Our little princess Parwana left to return home to Iraq this morning. Time and time again I've heard other staff and volunteers describe their experiences watching families leave as bittersweet. And though I'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 Parwana's head with its cute pink bow bob over her mother'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 wasn'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 "click" heard so often in these parts of the world. So in between all her smiles and laughter, she would make her tiny clicks 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. Parwana'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 it'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 God's grace in this way. Yet a well timed comment from Ruth about how Parwana's heart surgery, quick healing, and discharge to go home were significant reminders of God'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.
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 girl
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 mother
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 Parwana
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.