Akram's Heart Surgery

Saturday
August 22, 2009
A Good, Good End
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As we drove to the Amman airport today for Akram's flight home to Iraq, I could only thank God as I compared the vibrant young man next to me with the dying skeleton we first met 17 months ago.

I asked Akram if he remembered the words to the song which helped give us faith when we were first starting out:

It’s a long hard road, with a good, good end,
And if I keep on walking on past the crooked bend
I will meet my Maker,
I will meet my Friend,
It’s a long hard road, with a good, good end.

Give a listen to the song by clicking here, and join me in praising God for His amazing works!

Thursday
August 20, 2009
Finished!
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Today was a much anticipated day for both Akram and his mother as Akram received his final, conclusive echocardiogram from Dr. Tamir.

Both Akram and mother entered the hospital with several other families and the joy felt by all was entirely evident by the light hearted spirit that filled the room and the smiles that seemed to never quite fade from their faces. Below Akram is pictured with cardiologist Dr. Tamir, who first examined him 17 long months ago, as well as Mohammed and Hindereen.

While waiting for Dr. Tamir, Akram spent some time with Mohammed pretending to do an echo on an invisible patient! This brought plenty of laughs!
After his echo was done Akram happily declared, "Finished!"

After goodbyes to the doctors we left the hospital contemplating Akram's story and all that God has brought him through. After a long journey, Akram and his mother will be heading home tomorrow. Please continue to keep them in your prayers during this time of reunion and transition in their lives; that the protection of the Lord would surround them and that they both would know Him in a more intimate way each day.

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Thursday, August 13, 2009
Counting Down the Days
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Akram went today for what is believed to be his second to last echo before he can return home. While this is great news, both he and his mother were hoping that somehow this would be the very last echo in Israel, so they were somewhat subdued at first. But after a few minutes the joy of realization came through that perhaps as soon as ten days from now, they will return home at last. Um Akram was excitedly speaking with her other family members in Iraq several times after leaving the echo clinic. Now the countdown begins for their final departure, and we all want to make it count and fill it with good things for them. Please pray with us as we enjoy the coming daystogether.

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Wednesday, August 12, 2009

Celebrating the Miracles
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This evening our Jerusalem staff and all of our families went to a local park to celebrate with a picnic the miraculous reality that Mohammed, Akram, Hindereen and Sidra are all finished with their surgeries. In each case there have been extreme challenges, and for Akram and Mohammed, apart from the Save A Child's Heart doctors, they would have had no chance at a heart surgery and a full life.

The families are all very grateful to God as well, and to the doctors and nurses at Wolfson, and to all of us who have helped make their surgeries possible. We thank God for all these lives and the investment of His lovingkindness which has been made while they've been with us this far.

Sunday
August 9, 2009
Chest Pain Brings Good News
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This morning Akram came to us complaining with chest pain, and after speaking to the nurses and doctors at Wolfson we were advised to bring him in for a check-up. Thank God, all the results were good, and Akram was able to return home to Jerusalem with us this evening. Every test which he had showed nothing to indicate a problem: his blood oxygenation was 100%, his EKG was good, his echocardiogram showed no water around his heart or lungs, and a blood test showed no infection. After all the results came in, Akram got better news than any of us expected when Dr. Tamir granted Akram a positive answer to the question both he and Mohammed had been asking me since yesterday, "Can we go to the park?" I think this alone

made the trip worthwhile in Akram's eyes!

Besides all this good news, he also got to visit his little friend Sidra who is now in the ward recovering well, and may be dismissed tomorrow. Sidra and her mother are in isolation at the moment because of exposure to a patient with swine flu, and therefore surgical masks are required for a visit. At first Akram wanted nothing to do with that mask, but later couldn't resist coming in to see his happy friend after she grinned at him continuously through the window of the door to her room. It is a relief to all of us that the doctors and nurses could find nothing wrong with Akram, but let's pray that the pain is no longer a problem for him. He is well on the road to rebuilding his strength, and gaining health he's never had the opportunity to experience before. We are all thrilled for him as a probable return to Iraq should happen within the next several weeks - what a miracle!

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Thursday
August 6, 2009
A Great Echo!
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Akram is just getting better and better. We were able to spend time with him and mom today while they had his echocardiobgram completed and his sutures removed. Akram is still a little weak and needs our prayers to continue to receive rest for his body. Thank you for being such an important part of Akram's life. We are so happy to have him back in Jerusalem at the Shevet House, and so is mom!

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Wednesday, August 5, 2009
Akram Leaves the Hospital Behind
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Akram is home from the hospital! This after spending two weeks at the Wolfson Medical Center recovering from his heart surgery and unanticipated issues keeping food down. This marks the completion of the final major step toward

being able to do the normal physical activities of a normal young man his age. He and his mother were very excited to go home when they saw us arrive at the hospital; Akram had changed out of his hospital garb, had all his bags packed, and walked out to our van under his own power. Everyone was cheering him on as they saw him pass, and all the volunteers and other families at Shevet were excited to receive him when we arrived at the Shevet house in Jerusalem. If Akram's recovery continues normally, after a few echocardiograms and other tests over the next several weeks he will be clear to finally go home to Iraq.

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Sunday
August 2, 2009
Leaving the ICU Behind
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Today was a day Akram has been waiting for: he said goodbye to the main ICU and moved to the intermediate ICU. He began eating on Friday without the nausea, vomiting and diarrhea he'd been fighting, and they were able to remove his chest tube. He continued to do well yesterday, and today was able to walk on his own to get a shower. Following that, he was moved into the intermediate ICU. Praise God! The doctors fondly told him they hoped they didn't see him back in the ICU again, and Akram agreed with them. He was actually pretty disappointed he was going to be in the secondary ICU unit, hoping instead to be in the ward. But for now it's a good thing for him to be in the ICU because there is a virus among the children in the ward, and he does not need exposure to anything like that.

There is no estimate of his stay in the intermediate ICU, but we're hopeful he will soon be able to move into the ward, and then back to the house. The smile on his face today when he found out he could make the first leg of this journey was beautiful, and I"m sure the smile we'll see when he's dismissed for good will be the most joyful one of his life. Thank you for your faithfulness to pray for him and his mother through these many months. Needless to say, her countenance is also beginning to lighten with every day of Akram's improvement. Let's keep praying as the miracle of Akram's healing continues.

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Thursday
July 30, 2009
One by One
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Akram is taking things slow and steady after his catheterization (pictured here yesterday in the ICU). The complications following his major surgery at the beginning of last week are being addressed one by one. The worst problems were dealt with during the catheterization yesterday and the doctors have told us that everything operation related, namely his heart and lungs, look very good. The problem with breathing has apparently diminished, as Akram is neither intubated or on the forced respiration machine, he is presently wearing only the normal oxygen mask.

However the problem with eating remains, as Akram is vomiting anything put into his stomach. Akram’s mother had me flag down all the doctors one by one to see if they knew the cause or had plans to run more tests. After speaking to three doctors, they all reassured us that this was not a major problem. While two doctors didn’t want to speculate about the cause, one doctor believed it was the result of one of the drugs Akram is taking which is a very strong opiate. Akram’s mother was very concerned that Akram has not eaten in such a long time, but I was explained to her that he is being fed intravenously. Tomorrow will be another test of Akram’s progress as they will adjust his medication and again attempt to feed Akram through his stomach. Akram faded back and forth between unconscious and semi-conscious during my visit, which is an improvement over the visible pain he was in the last I had seen him. Akram’s mother is understandably stressed because of all the complications that followed his heart surgery.

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Wednesday, July 29, 2009
Source of Bleeding Corrected
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This morning, although he was looking around a little, Akram was quiet and lethargic on his way into the catheterization lab after being intubated Monday. About 2 1/2 hours later, doctors emerged with Akram saying everything went well, and they are pleased with the results of the procedure. Praise God!

He came back to the ICU still intubated as a precaution, but awake and aware of everything going on around him. After he was settled in again, I went in to see him. I was surprised at how much he wanted to communicate, and because he couldn't talk with the oxygen tube in his mouth, and I had a hard time reading his lips, he asked for paper and pen. He said he'd been asleep for seven days, and he wanted to get up and walk, so when could he do so? The nurse told him they plan to extubate him tomorrow, and at that time he should be able to at least go out in a wheelchair. Realizing he has a tube in draining his chest cavity, he asked if it would be out too - even drawing a picture of it to be sure we knew what he meant. The nurse said maybe after 2 or 3 more days, but that he can still go outside the ICU. He wrote in nice English letters: NO PROBLM. Then he began asking me when he'd see his friends Justin and David. He asked how Mohammed is doing, and Sidra and Hindereen, the other 3 Iraqi patients currently in the hospital. He was allowed to drink water on his own, and reminded me several times he'd been unable to drink anything for seven days either because of intubation, or the stomach virus he had. He also asked about his oxygenation level and wanted to know why it was only 98% instead of 100%. As you can tell, he was quite alert and well on the way to healing from all of his heart and lung problems. Dr. Houri, the head of the ICU, came to check on him, surveyed the oxygen settings and readings, and told him it looked good.

Um (mother of) Akram was very tired and worried as we walked to the cath lab this morning, and even though several doctors and nurses assured her that all would be good after his cath, she was anxious and emotional. She wanted to wait part of the time in the courtyard, then we came indoors to wait for Akram where it was cooler. When our Kurdish friend Mazal suddenly appeared asking if we were ready for her to translate for Dr. Tamir, Um Akram began to think this must mean there was a problem. She said she'd wait until Mazal had the news to tell her, and Mazal went upstairs. After a little while, she asked to go up too, and had a very grim look on her face. But the news was good - they had found the source of the bleeding and corrected it, then were continuing to finish the rest of the catheterization procedure. They said everything was going beautifully; Um Akram's face brightened a little bit. But her disposition didn't really change until Akram was back in the ICU awake and talking to her. After that she began to "be herself" again and was full of thanks to God. Akram was quick to give thanks to God today too when I went in to talk with him. We are ever-thankful for the healing Akram has received so far. Please keep praying for him, his mother, and their whole family as the final days of healing begin in earnest now.

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Monday, July 27, 2009
Akram Improving, But Mother Worried
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We arrived at the hospital today to find Akram's mother sitting outside with a very discouraged and serious look on her face. When I approached her, she told me Akram was not doing well, and would be having a test later today. When I had a chance to talk with a doctor, they described the test as a scope down his esophagus, and I thought it was to find the cause of the nausea and vomiting he's struggled with. However, she explained that this test was part of the echo they'd do because they wanted to look at the heart from the inside rather than outside the chest. This is the same way the heart is checked after surgery I learned. After the echo was finished I was able to speak with Dr. Alona who explained to me that the test shows Akram's body has compensated for his heart problems during his 18 years of life by using small vessels to help carry oxygen to the body. Now that his heart is repaired these same vessels are bleeding instead, and causing problems in his lungs. Therefore Akram will undergo a catheterization on Wednesday morning to correct the problem. After the catheterization they expect Akram to do well.

When the tube was put in place for the test, his nose began bleeding, and the decision was made to re-intubate Akram. His mother was very distressed over this, and somehow got the idea from what was happening that instead of a catheterization Akram would need another surgery. She asked me to check with Dr. Alona, and even after I did so, seemed certain this would be a surgery. While we were discussing it, Dr. Alona walked by us, and gave her final assurance face to face to Akram's weary mom that it would indeed be only a catheterization, and that should solve all the problems. I know this was a bit of a relief for Um Akram, but she seems to be at a point of fatigue which is feeding her worry and preventing her from hearing clearly that Akram should be fine after surgery.

Overall, the doctors have seen improvement since yesterday. Each time I was in the ICU today either doctors stood around Akram, or he was sleeping with the lights lowered, so I didn't have opportunity for a picture. Please know that he and his mother continue to need our prayers, and are grateful for them; his mother is asking me to ask you to pray.

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Sunday, July 26, 2009
Akram Struggling to Breathe
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Saturday afternoon we heard that Akram was having a hard time with his breathing, and not doing very well. But I was not prepared for how much he was struggling when I entered the ICU this morning. Even at first glance it was obvious he was not doing well because his color was not good. He was wearing a new oxygen mask which is connected to a machine which can force the air into the lungs, called a bi-pap machine. The mask itself must be pressed against the face to keep all the oxygen going into the mouth and nose, and is very uncomfortable, plus the flow of oxygen was very irritating to Akram. Besides this, he still has not been able to keep food or liquids down, and stays thirsty, but cannot drink without becoming sick. Even the medications for pain they gave him this morning came back up, forcing them to insert a tube in his throat long enough to give him the meds. The pills took effect rather quickly, and Akram began to rest, which was a blessing for both him and his worried mother.

Um Akram was clearly very tired and very anxious about her son. She feared another surgery, and asked several times about whether his heart surgery was ok. The doctors report that the heart is doing well, but the lungs are not doing as well. The bleeding which occured after his surgery last week caused blood to enter his lungs, and since his lungs have not been as strong as a normal person's, it has been a very slow process for the body to re-absorb this excess blood. A couple of days ago, Akram's blood oxygenation began to drop because of the problem, and the doctors hoped they would not have to re-intubate Akram. The bi-pap machine was the best solution, and praise to God, it has been helping him improve. By the end of the day the doctors said that they were able to turn down the pressure on the machine, and also that Akram was doing better overall. It still may be several days till Akram can eat again, so continue to pray for his body to remain as strong as possible from the IVs he will have to help him remain well-fed.

Akram's mom sent me with a special message to everyone who's been praying for Akram: "Thank you for praying. Please pray for Akram now." I assured her I would share this message with you, and that you will also be praying for her.

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Thursday, July 23, 2009
Akram Turns Up in the Intermediate ICU
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When we first got to the hospital today Akram was in the ICU, weaned from mechanical ventilation and sleeping. He seemed to be doing o.k. We asked if we could take a picture and they said yes and woke him up (we really didn't want them to but it was about time for his medicine.) We decided to let him sleep and we went to see Mohammed; after that we went to see Sidra and were surprised to see Akram now in the bed beside Sidra in the intermediate ICU!

This time he was awake and was alert. He wanted to look at the pictures I had taken, and really seemed to be doing good. They did have to open his chest the night before because some stitches had came loose and they had to restitch them.

We appreciate your prayers and support. God has already done some miraculous healing in Akram's life and He's not through yet. I believe God has a special plan for his life as He does for all His children.

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Wednesday, July 22, 2009
Akram Amazes Us Yet Again
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We visited Akram today less than 24 hours after what should be his final surgery. We learned today that the bleeding the doctors were reporting after the surgery yesterday became a more serious problem after we left. During the night the doctors were required to reopen Akram’s chest in the ICU in order to resolve the issue. Thankfully, by morning Akram was stable and the bleeding had stopped. He is having an echocardiogram in the picture above.

Akram seems to be very accustomed to the hospital setting, even having major operations it seems. Yesterday, with his eyes taped shut, a tube down his throat, and lines coming from all over his body, Akram was doing his shoulder shrug, his favorite Kurdish dance move. Today when I went into the ICU to visit Mohammed, another Iraqi patient, Akram’s mother called me over to the bed saying that Akram wanted to see me. I thought perhaps he had called for me earlier in a daze, but that I should go over to his bed to visit with his mother at least. When I walked over I was shocked, Akram’s eyes were wide open and he was looking straight at me, less than 12 hours after having his chest open. If that wasn’t impressive enough, Akram then proceeded to lift his right hand out from under the blanket to shake my hand, then with his left, pulled the oxygen mask off his face, and said in English as clear as a bell, “How are you?” I was completely floored. He was probably toughing out a lot of pain to impress me by doing this, but it worked. For a good 20 minutes we casually talked about how his operation went, how Mohammed was doing, and cracked a lot of jokes in typical Akram style. I told him before his surgery that Mohammed received parts of a cow heart to complete his surgery, so Akram was very curious to find out if any animal parts had been used on him; he suggested perhaps a monkey. After going through a list of possible animal candidates I was eventually able to convince him he was still 100% human; but he let out a “beheheh” like a sheep to conclude the conversation.

While Akram’s mother was understandably worried during the surgery, once she knew Akram was doing okay she demonstrated that she too was familiar with the hospital environment and appeared very calm and collected. She joined us for lunch today and seemed perfectly normal.

It’s still too early to tell just how long Akram will be required to stay in the ICU. We will have more updates when we receive any news.

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Tuesday, July 21, 2009
Akram Brave and Strong on Surgery Day
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We found Akram and his mother still waiting in the ward this morning when we got to the hospital - sleepy but awake, and anxious to go. Akram was very brave and strong emotionally as he was taken downstairs past a group of waiting nurses bidding him "Good luck!"

He had to wait a little while in the pre-op room which made him a bit nervous, but we were able to pray for him and his mom (above left, with Alex on right), which settled them, as well as share a few laughs before it was his turn to enter the operating theater.

Um Akram remained pretty well composed, and wanted to go first to a quiet courtyard on the hospital grounds where we sat outside in the morning breeze before the heat drove us inside. She didn't feel much like eating or talking, but was glad to be with the other mothers. We ate lunch together, and began the final vigil in the corner where we have a clear view of anyone returning to the children's ward after surgery. We got word from another mother that Akram was on his way, and his mom was able to greet the gurney long enough to give him a kiss as he passed by.

She was so thankful to see Akram returning and seemed to almost feel faint with emotion. After following Akram to the ICU we had to wait nearby for over an hour before we could go inside to see him.

When we entered, I noticed the nurses giving Akram blood, and when the bags were empty, they gave him plasma. This concerned me, so I asked one of the ICU doctors about it. He explained that Akram was losing alot of blood from the place where the heart-lung machine was connected. The staff felt confident that giving him the blood would stabilize Akram, but when we left early this evening he had not yet stabilized.

I called back after dinner and found out that the bleeding had stopped and he was doing well. Thank God! We can continue to pray for Akram to remain stable with no further bleeding problems.

We look forward to Akram's extubation tomorrow as we hope and pray for a supernaturally fast recovery for him. Please join us in prayer for this amazing young man and his loving mother.

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Monday, July 20, 2009
Akram to Surgery in the Morning
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Akram said his goodbyes to all the other children in Jerusalem today before heading to the hospital. Akram is like a big brother to them all, and they love him dearly. Um Akram bid an emotional farewell to the other moms as the reality of the event really set in for her. She was not feeling well today, and eventually had to be checked out at the emergency room before we could be sure she was strong enough for tomorrow's demands. In fact her day was more full of seeing doctors than Akram's was!

Akram had a rather slow day, but a good one. He was a trooper with the dreaded blood test, teasing with the doctors that he knew the best vein where they should insert the port in his arm. They had to stick him twice, but he talked and laughed with them all the way through it.

He happily went for his chest xray, and then had time to visit with Abu Mohammed and Mazal, as well as the rest of us. We explained that we'd need to take his mom to the emergency room, and then I went to check on him after several hours. After a few more hours, he called me to check on his mom. Once we joined him again in the ward, he was in his pyjamas, sporting a balloon hat

which a visiting clown asked me to take to him when we passed one another in the hall. Both he and his mom were in a good and thankful frame of mind when I left them, receiving call after call from family in Iraq.

Please keep praying for Akram's story of miracles to continue with tomorrow's surgery. His mother is very thankful the time has finally come, but expressed the same sentiment as every parent I've known, stating that when her son is doing well, she will be doing well too. We look forward to that day very soon!

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Sunday, July 12, 2009

Long-Awaited Surgery Draws Near
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We are all encouraged that Akram is scheduled to have his long-awaited heart surgery one week from today. Last week the doctors asked us to bring him to the hospital for an isotope scan of his lung to be sure the valve placed during surgery was still working as well as it seemed to be. The results were good, and everything is still moving toward next week's anticipated surgery date. Everyone in the hospital seems to know and love Akram, and he's very comfortable there. We visited what I refer to as the "Akram Gallery" of some of his many drawings now posted around the hospital, and he clearly enjoyed using his smattering of Hebrew with the staff as well.

While we wait for Akram's surgery, we try to offer him an outlet for his extremely creative artistic giftings. He has made everything from sketches to clay sculptures, to models of the doctors using - what else? - tongue

depressors. He is a truly gifted young man who we all enjoy having with us, although it is clear he's ready to leave us for home as soon as possible. It's been nearly one and a half years since he's seen the land of Kurdistan and the rest of his family whom he loves. We're very thankful for all God has done to bring him this far, and look forward to seeing his healing completed through the surgery offered by the Save A Child's Heart team of doctors next week.

Please keep praying for Akram, as well as his mother. They're both excited, but also a bit anxious for this surgery to be finished. Let us carry them before the Lord and watch how He will answer our prayers.

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Monday
June 29, 2009

First View of An Ocean
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Akram had a great time at the beach today in Tel Aviv with Hamza, Mohammed and some volunteers. When we told him in the morning that we were going to the beach he became instantly excited, since in his stay here so far he had not been able to go. As we approached the sea the view was obstructed with tall buildings, and the Iraqis were leaning from one side to another trying to see around them to catch their first glimpse of such a body of water, and finally after a turn they were able to see it and yelled and applauded in excitement. Akram and I joked about being careful not to get into the water too deeply in case the sea water would fill his lung back up again and he would have to get the tubes put back in.

The joking didn't stop him though, after trying out going in just up to his knees for a minute, he went for it, and jumped all the way in. He and the other boys got together to jump in and play in the sand on the shore. He, along with the rest of us, tried to bury Mohammed up to his neck in sand but Mohammed quickly became claustrophobic and burst out; Akram even made a sand castle model of Jerusalem.

Akram's mother was not one to be left out, she jumped in twice with all her clothes on and had a wonderful time herself.

After expending all his energy Akram lounged in a beach chair, ate some snacks, and enjoyed the view of the ocean.

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Sunday, June 14, 2009

Playing At The Park
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Akram had a great time this week visiting a local park in Jerusalem. Since having his lung surgery, he has experienced a tremendous amount of newfound energy and mobility, so he has been very eager to get outdoors and put it to use. When we mentioned that we could go to the park, his eyes lit up and he couldn't wait.

When we got to the park, we made use of what we had and spent a good 20 minutes improvising a game of Frisbee with a dinner plate. It actually worked rather well.

After Frisbee Akram had a good time trying out some of the nearby exercise equipment and after he tried every machine, we spent the rest of our time in the playground. Akram needed a little encouragement to go down the tallest slide, so I went down with him. He probably didn't enjoy the dizziness from the merry-go-round as much as he had hoped, but we had an epic battle on the teeter totter that was great fun for everybody.

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Monday, June 1, 2009

Speedwalking Through The Jerusalem Zoo
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Akram was released to the house in Jerusalem Friday to spend a week away from the hospital after we received word that the infection was gone. To celebrate his return in the same fashion that we sent him to the hospital, we brought him again to the zoo.

The contrast in Akram's ability to walk around is very noticeable. Akram excitedly speedwalks everywhere he goes now. He told me that before his lung surgery he was always tired, but he's never tired anymore, and he proved it as he and I left everyone behind as we sped through all the exhibits at the zoo. If Akram is doing this well after just his lung surgery, it will certainly be amazing to see the improvement after his heart surgery!

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Thursday, May 28, 2009

Celebrating Akram's Dismissal With Food And Friends
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Akram was discharged to the Shevet Center in Jerusalem tonight, fully recovered from the surgery which has amazingly restored the function of his long-dormant right lung. We celebrated with a picnic on the hospital grounds which attracted not only other Iraqi families but also a cluster of mothers from Gaza whose children are in various stages of recovery from their heart surgeries.

Akram’s heart surgery is now expected sometime in July.

We expressed our thanks to God through the words of an Arabic worship song:

You are awesome, Oh God
Awesome in your love
Awesome in your faithfulness
Awesome in your freedom
Also awesome in your healing

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Tuesday, May 26, 2009

Biggest Bear Hug
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Akram was doing well today when we visited him at Wolfson Medical Center in Holon. He seems happier now being able to have the freedom to roam around, get games from the entertainment room he likes, and just get out of bed in general.

In revenge for a victory he achieved over me in dominos two days ago, I gave him a thrashing today in checkers. Our friendship managed to survive and when I asked for a picture he gave me a the biggest bear hug he could muster. The

atmosphere in his room is very positive and light hearted, with Shadi, Raged, and Hamza's grandmother all receiving good news.

On the second take of the picture, Akram's mother poked her head between Akram and me, and Hamza's grandmother contributed her handbag. It was very good to see them all happy.

Akram told me the other day, that before this surgery he was tired to walk even short distances, but on the way to the cafeteria he was walking even
faster than me! When I asked him what the hurry was, he said after the surgery, he doesn't feel tired any more.

He is now on day nine of a 14-day antibiotic treatment for the infection that developed after his lung tubes were removed. If an X-ray and other tests on Sunday or Monday reveal his infection is gone, he may be allowed to come home to Jerusalem as early as the same day. If everything is good, this should be the last major hurdle before his heart surgery.

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Monday, May 25, 2009

Antibiotics Clearing Up Infection
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We were glad to learn yesterday that Akram may be able to come to Jerusalem for at least a few days this weekend! While he continues to recover, he is enjoying the freedom to walk around the hospital without tubes connected anywhere. He still has to report to his room of course for medicines and blood tests, and meals. The blood tests are checking the success of the antibiotics in clearing up infection in his body from the site of the drainage tube formerly in his lung. If he continues to improve, we'll be glad to welcome him back here on Sunday afternoon.

Keep praying as God keeps working miracles in Akram's life. Remember to ask God for perseverance for Akram's mother too, who is counting the days that she's been away from her family in Iraq. She is a thankful mother but one who is also anxious to see her son fully healed so they can return home together -- that will be a joyful day for all of us!

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Tuesday, May 19, 2009

All Chest Tubes Removed
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After waiting more than a month and a half after his operation, Akram has finally had the last of the tubes in his chest removed. This marks an important step toward having the heart surgery which originally brought him to us so long ago. Unfortunately, after the tubes were removed Akram's wounds were found to be infected, so he is presently being treated with antibiotics. However, I'm sure he much prefers that to having tubes in his chest. Because of this new complication there is no way to know at this point when his heart surgery will be. After running around the hospital tending to other things, I returned to visit Akram to find him enjoying his newfound freedom on a computer in the entertainment room, and like a normal teenager, he was too occupied with what was on the screen to divert his attention to the camera.

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Monday, May 11, 2009

Keeping His Sense Of Humor
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Among the staff we've had numerous good visits with Akram lately, and have enjoyed seeing him grow stronger as he waits for his lung to heal. At various times while hanging out together we've played cards, worked on learning Arabic and English from each other, talked together about God, and shared meals. All of us love him, as do the others who meet him while sharing the hospital room. He has a great sense of humor which undoubtedly is helping him through this long waiting period, and makes our time together pleasant as well. Today he pretended to kick the drainage box out the door as we talked about our hopes he won't need it for much longer.

Yesterday was a follow up visit from his lung surgeon, and we were all anxious to hear the report. She came in during the morning and first took the 'vaccuum tube' off of the drainage device for his lung. After 4 hours we were told an x-ray would be done, and afterwards perhaps a decision made about removing the drainage tubes which still remain in his chest. We found out after a while that it w

ould be much later in the day when the x-ray was actually done, and then no report would be available till the doctor studied the film. We decided to come back to the house and follow up with a phone call. When I called back last night the nurse said that his x-ray was good, and the doctor would not reconnect the vacuum tube, meaning Akram could be fully mobile. But she decided not to remove the drainage tubes themselves quite yet. When we visited today we found out that they will do a follow up x-ray on Wednesday, and if it looks good, perhaps the tubes will come out then - great news! We hope to get a better idea then of when they think he'll be ready for his heart surgery, for at this time we do not know of a specific time-frame for putting him on the surgery schedule. Meanwhile Akram is free to walk around and enjoy the beautiful spring weather and flowers at the hospital grounds.

We've seen God answer so many prayers in Akram's life, and agree with Dr. Tamir's exclamation when he saw Akram last November in Amman after Akram spent 6 months recovering from the tuberculosis which nearly took his life: "He's a miracle!" We thank God for this, and look forward with anticipation at how He will work next. Please keep praying with us. Remember Akram's mother too as she waits with him in the hospital. She too is keeping her sense of humor, but is ready for Akram to be able to have his heart surgery. We are thankful that God's timing is perfect!

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Thursday, April 16, 2009
Released To Ward Ahead Of Schedule
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We received mostly good news about Akram today. When we went to visit him in
the ICU we discovered he was not there. To our surprise, he had been released to
the regular ward today, ahead of schedule. Akram seemed very happy to be out
in the ward where he could interact with the other patients and have more
visitors. While the doctors are very pleased with the progress of his lung,
which continues to expand, they have told us that Akram will be kept in the
hospital with a drainage tube for a full month after his surgery. Akram and his mother seem to have made many friends in the ward, so hopefully the remaining 20 days or so will fly by.

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Monday, April 13, 2009
Less Pain, More Joking
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Donna and I visited Akram today at Wolfson Medical Center in Tel Aviv. He has been recovering from surgery he underwent six days ago on his right lung. Akram was in much less pain today than when I last saw him. He was wide awake, smiling, and happy to have a conversation and joke around. He showed off how he could fool the sensors attached to him to make it appear on the monitor that he wasn’t breathing, and make his oxygen sensor fluctuate violently. He also tried to convince me the draining collection from his lung was Pepsi, but I didn’t buy it.

The real medical situation has been nothing but positive. The doctors seemed very pleased by how well his lung is now functioning, and joyful because of their personal interest in Akram’s healing. We hope that in as little as one week’s time he may have his chest tube removed so that he can be up and about. When Donna and I left, Akram and I exchanged a handshake we had been practicing together before he went in for surgery, and he seemed in very good spirits.

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Thursday, April 9, 2009
Akram's Lung Is Working Again!
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To our joy we found Akram able to smile when we entered the ICU tonight following the end of the holiday for the first day of Passover. The news from the medical staff was even more encouraging: Akram's long-dormant lung, once written off as dead by doctors in Iraq and Jordan, is now alive and functioning!

This is confirmed both by imaging done today and also by the rising levels of oxygen saturation in Akram's blood. During our short visit we saw this rise from 83% to 86% of normal.

An Israeli Arab nursing student named Mohammed was closely tending Akram tonight, which is a blessing for Akram and his mother since he can explain things to them in Arabic. Mohammed told me that once he graduates there is no other place he wants to work then right there in the Wolfson pediatric ICU, where he says he can work with both his head and his heart.

Akram is still in considerable pain, particularly in the area around his right armpit where the skilled surgeon went in. His mother is faithfully massaging the arm and shoulder, and we can do our part by continuing to support them both in prayer.

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Tuesday, April 7, 2009
Akram's Lung Freed At Last
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Akram underwent surgery at 11am this morning on his collapsed right lung, one of the lasting effects of his grueling bout with tuberculosis. (Click the arrow below to see a video clip of Akram being wheeled into the operating room.)

In order to accomplish this repair, the doctor made an incision between his ribs and removed necrotic tissue and scar tissue which inhibit his lung from functioning. After a four and a half hour surgery Akram emerged from the ER and was transferred to the ICU where we received good news.

All reports are that the operation was a success, his lung is now free of the offending tissue and the hope is that now his lung will begin to inflate, a process

which is expected to take several days. The one complication I became aware of in the ICU was that Akram's blood pressure post surgery was unusually low, but the ICU doctor said that he had become slightly over-sedated and that it was not a serious problem. Akram has a long recovery ahead of him as this special surgery will require him to remain in the hospital up to a month, much of which he will spend with tubes inserted in his chest, as shown in the X-ray, for drainage.

Those on our staff who first met Akram in Jordan a year ago are especially grateful today, as we remember discussions with doctors there who judged at the time that his lung was dead and should be removed.

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Monday
April 6, 2009
Admitted for Surgery
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We brought Akram to Wolfson Medical Center in Tel Aviv today to be admitted
for his first surgery which is scheduled for Tuesday morning. Before we left Jerusalem Akram had a host of visitors and staff pray over him which was fitting after the spiritual journey Akram has undertaken the past few days along with the arduous physical journey that is well underway.

Akram will be kept in the hospital for at least two weeks and up to one month
after this surgery, so yesterday, rather than spending his last day of freedom cooped up inside I took him and his mother out for a little day trip. We stopped at a vista that looked out over the village of En Kerem, a small town bordering Jerusalem.

Akram's mother enjoyed the view and the flowers; Akram preferred a more fitting teenager activity: appropriating an unattended garden hose and spraying the countryside (and his mom and I just a little). Click the arrow below to play a short video.

We then entered En Kerem, where we visited a church on the site of St. John the Baptist's birth. Akram

and his mother enjoyed the church very much, taking time to reflect and pray, as well as appreciating the architecture, stained glass, renaissance paintings, marble work, and iconography found about the sanctuary. After hearing of Akram's journey thus far the Franciscan monk caretaker offered to have Akram blessed by the deacon. Akram was excited to receive a blessing, but I was disappointed that Akram wouldn't be able to understand a blessing done in English. To my surprise, after sharing my concern with the deacon, he switched to speaking Arabic without missing a beat and blessed Akram and prayed over him for his surgeries.

Akram had requested visiting The Garden Tomb, an alternative resurrection site for Jesus which is in a beautiful garden; so this morning after saying goodbye to everyone at the Shevet house we stopped by The Garden Tomb on the way to the hospital. Akram and his mother enjoyed wandering the garden, the calmness of which markedly contrasted with the impending surgery. After asking Donna about a stone pulpit at the site, and grasping what it was, Akram requested I deliver an impromptu sermon, to which I insisted we read the Scriptures provided in the pamphlet together; he happily obliged.

All around there was life springing up, flowers even sprouting out of split rocks. I found this to be not only a beautiful metaphor for the resurrection of Jesus, but for Akram as well, his incredible journey so far and the tremendous pain and difficulty he must undergo for what we believe will be new life when all is said and done. They even bear similar wounds, Akram having a terrible gash in his side where he has had previous lung operations, which tomorrow morning will be reopened once again.

After arriving at the hospital we got Akram and his mother situated in their room, and took Akram to be X-rayed, to have blood work done and lines put in his arm. I have stayed nearby Akram for moral support throughout the last few days and I wanted to be there for him especially when he was suffering the pain

of the needles. Akram showed more courage in this than I did, returning to a state of calm immediately after the painful parts were over. While I have seen many grizzly things in my time at Shevet, it was an especially humid today in Tel Aviv, and watching Akram get stuck in addition to the humidity proved a bit too much for me and I had to remove myself for a couple minutes out of fear I would faint (it was from the humidity, I promise). But everything on Akram's end was handled smoothly, when all was said and done, Akram and his mother were comfortable in their room, Akram doing some drawing, one of his many talents, his mother, encouraging him to eat more, one of hers. Donna and I prayed over Akram and his mother, exchanged hugs and kisses and promised to see them again the next morning for the surgery.

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Friday, March 27, 2009
A Trip To The Zoo
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Akram has been home with us in Jerusalem for several days now, and it has been apparent that the idleness of being at home has been wearing on him. Akram is the only male living at Shevet over the age of 3 aside from myself, so he has been secluding himself quite a bit.

With the day off from other work, I was able to take Akram out of the house to get away for a few hours. Akram and I went to the Jerusalem Zoo and had a great time hanging out, and looking at all the animals. We sat down by the chimpanzee exhibit for lunch and had a few good laughs at their antics. However, Akram would not believe that Americans enjoy the taste of peanut butter and jelly sandwiches
which I packed for our lunch. He kept to the fruit.

Akram did an impressive job walking around the park, though it was difficult to see him struggling and coughing; he couldn't make the climb to several exhibits. I hope you will join me in praying for Akram, that by the time he returns to Iraq he will know this difficulty only as a memory.

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Sunday, March 22, 2009
Trying to Restore Akram's Lung
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After his bronchoscopy and subsequent catheterization last Thursday Akram developed a very high fever. Through the weekend Akram fought this and found himself in slightly better spirits this morning. This sickness brought out flashes of the decrepit, pale young man whose body was once wrought with TB. Through it though a weak smile emerged chasing away the defeated infirmity.

We learned that on Thursday the medical team of Wolfson will be meeting with a TB specialist to determine if one of Akram's lungs can be made to work again. It was generally thought that the TB had completely incapacitated his right lung. There is concern that while Akram's surgery will not be that difficult his recovery may by dangerous. When a child has corrective heart surgery the change in physiology is extremely taxing on the lungs. With only one lung Akram's body will be severely challenged to accept the corrected heart.

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Thursday, March 19, 2009
Tired And In Pain
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Today Akram was not feeling so bright as he was recovering from the bronchoscopy yesterday followed by a cardiac catheterization. The latter had left him with pain in his groin and he was very tired. We pray that tonight he will have a good sleep and be fit to return to Jerusalem to await his call to go for surgery. The good news was that he was cleared of all traces of tuberculosis, which had debilitated him in Jordan. Two consultants spent time this afternoon discussing the complexity of his surgery. We pray that the peace of God will continue to rest on this young man and his mother and that soon he will be completely healed.

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Wednesday, March 18, 2009
Bronchoscopy Shows Total Healing From TB
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When we left the hospital yesterday, we thought Akram would be the first catheterization of the day today, so we expected to arrive at the hospital early to be with him and his mother. I called early to check the schedule again, and found out he would be the second or third cath of the day. Alex and I left in time to be with them, but when we got there, found Akram already in the ICU for the bronchoscopy. The doctors would not allow pictures, but from another part of the ICU area we could see the video screen of the inside of the lungs while the test was being done. I had no medical idea exactly what I was seeing, but it looked like healthy tissue to my untrained eye. When the test was finished I was able to go into the room with Um ("mother of") Akram while Akram slept, and we were told he would go straight from there to the catheterization lab.

Instead there was a detour back to the ward because the second catheterization had not finished. Alex and I left them to quickly eat lunch, and when we returned found that Akram had just gone upstairs for the catheterization. We found him groggy but awake, and after a few minutes Dr. Alona came in to give us the news from the bronchoscopy. Praise to God, the bronchoscopy showed Akram is totally healed of tuberculosis! His mother was thankful, but Akram was delighted! We all thank the Lord for His good work in Akram's body so far, and look ahead to His completion of it.

Just a few minutes later Akram was ready to go to the cath lab, and was able to walk in on his own. It seems to those of us here that since Akram's time in Jordan, Akram's mom is having to make the adjustment all mothers must make when our sons get older and begin to act like men ... too big to be mothered any more. So she said goodbye and we waited for the hour and a quarter together. When the test was finished, Dr. Alona said it went well, and they would schedule him for surgery after testing the pulmonary effusion of his right lung to determine how much it is contributing to his respiratory system. This is the lung which was most damaged by the tuberculosis.

Once Akram got back to his room he was having chills from the long day of testing and anesthesia. We left him doing well, and once again glad his mom was around to help comfort him and keep the blankets piled on.

As we pray, let's first give God great thanks for the miracle He's already done to save Akram's life. He has a drive and focus now to live - what a change from the young man who came to Jordan last year expecting to die! We are trusting that God has the perfect timing for every part of Akram's life, including this surgery. Pray for peace for Um Akram while they wait until the surgery is scheduled. We look forward to having them back here with us to watch how God's plan will come about.

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Tuesday, March 17, 2009
Preparing For Tomorrow's Catheterization
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Monday Akram had his first visit to Wolfson and his preliminary checks for surgery, including his echocardiograph. What a cool relaxed young man, so vastly different from last year in Jordan. But he has his war wounds from treatment in Jordan which he delighted to show anyone interested.

He has been through so much but is now a gentle, kind young man looking forward

to his cardiac catheterisation and bronchoscopy Wednesday. These assessments will clear the way for him to go forward for surgery.

At 11am Tuesday we received word in Jerusalem that he was to go down to Wolfson as soon as possible. Together as a group we prayed God's blessing over him and soon we were entering the hospital. He was very calm, and the peace of God shone through clearly as well as a cheeky grin.

Please continue to pray for this awesome young man who has put his life in the hands of the Master and the Israeli team. Akram's mother is very anxious. Please lift her up before the throne of grace often.

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