Nyan's Heart Surgery

Northern Iraq

Nyan's Farewell: Making Something Beautiful

Posted on Fri, 03/09/2012 - 17:58 by Kristina Kayser

I find it ironic that rainbows are made out of sunlight and rain. Perhaps these contrasting components were meant to mirror our human existence. In this life, joy and sorrow are often interwoven, and only God can join the two to make something beautiful. This rainbow over east Jerusalem, which I saw last week, reminded me of these things.

One "rainbow" I experience time and again at Shevet is saying goodbye to Kurdish families I love. This morning, our community sent Nyan and her mother on their journey back to Kurdistan. The sunlight, for me, was the joy of knowing Nyan is healing well with a mended heart. The rain, so to speak, was parting with a woman and little girl I now consider sisters. 

Last week, we discovered that Nyan would not require a second operation at this time and could return home much sooner than expected. Her departure was not immediate, visa issues giving us several more wonderful days to spend together. We were also able to secure one final echo at Sheba yesterday afternoon. Nyan, though compliant at the beginning, threw a royal tantrum for the remainder of the exam. The prognosis was unchanged from the last echo, except that her right ventricle function was slightly less than before. The doctor's discharge report quotes this result "might be connected to noncooperation."

Nyan will continue to receive follow-up care in Kurdistan with a local cardiologist. He will specifically monitor the right ventricle to determine when she needs further surgery in the future. For now, Nyan's heart is sustaining her with a boost of energy and appetite! Dr. Salem commented that today's final echo also served as a stress test for her heart. "She couldn't do this (referring to the screaming) before her surgery," he added with a smile. Nyan returned the smile as she waved and said, "Bye!"

Since Nyan and her mother were the only family in the house this week, they loved being around our community as much as possible. In preparation for their farewell party last night, Nyan's mother participated in making Purim masquerade masks with Madelyn and Sophie.

Later in the afternoon, she also learned to make chocolate cake with me, which we all enjoyed together after dinner. See the video below of Nyan and her mother seeing the finished product alight with candles.

Music, gifts, heartfelt words, and a DVD of picture memories encompassed a beautiful evening together. Nyan, decked with a Purim crown, was the queen of the hour. Her mother, beaming with joy, shared, "You are one family for me. When I first came, I didn't know you would become my family. I love you all!"

Just before leaving Jerusalem this morning, one last stop was made at the Garden Tomb. Nyan's mother thought it was beautiful and stopped to take lots of pictures.

When we approached the site of the tomb, I said, "When the women came to mourn for Jesus three days after He died..."

"He wasn't there!" Nyan's mother finished. "I saw the movie!" What a fitting reminder of life conquering over death, of something beautiful made out of joy and sorrow. The Giver of life continues to overcome, as we see a new heart being given to Nyan.

As Nyan and her mother made their way out of Israel through the Jordan Valley, God presented them with one more gift: a beautiful bouquet of wildflowers...super-sized. 

Nyan and her mother will always remain etched on my heart. Yes, there was both sunlight and rain in saying goodbye, but I am ultimately reminded of God's redeeming love and promise, which was just what the first rainbow was created to do. 

Addition to the blog, Sunday, 11 March, 2012:

Our coworker in Amman Mary provides hospitality to Iraqi families when they are in transit between Iraq and Israel. Several weeks ago, before Nyan’s heart surgery, Mary hosted Nyan and her mother in Amman. Nyan was very ill at that point. Now, these many weeks later, Mary hosted them again on their way home to Iraq, and writes of the change she sees:

“It is amazing to see the change in a child after they have had surgery and are ready to go home. It is like a change from night to day, even in the mothers. Nyan was not active at all when they were here several weeks ago. Her mother was carrying her around most of the time, I don’t believe she was even walking or attempting to. Now she is like a normal two year old, curious and walking and climbing all over the place! And she kept calling me Nana all the time, and I loved this.”

A Surprising - and Wonderful - Report

Posted on Wed, 02/29/2012 - 21:18 by Stephanie Ventura

Day after day we notice the strength that Nyan is gaining, with her ability to walk around the house, play, and communicate how she feels (which is usually baby talk that only her mother fully understands). In any case, this opens up more opportunities for outdoor activities. Both Nyan and her mother have never seen a beach, and so we spent some time yesterday and had a picnic on a sea-shell filled beach in Tel Aviv. Nyan has reservation about sand getting in her toes, but overall she enjoyed the view. Her mother, like a child, spent a while kneeling over the water, picking out as many multicolored shells as her eyes could glimpse.

Today, we returned to Sheba hospital in Tel Aviv for Nyan’s echo appointment. On the ride down, her mother whispered prayers in the back seat for good results. Since her last appointment with the echo cardiologist and Dr. Mishali (Nyan’s primary cardiac doctor that performed her VSD repair), it was discovered that one of her ventricles is functioning poorly and a leak has appeared. We were also waiting to know whether a second surgery is required to correct the transposition of her lower ventricles.

I believe we all went into Sheba with expectations of a new date for a surgery, and possibly some instruction on whether or not to increase or decrease medications to best suit the leakage of one of her valves. Instead, God provided a miracle: Dr. Salem, the echo cardiologist, said with a joyful tone and a big smile, “Her heart is doing so well, the leak is minimal, the medications have done what they needed to do for her…she can go home.” I was completely taken by surprise, so much so that I began to recite all of the past questions and concerns that were presented to us by various nurses and cardiac doctors. With consideration, he affirmed all that I said and continued to say that Nyan has had tremendous improvement in the past two weeks. They are confident that her heart will continue to improve daily. Her mother, who only knows Kurdish, kept nudging me as I smiled during the conversation with the doctor. “Aley chee? Aley chee?” (“What is he saying? What is he saying”) she kept asking. I proceeded to answer her to keep her involved in the conversation, and in that moment she gave into joy and started praising God.

So we left the hospital today with Nyan being discharged. Mixed emotions tell me that I am so utterly grateful for our Father’s healing hands on Nyan’s life, while bittersweet moments creep in and remind me that we are soon to send a dear friend and family back to northern Iraq. We ask you to join us in prayer for Nyan and her mother. Normally I would state a few areas in which prayer is needed, but this time I’d like to ask our readers simply to ask God how to pray. I trust He will communicate to you about what Nyan and her mother need. Praise God for what this day brings.

Introducing Nyan, The Chef!

Posted on Sun, 02/26/2012 - 21:50 by Stephanie Ventura

As Nyan recovers with us in Jerusalem, every day looks basically the same: lots of playing, music, several learning games, a bit of cartoons every now and again, going for walks, eating delicious Kurdish meals prepared by her mother, and occasional visits to a nearby bazaar. Today, however, she embraced baking. This little chef helped with ingredients and mixing together all that was on the table in order to create yummy biscuits that everyone enjoyed at lunch. Her mother stood by laughing as she watched Nyan steal a few bites of dough as we lined the cookie sheet.

We love watching each child engage in activities that bring a smile to their face and joy to their heart. Her mother laughed, and Nyan let an “mmm” with each bit. Our day baking together communicated our gratefulness in simply passing the hours together, like family.

Nyan Returns to Jerusalem

Posted on Tue, 02/21/2012 - 23:47 by Stephanie Ventura

We received a call today from Nyan’s mother, who said that even though she couldn’t understand everything the nurse was telling her in Arabic, she believed that she might be coming home to Shevet Achim in Jerusalem. Inferring from the excitement in her voice, we called the hospital to confirm, and we were instructed to wait for the doctor’s official release.

We drove to Sheba Hospital, and on entered the children’s ward found Nyan and her mother walking around the lobby with their bags. I asked what they were doing, and the mother’s response was that they were waiting for us. Nyan smiled and walked toward us with her arms out, her mother following behind. We waited for Nyan’s medications to be prepared, and then left for Jerusalem in good spirits.

As a surprise for Nyan’s mother, I was accompanied to the hospital by Aryan and his mother, who are fellow Kurdish speakers and friends. Nyan’s mother enjoyed the surprise greatly. Nyan also became friends with another young boy in the hospital, who was admitted into the same room. Not knowing if they were going to see each other again, their goodbye was filled with tearful hugs and kisses. He is standing on the right.

Everyone posed for a quick photo as we were about to leave the hospital. Nyan’s mother asked to have a copy before leaving for Iraq.

We can pray for the doctors to have wisdom in handling Nyan’s medical case, and also for the ventricles in Nyan’s heart to begin functioning properly.

Doctors Considering the Next Steps for Nyan

Posted on Sun, 02/19/2012 - 23:04 by Stephanie Ventura

We turned the corner today into Nyan’s room and found her sitting up in her bed playing with her mother. She took one look at our faces and grinned. “Dada!” she said, which translates to “big sister.” Her mother looked at us and laughed. It is amazing how much children become acquainted with those around them, and it is always a blessing when our Shevet children consider us family.

As we waited for Nyan’s echo today, which would reveal the progress of her post-surgery recovery, we sat in the lobby that is full of children’s toys. Nyan playfully posed for a photo and we discussed her progress with her mother, who is always eager to ask questions and to get the full details. 

Once we got around to the EKG and echo, Nyan wasn’t the least bit at ease with the little probes on her body. Her mother’s cooing helped somewhat but Nyan’s concerned expression lasted throughout the whole process.

After the echo, we were told that her condition is still under careful consideration with several of the ICU doctors. Within her heart, her right ventricle is functioning poorly. The combination of a new cardiac physiology and the aid of medication has not demonstrated sufficient improvement to dismiss the potential of a second surgery. At present she still suffers from backwards arrangement of the ventricles. The remaining question is when that issue will be taken care of, because it must be. Please keep her in prayer, as well as the doctors, since they have a big decision to make on her behalf. 

Nyan Acting Lively and Gaining Strength

Posted on Fri, 02/17/2012 - 00:00 by Hannes-Christoph Buchmann

Today´s visit at Sheba was really wonderful! Brian and myself were surprised at how well Nyan is doing after her surgery. She was a little bit shy, but so cute, and we were impressed to see her eating when we entered the room. She behaved really lively, and she didn’t stop eating and drinking, because her body needs more strength.

Also her mom was smiling and looked so happy. Brian and I were a little sad that we couldn´t talk with her, but I guess she understood that our team (including Stephanie, whom she asked for) is coming back tomorrow night from Jordan.

On Sunday the medical team at Sheba will decide when Nyan can return to Jerusalem to convalesce.

We are so thankful to the Lord and have a very good feeling about Nyan’s condition.

Craving Yogurt, and Recovering from Heart Surgery

Posted on Wed, 02/15/2012 - 22:27 by Stephanie Ventura

Just before leaving for the hospital on Tuesday morning, Nyan’s mother phoned us from there to say that Nyan did not sleep at all throughout the night because of hunger, and that she has no idea how to communicate with the nurses. She knows no English, Hebrew or Arabic, the languages that are used in Israel. She asked if we would be able to help her find out more information, and I said that we would be there within an hour to help. She let out a long sigh of relief, and you could hear the smiling through the phone when she said, “Inshalla, kwahafeez” (“God willing, bye”).

After we arrived we saw Nyan in bed, crying and helplessly shouting for her mom to give her yogurt. Her mother, looking at Nyan with a frown and then back at me, asked if I could please speak with the nurses about the possibility of giving Nyan food. It is hard for a mother to deny her child one of the most basic needs for the sake of medical reasons. Of course the child cannot understand this; which makes matters even harder. Hawre, another Shevet member who received heart surgery just a few weeks ago, tried to uplift Nyan’s spirits, but she wasn’t persuaded in the least.

Dr. Amir and Dr. Mishali were available to give us an update on Nyan’s progress: She is experiencing AV valve leakage, which is a common symptom after heart surgery. However, the worsening or improvement of this leakage in the next days will determine whether or not Nyan will require another surgery in the near future.

In any case, Nyan needs prayer. Please continue to keep Nyan in your conversations with our Heavenly Father and ask for His mercies on her progress.

The Best Possible Outcome on Surgery Day

Posted on Mon, 02/13/2012 - 22:21 by Stephanie Ventura

Upon walking into Nyan’s hospital room, we were met by her graceful mother and Nyan’s playful smile.

Nyan’s only complaint was that we did not bring anything with us for breakfast. The difficulty for all children prior to surgery is the fasting. Fortunately in Nyan’s case she was the first on the day’s operation list, so her fasting only lasted until 9 a.m. Her mother appeared calm and put together, making small talk about the night and Nyan’s disapproval of this whole experience.

In the hour before Nyan would be rolled away by the anesthesiologist, we played with Nyan using bubbles, balloons and all sorts of voices that caught her off guard. Although she was distracted from the various nurses coming in and out of the room in preparation for her procedure, she remained close to her mother and reached up for her hand several times. We managed to photograph the moment and her mother, who took notice of our camera saying, “She is sweet isn’t she?

We were so grateful for Dr. Mishali who took a few minutes to explain Nyan’s situation. He stated “For now we are not sure what we will do. Our hope is that a VSD repair will be successful. In the event that we are unable to perform this procedure, we will end her operation without fixing the VSD. If that occurs, a Fontaine shunt procedure will be performed within the next few weeks, or maybe months. This will consist of three operations to repair the hole in her heart and the transposition of her pulmonary artery.” This information was enough to cause Nyan’s mother to fear, especially since she held high expectations and hopes that one surgery would be enough to correct her heart. Her face read like a book. Each blink looked as if she was in slow motion, carefully taking in the reality of Nyan’s medical condition.

The hardest moment for Nyan’s mother was watching as her little girl was being put to sleep. Nyan’s last words before the medication put her out were soft whispers of “Dya” (the English equivalent of momma). This shattered her mother’s strength into pieces and her face was instantly drowning in tears. The nurse peeled her hand away from Nyan’s and took her outside in the corridor where she whimpered and helplessly fell into my arms, covering her face. She sobbed until she caught her breath and began praying in between breaths. Many times she stated (not to me but in prayer) that God was big and that our lives are in His hands. I waited for a moment of pause and affirmed this truth about our Heavenly Father being big and having authority over life.

When the surgery ended, Dr. Mishali walked toward us and Nyan’s mother was quickly on her feet. His expressions told me that good news was to be expected, and it was. He stated that a VSD repair was performed and that Nyan is doing well. He also said that for the next two days they will keep close watch on Nyan, and decide after that which steps are next. Nyan’s mother hugged everyone around her, smiled from ear to ear, and went off by herself to pray and give thanks to God for this outcome.

She walked toward Nyan’s bedside and gently stroked her hair. The day, and the element of the unexpected, put our emotions on a rollercoaster ride. And although the time went by slowly, each minute feeling like an hour, we all had the deepest gratitude for God, who gives life. Today He gave Nyan another chance at a healthy life, and while we may not know fully what to expect in the coming days, today’s events were a miracle to this family.

Please join us in giving God thanks for this wonderful outcome, and continue to pray that her heart will respond positively to the corrections made today, even that a solution will offer itself regarding the transposition of Nyan’s great arteries.

Nyan Suddenly On Deck for Heart Surgery

Posted on Sun, 02/12/2012 - 22:56 by Stephanie Ventura

The wait is over. The fortnight delay on Nyan's surgery that was communicated in the last blog is no more, and now we are expecting to see her enter into surgery tomorrow morning, praise God. One phone call from the doctors at Sheba brought excitement and anticipation for Nyan's mother, who smiled big and asked several times, "Really, it's tomorrow?" With the same level of excitement, those of us at the Shevet responded over and over with, "Yes!" 

At the sight of Sheba hospital Nyan became slightly distressed. She is quite observant for a two year old, and recognized her surroundings within minutes of entering the children's ward. She let us know quickly of her disapproval and let out cries of "Dya, nah" (meaning "Mom, no"). 

After an x-ray and a bit of waiting for the next steps, Nyan was rewarded with an ice cream and that changed her behavior completely. She became friends with everyone and held conversations without hesitation and without regard to where she was. 

We hope to report again tomorrow after Nyan’s heart surgery.

Surgery in a Fortnight, and Shevet for Now

Posted on Wed, 02/08/2012 - 22:55 by Brian Mace

A sudden call from Sheba Hospital this afternoon brought us to little Nyan's bedside, as she has been released to return to Shevet until her surgery, which has been planned for a fortnight's time.

However, on arrival, we found her still connected to the monitors, and with cannulas on one wrist and one foot. But it was not long until a nurse quickly removed everything. Nyan was very brave, but the pain was too much for such a little girl, and her monitors registered noisy interference (from her cries).

Her mum soon quieted her with a bottle of water, and the concentration required by a little girl when her mum is dressing her with clothes to be pulled over her head, which have only a very small head opening.

They both seemed to be delighted to return to their fellow Iraqi friends here at Shevet.