Valley Voices

Skilled, loving hands provide ‘amazing’ care for baby Jaxson

Ten-month-old Jaxson Bermele had a problem affecting his liver, a vital organ, that was solved during a special procedure by Dr. Roberto Gugig.
Ten-month-old Jaxson Bermele had a problem affecting his liver, a vital organ, that was solved during a special procedure by Dr. Roberto Gugig. Valley Children’s Healthcare

No two days at Valley Children’s Hospital in Madera are the same. And I have the privilege of seeing the amazing and wonderful things that happen here every single day.

The day Jaxson Bermele and his family came to Valley Children’s was no exception.

Ten-month-old Jaxson had a problem affecting his liver, a vital organ. The problem was so serious that without treatment, his liver could have failed. Invasive surgery was an option, but that would have required permanently removing a common bile duct, which can be a complicated procedure.

But luckily for Jaxson and his family, Valley Children’s own Dr. Roberto Gugig is the only doctor in central California – and among the few in the state – certified to perform a remarkable procedure that fixes serious digestive problems without subjecting children to major surgery.

Endoscopic retrograde cholangiopancreatography – ERCP for short – is a remarkable procedure that can replace some types of surgeries on the liver, pancreas and gallbladder. In Jaxson’s case, it would allow him to keep his bile duct and reduce his recovery time significantly.

Gugig is a member of the experienced team of nine board-certified pediatric gastroenterologists at Valley Children’s. By any measure, he’s a valuable member of our team, serving as associate director of Valley Children’s pediatric gastroenterology program and director of the endoscopy unit.

He’s one of the few gastroenterologists in the country to use an endoscope to perform both ERCPs and ultrasounds in pediatrics, a service he also provides at Stanford Children’s Health. Additionally, Gugig’s name is well-known in medical circles, and you’ll find him speaking at conferences in the United States and abroad, as well as publishing articles in respected journals and authoring book chapters related to his field.

But none of that really mattered to Carolina Martinez, Jaxson’s mother. She wanted a promise that Gugig and the Valley Children’s team would take care of her baby.

Gugig made that promise. He explained how he was going to fix the significant narrowing of Jaxson’s common bile duct – a passageway that allows bile to flow from the liver (where it’s produced) to the intestine (where it helps the body digest food.)

The duct is one of the body’s “main highways,” and if it doesn’t work correctly, bile builds up in the liver and produces a dangerous toxic condition. In a child Jaxson’s age, the common bile duct is tiny – 1.2 to 1.5 millimeters in diameter. That’s slightly bigger than the thickness of a credit card.

Think about performing surgery through a tube in a space that small for a minute – and you’ll see what Valley Children’s and its physicians are doing to bring modern techniques to heal the children of central California.

Jaxson slept during the procedure. His anesthesia was administered by a pediatric anesthesiologist specially trained to care for infants and children, on staff at Valley Children’s.

When Jaxson woke up, he was happy – as usual. He’s a good-natured baby with eyes that his mother describes as “deep ocean blue.” She used a single word to describe the care her son received from the skilled hands of Gugig: “Amazing.”

Jaxson returned home and picked up where he left off, crawling and pulling himself up on furniture – sure signs that he is about to take his first steps.

Gugig’s patients avoid the trauma and risks of a major operation, but they also get out of the hospital a lot faster. Many go home the same day they have the procedure.

We help many children like Jaxson, every single day. Some of the procedures they undergo are medically complicated, but our decision to provide them is simple. For more than 60 years, Valley Children’s has continually worked to improve the health and well-being of children.

And that is, well, nothing short of amazing.

David Christensen, M.D., is senior vice president for medical affairs, and chief medical officer of Valley Children’s Healthcare.

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