Therapy was always fun. It was never boring and towards the end, my body started to work a little bit. So, when you see your growth over the month, it really boosts confidence.
It was a typical day at track practice for 13-year-old Gabriella (Gabby) Brehm when all of a sudden, as she was approaching her last lap, Gabby felt her left arm drop. Quickly after she lost feeling in her arm, she lost sensation in her left leg and fell to the ground. Since Gabby was a young, healthy, athletic teenager, no one assumed it was as serious as it was.
Gabby’s mother, Angela, said, “I thought she had a pinched nerve or was bit by an insect. I’ve heard of tick bites that cause partial paralysis, so I had all of these thoughts of what could be happening.”
“My mom came to my school, and we were taken to the hospital in an ambulance. While we were in the ambulance, I was told my face started to droop,” added Gabby. Angela stated that it “was similar to a stroke. That’s when we knew this was serious.”
Finding a Diagnosis
Gabby was rushed to the pediatric unit of a local trauma center. The hospital immediately took her for a CAT scan, which revealed a brain bleed. She then had to get an MRI. “It got pretty crazy,” said Angela. “They even had to rip off her braces in the emergency room so that she could get the MRI. Luckily, all the doctors were at the right place and time.”
After several tests, the doctors diagnosed Gabby with a brain arteriovenous malformation (AVM) rupture in her right frontal lobe. An AVM means there’s an abnormal connection between arteries and veins. Since the rupture happened in her right frontal lobe, Gabby faced left-side paralysis. Days after discovering this, the doctors performed a cerebral angiogram to reveal the location and more details. The surgical team was able to embolize the AVM. However, they had to wait 10 days for a craniotomy, which allowed the team to access her brain and remove the AVM because they needed the blood to settle in her brain. “We learned that not all AVMs are operable or treatable. Luckily, Gabby’s was,” noted Angela.
It wasn’t until two days after Gabby’s surgery that she could finally move her left arm and leg. She spent 19 days in a local pediatric intensive care unit. “For 19 days, she couldn’t move. She couldn’t sit up. Luckily, she was able to swallow and did not have any cognitive issues. There were a lot of concerns surrounding Gabby’s diagnosis, so we’re somewhat lucky, we like to think,” said Angela.
Inpatient Therapy at Children’s Specialized Hospital
A few days after surgery, Gabby was transferred to Children’s Specialized Hospital for inpatient therapy. As any typical teenager, Gabby said, “I didn’t want to be there. I didn’t want to talk to anyone. I just wanted to get in and out. After time, the recreational therapy department really helped to be there.” Angela added, “the first few days were tough, she just wanted to go home, but that wasn’t an option.”
Time progressed, and Gabby began getting used to and enjoying her daily therapy sessions. She received physical, occupational, speech, and recreational therapy. During physical therapy, Gabby’s program included aquatic therapy in the pool and electrical stimulation therapy. She worked on her sitting balance, ability to perform rolling and different movements, standing balance, progression of walking skills, and her ability to negotiate stairs. Gabby’s speech therapy focused on targeting vital stimulation due to facial weakness, with a goal to help promote symmetrical smile.
Gabby’s Speech Therapist, Erica Bissonnette, stated “Gabby was always laughing and smiling, so our focus was to get that back as close as baseline and to help determine what life outside the hospital would be like. She progressed in all areas, and when she left with that big smile on her face, there was no doubt in my mind that she would excel in everything she set her mind to do.”
Gabby’s Recreational Therapist, Kelly Pico, shared “She was always ready and motivated for her recreational therapy sessions. She was determined to work hard towards her goals, which came from her love of sports, she was missing her teammates and maintained her drive through working hard in her therapies. She made my job easy! She always met me with a smile on her face and a wiliness to try new things.”
Angela highlighted, “in the beginning, Gabby needed a lot of assistance because she was wheelchair bound. So, it was difficult to get to therapy, but the patient care technicians and round-the-clock nurses made it easier and helped me make Gabby more comfortable. It was an adjustment for all of us, but the team taught and helped me get her out of the wheelchair safely. They were all great.”
“The first time we washed Gabby’s hair was a long process, and our patient care technician, Joanna stayed 3 hours past her shift to get Gabby ready for bed and braid her hair. This was the first sign that we knew we were in good hands.”
Gabby’s days at Children’s Specialized Hospital were very scheduled to ensure she received the proper therapy for her needs. “Therapy was always fun. It was never boring, and towards the end, my body started to work a little bit. So, when you see your growth over the month, it really boosts confidence and is extremely motivating. When I started to see progress, I wanted to work harder,” said Gabby.
Gabby’s Occupational Therapist, Emily Lowry, shared “She was always willing to try something new and kept working towards her occupational therapy goals. No matter what was thrown at her, she gave it her all. Her attitude will continue to drive her to achieve all her new goals at home.”
One of Gabby’s physical therapists, Amanda Pacella, added, “Gabriella was an absolute pleasure to work with during her inpatient stay at CSH. She is one of the most motivated and hard-working patients I have ever worked with. She made excellent progress with all of her goals in physical therapy, and no doubt will continue to progress at home and in outpatient!”
Gabby made the most of her stay. She and her mom loved when the RWJBH hospital cafeteria had sushi days and the easy access to Starbucks. When the weather was warmer, and Gabby had some free time, they sat outside to enjoy the sun. Gabby even went on a community out trip to the beach to prepare for her return to one of her favorite environments.
“We often utilized out trips as well as the therapy garden on nice days to engage with some vitamin D and making therapy as functional and fun as possible. Throughout her stay, Gabby was able to achieve that symmetrical smile and you could see her smile from across the room,” added Speech Therapist, Erica.
Angela stated, “Our time at Children’s Specialized Hospital was the best it could be. Everyone at the hospital made us feel very welcomed and supported. No matter who you saw in the hallways, they always said “Hi, Mom” or “Hi, Gab.” Everyone was so friendly and made it easier being away from home. We lived a little over an hour away, my husband had to work, and my son had to go to school, so it was just Gab and me. With the previous COVID restrictions, it was a challenge to see friends and family, but the hospital made accommodations, and it was great for her mental health.”
Getting Back to a Teenage Healthy Life
Gabby spent five weeks in the inpatient center at Children’s Specialized Hospital. To celebrate her discharge and progress, she had a Chick-fil-A party! She successfully walked out and headed home to see her brother and friends.
She overcame many obstacles during her time as an inpatient. “One of the biggest obstacles she overcame was patience and letting her body heal. Just working through some of the embarrassment. She was embarrassed with her deficits,” said Angela. “Walking out of the hospital was a big accomplishment,” added Gabby. “I couldn’t wait to hang out with my friends again.”
Gabby spends her free time playing games, listening to music, dancing, and making TikToks with her friends. She also loves sports and working out. Gabby was on many sports teams, including soccer, track, basketball, and lacrosse.
“Gabriella made significant progress during her inpatient stay, which is attributed both to her overall determination and family support. Gabriella was extremely hard working and driven by her background in athletics. I appreciated her tenacity and passion, and am very proud of her for all of her success,” highlighted one of Gabby’s Physical Therapists, Kate Vieni.
When asked what her greatest hope was for Gabby, Angela stated, “to get back into playing sports, and I hope she continues to make more recoveries. It’s a challenge, but she’ll get back soon.” Gabby added that she aspires “to be healthy” soon.
Angela said, “my advice for families going through similar situations is to trust the process. Decorate your child’s room. Gabby had a well-decorated room filled with cards and a life-size teddy bear from her soccer coach. You have to make the most of your time there.”
Gabby is seeing a local physical and occupational therapist and continues on the road to recovery. She even started practicing soccer and lacrosse again for the first time since her brain bleed and celebrated her 14th birthday with a big smile!