Dear CCAM Partners and Friends,

Thanks so much for continuing to pray for Buntheep's healing. Please praise the Lord with us for the very successful 20-hour surgery that started early yesterday morning and finally finished in the wee morning hours of today!

During Buntheep's first surgery back in the middle of November, the surgeons gained access to the tumor by going through the nose. That was less invasive than other approaches, and it is often the best surgical option for removal of tumors in the cranial cavity. However, due to the giant size of this particular tumor, the nasal approach proved to be much too restrictive. Also, because the tumor was very vascular (prone to profuse bleeding), Dr. Aldana and his team decided on a more radical approach this time, so that they could gain control over the bleeding and generally have more visual perspective and room to navigate.

After shaving off the front part of Buntheep's hair, the first surgical team led by Dr. Roy made an incision behind her hair line and carefully removed her forehead, eyes, and nose so that the second team led by Dr. Aldana, could get inside to remove the tumor. Hour after hour, using a microscope and laser, Dr. Aldana kept individually cauterizing the many blood vessels feeding the tumor and then removing the tumor bit by bit, until finally, he thought he had removed it all. However, a portable CT scanner in the operating room revealed that there was still more tumor hiding higher up. Therefore, the team decided to extend the surgery 6 more hours to get everything out. When the surgery was over, Dr. Aldana said that he had removed ALL that he could see! Praise God! There will be a follow-up MRI scan done tonight to verify that everything is gone.

After the second team removed the tumor, the first team returned to refurbish the inner landscape of the cranial cavity, reconstructing the partitions of bone that the tumor had demolished. For building materials, Dr. Roy used paracranium (lining of the skull) and fascia (tissue from the thigh). Finally they painstakingly closed up the skull and put Buntheep's face back together again. Praise God for giving wisdom to these surgeons! Please pray for healing of the thigh from which the fascia was harvested.

Dr. Aldana reported that the areas of the tumor that had appeared troublesome when studying the MRI scans earlier actually yielded to removal much more easily than anticipated. Although the tumor was wrapped around a major artery, there was a casing around the artery that separated the tumor from direct contact with the artery itself, so removal was greatly facilitated. Praise the Lord!

A neurophysiologist worked alongside Dr. Aldana throughout the surgery, using an instrument that measures muscle tremors to warn him whenever he came close to any nerve tissue. Therefore, as far as they can tell, the nerves of the inner ears, the optic nerves, and even the nerves providing the sense of smell, have all been preserved. The pituitary gland was traumatized by pressure from the tumor, causing its prolactin levels to be elevated, but the gland itself is apparently OK. Follow-up tests will evaluate its present function. Although the tumor had eaten through the bone protecting the brain, the covering of the brain was still in place; therefore, the brain itself was never compromised. Praise the Lord!

Before this surgery, Dr. Aldana showed me the most revealing MRI scans of the tumor. Comparing the scan made just before the second surgery with the one made just before the first surgery confirmed that the tumor was indeed shrinking. Although it remained spread out in many different directions, the later scans showed that it had definitely lost mass. The hole cut out by Dr. Aldana during the first surgery was visible on the follow-up scan. The picture looked like the tumor had been disemboweled, wounded, and traumatized, causing it to shrink and stop growing. Praise God for these answers to prayer!

Praise Him also for all of the positive improvements that we reported during the intermission between surgeries. Although that period seemed to be an unwanted delay, it turned out to be a very special time of physical and spiritual restoration for Buntheep, full of hope and pleasant experiences that prepared her for the difficult road ahead of her. The first surgery and the embolization procedure this past Tuesday caused us and the medical team to feel somewhat disappointed. It seemed that we kept taking one step forward and two steps back. But later God reminded me that on Mt. Carmel, He deliberately caused His sacrifice to be soaked with water, making it "impossible" to burn, before He sent heavenly fire to fall upon it and consume everything! God likes to make things impossible before He miraculously intervenes. That way, He alone receives the glory.

When we consider all the physical, financial, and social odds against Buntheep's being where she is today, we would probably all agree that this scenario is totally impossible. Praise God for His miraculous intervention!

I admit that I was also a little disappointed when God did not answer our prayers by just "zapping" the tumor out of there without more surgery. But yesterday morning, God reminded me about His creation of Adam and Eve in the Garden of Eden. After God had miraculously called all created things into existence just by His spoken Word, He then opted for the hands-on approach to fashion Adam from the ground He had already created. Was that a lesser miracle? Of course not! And after that, God Himself performed the very first surgery by putting Adam to sleep and making an incision in his side to remove a rib, from which He carefully crafted Eve. Reflecting on this and other scriptures reinforced what I already knew--that God uses many different ways to accomplish His purposes. Yesterday morning, my faith was greatly renewed to pray fervently that God would perform His special surgery upon Buntheep through His chosen human instruments, the doctors. And so He did!

Please praise our Lord Jesus Christ for hearing our cries for help last month when this emergency first arose and for bringing us miraculously and quickly to this particular medical center (Wolfson Children's Hospital at Baptist Medical Center, Jacksonville, Florida, U.S.A.)--a place that specializes in difficult children's surgeries, that utilizes operating teams made up of complementary surgeons and interventional specialists for maximum efficiency, and that is blessed with the most up-to-date operating room facilities (every piece of which was utilized for Buntheep's specialized case). Praise Him also that complete financial aid has been provided to pay for the astronomical costs involved, particularly facilitated through the networking of Nix Daniel, Hugh Greene, and Larry Freeman.

Praise God for providing wisdom and strength for the dedicated doctors and operating team who sacrificed themselves yesterday during the tedious and dangerous 20-hour procedure. Praise Him also for the excellent nursing care provided, both in the ICU and on the general floor. Praise Him for sustaining Buntheep herself during this grueling marathon and also for protecting her from many potential hazards (like excessive bleeding, stroke, and hormone imbalances which could cause kidney malfunction). And no matter how difficult the surgery or how painful the recovery process, she would surely have died had the tumor not been removed.

Buntheep is now beginning the long recovery in the ICU. Her vital signs and reflexes are normal, as they were consistently all during the surgery too. Her face is temporarily very swollen, but no scars are visible. The incision higher up on the scalp is bandaged, but when her hair grows back, that scar should be well hidden. She still has a breathing tube in, probably until tomorrow. However, even now, whenever she is awakened for a few minutes, she can communicate by sign language to answer questions. The audiologist's test today revealed that her hearing is normal. She has at least retained the sight in her left eye. On Monday, a full vision test of both eyes will be performed. Please pray for God's miraculous preservation of the left eye and restoration of the right one.

Buntheep's nose will remain plugged until next Wednesday to help support the new reconstructions in the cavity behind the nose and give them time to heal. After the breathing tube comes out, and before the plug is removed, Buntheep will need to breathe from her mouth. Pray that this will not cause her too much frustration.

The only real medical problem occurring so far is that she has a 101 fever. However, she is receiving antibiotics in her IV fluids to counteract any infection. We continue to praise our Lord Jesus Christ, the Great Physician!

In His Hands,
Gioia and Buntheep

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