Payman's Heart Surgery

Kurdistan, northern Iraq

Payman and her Grandmother Headed Home

Posted on Sun, 07/10/2011 - 22:31 by Jeff Sheehan

It is always a happy occasion when you are on your way home. So it was for young Payman and her grandmother. As I write this blog, they have just crossed over into Jordan and are on their way home to northern Iraq. 

To summarize her medical history in Israel: Three and a half year old  Payman received heart surgery on June 2 for the correction of a Tetralogy of Fallot by surgeons at Wolfson Hospital. Her post-operative period was complicated by a pericardial and a pleural effusion (fluid on her heart and lungs), so her stay in the hospital was longer than normal, approximately twenty-one days. Since being discharged, she has had no problems. Three further echocardiograms have shown good heart function and an improvement of the fluid complications. Her surgical wounds have healed well. Her observations have been stable, oxygen saturation recording at 97 % on room air. Most importantly, she is a healthy pink colour. Post-operative education regarding wound care has been given to her grandmother. 
In closing, we were all a little sad to see this little girl leave us. One gets used to them being around. We've witnessed her happy moments as well as the tantrums. Today of course, she was all smiles. We thank our heavenly Father for her healing and well-being. She has a bright future ahead.

Looking Stronger All The Time

Posted on Fri, 07/01/2011 - 16:26 by Donna_West

A strong and playful Payman walked to and from the car today for her echo appointment. That may not sound like a big accomplishment, but most children (some even as old as 9 years old) still want to be carried in their mother's arms instead of walking on their own at this point, especially so close to their return home. So, for this three-year old to personify someone with a healed heart by making the parking lot journey on her own two feet was quite a great accomplishment. 
The shy little girl who at first did not make eye contact with anyone and flinched in fear when anyone tried to lovingly touch her has now become a picture of confidence. She makes funny faces and pretends to be a mosquito (making a buzzing noise in-between giggles) before she touches you lightly as though the mosquito has landed. Then delighting to see if you are going to smack the imaginary mosquito on your arm or scratch because he has already bitten you, she then starts buzzing and giggling once more. The only "mosquito repellant" for Payman is getting out the camera to photograph this little

A Grandmother's Gift

Posted on Thu, 06/23/2011 - 22:27 by Donna_West

Payman's new heart has required about a three-week stay in the hospital. What a miracle, what a sacrifice. We thankfully acknowledge the gift of healing that only the creator can give. 
I remember the day we visited Payman when her grandmother was expecting to come back to the Shevet House with us that day. It was all she could do to contain her disappointment when she was told she would be staying in the hospital. She was just ready for this hospital stay to be over! As I looked at this three year old little girl with her head in her grandmother's lap, I told Payman's grandmother this: "This is a gift you are giving your granddaughter. She will have a new heart to last her a lifetime. She has shared a very special time in her life and she will always remember this and remember you being with her. She will remember this gift you are giving her, long after you are gone and she herself is an old woman."
As this grandmother's gift of self-sacrifice has been acknowledged and valued I have seen an almost measurable increase in the joy, love, and smiles on both of them. Your prayers have added the presence of God's spirit to hover around them. As we walked out of the hospital today carrying so many bags, balloons and a colored pencil art set, we may have looked like a bunch of "vagabonds" to some. But I continued to hear a word that sounded like, "oof" but it was spoken with a smile and hands lifted toward the heavens with joy from a grateful grandmother with a smiling granddaughter.

Bringing Cheer to Hospital-Weary Payman

Posted on Sun, 06/19/2011 - 19:35 by Donna_West

Kristina and I visited Payman this morning bearing gifts of rice, pita, bananas and cheer. The most needed gift was the gift of cheer and assurance that this long time in the hospital will soon pass.
It wasn't long after our initial greetings that Payman's grandmother wanted to know if we had come to take them back to the Shevet House. They have actually spent more time in the hospital than in Jerusalem during their 3 week stay in Israel. It doesn't take long to become weary in that situation. In an effort to add some movement and playfulness to Payman's day, Kristina applied some gentle tickling and teasing techniques that soon turned into a game of peek-a-boo with funny noises producing giggles.
The nurse told us an x-ray was taken this morning and an echo is scheduled for this afternoon. Their hope is that when all the tests are evaluated, Payman can be released tomorrow or the next day to return to the Shevet household.

Fluid on Payman's Lungs Delays Return to Jerusalem

Posted on Thu, 06/16/2011 - 21:51 by Donna_West

Prepared and hopeful for the possibility of taking Payman back to Jerusalem with us today, Jeff and I were surprised to find her in a different room at Sheba Hospital, right outside of the ICU on the fourth floor. We were told she has developed fluid around her lungs, and has already undergone a minor procedure to aspirate it. 

As I stepped into the room, I saw both grandmother and granddaughter resting peacefully. It was a beautiful sight. 
Please keep Payman in your prayers for a complete recovery and that her family will remain in peace as the Lord continues to work in her life.

8 Days Post-Op, Payman Recovering Well

Posted on Tue, 06/14/2011 - 18:20 by Jeff Sheehan

Payman continues to show improvement after her surgery, which repaired her Tetralogy of Fallot. She is now in a pediatric cardiac ward, in a two bed unit. Her grandmother continues to be with her. 
Her surgery was performed on the 6th of June. Eight days post surgery, her recovery has been straight forward. Her physical appearance displays a healthy pink colour, cool skin, and well oxygenated extremities. She is active, and moves freely, climbing over her bed rails to get a favourite toy. She is not short of breath, but does have some chest congestion, which is being treated with inhalation. This congestion is probably due to her inability to breathe effectively, as a result of her recent chest surgery. Regular analgesia, effective breathing techniques with physiotherapy, and splinting her chest with a pillow when she coughs, clears up this problem easily. 
Her nurse mentioned that her serum potassium and magnesium needed to be monitored and treated. This is routine postoperative management. Mentally she is responsive in a quiet and shy way, breaking into a smile when we played a little game with her. She is also saying a few words. She is not being monitored, which is a good indication that her heart rate and rhythm are stable. Her grandmother continues to be the friendly, familiar and supportive presence that this little girl of three and a half holds on to.

Less Medicine, More "Grandma Love"

Posted on Mon, 06/13/2011 - 21:01 by Donna_West

A team of four Shevet volunteers went to Sheba Hospital with some Kurdish food from home today. It was a game of hide and seek trying to find Payman and her grandmother in the hospital. The good news of the day was that she no longer is in need of the constant 'watchful eyes' of the intensive care unit. She had been moved from the fourth floor to the second floor. When we found her room, it was obvious that Payman's grandmother was glad to see us, but Payman laid motionless with only her eyes following us around the room without expression.
Payman's Grandmother didn't understand why they had been moved and was concerned because Payman had not spoken to her since the operation. I reassured her that the move indicated a need for less medical care and more "grandma love" and Payman will begin to talk with her again soon. Our co-worker Muna began to play with Payman and the laughter was very good medicine for everyone.
When I had the opportunity to get a little information from the nurse, she told me that Payman had had a brief issue with blood sugar levels after her surgery, which had been controlled with insulin. Yesterday she was not feeling well, so some additional blood work was done the results of which are not yet available. It was a delight to have a little 'play time' with this sweet little girl. Tomorrow we plan to return with warm socks and a few more toys to bring a little more laughter, joy and information to Payman and her grandmother.

Payman's Progress

Posted on Fri, 06/10/2011 - 00:00 by Kristina Kayser

It was a pleasant surprise to find Payman transferred from primary to intermediate ICU today. Her appearance certainly gives credit to a remarkable change in medical status from one day to the next. Yesterday she was still breathing with the assistance of a ventilator and sedated. This afternoon, Payman is breathing independently and moving freely in her bed!

Her grandmother, a particularly strong woman, pulled me to see Payman for myself upon arrival. I couldn't have resisted if I tried. It was a happy occasion seeing Payman making such progress. Doting over her graddaughter with light-hearted chatter and compliments, "Nana" ("Grandma" in Kurdish) Payman invited us to rejoice with her.

Payman opened her eyes briefly and hinted at a smile before drifting off to sleep again. Never have I seen a more beautiful portrait of peace than a sleeping child. Her soft rhythmic breathing brought a hushed tone to the room. Leaving Payman to rest, we prayed together and said goodbye. As we enter a time of Sabbath rest in Israel, I trust that God is healing Payman in her moments of quiet slumber.


From a Nurse's Perspective

Posted on Thu, 06/09/2011 - 22:43 by Jeff Sheehan

Payman continues to be in the Intensive Care Unit. She is still ventilated, but is now breathing for the most part on her own. The ventilator is able to sense her taking a breath, and refrains from any input. The first thing that impresses you is her good colour. The lips, fingers, toes look pink, indicating the improved blood supply and oxygenation. She is now lightly sedated, thus allowing her to breathe spontaneously. Her nurse indicated that she is progressing toward being extubated [Removing her breathing tube and disconnecting her from the ventilator]. The process is a delicate one and supervised by an anesthesiologist with the help of a nurse. This will be a progressive and vital step in Payman's recovery and wellbeing. Her grandmother seems to be coping well mentally and socially, which is a relief. In closing, from a nursing prospective, seeing a fellow nurse at work makes me empathize with her as she cares for the little patient, notes her haemodynamic status [displayed on the monitor, i.e. vital observations] and documents her progress. It is busy, exciting, and requires skill and dedication and it is all in a day