular level. After the 14 days of antibiotics the chest percussions should reduce back to twice a day and we should also be able to stop the Albuterol. However, the Pulmozyme will become part of her daily treatment.


Yesterday Gabrielle was tired and cranky as expected. This morning she woke-up as her normal active cheerful self. She is still getting use to the different treatments that she has to go through. As the week progresses hopefully all these treatments will become second nature to her and we can get through them without any fussing.

Prayer request for now are that Gabrielle becomes adjusted to her new treatments.

We are allowed to have visitors and have to follow the guidelines of the hospital. Visits from other family members and friends are encouraged during the day and evening hours. The routine visiting hours are 9:00 a.m. – 9:00 p.m. All family and visitors should wash their hands upon entering a child’s room. If a visitor has a fever, rash, diarrhea, vomiting, cold, or any recent exposure to communicable disease (chicken pox, measles, mumps), for the protection of our patients, they may not come to the patient care floors.


Gabrielle is in room 7533 at Vanderbilt Children’s Hospital. Take the Main Hospital Elevators up to the 7th floor and go to Pod C. There is a gray box on the right wall that will buzz the nurse’s station so they can open the door. You will need to sign in at the nurse’s station.

Jeff, Ashley, and Gabrielle