John's reflections and the next few days...

Thank you so much for your kind words and wishes for Iain. Seema and I have been frankly humbled by our friends who have been praying and sending positive energy Iain's way. Thank you!

Over the years we've experienced some scary days dealing with Iain's pulmonary hypertension. For me, today topped them all. After 14 hours of surgery and at 2 AM, one of Iain's surgeon entered our waiting room. I saw it in his face; the stress and concern were clear. He told us that despite all of their intervention, the bleeding had not stopped. He wanted to go back in and re-examine all of the connections. He further explained that he was having difficulty examining the blood vessel connections and chest cavity wall on the backside of the lungs near the heart, and may need to resort to removing the left lung to get access. He started talking about needing to make lateral incisions to open up access, when I gently interrupted and simply stated to him to "Please do what it takes and just stopped the bleeding."

Three hours later, he came back to say that he was done. No "smoking guns" were found, but he did have the time to examine all connections closely make a few small changes. Iain was on his way to the caridac ICU, albeit on an ecmo machine and with an open chest.

Seema and I gave the teams some space and time to get Iain transitioned and settled. When we approached his room, we saw a dozen or more people in and around his room. The ecmo nurses, so dedicated and skilled, were spectacular to watch as they adjusted and inspected and spoke in a cryptic language. The doctors analyzed the data, scenario planned and called out changes to infusion pump settings. It was a beautiful orchestra where everyone was in harmony and knew exactly what they were doing. I felt re-assured.

The day has been primarily focused upon reducing his bleeding and achieving a level of stability. As Seema stated, his bleeding has significantly reduced. The majority of fluids now appear to be lymphatic, a common outcome of lung transplants. We had some episodes this afternoon where we saw significant fluctuations in blood pressure. Hopefully that is under control now.

Our goal is to get Iain to a point where he can be weaned off of the ecmo system and rely upon his new lungs for oxygenation. Our biggest short term concerns are bleeding, followed by stroke due to blood clotting and kidney function. So far, we've seen no evidence of clotting in the ecmo, but it's just a matter of time. The anti-coagulation agents needed for the ecmo machine work against our needs to minimize bleeding. It's a delicate balance.

If we weren't asking irritating questions to all of the doctors and nurses, we were talking to Iain. If he can hear us, I'm sure he was irritated as well. I suppose one benefit of the paralytic medication medication is that he can't tell me to be quiet! (just kidding)

Tomorrow is another day of challenges. Hopefully we can start the anticoagulants and yet still control bleeding.

This evening, I took a picture of Seema with Iain in the room. It was finally a moment of peace...


  • Chrissie M

    Such a beautiful moment of peace. Hugs and prayers.

  • Sarah

    Keep fighting Iain. You have the most amazing parents and amazing medical team all fighting to get you through this. You are a brave, brave young man. My family and of course the dogs Annie and Harry are looking forward to seeing you back in Boulder very soon.

  • Cormacdowling

    I remember during the later years of our elementary school life you ended up getting a staph infection and was unable to leave the house for the most part. I remember biking every other day to your house to play video games and have nerf wars. It was probably the best summer ive ever had. And playing video games with you is probably the best parts of my week even though you are way better than me and i cant play without dying

  • Salvado Family

    John and Seema, Oh, how do we anxiously wait with you, follow your updates, hold our breath ... and just want to give you a gigantic HUG! We admire you, beautiful parents and your amazing Iain (and so sorry for having misspelled your name so many times earlier - I am sure it is irritating to you - you will be allowed to express your frustration out loud soon ;-) And what a remarkable medical team. Your description matches what team work ultimately is. The analogy to an orchestra is beautiful - with harmony, as well as cadence I am sure -- OK, maybe not melody yet, but we can anticipate that the bip-bips of the machines will soon start to fade. And soon, Iain will be able to sing louder than them! And now a few words for Iain (you are allowed to imitate our French accents ... as long as you don't make fun of us!!) You are an admirable and remarkable young man. And so handsome - I can tell that your parents posted nice photos of you with the direct intention to turn the girls' heads!! And I am sure it is working ;-) But more importantly, you are a strong and brave man. I remember listening to you as you passionately showed us your album of your trip to France and your visit to the Bugati factory. The sparkles in your eyes were like fires. And the words were flowing out of your month so eloquently. You remembered each model and many details that were very impressive. And I knew that day, deep in my heart, that you will go back to that place - standing strong and cured, and will thank them for the dreams they had allowed you to have. And who knows, maybe you will leave the place driving one of their little fireballs. We believe in you Iain. Stay strong young man. With all our love Marie-Laure, Jean-Baptiste, Paul-Auguste, Léonore and Gabrielle

  • lisapendergast

    Good job today, Iain. Keep fighting, bit by bit. Our hearts are with you.

  • Abraham Family

    Dearest Iain, John, and Seema, Thank you for your reflections, John and Seema. We've been checking for your messages all day. The most recent news and accompanying photo is the best update thus far since the surgery! Truly a moment of peace. Just when you thought you had no more strength to muster, and the moment was dark, it seems everyone found it in themselves to move a step forward into the morning light. And this includes Iain's awesome surgeon. Goodness, what an amazing team of medical professionals you're surrounded by. Iain, you've such remarkable will! You've managed somehow to keep up-- to go to school, have fun with friends, drive cars! You are certainly THE most courageous young man we know! By the way, there's big news in our garage! We got a new Jeep! You'll love the color (midnight blue with two-tone interior). Sharp! Dean can't wait to drive you around in it! You're on your way, Iain! You're all in our thoughts-- constantly! The Abrahams xo PS: Aengus says, "woof!"

  • Beth Butterfield

    Iain you are an amazing kiddo! Your strength and resilencey to challenges have always inspired me. Keep fighting and show those doctors the determination I know you have inside you!! I believe in you just like I believed in you when you walked into my Kindergarten classroom all those many years ago. You have always had a special place in my heart, stay strong buddy you got this!! Seema and John you are amazing parents stay strong and know your boy is in my prayers and thoughts. Big hugs and lots of Love to you all!! Beth aka (Mrs. Butterfield)

  • HeatherPrakash

    First of all - we love you guys so much!!! We can't say that enough these days! Seems more important than ever to tell those close to us how much we love them. We admire so much the strength that you exemplify, it's truly awe inspiring. Second of all , nephew of ours - there are so many people, those you've met and those who you will meet on a future visit, who are putting so much energy into willing you to fight through this challenge of all challenges and get stronger. A good friend asked me today if you knew what a huge fan base you have here in Los Gatos. You truly do - every single person we come in contact with - is literally putting all their thoughts and energy into wishing you well. Iain - you are loved more than you will ever know - by both people who know you and those who hope to have the chance to know you. ok, third of all .... Iain - and I hope you are really paying attention to this part as your mum or dad are reading this to you!!! You! have a lot of unfinished business here!!! YOU are needed here! YOU are supposed to ski with your cousin Sophia next season - you're supposed to be kicking her butt on the slopes next year!!! You and she have many more adventures in your futures - so many places to explore!!! YOU are supposed to be back here to tease your little cousin Sydney who doesn't have a big brother to toughen her up. YOU are supposed to be here to give your Auntie Heather grief for not eating turkey at Thanksgiving (even though she might be pretending to be vegan just to save you from your mum's chestnut stuffing that secretly has turkey liver cut up in it!). YOU are supposed to be here to drive your Uncle Simon's Porsche as the gateway car to your much cooler car - whatever that may be in your FUTURE. We love you so much!!! You've got this Iain!!! Auntie Heather, Uncle Simon, Sophia, Sydney, Piper , and your little brother - Simon (side note from Sophia - "Hey Auntie Seema - hope you're playing lots of Red Solo Cup, Drunk on a Plane - Iain's "favorite" country songs. Love you all! -Sophia)

  • David Young

    Iain man I just want to say that I've always admired you for your personality and attitude. I appreciate being your friend so much and as long as I've known you have always been a great guy. I'm thinking of you and wishing you love and strength to get through this! David

  • philmac

    Hi Iain. All of our family and close friends send so much love to you and your family and the amazing team at St Louis. There is a gigantic bubble of positivity surrounding you and your future. Phil, Jane, Jake & Holly

  • sanchitjain

    John, I wish Iain, you and your family all the luck and strength that you need in these moments. I have read all the posts since yesterday, and prayed for Iain everytime. I will visit a temple this evening to pray for him. Iain is brave, beyond words or imagination, just like his father. I am awed by the expertise and care the whole team of doctors is giving Iain, he is truly in safe hands. We all shall remain in gratitude for this excellent team of doctors. Lots of best wishes, Sanchit

  • Aunt and Uncle

    My Dear Sis and Brother in law, we very much look up to you and admire you with your focus and graciousness when times are frankly beyond imagination. My nephew, your job is currently to keep doing what you have been doing for years and telling PH that it's not the boss of you. You have plans in Colorado as well. My Geordie has been letting me know she misses you (for real) and I will tell you about it when I see you. Uncle Kurt needs his fishing buddy. I need someone to entertain Axel because he bugs me relentlessly....yes, I need a dog sitter so I can have a break from the barnacle Uncle Kurt calls a dog. I also had this idea that I need travel buddies to go to parts of the world that you would love to see. And there are cars you haven't driven, cars maybe that you need to design. Just sayin..

  • Young Schwemm family

    We continue to think about you, Iain, and your whole family and the wonderful team of people caring for you. We hope this is a good, stable day. David and the guys miss you a lot...all shenanigans are on hold until you're back in Boulder. Much love!

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