Aram's Heart Surgery

northern Iraq

Great is His Faithfulness

Posted on Mon, 06/23/2014 - 22:43 by Ruth Zellweger

Aram's case is one of the most complicated our Shevet community has dealt with over the past years. Throughout the past four months, he and his mother have had to overcome many obstacles. There were times when we thought we would never see him undergo heart surgery at all. Especially in the beginning, we could hardly make any progress in getting help for this precious little boy. And then his mother suddenly had to deal with the news that besides his severe heart defect, Aram also suffers from hydrocephalus and a possible brain tumor. At some point, it was even recommended to us that we send him back to his family in Kurdistan and just let him live out his days. I very well remember the afternoon when we discussed in Jonathan's office how we should proceed . And I love the fact that Jonathan didn't not want to give up on fighting for Aram's life even though it didn't seem very likely that he could be helped. But our loving Heavenly Father worked on Aram's behalf. He opened the doors at Sheba hospital – where Aram first had his shunt surgery to drain fluid from his brain and where he had his long awaited heart surgery today. And it has been a day to remember. 

Sophie and I left early in the morning to be at the hospital before Aram was wheeled into the operation room. On our way, we entrusted Aram, the surgeons, doctors, and medical staff into God's hands and asked especially for God's peace to fill and surround Aram and his mother throughout the day. When arrived at the children's ward, Aram was still asleep. He looked so peaceful.

His mother welcomed us warmly, thankful for our company. After a while she woke up her son to give him a bath before the surgery. Aram was really excited to see Sophie, his special friend at our house in Jerusalem, who every day cares for the families with so much love and spends many hours with them. Sophie entertained him well, and soon he wore fresh pajamas and was ready for the surgery.

Around 8:45 a.m., Aram was wheeled into the OR, and our waiting time began. It was obvious that it wasn't easy for his mother to entrust her beloved son into the hands of the medical staff, but she didn't break down. Instead, she radiated a strength and calmness I had not observed in her before. God was already answering our prayers! 

In the waiting room, which we had to ourselves, the three of us gathered, held hands, and then prayed for Aram's surgery, knowing that many more people all over the world were praying as well. We talked for a while, and then Aram's mother had tea and ate something before she and I napped for almost two hours. The whole atmosphere was so quiet and peaceful, which I don't always experience on surgery days.

We had just awoken and started to chat a little bit when, four hours after the surgery started, the door opened and Dr. Mishali, the main surgeon, entered the room. His warm smile already disclosed the good news without him having said a word yet. And then he shared with us that everything had gone well and that Aram soon would be brought into the ICU. Aram's relieved mother expressed several times her gratitude towards him and his team. An hour later, Aram was wheeled into the ICU, and we were able to catch a glimpse of him. The doctors and nurses accompanying him seemed relaxed, which always is a good sign that a child is stable. We spent the waiting time until we were finally able to see Aram with thanksgiving as we spread the good news about his successful surgery. 

In the ICU, we found little Aram in a big hospital bed, connected to several different tubes and cannulas. One thing that caught my eye right away was the beautiful skin tone Aram has. His body is now much more oxygenated. His fingertips and his lips now have a healthy, rosy color instead of the sickly bluish color from before surgery.

The doctor and nurse confirmed that he is stable, but also said that his surgery had been a major one. Although they usually try to extubate the children soon after surgery, they wanted Aram to rest and gave him more medicine to sleep. Their hope is to extubate him tomorrow if he continues to remain stable. After having made sure that Aram's mother was comfortable and well, Sophie and I left the hospital, leaving Aram and his mother in the capable hands of the doctors and nurses, and more importantly, in the hands of God. He has proven Himself to be faithful in Aram's life. To Him be all the glory. 

Eve of Healing

Posted on Sun, 06/22/2014 - 20:11 by Philip Rasmussen

Today we visited Aram at Sheba Medical Center where he has been kept for 12 days now– most of it just for observation– and it’s a difficult place to be when you do not see any progress or understand any of the languages; I was curious to see how Aram’s mother was doing. Last time we heard from the hospital, the oncologists gave the green light to the cardiac team to perform Aram’s heart surgery. We left Prophets Street today not knowing when his surgery would be scheduled, but as we arrived at the cardiac department one of the nurses came over to inform us Aram’s heart surgery is scheduled for tomorrow! Furthermore, the surgeon wanted to speak with the mother personally and needed someone to translate. I called a Kurdish Israeli who has offered Shevet Achim her help in translation, and over the phone she was able to deliver the surgeon’s message to the mother. The mother seemed very glad and grateful towards the surgeon and happy finally to see things move forward. The mother seemed much more cheerful than we have seen her before at the hospital. I do not think it is completely due to the surgery that will soon take place, that in itself is a frightening thing, but Aram himself is making small steps towards recovery from his other conditions as well. He has started speaking more, and the mother also said he does not cry as often. We did not hear a simple complaint from him today, which is quite unusual. Also, today we were able to bring them both some things they had requested; below you will see a picture of Aram playing with some of the stuff we brought them.

Not many kids would be excited over a thermos, but Aram is not like any other child. During his stay in the hospital he has mostly been eating bread soaked in hot tea, and I am sure the thermos will secure him some of his favorite cuisine in the near future. 

When I asked the surgeon about the complexity of the surgery that is to take place, he said that it will be a more tricky surgery, simply because it is rarely performed. The diagnosis of Aram’s heart defect is Transposition of the Great Arteries. When this condition is discovered beyond the newborn period, where the surgery should take place, an atrial switch is often the best option. The heart consists of four chambers where the two upper ones on each side are called the atria. The surgeon hopes Aram will have remarkably improved saturation and anatomical function.

Aram’s heart surgery, which was the very reason why he came to Israel in the first place, will take place tomorrow. Here he stands on the eve of his surgery, more than three and a half months after he first came to Israel, having gone through an enormous amount of obstacles. He has overcome many mountains so far, and we all surely hope and pray our Lord’s continuous care and healing over his life.

Moving Forward

Posted on Thu, 06/19/2014 - 21:16 by Ruth Zellweger

I had already planned on visiting Aram and his mother after lunch today, but a phone call during our morning meetings changed plans a little bit. We were asked to be at the hospital at noon to help with translation. Aram had been scheduled for an appointment with an oncologist. My first thought after hearing this was that the biopsy results must have come in and a cancerous tumor had been confirmed. I reached Sheba hospital just in time. Aram and his mother were still in their room, and I could tell right away that this wasn't their best day. Aram was crying a lot. His mother looked exhausted and told me that she doesn't sleep much at the hospital. The nurse started to prepare Aram for his journey to the oncology department, but at the last minute, the doctor canceled and told us that only Aram's mother and I should go there to talk with the doctor. We had to wait for forty-five minutes until we were called into her office. During our waiting time, Aram's mother was really worried about the well-being of her beloved son, who was now without her in his room on the ward.

When we were finally called in, the oncologist surprised us with the the fact that the biopsy results had come in indeed, which is a week earlier than we had thought. Then she told us that the biopsy has not confirmed a brain tumor. However, she thinks that most likely Aram has some sort of lower grade tumor in his brain and wants him to have another brain biopsy after his heart surgery. And this was the really good news of the day. The appointment with the oncologist today was meant to give a recommendation to the cardiologists that they go ahead with heart surgery. From the oncologist's point of view, they should proceed with his heart treatment as soon as possible. The only thing she requires before Aram undergoes heart surgery is another CT-scan of his brain to make sure that the shunt, which was created to drain fluid from his brain, is still working correctly. Aram's mother took this news well and seemed relieved that her son might have heart surgery soon. We are now waiting to hear of the results from the CT-scan and hope that Aram will have surgery in the near future. His oxygen saturation continues to be very low and he is in need of constant oxygen supplementation.

This young boy and his mother have already gone through a lot and still have many procedures and times of waiting ahead of them. Thank you for continually covering them in your prayers.

Covered in Prayers

Posted on Sun, 06/15/2014 - 21:28 by Rahel Eschler

Since the last time I saw Aram things have changed quite a bit. We were expecting to bring them home to Jerusalem for the weekend, but instead on Friday I learned that Aram had been moved to the cardiac ICU due to saturation drops on the surgical ward and was being kept there for observation.

Today I walked into the ICU and located the senior doctor who was able to give me an update on Aram’s situation. For now, his medical condition is stable in the cardiac ward and he is only on oxygen support. The cardiac doctor is still waiting for the results of the brain biopsy before he is willing to plan the next best move in his heart treatment. His hope is to get the results back during this week, and then decide the best course of action after meeting with all the doctors from the neurological and cardiac departments.

After locating Aram and his mother, neither of them were in the best of moods. Aram was having one of his fussy moments and was protesting his daily morning routine of getting washed. I searched his mother’s face in vain for a smile; instead I found a look of exhaustion. I equipped myself with gloves and helped get Aram finished, and changed his beddings after his mother finished cleaning him. For Aram’s mother it is quite a challenge to be so far away from home for such along time, especially in the hospital where no one else speaks her language. After being in Israel with us for over three and a half months, she now and then has moments of feeling overwhelmed and wanting to give up. But God has been faithful so far, even though we had to learn to be patient and wait for his right timing. It seems that Aram is closer than ever before to receiving full healing. Please pray with us, and for the doctors to make right decision about further treatment. We give thanks to our Lord for little, beautiful Aram, and we ask Him to sustain Aram and his mother in His peace and love.

Right at the end of my time at the hospital, I told the mom that I would return home to Switzerland in a few days and had come to say good-bye. It was a bittersweet moment as she thanked me for all the support and love. She also shed some wishful tears in hopes of returning home to her family soon. I covered them with prayers and waved a last farewell.        

Fuzzy Moments

Posted on Thu, 06/12/2014 - 22:59 by Rahel Eschler

Little Aram still has his fuzzy moments in between being calm and sweet. When Jesse and I arrived on the critical care ward at Sheba hospital, where Aram gets observed post-surgery, he was having one of his good moments: he was looking at a children’s book and babbling in his own language with a shy smile on his face.

The neurosurgeon needed some Kurdish translation from us to complete a medical examination checking Aram’s neurological status; this will help to decide about the further procedure. We waited quite a while for him, as we know surgeons are always very busy and hard to get a hold of. After some time he finally had a moment to assess Aram and his medical condition. He confirmed our impression of Aram recovering well from his brain biopsy.

Tonight, Aram will get moved to the normal surgical ward, and tomorrow if everything goes smooth there’s even a chance for him to be discharged. As we prepared to leave, Aram was getting fussy once again. We asked the mother if we could pray for both of them and she thankfully agreed. Please keep on praying with us for complete healing of Aram and wisdom for the involved medical team. 

Gratified Clarity

Posted on Wed, 06/11/2014 - 20:29 by Jesse Tilman

Aram continues his path of assessments and tests as we hope for his healing. Today he was scheduled for his brain biopsy, and thank God it took place. As Ruth and I drove through traffic from Jerusalem, the staff at Sheba hospital told us it might be canceled if we couldn't arrive soon to translate. We made it over an hour later than we had planned, but things still went forward. Walking into the Main Operating ICU Wing, we found Aram crying and hitting his head as usual. But his mother was glad to see us, and I soon began translating for a nurse with all the necessary information and instructions prior to the procedure. Aram's mother signed the anesthesia consent form and the staff prepared to go into the operating room with him. Soon we were waving goodbye as they wheeled his hospital bed away. 

We walked outside the ICU to a waiting area where a dozen people were sitting around. Sheba hospital has many large indoor spaces and some cafeterias nearby. I was thankful our area was light and airy with food stalls nearby in an open courtyard. We sat down and watched the computer monitor that gave readouts on the patients' status for waiting loved ones. Aram's mother was calm enough to eat half an apple and chat with us. A little time away from Aram's near-constant crying seemed good for her. Ruth and her went for a walk and a sandwich, while I practiced my Hebrew with an Arab Israeli whose baby was in for a procedure. The hospital staff told us it would be about 2 hours until Aram's procedure was finished. So, about two hours later, were called into a small conference room to hear from a doctor. He told us that everything had gone well and the biopsy had been performed successfully. A section of the brain had been exposed, and with the greater visibility this afforded the operating doctor could select what he needed to remove with greater discernment. Aram would also need a CT scan to make sure they "had not caused any harm," as the doctor put it, "with internal bleeding". Aram would be out in a few minutes, so we went back to the waiting room for a few last nervous moments.

Soon the secretary called us again and we filed into the large ICU room and walked to his bed as we recognized his familiar cries. He was still groggy and slipping in and out of sleep as we stood by him through his slow regaining of senses. They gave us some glucose-sugar water upon request for Aram to start drinking again after fasting since last night. After a few hours we prepared to go for the CT scan. We watched as two middle-aged nurses readied the bed, playfully argued through the whole process as we trooped down the corridor, waited our turn for the CT scan, completed it, and headed back to the ICU. There we waited for the next step, moving back to the Critical Care Ward in the Pediatric building nearby. Our transport came by and by and we traveled by the intra-hospital ambulance van. It took a while to settle back into the ward where they had come from this morning before the brain biopsy. Aram's many wires, tubes and medicines were all received in hand, and his appetite assuaged further with some milk. This quieted him down perfectly for at least 20 minutes!

After discussing with the nurses the next few days' care, we prepared to leave. Aram will be in that ward for at least 24 hours observation before moving to a more regular one. We hope and pray the doctors will have more of an idea what they can do for him when the new information from the biopsy arrives in the following weeks. After reminding Aram's mother to eat and take care of herself as well, we said goodbye, confident we left them in good hands.

Patience Through Pain

Posted on Tue, 06/10/2014 - 20:36 by Liliane Gasser

After worship, bible study and prayer this morning, Jesse, two mothers with their children, I traveled to the hospital, with many goals. We first left the mother of sweet Masa at Wolfson hospital for her daughter’s cathedarization, and then accompanied Aram and his mother to Sheba hospital.

After a long wait for paperwork to go through, we finally found ourselves watching a nurse prepare Aram for admission. One of the first orders of business was administering an IV line. At first, there was difficulty making it work on his thin little left arm, but fortunately soon afterward his right arm accepted the IV. But the poor boy cried very much, and my heart was sore for him.

His gracious mother was next to him all the while; I must say, it is a wonder how much patience a mum can summon when it is necessary. For me, this moment at Sheba hospital was a real lesson for my future. As I myself grow older, I become more patient in everything I do, and Aram’s mother’s example today was very impactful. Join me in praising the Lord for these and many more wonderful experiences today!

The Sheep of His Hand

Posted on Wed, 05/28/2014 - 21:33 by Kristina Kayser

Today was set to be a big day for Aram. His fragile, yet resilient brain was to undergo a surgical biopsy, during which doctors planned to remove a tissue sample from his tumor. I hoped to be a source of God's love and comfort to this boy and his mother. When I entered their room this morning, Aram's mother was in good spirits. Aram, on the other hand, was grumpy from fasting since three AM and wasn't afraid to verbalize his displeasure. The nurse came to give him a bath soon after I arrived, which was adding insult to injury for Aram. 

Time passed, and Aram was clean, fresh, and ready to go for surgery in his hospital pajamas. The only problem was the neurology team wasn't quite ready. One of the surgeons approached me with the news that due to a scheduling issue, the biopsy would need to be postponed until potentially next week. This was a difficult thing to share with Aram's mother, who was understandably disappointed. It was difficult for her to see her son go through the struggles of fasting, needle pokes, and blood tests in vain. Both she and Aram cheered up a little, however, when the nurse came to say since there would be no surgery, Aram could now eat and drink. Milk never tasted so good to Aram!

As I spent time with these two and sought ways to encourage them, I couldn’t help but recognize the beautiful changes in Aram of late. He is talking so much more now and even forming sentences. When his mother left the room at one point, he began speaking with me like a good friend.

I also noticed a small toy sheep clasped in his hands.

It's one of his new favorite things to play with, and it brings him much joy. I told Aram he too was a little sheep in the hands of God. And with his mother, I shared when we don't understand why problems arise, we can trust the Lord who holds the future. Psalm 95:10 says, "For He is our God, and we are the people of His pasture, and the sheep of His hand." How true this is!

Aram and his mother returned home with us and will wait until another date for a biopsy is scheduled. We hope it will be soon and continue to put our confidence and hope for Aram in our loving Shepherd’s hands. 

Aram Admitted For Second Biopsy

Posted on Tue, 05/27/2014 - 20:33 by Kristina Kayser

Yesterday I received a phone call from one of Sheba's pediatric neurosurgeons with important information regarding Aram. I learned that although a biopsy had been performed during his shunt surgery two weeks ago, the tissue sample obtained was not from his brain tumor. Thus, no conclusive results were determined regarding the tumor’s make-up and origin. To help move forward in Aram's treatment, a second biopsy is required this Wednesday. The origin of the tumor is, so far, a mystery to the doctors, who say it's like nothing they've ever seen before. Only a careful study of the affected tissue over the course of several weeks will provide the data needed to move forward with Aram’s treatment. 

Aram has been doing so well since the fluid pressure around his brain was removed that his mother was only slightly disappointed to learn about the requested biopsy. Of course, this procedure also means his heart treatment will be delayed as the cardiology team waits for the biopsy results. It seems, however, that Aram's mother is content to wait at the moment. What a gift from God!

While waiting for a room to be prepared and finances to be set in order, we had a nice time sitting outside together. Aram is getting better and better at sitting up on his own and is interested in his surroundings. Today he especially enjoyed pulling up grass and sprinkling it on his mother's dress.

I loved hearing him giggle and chatter as he played.

After a while, we stepped back inside the hospital, where the ICU team welcomed Aram for an overnight stay in preparation for tomorrow's surgery. Aram clearly remembered his surroundings from previous hospitalizations and made it plain he was not happy to return. Every nurse and doctor was welcomed with fearful cries. Once calm again, however, he and his mother became settled in their room. 

Please join us in praying for Aram to have a smooth brain biopsy tomorrow and for the doctors to have wisdom in helping our dear friend. The Lord is faithfully strengthening Aram, and we trust Him for all He has in store!

Aram Back On Base

Posted on Sat, 05/17/2014 - 20:31 by Jesse Tilman

Would Aram be cleared to return to the Shevet base in Jerusalem? This is the question we held in our minds as Elsie and I drove towards Sheba Hospital today. Before reaching the hospital, however, our trip was suddenly extended when the van broke down on Highway 1 just outside of Tel Aviv. With a few hours for thought, rest, reading, and exploration, we patiently waited for help to arrive. Soon Philip and Kristina came with a new car, and Philip stayed with the van while the rest of us continued on to Sheba.

In Aram’s room, we found an upbeat mother sitting cross-legged on her bed with little Aram cradled in her arms.

Their hope of leaving the hospital was apparent. Aram is doing so much better since I last saw him two weeks ago. Aware and responding, he sang songs with us and played games as we stimulated his responses.

The neurosurgeon also visited today and assessed Aram’s state. Viewing Aram’s head produced loud protests, but he was quick to quiet down. The shunt is on the right side of the back of his head, so he habitually rests on the left side when calm.

Soon the doctor declared he could confidently send Aram home with us.

After getting papers in order, we were cleared to head out. We gathered up everything and began the uphill climb to Jerusalem. On the way, we heard Philip had connected with a mechanic and was also on the road. We were glad to enter the Shevet Achim house with Aram and his mother and find some rest in good company after the day’s adventures. The other families welcomed the arrivals, and we left them to settle back in to their familiar home.