Our little princess Parwana left to return home to Iraq this morning. Time and time again Iâ€™ve heard other staff and volunteers describe their experiences watching families leave as bittersweet. And though Iâ€™m inherently suspicious of overly used terms, there really is no other way to describe this particular experience. On one hand, I was so contented to watch Parwanaâ€™s head with itâ€™s cute pink bow bob over her motherâ€™s shoulder as she walked out of the gate and out of my life this morning. Knowing that because of the heart surgery she received here in Israel she has a full life ahead of her has made me indescribably happy. But in another, more selfish way, I feel crushed. I felt as if I was just getting to know both her, her mother, and all their wonderful personality quirks. And I wasnâ€™t exactly mentally prepared to let them go so quickly. Because of schedule constraints, it was literally just yesterday that I got to spend some real quality time with both of them. Parwana had her last echo yesterday at the Sheba Medical Center (the results of which revealed a beautifully healing heart) and afterwards I had the pleasure of accompanying them to get some ice cream. It was a very good time. Parwana is just now getting the hang of the cultural tongue â€œclickâ€ heard so often in these parts of the world. So in between all her smiles and laughter, she would make her tiny â€œclicksâ€ full of attitude every time her ice cream would drip on either her shirt or the ground.
After our ice cream, we made several field trips to the playgrounds scattered around the hospital while Donna visited with the other patients receiving treatment at Sheba. Parwanaâ€™s mother relished in watching her daughter teeter joyously around the various oversized blocks. But soon enough it was time to leave for Jerusalem, where a departure party for Parwana and Shad was being planned.
The party was just as wonderful as so many others are. There was tea, a central sugary treat, music, gifts, laughter, pleasant scattered conversation, and a palpable feeling of gratitude in the air. Parwana thoroughly enjoyed all of her gifts, especially a large amount of crayons that she kept taking out of the box to admire, before placing them back in only to repeat the process all over again. She was thrilled even more by the slideshow which was made for her to showcase the highlights of her journey to health here in Israel. She loudly giggled the whole time at pictures of her, her mother, and all the volunteers before falling silent as she aggressively plucked the sprinkles off of her cake. All in all, I think itâ€™s safe to say that this little beauty very much enjoyed her last night here in Jerusalem.
Sitting there watching all of the festivities, I began to silently muse about how easy it is to take for granted that the children who come here for their heart surgeries will all seamlessly get better. For some, like Parwana, this is indeed the case. But other more complicated cases like Sana and Essa remind us that we should not and cannot presuppose on Godâ€™s grace in this way. Yet a well timed comment from Ruth about how Parwanaâ€™s heart surgery, quick healing, and discharge to go home were significant reminders of Godâ€™s faithfulness to give His children good things quickly put things back into perspective. We are all ultimately in His hands and subject to His mercy.
It was with this perspective that I bid my farewells to Parwana, Shad and both of their mothers this morning in the courtyard. We had time for one last photo-op for all of the families on the staircase:
And then prayed together and said our last goodbyes.
Parwana is now on her way back home to a family who can enjoy for the first time a healthy little girl. However, she will still need to receive heart surgery in a few years time to completely remedy the tricuspid atresia she was born with. Let us all rejoice, heartily thank the excellent medical staff who so skillfully treated (part one of) her condition, and above all give thanks to God for showing his loving faithfulness towards Parwana.
On Thursday it had been two weeks since Parwanaâ€™s heart surgery. Six days after the operation we brought her up to Jerusalem to continue recovering at Shevet Achim. She has had her ups and downs, with a passing fever that left the next day. In her happy times she laughs at everybody and enjoys receiving everyoneâ€™s love back.
Her echo appointment was scheduled for noon, but we waited two hours beyond that; there were many patients. This gave us a long time to wait and play with the little girl. We are all hoping she can go home soon and will grow to be a strong person. It makes me happy every time to see her walking a bit. Being weak, she hasnâ€™t walked on her own for a long time. Now she makes little steps of her own.
At the echo the doctor told me that her heart is healing well, that her fluid level is acceptable, and that Parwana can return to Iraq! She does not need to return to the hospital again. I told this to Donna, who said that all the children have two follow-up echoes before we release them home. The doctor agreed for one more appointment next week.
Parwana seemed to be in good spirits today, so long as no one bothered her while she played her games. And we are in good spirits from the good news!
Parwana was released to return to Jerusalem yesterday from the Sheba Medical Center. She currently seems to be in states of excellent health and spirits, and the only medication which is being prescribed for her is a small dose of aspirin. Please continue to join us in rejoicing over this beautiful little girlâ€™s quick, yet ongoing, journey towards a healthy heart.
On Friday's visit to Parwana and her mother, some of our staff found this little one already able to sit up, and able to eat solid food again. The nurse reported that Parwana was in good condition, and able to eat any foods, but requiring very careful limits on her fluid intake. In order to prevent water from gathering around her heart, it is important that Parwana drink only about one-half as much as normal. This was translated with emphasis in Kurdish to her mother. A beautiful change in the color of Parwana's nail-beds was noted now that they're receiving adequate oxygenation. Instead of looking pale bluish in color, there is a healthy pink tone, praise God! Her oxygen level is hovering around 80%. Parwana's mother was very happy and thankful for the improvement in her daughter's condition, and enjoyed the Friday visit.
Today Ruth and I visited Parwana, and found her improvement continuing. She was playing and smiling a lot, especially enjoying the visit of her friends Sana and her mother. Parwana's mom noted that Parwana is uncomfortable from constipation right now, so we spoke with the nurse about treating the situation. She brought us up to date on Parwana's condition: no more IV meds, no more oxygen needed, she can get out of bed and try to walk, and sit in her motherâ€™s lap as much as she wants to. Parwana was too weak to walk before her surgery, although she could pull herself up to stand and take a few steps before becoming short of breath. Knowing that she doesn't yet walk, we explained that she can stand up for now, and sit in her mom's lap. At first her mother was afraid to handle her for fear of hurting her incision, but once Ruth demonstrated the proper way to lift and hold her, it helped boost her confidence, and this baby girl was soon snuggled down in her mother's lap once more.
Before long, some gifts donated to children hospitalized during Rosh Hashanah (the Jewish New Year celebration) were passed out, and Parwana received a coloring book and markers, with which she began experimenting immediately. She wanted to sit on the bed again, out of her motherâ€™s lap, as she was really focused on making use of her new toys.
When she became bored with the coloring book, she also became tired and ready to lie down again. This time her choice of entertainment was paper towel peek-a-boo, which she really loves â€“ and we love playing along to see her cute smile appear beneath her 'hiding place.'
As we prepared to leave, Parwana's mother mentioned that she thought Parwana had a fever. Indeed she suddenly felt very warm, and the nurse said she'd come in right away. She took the opportunity to reiterate the importance of limiting Parwana's fluids, which we in turn reminded her mother in Kurdish. We had to return to Jerusalem, so we bade them farewell with hugs and kisses, and have since called back to check on Parwana. She does have a fever in fact, and it is being treated while results of a blood test are studied to determine its source. Let's hope the fever is not related to fluid build-up on the heart, and can be treated quickly. Her mother is tired from her bedside vigil, and needs the strength to persevere until they can return to the Shevet house. Please join us in prayer for precious Parwana and her lovely mother as her healing continues.
Early this morning as Ruth and I drove to the hospital, we sang a song together about being humbled by the majesty of God and the impact of His grace and love on our lives. Then we saw it in living reality as we spent the day with Parwana and her mother as Parwana underwent open heart surgery only four days after arriving in Israel.
This adorable baby and her mother were resting quietly when we arrived, and as nurses came in and out in preparation for her surgery, Parwana awoke. She was easily entertained by bubbles, a beach ball and a handful of shekels until it was time to go to the operating theater. The anesthesiologist administered a small dose of medication after all the permission forms were signed, but this didn't settle Parwana enough to keep her from wailing for her mother as the nurse lifted her from her mother's arms and carried her through the final door to the OR. This was an emotional time for Parwana's mom, but she quickly regained her composure and her strength as the wait began. We'd been told that Parwana's surgery would last around four hours, and spent all our time sitting together talking and resting in the waiting room near the OR. Before we knew it, three hours had passed, and doctors appeared to tell us that everything had gone well, and that Parwana would move to the ICU about thirty minutes later. Tears of joy mixed with laughter and hugs filled our group as we thanked God together for this wonderful news. Parwana's mother made excited and relief-filled calls to her family in Iraq while we waited. Just as predicted, half an hour later, doctors walked quickly from the operating suite to the ICU while we caught precious glimpses of little Parwana, already beginning to heal.
After being attended by the ICU staff so that all of her post-operative medications and oxygenation treatment was in order, Parwana was ready for her mother's company again. Even though I'd tried to prepare her for all the tubes and machines surrounding Parwana, her mother was a bit overwhelmed at first.
As she approached her daughter and spoke her name, Parwana opened her eyes and then went back to sleep. Seeing this response seemed to encourage Parwana's mom to step closer and take her place again as the stability in her little girl's world. Doctors came in and out checking on everything, and soon told us that within the next two hours Parwana would be extubated (removed from mechanical ventilation). Ruth and I were surprised that it could be done so soon after such a major procedure, but true to their words, before two hours had passed, Parwana had come out from under the anesthesia and was only on a small oxygen mask. And even more amazingly, only about half hour later, she needed only a nasal cannula to supply her body with enough oxygen! Initially Parwana was restless, quite intent on turning on her side and having her mother within reach, foremost on her mind finding the comfort of her pacifier. When the nurse told us she could indeed have her pacifier, and her mother was by her side, it seemed the missing link was found to settle Parwana. She began talking to her mother as she faded in and out of slumber, her small body already showing evidence of recovering from today's Glenn procedure.
Her mother commented about how white her skin looked, which was truly remarkable. But for me, the strength and resiliency of her body was the most stunning part of the afternoon. As Ruth and I commented about this, we were each reminded of the words we'd sung this morning: " ... humbled by Your majesty ... " God's majestic handiwork in creating the human body, giving wisdom to men to help heal it, and the body's response to receiving the help it needs, obviously comes forth from a heart of divine love, and with the aim of the fullness of life for humanity. And this is our prayer for Parwana: fullness of life! Today's successful surgery is the first of two which should completely heal Parwana's heart. The second is expected to take place one and a half to two years from now. Meanwhile, we're thanking God for all he's done today, and looking forward to having Parwana and her mom with us in Jerusalem again soon.
Psalm 8:3-5,9 "When I consider your heavens, the work of your fingers, the moon and the stars, which you have set in place, what is man that you are mindful of him, the son of man that you care for him? You made him a little lower than the heavenly beings and crowned him with glory and honor. ... O LORD, our Lord, how majestic is your name in all the earth!"
Yesterday, we heard the surprising news that there was a possibility of Parwana having her heart surgery this Thursday. So this morning, we journeyed to the Sheba Medical Center in order to talk with her doctors and discuss the surgery dates. And upon our arrival, her doctors confirmed that her surgery will indeed be tomorrow morning!
After we learned this happy news, I spent some time visiting with Parawa and her mother. Her mother seemed thankful that they did not have to wait a long time for her surgery. And this little girl with blueish lips and big, dark, beautiful eyes seemed to feel that something big was coming closer and closer. Perhaps it was because of this that Parwana did not want to let her Mother go even one step away from her.
Later, I showed both of them some pictures on my notebook in order to have an easier way to communicate with them. We laughed a bit together, and her mother seemed to be at peace. We are praying for this child we have already committed to our hearts that her difficult surgery tomorrow will go well.
A sleeping beauty awaited Tabea, Jesse and I today in the morning as we entered the ICU of Sheba Hospital. Since ParwanaÂ´s catheterization was delayed for about 40 minutes, we used that time and provided her mother with an Israeli sim card that would enable her to keep contact with her family back in Kurdistan.
After a while Parwana woke up and although still sleepy she didnÂ´t cry when she saw us. Tabea had brought a sweet childrenÂ´s book which they both then looked at. Her mother was tired but seemed to enjoy our company.
Around 11 oÂ´clock the head nurse of the OR-department came in and explained the procedure of the catheterization. The doctors expected the catheterization to be done within two hours. After one hour she would come out and tell us how things were going.
ParwanaÂ´s mom was allowed to come into the OR area until Parwana was asleep again, this time due to the anesthesia she was given. When coming out her mother had tears in her eyes. I did not need my limited Kurdish language skills to figure out that she was aching for her precious little daughter.
We waited in the waiting area outside the OR. The head nurse came, as she had promised, after one hour and explained that everything went fine and that soon Parwana would be brought back to Intermediate ICU. We waited, and waited, and waited... Finally, an hour later, the nurse appeared again. Seeing ParwanaÂ´s motherâ€™s anxious face she quickly told us that everything was ok. The doctors did a thorough examination of ParwanaÂ´s heart in order to determine what would be the best procedure for the heart surgery.
Around 2pm Parwana was brought to the ICU. She was crying for some time, but soon settled and went back to sleep. Her mother was relieved, and we spent the rest of our time at the hospital close to her and her daughter.
We are waiting now for the doctorâ€™s decision on the surgery date and the planned procedure. When we left the hospital at 4:30 pm, we left behind a tired but happy mother and a still sound asleep beautiful little girl. May our great God give them both tonight the much needed rest and peace in their hearts.
Today we were all surprised when, just the day after their arrival, both Parwana and Sana were invited to Sheba Medical Center for their first evaluations. Little Parwana was also asked to stay for a catheterization which is to be done on Tuesday morning. Her mother was calm and thankful, encouraging Parwana to settle down when her fear produced wails and tears, whether those were related to riding in a carseat, or during her echocardiogram and blood test. When Parwana was not being asked to submit to medical evaluations, she was happy and curious. She doesn't have the strength to walk yet, so she was scooting around the pediatric cardiology ward during each pause between admission procedures and tests.
Dr. Dannielli explained after reviewing today's echocardiogram results that Parwana has a complicated heart. She has a small, undeveloped right ventricle, and stenosis of the pulmonary artery. Tomorrow's evaluation will measure pressures within her heart to see which procedure is most appropriate for the repair she needs.
This precious little girl has quite a deep blue pallor to her skin due to the low oxygen level in her blood. Even scooting about the floor and pulling herself to a standing position leaves her panting for air. Today I saw her blood oxygen level drop to a low of 42% when she was screaming in pain when the IV cannula was inserted, then rise to 69% when she fell asleep shortly thereafter. Although her body is weak, her willpower is strong. Once she was focused on a barrage of bubbles blowing around her bed, and stopped crying for a few minutes, she began watching the doctor do his meticulous work. She didn't cry anymore, but seemed to be studying what was happening with great interest. As the nurse finished applying tape and bandages, Parwana showed her mother the new items as if she were showing off accessories for her wardrobe! It was then that she fell asleep, and Jesse and I bade her mother farewell.
Parwana's mother seems a strong and wise woman in how she cares for her daughter under these intense circumstances, but is facing a life-shaking time in the coming days and weeks. Please pray with us that doctors will find the pressures in Parwana's heart to be within the range to allow the very best surgery option for her tiny heart. Pray that her mother and family will have the peace which comes from hope in God's work on their behalf. And pray for the Sheba medical team as they become the hands of healing which answer our prayers.
How beautiful and how blue. Those were the first two thoughts as Michelle and I greeted Parwana and her mother at the airport last night.
Parwana was very tired and leery of all the new faces, but after a long night's sleep she reappeared more cheerfully (peeking around Madelyn on the left) at the breakfast table this morning.
And by the time we reached the border crossing into Israel, Parwana seemed almost happy.
The Israeli staff made great efforts to expedite Parwana's entry when informed of her cyanotic state, and as a consequence we reached Prophets Street in good time for a warm greeting from the community, to be followed by a homemade meal.
Now we let Parwana settle in before facing the terrors of the hospital in Israel!
Two-year-old Parwana is severely cyanotic, with oxygen levels of only 55% of normal leaving her blue and weak.
We have applied for her visa to come to Israel for catheterization and, God willing, lifesaving surgery. We hope she'll be with us in early September.