When COVID-19 shut down schools and other activities, many kids developed new interests and hobbies. For lifelong NASCAR lover Tristan Brunelli, that hobby was racing cars — where he was the driver.
Before his fourth birthday, Tristan began experiencing swelling under his eyes, which eventually expanded across his entire body. After visiting a community emergency room where blood tests revealed nephrotic syndrome, a kidney disorder that prevents the body from properly filtering waste and excess water from the bloodstream, Tristan was transported by ambulance to CHoR, where he began his journey with Dr. Timothy Bunchman, professor and chief, nephrology, and other members of the nephrology team.
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When Dr. Bunchman arrived in Richmond over a decade ago, he began building the hospital’s nephrology program by hiring team members including physicians, nursing staff, a social worker and dietician. In 2014, nephrology became our first program to be included on U.S. News & World Report’s Best Children’s Hospitals list, a designation that was given for the ninth time with the 2023-2024 ranking. Rankings are based on clinical data including procedure and patient volumes, infection prevention, patient safety, availability of specific care and nursing staff as well as an annual survey asking 15,000 pediatric specialists where they would send the sickest children in need of care in their areas of specialty.
“We maintain that ranking because of this incredible group of people who have one philosophy, which is ‘yes,’” said Dr. Bunchman. “We’re passionate about excellence, and there is no compromise.”
The nephrology team treats patients with conditions ranging from more common diseases like kidney infections and kidney stones to kidney transplants and rare organ abnormalities. The team also collaborates with other specialists including urology and endocrinology to provide multi-disciplinary care.
In the early years following his diagnosis, Tristan was hospitalized several times for recurrences of symptoms. Two years later, Tristan was prescribed a new medication, which he continues to receive by infusion every 12-18 months. Although he hasn’t needed inpatient care since he began his infusions, his family remembers what it felt like to have a child in the hospital. Tristan’s parents, Jess and Daniel, said they appreciate the Children’s Tower’s private rooms, in-room bathrooms and family-friendly space and amenities. The Children’s Tower opened spring 2023. Tristan, who has toured models of the new rooms, said he’s excited about the color-changing lights, televisions and bigger beds in each of the private rooms.
To express their thanks, the Brunellis made a generous gift to support the Children’s Tower and the nephrology program in 2020 and have continued making contributions annually. Adding CHoR’s logo to Tristan’s racecar is another way they hope to let others know about the hospital and the team members who have supported their family throughout Tristan’s journey.
"We have such love for Children's Hospital," said Jess. "We want to make people aware that there are places like CHoR to help."
When Tristan comes to the Children’s Pavilion for medication infusions, he said he enjoys playing games on the Wii, iPad and Switch, watching movies and building with Lego® bricks. Jess appreciates the attention team members give Tristan by checking on him often during the procedure, which can take four to five hours.
Whether he’s providing inpatient or outpatient care, Dr. Bunchman said partnering with families and having relationships built on mutual respect are the most important ways to manage patient care — something he said the Brunellis do well. He talked about how the team’s nursing staff educates patients and families so they know how to manage care at home and when to call the team for help. He also talked about the importance of communicating with children.
“Including the child regardless of his or her age in discussions and decision-making soothes concerns and allows kids to be involved,” said Dr. Bunchman. “This puts the child at ease and maintains a higher level of communication.”
Daniel remembers when they learned about Tristan’s diagnosis and the availability of care in Richmond. Not having to travel out of town or leave Tristan’s younger brother were so important during the early days.
“Children’s Hospital has all the support and programs to help kids,” said Daniel. “No matter where you’re from, the hospital is here for everyone.”
Every year, 170 Children’s Miracle Network Hospitals identify a “champion” in their community to serve as a representative for children they serve. Tristan will spend the year advocating for kids at CHoR with local partners like Panda Express, Costco, Walmart and Rite Aid.
By Alissa Poole
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