Mohammed's Heart Surgery

Kurdistan, northern Iraq

Mohammed is Stable

Posted on Sun, 10/15/2017 - 21:13 by Maxine Stuart

Today Mohammed had a few nurses around him when I came in to the ICU. This was a slightly worrying sight at first, but as I got closer, I saw they were just doing routine checks and administering his medication. They gave me a good report. Mohammed is stable, he is still intubated, but they hope to be able to close his chest today which is good progress.  His mother seems to be doing well, is at ease, and comfortable going with the flow. She regularly checks on Mohammed, and is always close by. She will come back to the Shevet house with us tonight to get some rest as there is not much she can do in ICU. She will need to save her strength for Mohammed’s days of recovery in the children’s ward. 

Please really pray for Mohammed and his family. Because his surgery may only sustain him another 10-20 years before he will likely go into heart failure, I cannot imagine the emotional pain this means for his parents. To know you may lose your son just as he is becoming a young man. Mohammed and his family need a miracle from God, The Creator of all life and The ultimate Healer.


Posted on Tue, 10/10/2017 - 22:34 by Deborah Burke

The Wolfson Paediatric Intensive Care Unit is quiet, just 3 children in there, 2 of them being Shevet Achim babies. Mohammed is one of them.

After a rough afternoon immediately post-surgery, the ICU doctor reported that Mohammed was stable overnight. His chest remains open and he remains intubated. The doctor described him as a "gentle" baby who needed to be gradually weaned off the ventilator. I took this to mean he needed to be treated gently given his previous instability. It is a blessing that it's the Sukkot holidays, the ICU is quiet, and that the ICU staff have plenty of time and personnel to watch over this little one who has had quite a fight during his time here in Israel.
Mohammed's mother returned to the hospital this morning after staying at the house overnight for the farewell party of 3 of our children. Her spirits seemed to be good although it is a bit difficult to gauge her true feelings because she is a very sociable and humorous person. We need to uphold her in prayer that she finds strength and peace, and especially over the next few days as she keeps a vigil over Mohammed. It is expected that he will have his chest closed in 2-4 days and be extubated. Let us be praying that this time-frame runs to schedule. 

Mohammed Undergoes His Second Operation

Posted on Mon, 10/09/2017 - 22:48 by Alexa Bigl

Mohammed remained unstable yesterday afternoon and last night, so this morning he was brought urgently to surgery. The team had a couple of options of how to proceed, and decided the best course of action was to perform an atrial-switch of Mohammed's heart. So, Mohammed is now in the ICU with his oxygen saturation at normal levels (94-100%) and we hope no longer in need of any future surgeries! The ICU and cardiology teams both reported a good outcome for the surgery and Mohammed is much more stable, the best he has looked since he underwent his pulmonary banding surgery. It's a bit disappointing for the team at Wolfson that this was the final outcome because the purpose of doing the pulmonary banding was to prepare Mohammed's heart for an arterial switch in the future, but his heart and body could not handle this intense step.

The two-step surgery is preferred whenever possible because it allows the child to live a normal life-span. The surgery they performed today (the atrial-switch) is often the second-choice because the child will not life a full life-span with this type of repair. But Mohammed's heart and body could not handle the two-step repair and the surgical team needed to undo the pulmonary banding and perform the atrial-switch today. So, we praise God Mohammed's heart is repaired and his oxygen saturation levels are normal. But much prayer is needed as Mohammed's family processes the implications of the type of repair that was necessary.

Mohammed's right ventricle is pumping blood to his entire body, whereas it should only have to pump to his lungs. So, his right ventricle has a lot bigger job than it was intended for. This is why his life-span will be reduced. After some years (it's difficult to judge, but perhaps 10-20 years) the right ventricle will become too tired from pumping blood to the entire body and Mohammed will go into heart failure. We are optimistic about the type of advances cardiac medicine will see over the coming years and prayerful Mohammed will be the beneficiary of these advances. Please join us in praying for Mohammed and his family. We are so thankful he received his surgical correction today and is doing very well now. And we pray for Mohammed's little heart and his life, we entrust him to our Heavenly Father.  

Pray for Mohammed

Posted on Sun, 10/08/2017 - 23:15 by Alexa Bigl

Mohammed remains in the ICU, sedated and intubated with an open chest. The left side of his heart is reacting well to last week's surgery; growing stronger as it should. And this growth is happening rapidly. The cardiology team is pleased with what they are seeing and we are prayerful Mohammed's complete repair can take place during their current visit here in Israel and a return in 6-12 months will not be necessary after all. However, at least a few more days will be necessary for Mohammed's left ventricle to be strong enough to handle pumping blood to his entire body, which it will need to do after the complete repair operation.

The trouble is that Mohammed is not currently stable so the ICU team is playing it hour by hour to see if they can wait the necessary days for the full surgical correction. Currently, Mohammed's lungs are receiving too much blood flow, causing his instability. To help compensate for the increased blood flow Mohammed was changed onto an oscillatory ventilator today, and the ICU team is hopeful this will help stabilize Mohammed some. The inter-disciplinary team at Wolfson wants to give Mohammed's left ventricle as much time as possible to grow and be ready for the big surgical correction. In order to give this time a small operation may be necessary to tighten the band around Mohammed's pulmonary artery, decreasing the blood flow to his lungs. But the team is trying many measures to avoid this operation. Having it will mean Mohammed will ultimately need three surgeries. Because Mohammed is unstable, the team is ready to react and alter plans as needed, prepared to save Mohammed's precious life at any moment with different interventions.

Please lift this boy in prayer and also the wonderful team at Wolfson. May God guide their minds and hands as they strive to take care of Mohammed. And lastly, please pray for Mohammed's mother. She is handling the stress of the situation with some denial and we hope and pray we are able to fully communicate with her and she understands all that is happening. 

Step One, Complete

Posted on Mon, 10/02/2017 - 21:22 by Alexa Bigl

**Update, October 3, 2017**

Mohammed was not stable last night. This morning I saw him when I brought his mom back to stay with him in ICU. Although his situation became more stable with time, the doctors decided not to close his chest yet. They are now planning to close his chest tomorrow and hopefully they can extubate him the day after. Please keep praying for this special boy. Continue reading below for more details about how his surgery went yesterday.

Lindsay and I headed to Wolfson this morning to be with Mohammed's mom for his surgery day. When we arrived Mohammed was fast asleep and Mom was visiting with Herdi and Zhyar.

After some time, we woke up Mohammed to get his diaper changed and his IV disconnected. Then he was ready to be taken down to the OR.

We started to head towards the children's pre-op room but upon arrival we were asked to be in the main, adult pre-op area.

This was a first for me and a bit overwhelming for Mohammed and his mom.

There was lots of activity all around and Mohammed remained on the brink of tears during our wait. Luckily, the wait was short and Mohammed and his tearful mom were wheeled into the OR for Mohammed to be sedated before Mom came out and Mohammed was intubated. 

After Mom spoke to some family members on the phone, we had tea outside and began our waiting. Mohammed's mom visited with the other Kurdish families throughout the morning and seemed relatively at ease. Later in the morning we headed over to the store across the street for some shopping. Ronas' mom accompanied us and we enjoyed looking around and purchasing a few gifts for their children. 
When we got back to the hospital we grabbed some lunch and before we could eat we learned Mohammed's surgery had finished up. So we were soon able to get an update on how the surgery went and see little Mohammed. The operation went well and the band is in place around his pulmonary artery to increase the resistance so his left ventricle has to work harder, which will in turn increase the strength and muscle of that ventricle. Mohammed's chest is open for now, but the team has reported if all remains well tonight his chest will be closed tomorrow. 
Mohammed's mom was excited to see her son. Once she laid eyes on him and had heard all was well and she could relax a bit, she was ready to return to our Jaffa house. She will sleep here tonight and return to her beloved son tomorrow. May the Lord's hand of healing be over Mr. Mohammed and may His peace reign over his mom, amen. 

Mohammed's on the Schedule

Posted on Sun, 10/01/2017 - 22:40 by Alexa Bigl

Mohammed has completed his course of antibiotics and the blood tests show he is now infection-free! So, the doctors are ready to perform step one of his two-stage heart repair. Mohammed is on the schedule for tomorrow to go down to the operating theater in the morning. His mom is anxious but also happy the day is nearly here! 

Please pray for Mohammed and his mom. They are both emotional and Mohammed's mom is a bit overwhelmed with considering she and her son will need to come to Israel twice and Mohammed will undergo two big surgeries. But we are thankful the Lord is the almighty healer and we are thankful He has worked for Mohammed to be here in the care of the wonderful Israeli doctors at Wolfson. Thank your for your prayers for tomorrow!

Watching and Waiting

Posted on Sun, 09/24/2017 - 21:07 by Deborah Burke
"But as for me, I watch in hope for the Lord, I wait for God my Saviour; my God will hear me."
There is more waiting in hospital for Mohammed. An infection in his blood caused his temperature to rise and he has commenced a 10-day course of antibiotics. He is up to day 4 today. At the completion of the course the medical team will review Mohammed's health and either discharge him before his surgery for a break or keep him in hospital for surgery.
Mohammed's mother is patiently biding time, watching and waiting. It must be so difficult to be totally dependent on a lot of foreigners for medical treatment, accommodation, food, and not to mention the language barrier. Bless this mother, sometimes we just laugh at our inability to have a proper conversation. Please pray for enduring patience for her and for Mohammed's infection to clear within the next 6 days, believing, like Micah, that God will hear us.

Plans for Mohammed

Posted on Tue, 09/19/2017 - 22:21 by Alexa Bigl

We headed up to the echo department this morning with Mohammed's mom to hear from the cardiac team about surgical options for Mohammed. Dr. Tamir sat with us and explained about the anatomy of Mohammed's heart and the two options for surgical correction. There is an option with two-steps and an option with one-step. The one-step option would mean Mohammed's oxygen saturation of his blood would be immediately brought up to a normal level and after the one surgery he would return home to Kurdistan and be done with surgical interventions for the remainder of his life. This surgery has a downside of after some years (typically 10-20) the heart will go into failure and there's no additional steps that can be taken.

The two-step option means Mohammed would need to receive one surgery now, return to Kurdistan for 6-12 months, and then come back to Israel for the full heart repair. Although this is a two-step process and it would be another year before Mohammed's oxygen saturation was up to the normal levels, the long-term outcome is a big benefit; Mohammed would have the chance to live a full life-span. 

After Mohammed's mother agreed with doing the two-step procedure, the doctors were encouraging that this is a very good choice. Mohammed's first surgery, which will help prepare his left ventricle for the big switch (the surgery that will take place in 6-12 months) is scheduled for this coming Sunday. Mohammed remains hospitalized tonight due to a fever he sprang this morning. The hospital is hopeful Mohammed will have a chance to return home to our Jaffa base for a couple days before being admitted for Sunday's surgery. Mohammed's initial echo had some information missing, so Dr. Sagi took a few minutes to take some additional measurements related to the size of Mohammed's left ventricle via the echo machine.
Mohammed's mom had many follow-up questions and points she was looking to clarify, but she remained happy with the decision for the two-step surgery. Please be praying for Mohammed and his mom. Pray for Mohammed's fever to be gone, peace for his mother as she has a few days to continue thinking about the surgical options, and for the Lord's hand of healing to be upon Mohammed.

Mohammed's Been Assessed

Posted on Thu, 09/14/2017 - 21:56 by Alexa Bigl

Mohammed had all his initial assessments completed today! We began in the children's ward with a wide array of tests from urine samples to blood tests to an ECG and vital signs. Mohammed was also weighed and measured and had a general physical examination. He was quite upset about all the tests but by the time we were wrapping up at this department he was becoming more accustomed to the doctors and nurses and was doing better. And his mother was so strong. She constantly worked to keep Mohammed calm and she was not upset by her son's crying, instead comforting him continuously. 

Our co-worker, Coby, then brought him and his mother upstairs for Mohammed's echo. The doctors said it's a very typical d-TGA anatomy and he is a good surgical candidate.
Due to Mohammed's age, the surgical options are a bit more difficult, versus if he was a young baby. The doctors will need a CT scan and will sit to discuss which surgical plan will be best for Mohammed this coming week. Please join us in praying the Lord's wisdom reigns. 
After finishing all the different tests of the day, it looked like perhaps Mohammed could come home. But the blood tests came back with some troublesome results and they have admitted Mohammed to the hospital. We will hear tomorrow if the admission will just be overnight or if he will need to stay for a while. Ultimately, we are happy to know Mohammed is safely in Israel and will soon be receiving surgical correction to have a healed heart; praise God! 

Welcome to Israel, Mohammed

Posted on Wed, 09/13/2017 - 19:20 by Alexa Bigl

Blue Mohammed and his mother safely arrived to Israel this morning. Along with Zhyar and Lawan, they were accompanied by helpful security workers at Ben Gurion. The mothers appreciated receiving the help finding us in the welcome hall and with their many bags. 

Mohammed's mother was anxious to let her family know they were with us and in Israel. So, we sat for a while in the airport and got the mother connected to the wifi while I assessed Mohammed's condition. He is stable, although blue, with his oxygen saturation fluctuating between 60-80%. 
We had planned to bring Mohammed and the other children straight to Wolfson from the airport. The situation where we bring them straight away to the hospital is always difficult for the incoming families because they are so exhausted from traveling overnight. So, we were happy to be flexible when Wolfson asked us to change the initial assessment day to tomorrow. 
We were able to head back to our house and get the mothers welcomed and comfortable here at our Jaffa base. While Mohammed was crying whenever his mother set him down at first, he is becoming more comfortable quickly. He was contentedly sitting downstairs later this afternoon playing and eating chips while we tried to tease some smiles out of this little cutie. 
Thank you for follow and joining us in Mohammed's journey towards a healed heart. Your prayers will be much needed and appreciated. Let's lift up Mohammed and his mother to the Lord, asking Him to give them a good rest tonight and be prepared for their big day tomorrow at Wolfson.