At six, Briella knows hospital days. Her brother helps her face them.

On a day she was due at the hospital, Briella Lummus began to cry.

“I don’t want to be brave again!” she told her family, her mother, Kelly, recalled.

Her brother Zachary came over and hugged her. He had been through medical appointments and cranial surgery himself.

“I know it’s so hard to be brave Briella, we can do it together,” he told her.

For Kelly, watching the two children comfort each other brought pride and heartache at once. Her six-year-old daughter has already had two open-heart surgeries, and hospital visits are a familiar part of family life in Alpharetta.

At home, Briella sings, dances and turns cartwheels through the house. She recently started gymnastics, following her older sisters.

“She fills every room with giggles, smiles, a compliment and hugs,” Kelly said in written answers to North Atlanta Star.

Kelly and her husband, Nathan, first learned about Briella through their adoption agency. Their social worker knew the couple set aside a date night each week and asked them to review the baby’s medical diagnosis and consider whether they could meet her needs.

One of their biggest questions was whether the specialists Briella would need were available locally. Two of their other children had already received care through Children’s Healthcare of Atlanta.

Briella was born with tetralogy of Fallot, a congenital heart defect, and had her first open-heart surgery at three days old in Delaware, according to Children’s. She later continued her care at its Heart Center and underwent a second open-heart surgery at age two.

The family had initially been told another open-heart operation would probably not be needed until her teenage years, Kelly said. After bringing her home, they learned that her heart and arteries were more complex than they had understood. She has since had multiple catheterization procedures and received two stents.

“We have come to learn that her cardiac care will be life long and definitely more than a ‘one and done’ surgery,” Kelly said.

Kelly said Briella will need further valve treatment. Her care team continues to monitor her heart as she grows.

Briella also has a rare genetic syndrome. Kelly recalled being told her daughter might never walk or talk. One morning, when Briella was about six months old, Kelly was lifting her from her bassinet and saying good morning. Briella looked at her, smiled and said, “Hi!”

Now in kindergarten, Briella talks openly about her “special heart” and calls her surgical scar her “brave mark,” Kelly said.

When she once felt her heart racing and had trouble breathing at school, she told her teachers she needed the nurse. She turned out to be fine, Kelly said, and the adults praised her for speaking up.

At the hospital, she knows which arm she wants the blood pressure cuff on and looks forward to the child life specialist who brings Play-Doh. When her brother needed emergency care for a dislocated thumb, Briella asked for a child life specialist for both of them.

Her siblings have learned the routines that come with hospital stays. Sometimes Kelly stays with Briella while Nathan is home with the other children. Sometimes relatives come to help so he can join them.

Her older sisters offer hugs and make welcome-home banners. Kelly keeps their teachers informed when a procedure or surgery is over. Through Children’s Kids at Heart program, the siblings have joined art classes and outings to aquatic centers with other siblings of children with heart conditions.

Kelly and Nathan adopted all four of their children. Looking back on the calls that brought each child into their lives, Kelly said they would say yes every time.

On days free of therapies and appointments, the family heads for shaded parks. At Webb Bridge Park, the creek and sand pit are favorites. They hike and visit the farm animals at Autry Mill Nature Preserve, stop at Brewable for drinks and cake pops, and go to Halcyon for evening ice cream.

In summer, the children play on the greenspace while a band performs.

Kelly said the family has leaned on its faith in God through the hospital stays and surgeries.

“We have learned that health is not a guarantee in this life,” she said, “and so we take each day as it comes, and we try to make the most of every opportunity we have as a family to create loving memories with our children.”