Updates on Samaah

Born on August 25, 2006, Samaah is back in Saskatoon after spending her first few days in Stollery Children's Hospital in Edmonton.

Thursday, August 31, 2006

Just spoke to Hassan, and the doctors have decided to keep Samaah off the heart/lung machine that was helping her breathe/pump blood prior to the surgery.

Insha Allah, they will be monitoring her very closely for the next 24 hours to ensure that Samaah is capable on her own.

Also, Hassan wanted to pass the following quick message to all:

“Jazakum Allah Khairyan to everyone and may Allah reward all of you.”
Alhamdullilah, the surgery has just been completed. The doctors sound optimistic, however the next 24 hours is an extremely critical time and will help determine the success of this procedure.

May Allah make it easy for them.
Samaah has gone into surgery now. Please make dua for Allah to make this time easy for Samaah, Naila and Hassan.

I just spoke to Naila and she wanted to pass this dua along to everyone:

"May Allah forgive us all. May He shower us with His mercy and blessings. May He place peace and happiness in everyone's heart. May He grant us only what is best and save everyone a spot in Janaah. Ameen."

May Allah reward all of you for taking a few moments from your time to ask the Almightly for the ease, patience, understanding, wisdom, and the many countless blessings that he has bestowed on Naila, Hassan and all of us. Ameen.

May Allah also reward all of you for praying for Samaah, so that He in His Infinite Wisdom grants what is best for her. Ameen.
Surgery has been moved to 11AM Edmonton time (1PM our time) insha Allah. Allah knows best.

Wednesday, August 30, 2006

Surgery is scheduled at 7:30AM Edmonton time (9:30AM Toronto time) tomorrow insha Allah.

Its supposed to take 4-5 hours, but may take longer depending on the progress of the surgery.

Please continue to make dua.
I talked to Hassan a couple hours ago and he says the surgery will happen tomorrow, inshaAllah. In the mean time, Samaah's getting stronger and stronger mashaAllah and is beginning to open her eyes a lot more now. Hassan says she has beautiful, black eyes. "Pure eyes."

May Allah protect her, give her complete health, and make her a source of pleasure for her parents in dunya and in akhirah.

Hassan and Naila are doing fine as well. Their strength and their belief in Allah (SWT) and His qadr should be an inspiration for all of us.
Alhamdullilah, Samaah is doing better each day with the help of the heart/lung machine. The doctors are pleased with her progress and feel she is ready for the surgery. They are also trying to ensure that after the surgery she will no longer require the heart/lung machine to help her breathe/pump blood.

However, the doctor performing the surgery has 2 other surgeries scheduled today, so it may be performed tomorrow insha Allah. Allah knows best.

Also, the doctors have informed Hassan and Naila of the risks/complications that stem from this type of surgery. There are a lot of unknown variables that can prove to have consequence, so insha Allah please keep making lots of dua for Samaah and her parents.

Tuesday, August 29, 2006

Dr. Kashif Yousuf's update on the technical aspects of Samaah's condition:


This is just a follow-up Samaah’s current medical condition. If you are reading the blog for the first time, it may be helpful to read the August 27 posting describing her congenital heart defect (Total Anomalous Pulmonary Venous Drainage [TAPVD]).

We previously described that a septostomy (making a hole in the septum; the septum is a wall which divides the left side of the heart from the right) was most likely completed on Samaah’s heart. However in patients with TAPVD, an Atrial Septal Defect (a hole in the septum of the atrium [upper chambers of the heart]) is found and that is the case with Samaah. So the septostomy was not necessary, since a hole, which connects the right side of the heart to left, already existed.

However, over the weekend, physicians did complete a procedure that keeps the hole in the septum patent, which ensures that the left side of Samaah’s heart continues to receive some oxygenated blood that can then be pumped to the rest of her body.

A complication, which about 50-60% of patients with TAPVD develop is pulmonary vein obstruction. Just to recap from the August 27 post, in Samaah’s heart, the pulmonary vein is the vein that carries oxygenated blood from the lungs to the right side of her heart via the vena cava. When pulmonary vein obstruction occurs, the heart is unable to get oxygenated blood into the right side of the heart, and thus the blood is not able to travel to the left side of the heart via the Atrial Septal Defect. This then causes the rest of Samaah’s body to be deprived of oxygenated blood.

To try and resolve this problem, physicians needs to break the “clot” or the “obstruction” which has occurred in the pulmonary vein. Following the breaking of the clot, the physicians insert a stent (a hollow tube) in the vein to ensure that the vein does not re-clot. Veins that clot once, have a propensity to clot again, and that is why this preventative measure is ensued.

Both of these procedures (keeping the atrial septal defect patent and unplugging the pulmonary vein) can be completed with cardiac catheterization. Cardiac catheterization is a non-invasive procedure that allows physicians to complete the above-mentioned tasks, without having to invasively make an incision (cut) into the patient’s chest.

In cardiac catheterization, physicians feed a small catheter (hollow tube) into a large vein in the patient’s thigh. This vein (remember vein is a vessel which ultimately ends up opening into the heart) allows the catheter to be fed all the way into the patient’s heart. Using this catheter, physicians inject a radioactive dye into the patient’s blood stream, which can then be imaged using a machine similar to the x-ray machine (the machine detects the radioactive dye and provides a picture of the vessels which have the dye present within them). Thus the physicians are able to see exactly where the catheter is within the heart, and are able to complete the procedures described above.

Some of you may wonder why Samaah has not received her surgery yet. Well, the pulmonary vein obstruction occurred in Samaah’s case which needed to be resolved, and Alhamdulillah has been resolved already. The physicians are just allowing Samaah to recover from this non-invasive procedure before they move onto the open-heart procedure with which they can permanently resolve Samaah’s congenital heart defect. Also, our dear Samaah developed another complication known as pulmonary edema (fluid in her lung space). This complication can be treated medically, and does not require any procedural intervention. Alhamdulillah, the fluid has settled down significantly, and we hope that by tomorrow Samaah will be in a better position to receive the final surgery.

Please continue to remember Samaah, Hassan, and Naila in your duas in this difficult time.
Spoke to Hassan a few moments ago. Sounded a bit sleepy, but he had quite a few updates. Samaah is now slowly beginning to open her eyes more often and her swelling caused by the fluid retention has significantly decreased. Alhamdullilah, this is more good news. She also received her first stuffed animal from one of the amazing nurses at the hospital.

Naila and Hassan are also doing well, but very tired as you can all imagine. The intensity and lack of sleep in the last few days are beginning to catch up to them. And since it is unlikely the surgery will take place today (most probably tomorrow), they will definitely need to regain some energy and prepare themselves for tomorrow's activities. Also, on top of the current situation, the night before last, Hassan discovered his car had a flat tire, Subhan Allah! So he spent some time yesterday following up with that so that they can keep mobile between the hospital and my parents house (about a 15 minute drive). May Allah make this easy for them.

Hassan and Naila do also try to read the blog if they can, so feel free to write any duas or well wishes in the comments section. I'm sure it will help provide the support that they need at this time insha Allah.

Also, Aunty (Hassan's mom) and Sushmita (Hassan's sister) are leaving back to Saskatoon today. From there they will be flying out Bangladesh early tomorrow morning. Originally scheduled to be in Canada for one month, she extended her return flight twice and is now only leaving as her Visa is about to expire. But she is planning to return to Canada to visit Hassan, Naila and Samaah next year insha Allah. Aunty is an amazing woman, Masha Allah. Her patience and sincerity are truly admirable. May Allah make the journey easy for them.

FYI - when Samaah was born she weight 8.1 Lbs Masha Allah!

Monday, August 28, 2006

Just spoke to Hassan and Naila and alhamdullialah, they are in good spirits. Samaah is still connected to a heart and lung machine to help her breath and give her own heart/lungs some time to recuperate and become stronger prior to the surgery insha allah. She is also being nourished by some type of lactose breast milk equivalent and Hassan said she looks much healthier. Most likely the surgery will be taking place on Tuesday or Wednesday. May Allah make that time easy for them.

Hassan was also able to get some extra leave from work, alhamdullilah. His manager was very understanding of the situation and told Hassan to not think about work at all. As for Naila, she's back to making fun of Hassan, so looks like Naila's on track to a speedy recovery, masha Allah.

Please continue to make dua.

Sunday, August 27, 2006

Updated description of Samaah's ailment by Kashif Yousuf

Many of you have questions of what exactly is going on with little Samaah’s heart. I will try my best to summarize the condition of her heart in this post, InshaAllah.

The congenital (implying she was born with it) heart defect that Samaah has is known as Total Anomalous Pulmonary Venous Drainage (TAPVD).

When describing vessels in this post, I will refer to them as either veins (carry blood to the heart) or arteries (carry blood away from the heart).

Our heart essentially comprises of four chambers: two on the right, two on the left. In a typical adult, we have about 5 liters of blood running through our system; Samaah probably has close to half a liter. The average baby’s heart will beat about 130-150 times per minute, circulating that entire volume of blood through her entire body.

Little vessels (veins) collect blood from different parts of the body, and eventually the blood ends up in the right side of the heart through one of the largest veins in our body (known as the vena cavae). Then the blood exits the right side of the heart through one of the biggest vessels (artery) in the body: the pulmonary artery. It is this artery which takes this blood to the lungs. Here the blood is oxygenated (oxygen molecules attach to the blood so that the blood can then circulate throughout our body and provide our different muscles with oxygen).

This oxygenated blood then makes its way to the left side of the heart through a vein: the pulmonary vein. The left side of the heart then goes on to pump the blood out through the left side of the heart using a large vessel (artery) known as the aorta. The aorta has many smaller branches of vessels (arteries) which carry oxygenated blood to different muscles in our body and provide these muscles with oxygen which is essential for them to function. Eventually these muscles use up the oxygen from the blood and deoxygenated (oxygen-less) blood makes its way into small vessels (veins) which then make their way back into the right side of the heart and the cycle continues to repeat itself. One heartbeat represents one cycle. It truly is amazing how this whole cycle can take place about 130 times in one minute in little infants like Samaah. SubhanAllah.

So this, in a nutshell, is how a normal heart functions.

In Samaah’s case, the oxygenated blood which is leaving the lungs and should be entering the left side of the heart through the pulmonary vein is INSTEAD entering the vena cavae which then brings the blood back to the right side of the heart. So the right side of the heart is under a lot of stress since it is receiving double the volume of blood that it should be, whereas the left side of the heart is not receiving much blood flow at all.

In essence, Samaah’s heart is sending all of the blood (oxygenated and deoxygenated) back to the right side of the heart and the blood is not making it into the left side of the heart, so that it can be pumped to the rest of the body.

So, the problem is Samaah’s body and its muscles needs oxygen to function and no matter how much oxygen she takes into her lungs, the oxygenated blood is not making it into the left side of the heart so that it can be pumped to the rest of the body.

So how is little Samaah managing without oxygenated blood? The doctors have completed a small procedure known as a septostomy (making a small hole between the left and the right side of the heart). This allows a connection between the two sides of the heart and some of the oxygenated blood which is inappropriately going to the right side of the heart is able to drain into the left side of the heart as a result of this hole. This way, it is able to circulate throughout our body. Also, Samaah has a tube in her trachea (throat) which is pumping a high concentration of oxygen into her lungs, so that her blood becomes as oxygenated as possible.

Now this “septostomy” is just a temporary solution. The curative (permanent) solution for this problem is actually performing open heart surgery, and re-positioning the pulmonary vein so that it drains into the left side of the heart INSTEAD of the vena cavae. This way, one continuous cycle can be restored and the right side of the heart will not continue to face excessive stress and the oxygenated blood will be able to drain into the left side of the heart. As a result, the small hole which the doctors have made can also be repaired as it will no longer be necessary.

InshaAllah this large procedure should be completed in the next day or two, and we pray that Samaah will come out successful from this surgery.

If you have any questions about this procedure, feel free to post them on the blog and I will try my best to clarify things for you, InshaAllah.
From the vague description provided by Hassan on Friday, we had incorrectly assumed that the condition was transposition of the great arteries. The actual condition is very similar, but not the same. Kashif is working on providing us the description of the actual condition. Sorry for the confusion.

Dr. Kashif Yousuf generously provided the below to give us some idea of Samaah's heart condition:

Many of you have questions of what exactly is going on with little Samaah’s heart. I will try my best to summarize the condition of her heart in this post, InshaAllah.

The congenital (implying she was born with it) heart defect that Samaah has is known as Transposition of the Great Arteries.

When describing vessels in this post, I will refer to them as either veins (carry blood to the heart) or arteries (carry blood away from the heart).

Our heart essentially comprises of four chambers: two on the right, two on the left.
In a typical adult, we have about 5 liters of blood running through our system; Samaah probably has close to half a liter. The average baby’s heart will beat about 130-150 times per minute, circulating that entire volume of blood through her entire body.

Little vessels (veins) collect blood from different parts of the body, and eventually the blood ends up in the right side of the heart through one of the largest veins in our body (known as the vena cavae). Then the blood exits the right side of the heart through one of the biggest vessels (artery) in the body: the pulmonary artery. It is this artery which takes this blood to the lungs. Here the blood is oxygenated (oxygen molecules attach to the blood so that the blood can then circulate throughout our body and provide our different muscles with oxygen).

This oxygenated blood then makes its way to the left side of the heart through a vein: the pulmonary vein. The left side of the heart then goes on to pump the blood out through the left side of the heart using a large vessel (artery) known as the aorta. The aorta eventually has many smaller branches of vessels (arteries) branching off it which carry oxygenated blood to different muscles in our body and provide these muscles with oxygen which is essential for them to function. Eventually these muscles use up the oxygen from the blood and deoxygenated (oxygen-less) blood makes its way into small vessels (veins) which then make their way back into the right side of the heart and the cycle continues to repeat itself. One heartbeat represents one cycle. It truly is amazing how this whole cycle can take place about 130 times in one minute in little infants like Samaah. SubhanAllah.

So this, in a nutshell, is how a normal heart functions.

In Samaah’s case, the two biggest arteries of our heart have been transposed (switched). So the pulmonary artery, which normally exits the right side of the heart and takes blood the lungs, is now exiting from the left side of the heart. Concurrently, the aorta is exiting the right side of the heart in Samaah’s heart.

In essence, Samaah’s body has two parallel cycles of blood-flow taking place. So going back to what we discussed earlier, little veins collect deoxygenated blood from muscles and take it the right side of the heart. The blood then exits the right side of the heart through the aorta INSTEAD of the pulmonary artery. The aorta then goes onto take this deoxygenated blood to the rest of our body which cannot really use the blood (because there is no oxygen on it) and the blood then returns to the right side of the heart. By the same token, there is a parallel cycle taking place in the left side of the heart which keeps recycling oxygenated blood.

So, the problem is Samaah’s body and its muscles needs oxygen to function and no matter how much oxygen she takes into her lungs, this is not ending up throughout her body.

So how is little Samaah managing without oxygenated blood? The doctors have completed a small procedure known as a septostomy (making a small hole between the left and the right side of the heart). This allows a connection between the two cycles and some of the oxygenated blood which is cycling only in the left side of the
heart is able to make it to the right side and thus reach the different muscles in our body. Also, Samaah has a tube in her trachea (throat) which is pumping a high concentration of oxygen into her lungs, so that her blood becomes as oxygenated as possible.

Now this “septostomy” is just a temporary solution. The curative (permanent) solution for this problem is actually performing open heart surgery, and re-positioning the two great arteries into their required position. This way, one continuous cycle can be restored and the small hole which the doctors have made can also be repaired as it will no longer be necessary.

InshaAllah this large procedure should be completed in the next day or two, and we pray that Samaah will come out successful from this surgery.

If you have any questions about this procedure, feel free to post them on the blog and I will try my best to clarify things for you, InshaAllah.


The fluid that had developed in Samaah's lungs has subsided, alhamdullilah. Now, the doctors are just waiting for her heart and lungs to get a bit stronger before they perform the surgery. Naila is also doing well. Nurses have checked up on her and she is recovering nicely, masha Allah. Her and Hassan have been able to stay in room right next to the baby's.
My mom (lives in Edmonton) said the baby looks exactly like Naila and has round cheeks perfect for kissing. Can't wait insha Allah.
You can post your duas, well wishes and questions as comments to any post on this blog and I will inshaAllah make sure that they reach Hassan and Naila.
Doctors have confirmed that the surgey will happen in another day or two, inshaAllah. There is some water in the lungs and the docs are waiting for it to go down. Once that happens, Samaah will be able to go into surgery. As Hassan puts it, "its a good news." Alhamdulillah.

Saturday, August 26, 2006

Just talked to Hassan. Doctors performed a minor surgical procedure on Samaah today, which will inshaAllah help her heart become stronger. The procedure was Alhamdulillah a success and she is doing well. This will prepare her for the bigger surgery inshaAllah. They expect to perform the open heart surgery in two days.
Samaah was born on Friday, Aug 25 in Saskatoon. Shortly after birth she was diagnosed with a congenital heart defect. Late Friday afternoon, she was flown to Edmonton, where she is currently on breathing support.

It was orginally expected that surgery will be performed right away, but doctors in Edmonton believe her to be too weak to go under surgery.

Update's on Samaah's condition will be regularly posted here, inshaAllah. Remember her and her parents, Hassan and Naila, in your duas.