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Ahmad's Heart Surgery

Sunday
December 16, 2007 

A Place They Call Home
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I spoke to Ahmad's mother and she informed me that 2 1/2 months ago they left their home in Gaza for Wolfson Medical Center.  It's been almost six weeks since his heart surgery, and Ahmad is doing very well physically. As of today, he is now off his heart medication.
 
When he came to the hospital, his oxygen level was below 70%, which contributed to the blueness of his extremities. Today, his oxygen level is 100% and his color is back to normal and looks healthy!  In the last 2 1/2 months, Ahmad has had two operations and one heart catheterization. Today his blood tests and echo results came back normal, so according to his doctors, he will be released to go home tomorrow.  
 
Ahmad seems to be in good health now, but after spending these long months in the hospital, Ahmad and his mother are emotionally drained and want to go home to Gaza. His mother said that she has missed some of their most sacred holidays and she is hoping that she and Ahmad will be home with family by Wednesday to celebrate the upcoming Muslim holiday. I have seen Gaza from outside the Erez barrier, and often wonder how people can live in the conditions that exist: not being able to enter Israel, very little food, electricity for just a few hours each day, and continual struggle within and across its borders. But to this mom, although grateful to all for a healthy child, she wants to go back to Gaza , behind the Erez barrier--a place that she and Ahmad call HOME!

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Saturday, December 8, 2007 
In the "A" State
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When I walked into the intermediate ICU yesterday (Friday), I found Ahmad awake and alert. I offered him some sesame biscuits and he was happy. As I whipped out my camera to take a picture of Ahmad's alert and happy self, his mother started to fumble in her bag and told me "Stanna shway", meaning for me to wait for a while. She fished out a cute red-blue-white toboggan and put it on Ahmad's head. I got both of them to pose for me and all of us were very happy.
 
In the afternoon, when I visited Ahmad again with Donna, we found him watching TV intently. He is beginning to recognise Donna and me, grinning widely and moving his body happily (click the play arrow below to see!).


It is a joy to watch Ahmad in the "A" state again -- awake, alert and active! Each time he had his 'down' days, he got us all pretty worried because not only would he look listless, but his vital signs would be quite bad.

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Wednesday, December 5, 2007 
Left Ventricle Damaged
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When I first walked in to visit Ahmad, he was sleeping. His mother was very tired and upset. She asked me to please find out what was going on with her son. I asked one of the doctors what was going on with Ahmad, and he told me that since his surgery was prolonged, his left ventricle has been badly damaged. When his left ventricle begins to get overworked, Ahmad begins to lose his breath, and his lungs fill up with fluids. Dr. Katz told me that they are working on this problem but it's very difficult because of the damage already done. He also told me that there might be some neurological problems due to the length of time Ahmad was heavily sedated. Since Ahmad has been in intermediate ICU, they have been slowly decreasing his medication, and once he is completely off the medication they are going to do a CT scan to see if there are any problems.

Dr. Katz said that Ahmad is doing well. Each day he is slowly progressing but it's just going to take some time. He will be in the hospital for a bit longer but he is thankful that at least he is getting help and therapy which he would not receive in Gaza. Once I explained all of this to Ahmad's mother, she was very sad and began to cry. She said that she doesn't understand, and that she doesn't see any improvement in her son. After awhile Ahmad woke up and was wanting to eat some chips. He still isn't eating or drinking that much, but he was a little alert and laughing. He is still on the way to recovery but not there yet. Please keep him and his tired mother in your prayers.

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Sunday, December 2, 2007 
Ready to Dance
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It is such a joy is see Ahmad back to his old self... grinning away and active once again! 
 
After enduring the stress of seeing her son sedated from his first operation to the second, and then taking a turn for the worse last week when the fluid around his lungs did not subside, Ahmad's mother is a happy mother today, all ready to hand Ahmad whatever he calls out for.
 
With Ahmad fully alert this evening, his mother wanted to feed him some peanut-flavoured rice-puffs because "Ahmad no eat" (Ahmad has not been eating). But the nurse told her to wait while she checked with the doctor, who promptly approved! Dr Nir explained to me later that Ahmad is low in salt, and the snack would do him some good. 
 


Once his hunger and thirst were satisfied, Ahmad seemed ready to dance and maybe even have a game of soccer! And I'll soon have to watch out for his outstretched hands when I'm near Ahmad because he used to love grabbing either my camera or my glasses during his pre-operation days at Wolfson.
 


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Thursday, November 22, 2007 
Coming Out Of Sedation
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When I walked into ICU last night, I was a bit surprised to see Ahmad’s condition. He was taken off of the oxygen tubes yesterday, praise the Lord. But I saw a very skinny boy. He has lost so much weight within the past two weeks. His mother was very concerned and worried for him. She asked me when he would be able to start eating normal food again. Right now they have him hooked up to a feeding tube but his mother is ready for him to start regular food again.

As one of the doctors was making her rounds I decided to ask her how Ahmad was doing. She said that he is doing well, but it is going to take time and the feeding issue all depends on him. They had him heavily sedated for a few weeks because he was connected to an oxygen machine but now that he is off of the oxygen they are slowly starting to decrease his medication. Hopefully soon he will be eating normally again and adding some meat to those bones.

As I was watching Ahmad there were times that he would look at me and I thought he remembered me, and then there were times where he was just staring out into space. I brought along a coloring book with me, not knowing if he would be able to color, but when I gave this to him a huge smile came on his face and he looked up at me. He just smiled and smiled. We opened up the coloring book and I was asking him where is this and where is that, and he just looked up at me with a huge smile. Ahmad’s mother began to smile and she kissed him. She told me that he did remember me and that she was grateful that we brought a smile to her son’s face again.

Ahmad’s mother was very happy and pleased after seeing her son smile again. It’s been very difficult for her being away from her family in Gaza and being at the hospital for almost two months.  She knows that Ahmad still has a bit to go before he will be released to go home. But I reminded her that he has came a long way and his surgery was a very difficult one. She is so thankful for what has happened to her son and that he will have a healthy and normal life. I shared with her yesterday that in a few months he will be playing soccer and riding a bicycle and she just had a huge smile on her face and said, "God willing."

Please continue to pray for strength for Ahmad’s mother, and that Ahmad will be able to eat normal food and gain some weight.

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Tuesday, November 20, 2007 
Treatment to Release Chest Congestion
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I met physiotherapist Tali today when I visited Ahmad in the ICU. She has come to give Ahmad some physiotherapeutic treatment to help release the congestion in his chest. It is interesting to watch how simple it seems. Tali was gently thumping Ahmad's back while singing softly to him. The singing, she says, helps Ahmad to relax; while the gentle thumping on his back will coax his body to cough out whatever is causing the congestion in his chest. (Click the play arrow below to watch a video clip of Tali and Ahmad.)
 

 
After the thumping came the exercising of Ahmad's legs, and the physiotherapist alerted me to Ahmad's response -- he started to push and 'cycle' with his legs on his own! I watched and chatted with the physiotherapist Tali to find out more about the technique used. In less than five minutes, Ahmad started to cough. "Yofi!" (Great!), Tali encouraged Ahmad.
 
With the help of a nurse, Tali adjusted Ahmad into an upright position and put his head to one side. And just in time too -- Ahmad coughed and vomitted a whole lot of sticky liquids, which probably included the medication he was just fed with a while ago. Thereafter Ahmad looked very relieved and soon his eyes became droopy... then he was able to get some sound sleep! His mother, the physiotherapist and I were all very pleased. Only the nurse in attendance was a bit concerned. That's because she was not sure how much medication Ahmad had regurgitated with his bout of vomiting, and how much should be administered to him to replace it!
 
But one thing for sure, Ahmad is feeling much better today after his "physio-treatment" and he can enjoy a good rest.

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Monday, November 19, 2007 
Off the Ventilator
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It was a joy to see Ahmad sitting up in his bed in the ICU this evening with his mother, now smiling again, talking with him as she sat by his side. Thanks be to God that Ahmad is at last able to be off the ventilator. He was wearing only an oxygen mask, and clearly has a very big appetite at this point - the 20th day in the ICU after surgery. As you can see, he appears to have lost weight while intubated, although I am sure his mother will help him make up for lost time now that he can eat again. In the meantime, he appeared to even be eating the oxygen as it flowed from the mask!

Please keep praying for Ahmad to regain his strength and move through the rest of his recuperation process quickly with God's touch. I look forward to seeing him happy and active again in the children's ward in the coming days.

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Sunday, November 18, 2007 
On Mechanical Ventilator After Collapse
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When I met Ahmad's mother along the corridors this morning, I was surprised to see the sullen look on her face. Ahmad was doing well last Thursday and should be better by now, I thought. But I was told that on Friday, Ahmad "collapsed", and had to be hooked up to the ventilation machine once again. This is to enable Ahmad's body to rest, while the machine does the work for him.
 
Doctor Nir explained that all children who are put on the ventilators have to be sedated, to ease their discomfort of having tubes running down their noses. As such, I found Ahmad 'asleep' in the ICU. But the moment his mother lifted up the blanket to show me the tubes and sensors attached to his body, Ahmad opened his eyes wide and he kept staring at his mother!
 
I joked with Ahmad's mother, saying that Ahmad was scolding her for exposing him, and I pulled the blanket over him. That's when he seemed to be dozing off again yet struggling to stay awake. When I asked the doctor what was happening to Ahmad, I was told that Ahmad is gradually coming out of his sedation.  (Click on the arrow below to watch a video clip of Ahmad opening his eyes.)
 

 
Ahmad's condition is stable now, and he may be extubated on Monday. Ahmad's mother is really anxious to see Ahmad active again, as he has been mostly in the sedated state since his first operation on the 29th October.   

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Thursday, November 15, 2007 
Awake and Active
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For over two weeks, each time I saw Ahmad in the ICU, he was in deep sleep as he had to be heavily sedated after his two operations to prevent him from yanking out the various tubes and instruments attached to his body. But today, Ahmad was seated upright on his bed and had his eyes wide open when I saw him in the ICU.

 
And guess what, Ahmad is beginning to get active again! Just take a look at the video clip below and see how he seems all ready for his next soccer game! (Click the arrow to play the video.)
 

 
Dr Houri gave an update on Ahmad's condition. A lumbar puncture was done on Ahmad to look for signs of meningitis, and thankfully the result was negative. Also, the pressure of fluids in Ahmad's head has gone down.
 
Today, Ahmad was extubated and each time he coughed, the nurses would encourage him with a "Kwayyes!" ("Good!" in Arabic) because it was good that he could cough up the fluids inside him. Nevertheless, the nurses had to insert a tube in his nose to extract the fluids by suction. Ahmad's mother, who had been catching up on her sleep, came into the ICU just when the nurses were about to carry this procedure, and she was present to hold him while it was being done.
 
"Inshallah" (GOD willing), we can expect to see Ahmad running about once again, the active boy that he was even before his operations.

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Thursday, November 8, 2007 
Chest Closed Today
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Today Ahmad’s chest was sewn up. His mother seemed very relieved. I spoke with one of the doctors and he told me that the past few days Ahmad has a lot of fluid drainage, but that it seems to be under control now. There is still some drainage but not like before.

The doctor told me that hopefully they will be able to
take him off of the oxygen tubes within a day or so.
Since they have been able to decrease the fluid in his lungs they will soon be able to take him off of the oxygen.  Praise the Lord for this.

He is doing well but it’s going to take a while for his recovery. His surgery was very difficult. Ahmad will be in ICU for another week and this is really draining the mother. They have been here for several weeks now. Please continue to keep Ahmad and and his mother in your prayers.


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Tuesday, November 6, 2007 
Temporary Pacemaker
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Ahmad has had his second operation and is doing well. I couldn't believe today how good he looked.  His lips and tongue were so pink and his fingernails were white. As I observed Ahmad and the nurse taking blood from him I could see how tired and worried Ahmad's mother was. She couldn't understand why there were so many things attached to her son. They are having to drain fluid from his lungs and she was very unhappy to see this. They also have an external pacemaker attached to Ahmad and she was worried that he would have a pacemaker the rest of his life. I spoke to Dr. Alona and she explained to me that they will keep this external pacemaker on him for two more weeks, and then they will disconnect this from him.  They have placed this on him just for backup in case of an emergency. She told me that the type of surgery Ahmad had didn't effect the part of the heart that he would need a pacemaker, and not to worry--that he will not need one long-term.  Once I translated this to Ahmad's mother, she was very happy and all I could see was a big smile on her face.  She is so concerned for him and is always asking questions. The next few weeks are still going to be very difficult for Ahmad and his mother. They still haven't closed his chest and they are draining a lot of fluid on his lungs.  Let's continue to pray for Ahmad and his mother.

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Sunday, November 4, 2007 
Second Surgery Today
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Ahmad had his second surgery today. He was in the operating room for the duration of my visit at Wolfson, so I could not see him. But I was able to snap the above photo of Ahmad's mother waiting during his surgery. To her right is the mother of Tara, a baby from Iraq who is waiting for her second surgery.

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Thursday, November 1, 2007
Oxygen Levels Improving
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What a happy camper Ahmad's mother was today. The first thing she told me was that Ahmad's oxygen levels had increased and that his fever was gone. After she spoke those words a huge smile came to her face. She has been very worried for her son the past few days but, thank God, he is doing better today. She also told me that the doctors told her that on Sunday Ahmad will undergo his second operation. She knows that this one will be the most difficult one but she is ready for it, I believe. After hearing the good news, LC decided to take all of the mothers to the computer room to let them view the updates that we have posted.

For some from Gaza, this was the first time they had ever viewed our website and seen the blogs. They were so pleased and happy to see their loved ones on the Internet and to know that so many people care and are praying for them. Please keep Ahmad's mother in your prayers. She was having a good day today but she still needs strength.

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Wednesday
October 31, 2007 

After Five Weeks, Finally Surgery
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The waiting is finally over.  Ahmad has been at the hospital for 5 weeks before he had his surgery on Monday.  The hospital would set up a surgery date and then something would come and they would have to postpone the surgery.  His mother became very frustrated and tired and wanted to return to Gaza.

This past Sunday was suppose to be his actual first surgery but they delayed the surgery until Monday. When I spoke to Ahmad's mother she told me that on Monday if there is no surgery she will return to Gaza.  So Monday evening I called her and she told me that Ahmad had his surgery.  She was very pleased and happy that the journey for her had truly started.  When I visited Ahmad and Um ("mother of") Ahmad yesterday he was doing well.  He had a bit of a temperature and he was sedated. They want to keep him sedated because even though he has a heart problem he is still pretty hyper and active.

Today when I visited Um Ahmad I could tell that she was very concerned for Ahmad.  His oxygen levels dropped during the night and she was concerned with
all of the tubes that are everywhere. I spoke with one of the doctor's in ICU to give me an update on Ahmad. The doctor said for the first surgery he is doing
well.  The oxygen level might drop even more before he has his next surgery because the first surgery didn't have anything to do with the oxygen level it was just to bend on the pulmonary artery and get the blood flowing a bit.  The doctor said that Ahmad will have another surgery but they aren't sure when.  The doctor's will have a meeting tomorrow to discuss Ahmad's case and what are the next steps for him.

Please keep Um Ahmad and Ahmad in your prayers.  Um Ahmad is becoming very tired and she needs her strength to be able to cope with the next few weeks or so.

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Our name Shevet Achim is taken from the Hebrew of Psalm 133:  How good and how pleasant for
brothers to dwell together in unity... for there the LORD commanded the blessing--life forevermore.
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