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Balloons, Bella - Healthy Hues Color The Skies
Nine-year-old Bella Gardette of Riverbank was selected as the patient ambassador for the Color the Skies Balloon Festival in Ripon over Labor Day Weekend that benefited Children's Hospital Central California.

Bella is being treated for DiGeorge syndrome, a rare chromosomal disorder that occurs in one of every 3,000 to 4,000 live births that causes small stature among a number of complications. Bella receives treatment at the Hospital's Modesto Pediatric Subspecialty Center as well as at the main campus in Madera.

As the official patient ambassador for Color the Skies, Bella took part in activities before and during the festival, and enjoyed a ride in one of the festival's hot air balloons. The festival was founded in 2006 by Greg and Jessica Coleman to bring awareness and financial support to the region's only children's hospital.

"Ever since she was a baby I was concerned about her small size," said Rachelle Gardette of her now 9-year-old daughter. "But I was told she was just petite."

Bella's weight and length were within normal ranges at birth, but at age 2 she weighed just 15 pounds, while most 2-year-olds weigh twice that amount. When she reached 5, Bella remained under 30 pounds. Her height and weight kept her below the third percentile for growth.

With a dad nearly 6 feet tall and a mom of 5 feet 8 inches, Bella's stature seemed odd but not alarming. However, concern heightened when she began having episodes where she lost her ability to coordinate muscular movement and articulate words. The family visited multiple doctors on a quest for answers. More than two years passed with no diagnosis, even after an inpatient stay at a Bay Area children's hospital when Bella was 7 years old.

"We kept switching doctors to find one who could help us," said Gardette. "Then we finally switched over to Valley Oak and met. Dr. Bolton."

Dr. Kathryn Bolton, a pediatrician for more than 20 years, practices at Valley Oak Pediatric Associates in Modesto.

"I thought there was something we were missing," said Bolton. "What really brought things to a head was when she had this funny spell that affected her speech. She already had some difficulty with articulation and had hypernasal speech, and I thought this is too much all in one area for there not to be an underlying cause."

"Dr. Bolton said she wanted to refer us to a children's hospital," explained Gardette. "She mentioned the Bay Area hospital we'd already been to and Children's Hospital Central California. I wasn't familiar with the one in Madera but I told Dr. Bolton we weren't going back to the other one, and she said, 'I've had really good history with Children's Hospital Central California'."

Bella visited the neurology practice at the Hospital's Modesto Pediatric Subspecialty Center where neurological causes were ruled out.

"She was able to see Dr. Seetharam here in Modesto, which was great," said Dr. Bolton.

Bella's pediatrician also sent the family to a pediatric endocrinologist at Children's, who determined Bella's small stature was not rooted in her endocrine system. Next the Gardettes met with Dr. Natalie Hauser, a clinical geneticist at Children's. Dr. Hauser diagnosed Bella with DiGeorge syndrome, a rare chromosomal disorder that occurs in one of every 3,000 to 4,000 live births.

"Once we got that result, it all clicked," said Hauser. "We try to put everything together here at Children's. We look at the whole child and try to find the one underlying condition that explains the different symptoms. Once we knew it was DiGeorge syndrome we were able to anticipate other things to look for. When Bella's parents saw the list of symptoms and found many that fit with their daughter, it explained so much about her. They were glad when things finally came together."

Bella did not have a cleft palate, but since 69 percent of DiGeorge syndrome patients have palatal abnormalities, Dr. Michael Dunham, medical director, otolaryngology, and Dr. Peter Witt, medical director, plastic surgery, at Children's Hospital also became involved in Bella's case. The pediatric specialists identified and repaired structural malformations to improve her speech.

"We're no longer in the testing phase; we're now in the treatment phase, which is such a great place to be," said Gardette.

"One of the things so rewarding about my job is meeting parents who have been searching so long for an answer and we're able to help them with a diagnosis," added Dr. Hauser.

Bella was again referred to the endocrinology practice to begin treatment with a growth hormone.

"Right now Bella is 45 pounds, and we're so excited," shared Gardette. "Our next benchmark is 50."

Bella is still about 15 pounds under the normal weight for her age, but with the mystery of her small stature solved, her prognosis is looking up.

"We've got a bunch of kids coming down there to Madera, and they're doing a fine job for them," said Dr. Bolton. "They are definitely filling a need in our community."