On Wednesday night the Shevet Achim community in Jerusalem gathered at 29 Prophets Street to celebrate Asma
Last night and this morning, Asma and I just had the giggles. We were laughing over the silliest things, tickling each other, talking, remembering funny things that happened during the last month...special moments that I will wrap into my memory box and treasure forever. On the long road trip to the hospital this morning, we went from learning English, to learning Kurdish, to memorizing the "Down by the banks of the hankey-pankey" (a hand clapping game I taught her), to listening to her favorite Kurdish song, to breaking into tears at the news that Aryan is coming home today. Below is a picture of Asma and her little friend Aryan.
As we sat outside of the examination room awaiting her last echo, Asma told me about her many friends back home. She fondly thought of her best friends who have called her while she has been here. She misses them. How could I blame her? Asma is just 13 years old and has already missed an entire month of school. Here, she hasn't been able to express herself fully, because of the language barrier. As much as I would like to hold on to her forever and keep her here, I know the time is coming up when I must let go. According to the doctor, that time is soon.
On the medical side of things, Dr. Sagi reduced Asma
"Lub-dub, lub-dub,..." Checking Asma's vital signs yesterday evening was exciting. It was the first time I could hear her heart after surgery, and instead of hearing a "shooo" sound for her beating heart, I heard a solid lub-dub! Praise God! I was so excited to hear a healing heart working properly, giving Asma the hope to live her life to the fullest.
Our concern, however, centered on her low blood pressure, pain in her left abdomen, dizziness, and her poor appetite. Upon calling the hospital, the doctor asked to admit her that very night for various blood tests and an echo in the morning. Asma's mother began to sob heavily at the news, disappointed that they needed to return to the hospital, potentially delaying her eventual return home to Iraq.
Every procedure at the hospital produced a plethora of questions, such as, "Why do they need to draw blood?" "When will they know the results of the blood tests?" "Why did the nurse ask that?" and finally as we left, "Will you be here tomorrow morning for the echo?" My limited vocabulary meant that I was frantically flipping through my pages, picking up words here and there, trying to reassure the mothers everything was alright. I say "mothers" with a plural because Hawre's mother, Aryan's mother, and Asma's mother were all in this together as a family unit, wanting to know the details of the progress of each of their children, demanding to have all of the answers.
As we walked into the hospital today at noon, with pride mother and daughter declared that Dr. Alona had said everything was well, no problems, an echo is scheduled in one week
Asma has made such good progress that we were asked to collect her from Wolfson Hospital today and bring her back to Shevet Achim. At the time appointed she and her mum were waiting, but we had a further hour's delay whilst medication was being put together for her.
Asma was obviously delighted to be leaving the hospital after a long wait and she appeared to be both happy and content on our long drive back. She even practiced her English on a few occasions, and she speaks well! She was welcomed by the other Iraqi families here, and by our staff, with open arms. How lovely to have her back with us again.
Asma will be returning to Wolfson hospital for her first post-op echo on Monday, January 30th.
I rushed through the hospital corridors, a packaged red Gerbera Daisy in hand, peeking into each room to spot my Kurdish delight. The last time I had seen her had been in the ICU after surgery on Sunday evening (less than a week ago, but it has felt like forever!). Apparently she's been out of the ICU since Tuesday! Reaching the end of the hall and still no sign of her, I ran back to our group that was making a hospital visit today, breathlessly asking, "Where is Asma?!" A nurse standing nearby overheard me, smiled, and guided me into her room, just as Asma's mother stepped into the corridor. What a joyful reunion with both Asma and her mother! Kisses and hugs, smiles stretching ear-to-ear, a healing heart with just one tube still connected to her body, and a red daisy in hand...what more could a girl ask for?
I told Asma that I wanted a picture of her, but she was hesitant, wrinkling her nose, pointing at her matted hair, and saying she doesn't look good. My purse happened to contain the perfect solution: a comb. Her mother and I helped her sit up so that I could gently comb her thick, luscious, wavy hair, as I updated them about Yaqoob's arrival last night, as well as how Najlaa and Hawre are doing back at our Jerusalem home. With each stroke of my brush, my heart was ready to burst with joy and excitement at seeing Asma doing so well so soon after surgery. I cannot wait to listen to her heart through a stethoscope and not hear the "shoo" noise in her heart--the first heart abnormality I had ever heard, a heart that didn't make a "lub-dub" sound. Suddenly, I stopped what I was doing to squeeze her tight and tell her how happy I am to see her again. She laughed with a twinkle in her eyes. Then they related to me how sad they were yesterday, when the two were placed in isolation, in fear that Asma had acquired an infection. After playing with the flower and a camera, Sophie (our volunteer from China) and I braided her hair.
Dr. Tamir came in at just the right moment, kindly explaining Asma's progress, giving us hope that she will be ready to go home by Sunday! We hung around long enough to see the drainage tube, which gave her slight discomfort, taken out today. I would like to think that we were the right anesthesia for that moment, because she told me, beaming, that she had no pain during the short procedure. This time, as I left, there was a large smile plastered across her face, and a cheerful goodbye wave. No tears. No fear. Just hope for a better future.
After open heart surgery, the first few days are typically measured by several significant milestones. Asma experienced her first step of recovery today by being extubated. This simply means that the ventilator providing respiratory assistance was disconnected. She is now breathing independently and using a mask for supplemental oxygen. The general anesthesia has also completely worn off. Her mother happily reported that Asma opened her eyes at 10:30am this morning.
When I asked what was the first thing to come from Asma's lips, her mother said, "Ow!" ("Water" in Kurdish). We laughed together as I explained that English speakers would think Asma was in pain by saying "ow," rather than asking for water.
It was beautiful to see joy in her face. I recognized relief as well when the doctor reported that Asma's is progressing as she should without complication. "The first few days after surgery are difficult," I further explained, "but they will get better." Asma's mother had faithfully sat by her daughter's side through the night, keeping vigil until the moment she awakened. She was resting again when I saw her, this time without the use of sedatives. Her mother agreed that her sleep is good for her body's healing.
As Proverbs 127:2 says, "[God] gives His beloved sleep." I am thankful to pass on this encouraging news to you today and hope it lifts your spirits, as it did mine.
(This blog was co-authored by Shevet volunteers Kristina Kayser and Liliya Semenyuk.)
On our way to the hospital, we received a phone call from Stephanie, who had been in the hospital all morning: "She's being taken now." What?! Five minutes later, I (Liliya) was rushing towards Asma's room, almost crashing right into her as I rounded a corner. "Lily!!" "Asma!!" We hugged in relief, and I saw her for 30 more seconds before she was whisked into the ICU for pre-op procedures, including anesthesia. That was half past noon, though she didn't go for surgery until just after two.
The hospital staff wasted no time in rushing Asma to the OR, not even pausing for us to get a good look at her. As soon as the automatic doors shut to the surgery unit, we could do nothing but go back to wait. Many mothers prefer stationing themselves in the ICU waiting room, but today's warm weather was too lovely to pass up. We (Kristina, Liliya, Asma's mother, Hawre, and Hawre's mother) went outside to sit in the hospital garden and enjoyed the afternoon sunshine and each others' company for the next hour and a half.
Whether it was learning Kurdish, talking about life, drawing, or teaching them to make a balloon dog, the laughter and friendship were clearly medicine for the soul for Asma's mother. Her mind seemed more at ease as her burden was shared by friends. Afterwards, Aryan's mother even convinced her to eat lunch and drink some tea. As the waiting continued, I (Kristina) noticed Asma's mother gently fingering a colorful string of beads. As she silently prayed, the beads moved through her hands one by one. Telephone calls, meanwhile, steadily streamed in. Prayers continued uninterrupted.
Asma's mother had just asked if we could check on Asma's status when she suddenly rounded the corner to be wheeled into the ICU just after 5 pm. The tears spilled freely over her mother's cheeks in relief at seeing her daughter post-op, albeit intubated and unconscious. I hugged her and said, "Praise God! He heard your question before you even spoke it! He loves you!" She nodded her head and smiled. After another full hour and a half, entrance was finally granted into ICU.
Our first glimpse of Asma was difficult because she was fighting the sedation and mildly thrashing about. Her mother attempted to soothe her as she struggled to stay awake, begging for water. Much to her mother's dismay, the nurse pleaded her not to touch her anymore, so that Asma's sleep would not be hindered. It wasn't until stronger IV sedation was given that Asma fell into peaceful slumber. The medical report is as follows: a full repair of the VSD was made as well as the right ventricle's double chamber corrected. The surgery went without complication and she will remain in ICU until further stabilized.
There is much to be thankful for. While Asma's mother is still carrying the weight of past tragedies, she is also rejoicing in today's triumph. Each moment, each breath, each beat of Asma's new heart is a reminder that life is a gift.
The more I get to know this delightful thirteen-year-old, the more I see how lovely Asma is. She seems to be on that defining line between young woman and little girl. Trying very much to look and act grown-up in demeanor and dress, I can still catch glimpses of her child heart. Today was her first visit to Wolfson Hospital for preliminary tests and assessments. With this came a wave of fear and concern from both she and her mother. As mentioned in a previous blog, Asma has already lost two sisters to heart complications. The weight of family tragedy was fresh on their minds. As vital signs were being measured, I noticed her sitting quietly, deep in thought, and I wondered how she was processing everything. The only thing which made her cry was the very unpopular syringe assigned to draw blood for lab work. Hot tears ran down her cheeks. When I told her it was all over, she quickly composed herself once more.
Scattered throughout the day were stretches of sitting and waiting, but no matter to Asma. She took this as an opportunity for an impromptu school session. With notebook and pen in hand, she wrote down as many new words as possible from our English and Chinese-speaking volunteers. I love her curious mind, always probing and seeking! Her aspirations to become a pediatric cardiologist are well matched with her passion to learn. Another aversion came in the form of Pomadora, Wolfson's clown in residence. Asma laughed shyly as she snuck up beside her for a picture.
The final and most important examination of the day was an echocardiogram (echo). Dr. Alona and another doctor treated her with such sweet affection and gentleness. I believe this helped ease any fears of the day still remaining in her heart. The echo confirmed Asma's diagnosis of a VSD and a Double Chamber Right Ventricle (DCRV). The VSD is a breach between the two lower chambers of her heart that will be surgically sealed. The second problem lies in the fact that her lower right ventricle (chamber) has an unnecessary layer of muscle that will need to be re-sectioned. Dr. Alona stated with confidently that her diagnosis is not complicated and that "her surgery will be straightforward." Praise God for this good news! Both Asma and her mother looked relieved and happy when I conveyed the report, as if a burden had been lifted from their shoulders.
Time will tell when Asma will undergo open heart surgery, and we pray it will be soon. Her last question of the day was why the incision would be at the center of her chest rather than to the left where her heart is situated. Before I could respond, her mother stepped in and provided an answer that left her content. May Asma's curiosity continue to enrich her life with mystery, and wonder, and beauty.
Everything felt new. The shops, the harpist in the streets, the train in the distance, the artwork, the various smells of food coming from small shops... Asma, Hawre, and their mothers brought to us a fresh pair of eyes, a new perspective, to the Jerusalem street we've walked on many times.
Their joy of being beyond the walls of Shevet for the first time quickly infected us too, and the carefree laughter gave us much ease. Whether it was Kristina singing through the snapdragons, Sophie learning to count in Kurdish, or me getting in trouble for touching a unique flower for sale, we found plenty to laugh about. The experience can be likened to baby birds learning to fly on their own, as we gently nudged them out of the nest to be free to explore on their own.
We then took the two families out for some cookies and tea, ultimately spending quite a bit of time in the cafe, as they relayed bits and pieces of their preparation for Israel. By the time we left, the moon was out. A fresh wave of giggles overtook us as Kristina accidently added a syllable, effectively calling the full moon a "cow," which Hawre relayed to us with a deep mooo.
We took a "shortcut the long way" through a park to get home, because they said they weren't ready to go yet. Well, we weren't quite sure what their reaction would be to a small playground meant for young kids