Karim's Heart Surgery

Tuesday, April 1, 2008
Weeping With Those Who Weep
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I have no pictures to show you of the past week's events other than the ones I can paint with my words..... yet words will not convey what the past week has held. I will share with you some of my experiences and impressions about them as best I can. If I can make one overarching comment about it, I will say that our God is the God of ALL, in every way, in all of the joys and all of the sorrows.

As you know, Karim did not survive the doctors' third attempt at heart surgery. When we found out this news, we were stunned but immediately began to do everything we could to help Karim's mother, and to deal with the many details involved in moving the body. She was hysterical in her grief. I was so thankful I was not there alone, but had Keleigh and Alex to help - it took all of us to manage everything happening - and that our Kurdish translator could speak the heart language of this mourning woman and help her understand, release her grief, and yet keep a bit of control over her display of emotions.

We went back to Haifa where Pastor Philip and his congregation had met Karim and his mother when they'd arrived, and who Karim's mom had called often, including earlier that day before Karim's surgery. At this point in time however, there was only bitter grief in her heart, and she was not able to receive any consolation from anyone. The mothers with whom she'd travelled from Iraq and Amman into Israel were all reminders of her emptiness since their children were still living and hers was not. One of the mothers came espcially to comfort her, but she sent her away, even cursing her in her blind grief. Since it was impossible for the women to share an apartment under these conditions, it was a blessing that the family in the adjacent building, with whom Karim's mother had become friends before Karim was moved to Tel Aviv, invited her to their home for the night. She seemed calmed there, although she was inconsolable. We left her there after seeing that she had someone to sit with her through the night, and from whom she would receive comfort, and we drove back to Jerusalem.

After some much-needed sleep, we all worked together on how to plan the travel back to Iraq. There were so many details to be worked out in all three countries involved, and it took many calls and lots of teamwork to manage them. Again I praise God for His body of brothers and sisters connected by our love for Him. I prepared to go back to Haifa to be the escort to Amman, and left in late afternoon on the bus. Pastor Philip, his wife and one of their sons met me at the bus station. We went straight to the apartment where Karim's mother was staying, and when she saw me, Philip and I became a target for the anger of her disappointment. We all talked with her and settled her with prayer, and it was decided that it would not be helpful for me to stay with her that night since the family she was with wanted to continue to have her in their home. God provided me the opportunity to stay with Pastor Philip's family instead.

When we left Karim's mother, we went across to the apartment where Lozan and Kale are staying. It was my first opportunity to meet these families , and I was struck by the contrast of the situations and circumstances I was experiencing. God was present and aware of every detail ... I began to hear Romans 11:33-36 going through my head:

Oh, the depth of the riches of the wisdom and knowledge of God! How unsearchable his judgments,and his paths beyond tracing out! Who has known the mind of the Lord? Or who has been his counselor? Who has ever given to God, that God should repay him? For from him and through him and to him are all things.

Although sad about Karim's death, and grieving with his mother, here in this apartment one of the mothers went to get some worship songbooks so we could sing together in praise to the Lord. She was rightly expressing her thanksgiving for her daughter's successful surgery. After the excruciatingly intense and painful events of the previous days, this was such an encouragement to me.

It was decided that since my presence had caused Karim's mother to have such a strong reaction the night before, I would accompany Kale and Lozan to their hospital check-ups on Thursday morning. As I went with Pastor Philip and these ladies and daughters, I had another blessing in the midst of the struggles of the week - I got to see Sana again! She and her mother came into the waiting room for Sana's tests after dismissal, and we were all delighted to see one another. After just a little while it was time for me to go to the apartment and join Karim's mom as we began what I have called the long funeral procession home. We had gotten all the paperwork done so that the body could leave Israel and enter Jordan, and were meeting the ambulance at the crossing. I knew this would be a very difficult time of "reunion," and wondered if there would be a repeat of the violent grief shown at the hospital. When she understood that it was time to go, and that Karim would be waiting for us at the border, she left the home of her friends without a fuss, throuhg great physical effort because of her sadness. The rest of our trip was filled with weeping and mourning songs.... and we wept with her along the way as she expressed her broken heart.

When we arrived at the border, everything had been done to help us get through as easily as possible. I am so thankful for the relationships we have on both sides now which allowed the maximum amount of compassion to be shown to this woman in her hour of need. The authorities made the decision to allow the transfer of the body within the border of Israel, so it was in the back of the ambulance that she was reunited with her son's body. Although I had been concerned that she would collapse again, she instead was comforted by being there with him. We rode together up to Amman; Karim's mother and his body, Keleigh, Fred and me, and a Red Crescent driver and assistant.

Since all of our usual accommodations in Amman were filled with patients awaiting transfer to Israel, or going home after successful surgery, we did not have a plan for where we might stay, but knew that God did have a place for us. Our planning had to be spontaneous based on the legal issues involving moving the body, so we continued turning to God with our requests and trusted Him to work. We were reminded of a contact we'd made just a few days before who had connections in Amman, and asked him about a place to stay. After only a few hours we were blessed with a lovely apartment and two new friends in Christ who opened their home to us when we arrived on Thursday evening.

Because there are no flights from Amman on Friday, the sabbath there, we had a little extra time for the details of travel into Iraq, yet the sabbath also meant that government offices were closed. We again didn't know how God would work things together, but found that the network of officials needed in such circumstances were willing to help us as much as possible even on the sabbath, and we were hopeful that we could indeed fly out on Saturday morning to Iraq. Karim's mother rested on Friday while we handled the details needed and purchased a ticket for my travel after it was decided I would be the one to accompany her home. Her prior anger expressed toward me evaporated as her grieving process continued, and she didn't want me out of her sight. It took all three of the Shevet volunteers on the ground to manage everything, and our hosts made us feel at home throughout the process, which was a blessing.

On Saturday morning, Diyka Karim seemed to enter a different phase of grief as she prepared to go home. She was more subdued and was weeping instead of wailing. When we arrived at the airport, as soon as we entered the terminal to await the flight, God blessed us with a family sitting beside Karim's mother who spoke English and were going to the same city we were. God reminded me of the many times we'd brought mothers and children to the airport and found families for them to talk with and be looked out for as they returned to their respective cities.... and now He was doing the same for us as we were the ones flying and needing help. What a wonderful Lord we serve! Little did I realize how vital the man's help would be. He translated and even accompanied the airport officials once we arrived in Iraq to help with the release of the body there. His wife was able to be a special comfort to Karim's mother as I needed to focus on some of the details of travelling this final leg of the journey, with Keleigh and Fred's assistance. Truly, without teamwork and all those God brought alongside us, we could not have done all that was required. But our God is a defender of the widow and near to the brokenhearted, and helped us all the way.

After a flight punctuated by mourning songs on the plane, and the compassionate assistance of the airline staff, we arrived at our city. The family God brought alongside remained with me and Karim's mother until the body was cleared to leave the airport grounds and be turned over to the family. It was at that time that the family ran towards the airport vehicle and surrounded the casket with weeping and wailing, and I was quickly escorted away to join some of our connections here who are my hosts. It was here that I experienced another of the extreme contrasts of the week... leaving a place of heavy mourning which surrounded that vehicle, and stepping into a group of encouragers who were there to provide for and comfort me, while praise music filled their vehicle. Truly our God is the God of all.

My host here went to the funeral in Karim's family's city on Sunday. His body was buried immediately upon arrival there, but the funeral itself is still ongoing, lasting for three days. I have had them on my heart continuously, and am thankful for every prayer that has been spoken for them, and for us as we've ministered to them. Even in the intensity of the past week, God has blessed me greatly in this experience. I will share the many ways He has also allowed me to rejoice with those who rejoice, in a separate blog. Thank you for all of your prayers.

11:00 pm Tuesday
March 25, 2008
Karim Died Today
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The day started around 3:30 am for Donna. She called me around 4:00 am to let me know Karim might not make it through the latest resuscitation. So I went to the hospital and met up with a very tired, but strong in character, Donna Petrel. She had about two hours of sleep that night on a waiting room couch. Donna and Karim's mother were in the conversation room, which is the room where they go to have difficult conversations about their loved ones. There are pictures of children all over the walls; some of them success stories, others not. The doctors take them there. The mother hadn't eaten and pretty much had not slept in several days. She had small naps here and there.

When I got there, Karim had stabilized a little bit. The blood pressure had quit dropping, unlike hours before when the ICU staff thought it was the end. I went in to see Karim at his bedside and I looked around at the medication that was being given to him. At one point Donna counted all the infusions and there were at least 12. For instance, one of the infusions was a giant needle of adrenalin. To have a perspective on Karim's mother, you may have to have lost someone yourself. She had lost her husband due to the harsh reign of Saddam Hussein, and was now facing the perspective of losing her youngest son, through the reign of heart disease. She does not grieve quietly. For her and culturally, the way that she processes anxiety is one that manifests itself through flailing arms, grabbing people suddenly, shrieking, and kissing the Quran and caressing her son on the table. To be very fair to her, it's part of her personality and part of the culture to have very dramatic outward expressions of worry and grief. In her country, this would be expected of her.

I felt at one point that the doctors were saying that the condition was not changing. It was not hopeful but they were going to continue giving him these medications. I left for a period of time to run some errands in Tel Aviv and received a very encouraging phone call from Donna announcing that they had decided to do a heroic surgery for him. It means a last-ditch effort at trying to save him. The risk was off-the-charts high. The only other option was to surely watch him die on all these medications. Opening a closed artery could have begun to heal his heart. We were all hopeful. We shared with the entire Shevet team the news of this ray of light.

Preparation for the surgery was going to last as long as the surgery itself. They actually brought him in an ambulance from the ICU to the operating theatre, which wasn't far, but they had to do this in order to have all his medications with him. The ambulance driver did a double-take when he saw all the medications.

The operation began, and about an hour and half into it, around 3:45, Keleigh called to say that he had died during the procedure. The doctor came out to try to share what happened and the mother began to be inconsolable. It took a crew of people to try to escort her out of the public area in order to try to calm her down. Donna, Keleigh, Alex and the loving translator Suzan took five or six hours to do so. There were periods of quiet, there were lulls.

We've taken Karim's mother to spend the night in Haifa, and are now here in the car discussing how to explain this to you and to the readers. The most obvious thing is that God is in control no matter what we see. Most of our prayer time in the car was about trusting in the Lord. Two songs that came to mind were: How Great Is Our God, and Blessed Be Your Name. So here we are trusting God on the way home from Haifa, where the believers there need prayer trying to console her.

Tomorrow we'll be bringing the body by ambulance to the Jordanian border, and it will be met by another vehicle on the Jordan side, and then transported up to Amman. Thursday morning Karim's mother will board a plane with the casket and fly home.

It is difficult to be in this place, but God has always called us to be in the middle of others' sufferings.

Tuesday, March 25, 2008
Karim Having Surgery at Noon Today
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I've just spoken with Donna on the phone. (Donna spent the night caring for Karim's mother and praying at Karim's bedside.) Donna says that Karim will have another surgery at noon today, Israel time. The doctor performed an echocardiogram today, and found that one artery between the atria of the heart is not large enough. Though the surgeon has already enlarged it once, he wants to try again, in an attempt to relieve pressure from the other side of the heart.

Donna asks that we pray fervently not only for Karim's surgery, but for Karim's mother. After a hellish night including four hours in the emergency room, Karim's mother is being treated for a urinary tract infection and nausea. And her emotions are "maxxed out."

Rules on picture-taking are strict, and Donna feels it would not be appropriate or respectful to photograph Karim in his current condition.

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Monday, March 24, 2008
Karim Stable, Kurdish Angel Appears
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Because of Karim’s critical condition the Shevet team is attempting to provide someone to be with his mother around the clock. Last night I stayed with her. In one way I feel a prayer has been answered. About an hour after I arrived last night I was sitting in the waiting room with Karim’s mother when all of a sudden a man (a Kurdish Jew?) overheard her speaking on the phone in Kurdish. He asked her in Kurdish if she was the mother of Karim and she said “yes!” Immediately the two engaged in conversation. Tears of joy filled her eyes as she was able to finally communicate with someone her age. While he was visiting he was able to speak with her family in Iraq and give them an update. Today that same man brought his wife and daughter up to the hospital for another visit. They are a wonderful family who has taken on part of the responsibility of caring for her. Praise God for this blessing!

Donna has taken the night shift this evening. Please pray for her. She will be sleeping at the hospital comforting Karim’s mother. I recently called her for an update and she informed me that she is currently in the emergency room with Karim’s mother. She is being treated for dehydration and possibly some type of kidney or stomach problem. She was going in for x-rays as we were getting off of the phone. It is not only her health that is becoming a problem but also her mental state. Today she sat on the floor at Karim’s bedside for hours praying,
chanting and crying. She is also without sleep.

As for Karim, his circumstances have not changed. He remains in a relatively stable state. There was never a need for resuscitation today although his heart remains weak and his blood pressure is very low. I would like to encourage everyone to continue to pray. If this child lives it will be because we as a body of believers have requested this of God.

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Sunday, March 23, 2008
Desperate Love
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Dear ones, I hope not to sound melodramatic in today's blog, but instead to try to bring you inside the work of Shevet Achim as we experience it with all of our human limitations and dependency on God's mighty strength. It is my prayer that it will spur your prayers.

If it was humanly possible to somehow produce the miracle of saving the life of one's child, every parent faced with the situation of Karim's mother would do so. I spent the last 24 hours watching her act out of desperate love to find such a miracle in an intensely helpless situation. Besides being emotionally drained and exhausted, she is unable to eat or drink and has hardly slept, according to the nurses, so she is physically exhausted too. It was in this condition that she received the news yesterday afternoon through our Kurdish translators that her son's heart was only being kept beating with machines and medicines and that perhaps a transplant was the only hope. From that point on she began calling everyone she could to have us tell them over and over "everything the doctor said." She would also call others and hand the phone to the medical staff so they could tell her the same news over and over again. It was difficult to settle her down long enough to know whether she was beginning to understand, because she would walk away and make another call and hand someone the phone. These dear translators did a wonderful job trying to explain, encourage and calm Karim's mother. Despite everyone's efforts she was comfortless; many times through the night I wondered what my reactions would be if I were dealing with the same trauma.

I continually offered her food and drink for some strength, and she continually refused...wanting only to be with Karim. My coworker Keleigh's company and attention were a sort of anchor to her in the afternoon, because they had formed a relationship in the past weeks, but when she left, Karim's mother decided I was a reasonable substitute to help. After a few hours she began to pull me with her wherever she went; when she prayed for Karim, I prayed for them both. I let her know this is what I was doing, and it seemed to settle her a little. Sometimes she would sit beside me in the waiting room and then lay her head over in my lap and moan...and I prayed the Lord's presence would minister to her broken heart. I tried to get her to sleep in the hospital's room for parents, but she refused. She eventually posted me in the waiting room and went inside to sit with Karim around midnight, but came out a little later to pull me in, post me by his bed, and disappear. I was not sure where she went, but after an hour, hoped she was sleeping. I went out and found her indeed asleep, apparently settled because her son was not alone in the ICU. She slept for about five hours, and came into the room shortly after sunrise this morning.

I had been watching daylight appear in a reflection of a hospital window, remembering today all over the world many people were celebrating Resurrection Sunday. I thanked God that here in Israel today the celebration of the defeat of Haman in the Esther story, and the defeat of sin by the sacrifice of Jesus, the perfect Lamb of God, were being celebrated on the same day. I prayed that we would see the miraculous manifestation of God's salvation demonstrated in the restoration of Karim's body by God's life-giving touch. I continue to believe for it at this hour.

As doctors began their early morning rounds, she nudged me each time to talk with them, though I assured her when they finished talking among themselves I would do so. After the surgeon came in he surprised me by saying he was a little optimistic that although Karim was very critical, he might have a 50-50 chance to recover, and since he had been stable for the past 24 hours, they would try to close the chest either today or tomorrow pending his continued stability. Then it would be a waiting period to see if his body could become strong again and heal, a period which would take probably at least two weeks. After I spoke with the translators about this to pass the news on, the mother's phone rang, and she left the room for a few minutes. She came back in and took my hand and walked me to the surgeon's office, apparently convinced that another surgery would be what would help Karim. The doctor -- all of the staff -- was kind and gentle and patient with this dear mother as she called the translators and had several conversations. The fact there was not a surgery scheduled really upset her, although in reality we'd gotten a tiny glimmer of hope in the morning's report.

As we re-entered the ICU we found a screen in front of Karim's room and were told we must leave immediately, for he was being resuscitated again. It became a momentary challenge to keep her out of the room, but she suddenly dropped to the floor outside and began to cry out again to God for the life of her son. She prayed and sang prayers and recited the names of God on her prayer beads as she focused her attention on getting God's attention. Several times she arose to try to go in, and on one of those occasions a doctor came and told me that Karim could die at any moment. As I called Alex in our Jerusalem office to prepare him for this possibility and he took the time to pray, he made a statement which was stabilizing for me of God's total power in such times, so that we can only stand back and let Him be God even when we do not understand His ways. Simultaneously Karim's mother was back on the floor, and I joined her there as she began to thank God even in her desperation. She noted who He is, and called out for her son's life. I thought on the reality that He is the God who hears, and the God who knows everything which is in every heart.

After a short time, Karim's mother opened the door again and began to go inside without hesitation. I admit I was braced for the worst, but instead found Karim in stable condition again on his bed and the ICU calm. In the hours that followed I spoke with the nurses on duty and a few of the doctors who said that this event was a big set-back, and that they of course could not consider closing the chest now. We learned later in the afternoon that one of Karim's kidneys has failed and that his liver is beginning to fail as well. We continue to pray for the same power that raised Jesus from the grave to raise Karim to life and health, for God's great glory.

Karim's mother needs intense prayer, as do we, as those who are beside her at this time. Please join us in looking to God for what only He can do for Karim, for his mother, and for us. We are keeping volunteers with this dear woman round the clock to provide the Lord to a chance to use us to comfort and strengthen her. We will continue to inform you about what is happening.

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Shabbat, March 22, 2008
Surgeon Sees Transplant as Only Option
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The doctors came to Shevet worker Keleigh Glisson this warm Shabbat afternoon with a new assessment from the surgeon about Karim's condition. At this point Tel Hashomer's pediatric surgeon is saying that Karim needs a heart transplant. He continued by saying that Karim is a poor candidate to be put on a list for a transplant because of his tourist status and other medical conditions such as seizures and renal problems.

Strong medications are the only thing keeping his heart functioning at this point. When the medical team tries to wean him off the medications the right side of his heart collapses and he enters cardiac failure. The ICU doctor remarked that he has not seen patients recover from this.

Friends, let us pray our good Lord will give an example of his power to this ICU doctor by bringing our dear friend Karim back from this brink. Also pray for the Shevet team here as we look to Israeli officials for help with the heart transplant issue and offer Karim's mother the comfort of our Lord.

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Friday, March 21, 2008
Karim Made It Through the Night
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Last night Karim’s mother was very emotional. She told us she had a feeling that God was going to take her child. This morning she seemed to be doing better. Doctors reiterated that Karim's condition is very serious and that we could lose him at any moment. As you can see from the pictures, Karim hardly looks like the same boy who went into surgery over a week ago.

The good news is that he made it through the night. His nurse informed me that he probably will not show any signs of improvement for at least a few days; all they are looking for at this point is for Karim to stay alive.

We have heard of so many people all over the world praying for Karim. I really believe this is what has sustained his life thus far. Please continue to pray! Pray that Karim would immediately begin to show signs of improvement. Pray for wisdom for us--the Shevet team--as we try to provide continual comfort to Karim's mother during this difficult time.

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Thursday, March 20, 2008
Karim Resuscitated After Cardiac Arrest
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We visited Karim in the hospital today to help comfort his mother. Karim is having a difficult time recuperating after his surgery. His blood pressure is dangerously low and his heart is having a hard time pumping his blood after the surgery. One of the Iraqi mothers who speaks Kurdish was with us, and was doing her best to comfort Karim's mother.

Shortly after we arrived Karim went into cardiac arrest and had to be resuscitated. One of the doctors leaving several hours later seemed to say that Karim was stable, but the look on his face told a different story, and we did not hear anything from the doctors after that.

We did our best to tell the mother that her son was going through a difficult time without telling her how grave the situation was, but the mother's intuition had her on the floor in tears, praying that her son would be restored.

Please pray that Karim is able to make a full recovery. He is in a big fight right now. Pray also for the health and comfort of his mother who is so alone at the hospital--no one there speaks her language and the other mothers have their own children to worry about as well.

We have no new pictures to include this time, because we were not even allowed to enter the ICU. But by clicking the play arrow below you may see a brief video of the mother's bedside vigil taken late Wednesday night.

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Wednesday, March 19, 2008
Second Emergency Surgery Tonight
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When Karim arrived in Israel from Iraq, doctors found his heart defect so complex that he was referred to Tel HaShomer, Israel’s largest hospital. Since his heart surgery last Monday they’ve been fighting to stabilize him, and tonight he was rushed back to the OR for a second emergency surgery.

Karim’s mother pulled back his blanket when I visited tonight after the surgery. I think she wants to share with us the trauma of seeing her beloved son between life and death, his chest left open in case doctors have to quickly go back in. Please let this encourage us to pray for Karim and his mother.

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Monday, March 17, 2008
Shifting Between Stable and Unstable
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We were able to speak with Karim's doctors yesterday. They informed us that his condition is continually shifting from stable to unstable. Karim's heart is not strong enough to pump blood to his entire body and is beating irregularly. In addition, he has acquired some type of infection and fluid in his lungs. The doctors have asked the head of cardiology if there is anything more that can be done to help improve his condition, but they were informed that all has been done.

Karim's mother has been comforted by another mother from Gaza whose child is also in the hospital; however, that mother is scheduled to return to Gaza today, leaving Karim's mother all alone. Yesterday we were able to spend a few hours with her, but she was still very upset when we left.

Please continue to pray for Karim's overall recovery and his mother's isolation. Pray that God would send someone to comfort her and help her carry this burden.

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Tuesday, March 11, 2008
Karim in Fairly Stable Condition
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Today we were able to visit Karim and his mother at the hospital, accompanied by an interpreter. Karim remains in the ICU in a fairly stable condition. The doctors informed us that they were able to repair the hole in his heart and move a valve in order to help correct the enlarged upper right chamber of his heart.

Karim's mother wanted to know why many of the other children in the ICU were awake already. The doctors explained to her that Karim’s surgery was more complicated than most. His blood pressure remains very low so they are keeping him sedated, but they will continue to assess his situation in order to
determine the appropriate time to reduce the sedation.

Please pray that Karim’s blood pressure will grow stronger and for his overall recovery. Also pray for his mother’s loneliness and isolation during this time.

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Monday, March 10, 2008
Today's Surgery Long But Successful
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Karim’s surgery took place today and ended up taking longer than expected. He went into surgery at 8:30 a.m. and we didn’t hear anything from the doctors until around 2:00 p.m. The doctors informed us that the operation was successful, but because Tel HaShomer Hospital isn’t a hospital that Shevet Achim normally works with, the doctors were reluctant to give any details on the success of the surgery. In addition, cameras were not allowed in the ICU. Hopefully tomorrow we will have a better understanding of Karim’s circumstances and we will be able to take some photos.

Karim’s mother (pictured above on the left side of the photo) only speaks Kurdish, which was a bit of an obstacle. Today two other mothers who spoke both Kurdish and English were able to comfort her during the operation and do some translating once we were able to speak to the doctors.

Please pray for Karim to remain in stable condition throughout the night and for his overall recovery. Also pray for his mother, who feels isolated due to the language barrier and continues to be very worried about her son.

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Sunday, March 9, 2008
In Good Spirits On Eve of Surgery
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Karim is very excited about his surgery that is scheduled to take place tomorrow (Monday, March 10, 2008). Today he was transferred from Haifa to Tel HaShomer Hospital in Tel Aviv.

Today we spent time with him and his mother while awaiting one last echo before his surgery and his admittance into the hospital. Both he and his mother seemed in very good spirits, although the smile on his mother's face quickly turned to tears once she heard the sound of her son's heartbeat during the echocardiogram. His mother is very scared and the language barrier no doubt contributes to this. In addition, the doctors are unsure if his surgery will be done in one operation or a series of operations. His condition is very severe.

Please pray that the doctors would have wisdom in deciding how to handle Karim’s unique case, that his surgery will be successful. And pray for Karim’s mother who feels very alone during this scary time in a country where she is only able to communicate with one or two people.

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Thursday, February 28, 2008
Eager to Begin Treatment
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Karim was glad to see us on Tuesday, and was quite talkative. Only problem is, I didn't understand what he was saying. Karim was glad to be able to sit and talk to another male figure as he has been in the apartment waiting for news on his surgery with all women and girls. Please pray for Karim and his mom who is anxious to see the healing process begin. We had an excellent opportunity to pray with Karim who said "yes" over and over as we prayed.

Today we took Karim to hospital because he was complaining about chest pains and difficulty breathing. After the doctors looked at him, they prescribed some medication and sent him back to the apartment as they continue to wait on the hospital to make the final arrangements concerning his surgery. Karim was in good spirits but is biting at the bit to begin his treatment so he can go back home.

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Tuesday, February 12, 2008
First Echo Brings Laughs, And a Challenge
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Karim sat timidly this morning awaiting his first echo in Israel. The pediatric cardiologist who invited Karim to Israel, Dr. Avraham Lorber, introduced himself with a handshake and warm smile before bringing Karim into the examination room.

As soon as Dr. Lorber placed began trying to perform the echo Karim got a case of the giggles. Lorber continually told him to be still, that he was a big boy, and that this was not helping.

Unfortunately his laughter was contagious and spread to Lorber and the staff. This of course drew out the procedure but at least we were all laughing.

During the echo we discovered that Karim has a large hole in the upper ventricle of his heart. This prolonged condition has caused an additional problem. Karim’s upper right chamber of his heart has been enlarged over the years due to the unchecked hole. This ventricle now makes up for 70% of Karim’s heart. Karim will have a catheterization tomorrow to further explore the problem.

What originally was a simple repair is now complicated by the enlarged chamber and the strain it has put on the valves of the heart. Please pray that we all keep laughing and see the joy of the Lord’s work amidst difficulties to come.

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