Payman's Heart Surgery

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Payman
Age: 
3
From: 
Kurdistan, northern Iraq
Diagnosis: 
Tetralogy of Fallot

The High Intensity Environment Where Payman Rests

Posted on Tue, 06/07/2011 - 18:33 by Jeff Sheehan

Intensive care is high level care, managed by highly skilled & trained medical staff. Up to the minute information displayed on a monitor gives us a picture of a patient's overall status. To keep track of the delicate balance of inner body function, blood tests are carried out at regular intervals. The feedback provides details of adequate ventilation, vital organ function, and electrolyte imbalance. All this allows the medical team to intervene if necessary & provide sedation, analgesia, minerals, nutrients, & inotropic [heart strengthening medication] support.
 
Three year old Payman is at present in this high care environment. She is still ventilated, sedated & paralyzed, to give her body optimal rest & recovery from major open heart surgery. The doctor who was present during our visit was doing an echocardiogram on her. He informed us that she was doing well and that her vital observations backed up his prognosis. 
Payman's grandmother was also more in control of her feelings. Her verbal responses showed less anxiety. In closing, a visit like this makes one feel good. The opportunity to spend time and have fellowship with someone who is far from home, who is concerned about the invalid husband she has left behind and her sick granddaughter, tells her that we care.
 

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Mending Hearts on Payman's Surgery Day

Posted on Tue, 06/07/2011 - 00:39 by Kristina Kayser

Life is often etched with overwhelming pain, yet the redeeming factor in it all is that God is not absent in our struggle. At the very core of human experience and suffering is the truth that "through the Lord's mercies, we are not consumed. His compassions fail not. They are new every morning" (Lamentations 3:22-23a). The poignancy of this scripture was manifested in the timing of Payman's surgery today. 
During the night Payman’s oxygen levels began de-saturating to critically low levels. A breathing mask was applied in order to stabilize her right up until transfer to the operating room (OR). Unlike her initial resistance to oxygen therapy a few days ago, Payman seemed to welcome the cool pure flow of air this morning. Only briefly did she remove the mask to blow a few bubbles. Her grandmother's love for her overflowed in kisses and gentle rocking on her lap. 
Parting was a difficult affair when nurses arrived to take Payman into the OR at 9:15am. It would be six long hours before we saw Payman on the other side of surgery. As surgeons carefully cut through layers to commence a difficult cardiac repair, Payman's grandmother opened her own heart to Jean, Suhail (Shevet members), and I. Distress for her granddaughter stirred up reflections of a painful past and the wounds which fear has inflicted to this day. We all saw a woman who needs deep healing of a different sort. Suhail and I shared the words of Jesus from John 14:27, "Peace I leave with you, My peace I give to you, not as the world gives do I give to you. Let not your heart be troubled, neither let it be afraid." She accepted this promise like rain falling on thirsty ground. 
 
Payman's parents, also fearful for their daughter's life, called frequently to check her status, and silence from the OR became deafening. Tears flowed from her grandmother as strength succumbed to worry. Just after 3pm, the surgeon appeared with an encouraging report. The operation took longer because of the challenge of closing two openings in her upper and lower chambers but ended successfully. Everything that doctors hoped for was accomplished!
An hour later, I accompanied Payman's grandmother to Payman’s bedside in the Intensive Care Unit (ICU). The site of a bloodied blanket and unsightly chest tubes became too overwhelming for her. She was ready to escape to the waiting room after several minutes and weep. 
No amount of reassuring words could console her, and she pleaded with me to stay with her overnight. I hugged her and shared once more the promise Suhail and I had shared previously. Soon after, she was reunited with another Kurdish mother in the children's ward. 
 
Payman will remain in ICU through tomorrow as doctors monitor her mending heart.  As God continues a work of healing in both Payman's life and her grandmother's life, I pray they find His mercies new every morning and His peace a shelter each night. 
 

 

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A Day Filled With Grace

Posted on Thu, 06/02/2011 - 00:00 by Kristina Kayser

Surely, we "do not know what a day may bring forth," (Proverbs 27:1), yet we can rejoice regardless in the hope that God's grace is always sufficient. The sun rose over Jerusalem as our faithful VW van headed towards Sheba Medical Center this morning. Inside was precious cargo: a sleepy three-year-old girl named Payman and her faithful grandmother from a war-torn city in Northern Iraq. Payman's journey to Israel was prompted by a life-threatening heart condition called Tetralogy of Fallot. There are four malfunctions in her heart that need critical intervention – intervention that couldn't be found in her home country. Jeff (fellow Shevet nurse) and I have been closely monitoring her this week due to low oxygen levels. Despite having bursts of energy, she quickly fatigues and struggles to catch her breath.
I've also observed Payman to be strong-willed at times, which may reflect in her a resolution to live. With parents unable to escort her to Israel, Payman's grandmother considered the cost and came to her side. The sacrifice was leaving behind her paraplegic husband who is wheelchair-bound and fully dependent on his wife's care. Fearful for her husband's well being, this woman has shed tears from the moment I met her until now. She longs for her granddaughter to be made whole, while aching to be home with her husband. 
 
As we waited for Payman's first evaluation and echocardiogram, her grandmother began sharing the tragedies her family has endured in Iraq. She shuddered upon mention of Saddam's name as she recounted the battle that left her husband paralyzed over twenty years ago. The heavy burden she carries, however, was lifted for a moment when Gaddy (fellow Shevet member) invited her to a game of billiards during the wait. She smiled delightedly, cue in hand, as Gaddy looked on amused. Shevet certainly provides grounds for reconciliation and friendship on many levels. Only God could bring people together from such different backgrounds! 
When the time came for Payman's electrocardiograph (EKG), she was as calm as could be. The EKG is a noninvasive procedure that reads the electrical activity of her heart, giving doctors a way to measure abnormal heart rhythms.
This was followed by an echocardiogram, which sent Payman into a tizzy. Perhaps the unfamiliar setting and the ultrasound probe moving across her chest instilled fear. Nonetheless, after her grandmother climbed onto the exam table and Payman cried herself to sleep, the test was completed.
Dr. David decided that the echo's 2-D imaging was not sufficient and that a 3-D CT scan on Sunday would further confirm her diagnosis. If all went well, surgery would be scheduled as soon as Monday, June 6th. We proceeded to leave Sheba rejoicing in how quickly things were advancing. 
 
Then suddenly, Gaddy and I noticed Payman began losing her balance and turned a frightening shade of blue in her arms and face. We immediately returned to the cardiology department, where doctors agreed it was best to monitor her for the next twenty-four hours. Soon after being admitted, Payman's oxygen saturation plummeted from the eightieth percentile to the thirtieth percentile. Screaming from fear made breathing even more difficult as she fought to remove the nasal canula from her nose. This created the need for a sedative in order to calm her. Nurses and doctors swarmed at her bedside trying to assess and stabilize her.
In the end, a central venous line was placed in her neck after multiple IV sticks in her arms and feet failed. A second sedative was given, bringing Payman into blissful slumber and increasing her oxgyen level. Her grandmother wept over her but seemed relieved to see Payman peaceful at last. I marveled at the grace and timing of God in today's turn of events, thanking Him for preserving this little girl's life. A recent quote I read summarizes my thoughts on this tumultuous yet grace-filled day: "Since this little world first swung in space, there never has come a day of which you could not sing, 'This is the day the Lord hath made, we will be glad and rejoice in it.' Nobody but God would dare to make a day...He dares because He knows that He is mighty enough to control it." – from the book Watchman on the Walls, by Hannah Hurnard. 
 

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Payman from northern Iraq

Posted on Thu, 05/26/2011 - 13:43 by danny

Three-year-old Payman is from a city divided by violence in northern Iraq. Her heart defect (called Tetralogy of Fallot) has left oxygen levels in her blood at only 76% of normal. Without surgery her life is at immediate risk; with surgery he can have a full and normal life. We hope to bring her to Israel within the next three weeks.

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