The remainder of the team left Kampala today. The ICU team would have just taken off in the last 30 minutes, actually. We went in to check on all the children one last time before our departures. Thankfully, everyone is doing so well that the team did not work full shifts yesterday and overnight. In the past, we have left with patients still on the ventilator. This is not the case this year and we are so thankful!
Fredrick, Patience and Barbra are in the ward, leaving only Ukasha right now in the Step-down unit.
Best pic ever of Barbra and Patience- thanks Sara Joyner!
Barbra and Patience were really full of energy this morning already while Fredrick had just awoken, his mom said. Trina was actually able to get him to smile for her picture! I got a more serious, tough- guy look for my picture!
Priscilla was pretty somber still this morning. She needs to move to the Happy Room next door (we dubbed the Step-Down unit this on our first trip as the kids usually suddenly turn the corner in there to smiling again!)
We said our last goodbyes and went back to the hotel to pack. Some of the ICU team decided to try a ride on the boda bodas again, this time to the market. Here they are before! ( and I know there all made it out safely as we have texted since then! :)
Becca, Trina, Sheila and Dr. Mastropietro
A brief thank you to all involved just doesn’t seem to be enough. This week was the perfect summation of our 5 year commitment through the MOU signed between GOLI, UHI, and the government of Uganda. It was a great way to see just how far UHI has come in the five years. We did not have near the equipment issues noted in the past. The facilities and organization are improving greatly. The surgeons skills are great, showing this through several independent cases and most with minimal involvement by Dr. Turrentine. The anesthesiologist Dr. Joseph was very involved this year, and Murra the perfusionist is really quite independent. Ben and John the scrub nurses are independent and wonderful as well. A more steady staffing of very involved nurses were there this week as well. Overall, just a wonderful, satisfying week of seeing the “fruits of our labor” through the five years. We operated every child originally planned who was operable. Unfortunately, the emergency add-on weighs on our hearts and minds. We know, however, that valuable lessons are learned in these situations as well and it was Baby Shanel’s only chance.
The Riley/Rotary Team has many to thank for this opportunity to serve…
I am sure more will be added, so please check back!
Rotary Club of Kampala North for your great partnership for these years!
Rotary Club of Greenfield for the Gift of Life Auction funds used toward this grant and overall amazing support!
Rotary D9211 and Rotary D6560 for district funding support.
Rob Raylman for your leadership and overarching vision to make a sustainable heart institute in Uganda. We are proud to be a part of it!
Grace Agwaru for booking our hotel arrangements and generally looking after the team and the patients.
Sara Joyner who wrote and helps to implement the Global Grant this year. It was so helpful to have her along as a bonus as well! Seeing the grant in action makes all the difference!
Abbott who donated cartridges for the iStats (for bedside lab results).
The UHI team for so kindly allowing us to work alongside of you. Such a kind and caring group of health professionals!
And lastly, every team member from Riley! Such a hard-working group of people who donate their vacation time to come along and work longer days than even when they are at home…Leaving their families to help other families. Thank you all so much for representing Riley and Rotary in such a caring way!
We were taught this week that Ugandans don’t say good-bye, but instead a phrase that means “Come again and again and again…” We would love someday to come again!
Last evening became a little more complicated after ending the blog post… Ugandans were apparently celebrating the 100th Anniversary of their Police. So, unbeknownst to us, they were blocking off certain streets throughout the late afternoon. Traffic is always crazy here, but this was taken to a new level! For a 5 minute drive if no traffic, last evening’s drive was over 1 hr.
We had thought the 5 Team members deciding to ride the boda bodas (motorcycle taxis) from the hospital were crazy, but they probably made it back to the hotel in less than 10 minutes. We took a picture as we were sure they were walking to the craziest thing imaginable. They passed us once and unfortunately no one was able to catch a pic, they went by so fast! :)
This was certainly not what we planned when we were able to leave with ALL of us from the hospital, but 20 minutes later than ideal. It was really quite stressful knowing the Kampala North. Rotarians would have a bus for us at 6 and we were stuck in the jam until 6:30…sweaty and nasty from the day and long bus ride. With no access to phone and texting like at home to notify our Rotarian hosts of our tardiness, this was worrisome. Some took longer than others to ready for the Nderre Dance Troupe show, so we departed the hotel even after the show had begun. Even more traffic en route, then we finally made it with MANY apologies to our host Rotarians.
Then, special police/Dept of Defense guests arrived late to the show as well. Apparently, this extended the show significantly. We were told it would be over at 10 and so we arranged for night coverage at the hospital for Trina and Dr. Mastropietro until 10:30, but here we were at 11:15 still waiting for the show to wrap up! After waiting for our bus and telling our wonderful hosts our thanks and again apologies, we left at approximately 11:30. It was midnight before our night shift arrived to UHI. Again, our apologies and thanks to now Dr. Joel covering for them so they could be part of the fun group activities!!
So, on to today! Our OR group of Dr. Walker, Dr.Schimmelpfennig, Mike, Chas and Ashley left today as the OR work is done. They will have a little time to do some personal travel at the end of this. Well-deserved! They all worked incredibly hard this week! Safe travels!
Sara and I left a little earlier than the remaining team to go with Grace and meet President Jane from RC Kampala North to be guests on a radio show. I had done this once before with President Godfrey at least 2 years ago. I was rather anxious, but the host of RadioNow’s Health Net show Dr. James along with Grace and President Jane made the hour long show go faster than I anticipated, thankfully! Unfortunately, they only allowed 2 guests in most of the time. It would have gone much faster and better if IPP Sara could have talked too! We talked about congenital heart disease in general and how we have all worked together to build capacity and transfer skills to UHI over the last 5 years. We encouraged Ugandans listening to seek medical help for their child’s illnesses and not lose hope in the medical community. Help is here in Uganda and their surgeons are completely capable of treating their child’s medical ailments here in Uganda in most cases. Grace was telling us this morning that only 3 children were sent out in the last year for surgical repair abroad. This is in stark contrast to the first year of “Our Hearts are in Uganda” in which there were 66 children sent abroad. Because the list was so long and the facilities and staff unable to operate many things on their own, these children were sent abroad. The program has come so far! We thank Dr. James for the invitation to talk about our Rotary and health professional partnership that have helped to move this program along.
The rest of the team went on to the hospital to check on the children. All were continuing to do well. Patience and Barbra will move to the ward and Princess will likely move to the ward. Priscilla had a slight worsening on her Chest Xray, so she will stay in the ICU.
Barbra and Patience greeted us in the hallway when we arrived all dressed in their normal clothes, not even looking like patients! They are so fun and full of life now it is impossible to see them and talk to them without smiling.
Barbra also wrote an amazing “Thank you” note to us…So sweet! (Amazing she thinks these Hoosier accents are from the UK!- sorry Chain of Hope!)
Barbra’s note to us in the card
Fredrick is doing well, walking around quite a bit, but tripping all over his hospital gown. We would try to tie it up for him, but he would pull it down or have someone else completely untie it. He is a sweet little guy!
Ukasha was eating some and doing better as well, still preferring his thumb over anything else.
We had a short meeting to discuss the future of our collaboration with Dr. Mwambu and Dr. Oketcho.
Then we all gathered for that special moment of the “Celebration of Life” Party in the ward with all the families and the kids able to come down to the ward. It is always a special moment of all the teams (still left behind) and the families.
After this, we packed up to head back to the hotel with our trunks and equipment. Patience and Barbra met us at the bus to feed us cake! This meant they had to walk up two flights of stairs plus the walk from the ward (at least 50 yards). What a great testament to how much better they feel!
We were free to have a little time to relax and souvenir shop before checking on the patients tomorrow then leaving. So excited to see the kiddos one last time before we leave. Making sure they are all in the best position while we leave is so important as they recover.
Until tomorrow when we say goodbye….
Riley/Rotary Vocational Training Team Trip 2014 to Uganda Heart Institute- Day #7- Last Day of Operating
It’s really hard to believe today is the last day of operating! Somehow it seemed to have gone so fast! The night team of Dr. Mastropietro and Trina did a GREAT job overnight and to our surprise Princess was extubated! (Off the ventilator).
She is doing so well and only on a nasal cannula oxygen. So excited for her parents and little Princess!
Fredrick is doing well and will move to the ward today. He is still quiet. When I inquired about how he is doing this morning, he replied the typical “fine” (without much enthusiasm). Anna is taking care of him today and said, “Wow, he must really like you because he responded!” My little friend Fredrick! ;)
Ukasha is doing great and will move as well. He was found in the ICU this morning asleep and sucking his thumb. So precious! The anesthesiologists take great care to notice these things before surgery, so that little ones like Ukasha can still get to his thumb for comfort despite the IV’s and art lines needed.
He was taken for a little walk to the Step-Down unit with the Physiotherapist and his mother. He was not happy! But he walked all the way…
Priscilla is doing great as well. She was enjoying a juice as we rounded in the ICU. Her mother Jennifer is thrilled and took Barbra’s father, with a better camera in to the ICU to take her picture. It is really so sweet to watch the families bond in this week!
Aaliyah is our first patient to the OR this morning. She has a large VSD. She comes from some rather he harsh conditions it seems in that her father abandoned her and the mother Ayida when he realized she had a health problem. Her grandmother looks after her while the mother works a secretarial job. She has some low sats and she has not been able to grow normally. She is so small for her age. She is unable to stand alone or walk. She will grow and be much stronger after her surgery!
Aaliyah went back to the OR with Dr. Schimmelpfennig and Moses, UHI’s fantastic anesthesia assistant. She did well with the handoff and Moses was so kind and eloquent in explaining to her mother what to expect.
The party girls in the step down unit seemed initially a little quiet, but it must have been a late party last night and they were sleepy! By 10 AM, they were singing together and walking about, blowing bubbles, and at one point we looked in to see Patience standing on her bed playing! They are so full of life already!
Sheila and Becca were busy all morning with giving out the rest of the trunkloadS of toys she gathered for the children. Sometimes the surgery schedule is a moving target, especially before we depart Indy. So, preparing the appropriate toy for age of the children operated can be difficult ahead of time. Sheila had it ALL covered. She saw the children awaiting echo this morning who were outpatients and she and Becca looked like Santa came early to UHI this morning!
Two children originally on the operating list had to be taken off due to acute illness and another tested HIV positive, unfortunately. Another 26 yr old with congenital heart disease just recently discovered will hopefully be operated along with little Edrin who is now sick in the next couple weeks by the UHI team alone. It is a great feeling knowing that although we will leave soon, these children can and will be taken care of by the UHI program!
Dr. Turrentine came out and reported he never scrubbed in for Aaliyah’s surgery. The UHI surgeons did this entirely alone with just a few pointers over the drape here and there… The team joined Rob for a little close-out report starting at noon while the UHI team finished the case and transferred her to the UHI ICU nurses.
While we finished the 2hr debrief meeting, Rotarian Sara came out to greet the visiting Rotarians scheduled at 1 PM. I cannot overstate how great it has been to have her here! While my Rotarian Team leader duties required me to be in the meeting for information to share in the grant close-out report, she was able to be the Rotarian host to the local Rotarians and Interactors in the unit. Very important visitors came in that time with the Country Chair Henry, DGE Bob from RC KN. Then RC KN Rotarians brought Interact students who showered the families in the ward with essentials (and a lot of candy!). Then, more visitors from RC KN, including President Jane, Charlie, CiCi, and Stephen. The local Rotarians, Rotaractors, and Interact have been so involved! We really appreciate their partnership. It is amazing what we can do together through Rotary!
Rotary’s involvement with helping to build UHI to this point has been commemorated in a plaque dedicated in April which Rob really wanted the Rotarians to see…
Anesthesiology went first in our debriefing meeting as they needed to exit for Benita, our next patient to go to the theatre. Benita is another 3 yr old gal who comes from fairly close- Makere. She is her mother’s only daughter. She is the child who was scheduled for yesterday as the third case, but was delayed as she was eating. There is a large ASD causing her to have cough and difficulty growing. She has recurrent resp tract infections and a pretty chronic cough.
We planned to leave the hospital in two staggered groups if needed to make an event this evening with the RC KN Rotarians. Assuming the OR may not be done in time, plans were made and trunks were packed. Most of the OR team leaves very early in the morning, while the ICU team will stay until Sunday evening. The units will be full of children in various stages of healing, from standing on their beds playing to just Postop day #1, so…much to still care for…
After a full day and the most heartfelt thanks from many of the parents, especially Princess’s mother, we leave with hearts full and thankful for the people and children of Uganda! Words cannot express the thankfulness in these parents’ eyes as they try to describe how they have not slept in months or years worrying if their child will make it. Now they can rest better knowing our teamwork- Riley team, UHI team, RC Greenfield and RC Kampala North, D6560 and D9211 Rotarians, and GOLI and GOL auction contributors- have changed the lives of these beautiful children!
We look forward to an evening of African Dancing with the Rotarians at a show by the Nderre Troupe!
One of our honorary teammates departed this morning…Riley Echo Tech Amy Potter joined the team outside of the grant/VTT team and booked her own trip to spend some time seeing what her Riley friends do on their “vacations”…She is off now with a friend outside of Kampala for new adventures! Thanks, Amy!
We arrived at UHI this morning and Dr. Mastropietro and Trina have been busy all night managing Princess. She is doing well, but has required lots of attention all night long. Good thing Fredrick is low key!
Dr. Mastropietro and Trina changed over information to the day team. They changed and were on their way back to the hotel with George the driver. They worked hard all night long. Thanks team!
The first patient in the OR for the day is 3 yr old Ukasha with Tetralogy of Fallot. He is a sweet little guy who apparently loves to go pantless! Every time we would go into the ward, he seemed to be sans pants… His mother would put some pants on him, but he would continuously try to pull them off. He is the youngest of 10 children, so mom is not rattled by much! She apparently called for dad when we approached last night as he appeared and was able to speak English to us. Ukasha was diagnosed just 3 mos ago. His sats are in the 80′s%, so he definitely squats when he plays and is tired and winded easily.
Dr. Walker takes him back to the OR. He did very well and sucked his thumb the whole way. Dr. Schimmelpfennig, Dr. Walker, Chas and Ashley get him all set with the UHI team with lines and IV’s needed for surgery. Dr. Joseph, the anesthesiologist is unable to come today, but another Anesthesiologist, (incidentally a Rotarian!) is assigned with the team today from UHI. Murra and Mike are busy working together on the bypass machine as well. Ukasha’s case goes well with the UHI surgeons scrubbed alone until on pump and then again to close. Ukasha is back to the ICU about 2 PM after starting the case at 8:45AM.
Sara and I spent the morning with Barbra and Patience in the step-down unit. They had amazing, fun, and outgoing UHI nurse Sylvia with whom every day feels like a party for the kids, it seems! She speaks Patience’s language from Northern Uganda, Acholi. Can’t begin to tell you how much this has helped in the recovery of Patience! The girls seem to be having a ball and feeling so much better today. They had a busy morning of walking to the ward, reading aloud, coloring (“shading” as the Ugandan children say), working puzzles, and having water and goldfish snacks. Patience is certainly warming up to us… She is letting on that she may know more English than she wanted to let us know initially. Although they do not speak the same language and they are separated by 3 years in age, these beautiful girls are forever bonded by this life-changing experience…We are so happy to have witnessed this amazing bond this morning!
The RC of Kampala South Rotarians joined us today to meet the children and support the team. They were escorted by our Host Rotary Club counterparts from RC Kampala North. They filled the ICU in 3 groups and had a great group pic! Of course, all readers from Riley would be amazed Dr. Turrentine would allow this many visitors in the ICU, I’m sure! :)
The team shifted through a fantastic lunch when they could of Chicken curry, rice, veggies, and for the more traditional fare-pizza (still a little different from home :) ). Our RC Kampala North Rotarians Barbara and Grace have been taking great care of us with waters and coffee(and Doritos for Dr. T)! Dr. Schimmelpfennig went to get Priscilla. Finally, her third time scheduled is a charm and she was taken to the “line” toward the OR by her mother Jennifer and her aunt. Her eyes looked a little fearful, but she posed no fight to the OR. Again, her surgery went well with the UHI team doing most of the repair of her VSD.
We had planned a third case for the day with Benita who is 3 yrs old also. She has a sizable ASD and was just admitted yesterday. Her mom’s only child, she was found sleeping by her mom, propped on her belly and wrapped in the bends of her legs. She was really sweaty when it pulled back her sheet that covered her to examine her, so I worried she was in some congestive heart failure. However, her xray was considered OK and the exam not reflective of any troubles, so I guess it IS Africa and she was just hot! :). Dr. Cordes had not seen her echo, so Dr. Aliku, the pediatric cardiologist who has been here yearly from our first trip in 2010 does her echo with Dr. Cordes looking on. Dr. Twalib Aliku has traveled from Northern Uganda-his new post as only the third Pediatric Cardiologist in all of Uganda since finishing his fellowship at UHI- to spend a fifth week of skills training with us. He is such a kind and knowledgable doctor. As Dr. Cordes says, “Some people are just meant to be doctors…and he is one of them.” He actually identified and referred Patience, our first surgical patient of the week. It was so special to see his proud smile as he walked to the ICU to see her Tuesday with his teaching rounds of residents behind him. This may have been his first patient to see through to surgical repair… His face said it all…he may have been as happy as her parents! :)
Dr. Judith is an adorable, smart, outgoing fellow in her first year as a Pediatric Cardiology fellow. We so enjoyed having her in the OR yesterday as she asked questions and enjoyed the view of the new video headlight. It seemed she had never seen such surgery or at least from that point of view! When she finishes, this would make her the first female Pediatric Cardiologist in Uganda (and only the fourth overall!)
Dr. Schimmelpfennig later went to the ward to check out Benita also, but she was eating! They had been told her surgery would be tomorrow so she could eat. So, obviously we would not have three cases today and will do two tomorrow. The team wants to help as many children as possible while here, but teaching is a key part to the Vocational Training Team concept and grant that brought us here through Rotary International. Tomorrow, Benita!
Our internet connection was out most of the day in our normal corridor, so we went to another hall/stairway/patio to have access to online info and brief connections back home. The views you see here… Add to the list of things you will never see outside an American hospital…Although somehow beautiful…
We finally have most of the nursing staff furnished with the Rotary surgical hats…Fifty-five hats were snatched up in no time! Here are three of the many wonderful nurses here- Anna, Harriet, and Sylvia. We are so thankful for their hard work on these long shifts!
Priscilla returned to the ICU and transitions well. Dr. Mastropietro and Trina arrived a little late due to terrible traffic, but they were ready to work. Dr. T had plenty of time to visit the celebrities in the step-down unit…
We too encounter some unusual traffic jams on the way to the hotel at 8PM on a Thursday, but everyone is pretty tired and skips the late group dinner option for retiring early to the rooms. We will rest, relax (and blog ;) ) and be ready for a last full day of operating…
The team was up and ready to start anew today for some beautiful, sweet children. Everyone headed onto the bus at 7 and we were ready to go. Frederick already has lines placed from yesterday, so the OR team knew it could be a quick start. Trina and Chris had an uneventful night they said. The girls in the step-down unit are doing great, eating more, chest tube output is low, so they should have lines removed and one more day there before moving out to the ward. Frederick was doing well. His mother Molly says he was ready and not scared, but the OR team said he was quite scared yesterday. We hate that he has to go through this again. Dr. Walker gave him a little dose of some medicine to relax him for his trip to the OR.
I evaluated Frederick a couple days ago for his preop workup. He is an adorable, energetic 5yr old from Lira in northern Uganda. His mother Molly and his father is Kombe Dennis are both with him. Dennis is a very well-spoken gentleman who told me Fredrick has an older brother Kombe Emmanuel who is almost 10 and a younger sister Diana who is 3yrs old. Frederick was diagnosed just one year ago with Tetralogy of Fallot when he was easily fatigued and developed a cough. He is considered a “Pink Tet” as his oxygen sats are good at rest. He has a tight infundibulum though on echo, so he must have desats with activity. His father does report he squats when he tries to be active. They are a lovely family and we are so happy to give him a chance at a fuller, more active life without squatting!
Frederick’s surgery went well. Ashley scrubbed in with Dr. Turrentine after the UHI team started the case and cannulated and on bypass on their own first. Dr. Turrentine wore his new video headlight this trip- provided through a District 6560 Rotary grant in 2013-2014 year. Wow! What a great addition for teaching! With so many surgeons at the table in a small incision, it was so helpful to have the monitor to see the tiny valves. It was key when Dr. Turrentine was explaining to Dr. Oketcho an important step of suturing in the VSD patch without catching the Aortic Valve leaflet (amongst many other teaching points along the way- this just happened to be one I caught!)
Lucy, Rob and Grace came to UHI with the precious cargo also! Lucy- you are the saint of the week! We will need it definitely for the second patient of the day, so it came just in time!! Thanks to Rob for all the texting and calling London to coordinate. Wow!
In this time, Dr. Schimmelpfennig and Dr. Walker checked over Ashaba Princess- how beautiful is that name for this adorable girl?! She has Down’s Syndrome and is the second of her parents Scovia and Robert. They also have a 4 yr old boy at home. She was diagnosed at 8 months old with a large inlet VSD with secundum ASD. She is a small, approx 17pound sweetheart who likes to clap and throw her toys off the bed! She was discovered yesterday to have hypothyroidism as well. Princess was started on some thyroid medications and will be watched closely for any vital sign issues requiring extra medication (stress dose steroids) after surgery.
A group of Kampala North Rotarians came to visit the team and patients. They had great questions and enjoyed seeing the patients and their families. We certainly expressed our appreciation for the RC KN’s partnership!
Frederick’s surgery went well and he was brought back to the ICU team. He was taken back by all UHI nurses Harriet and Agnes with oversight only by Sheila and Becca. He settled in nicely with all the expected adjustments in medications and fluids. His parents came back to visit a little later. They were all smiles and full of hugs and “thank yous”! Dennis and Molly are just wonderful!
Little Princess was taken back by Dr. Schimmelpfennig next, about 2 PM. She has a large VSD and the thought was to consider banding her to help with her symptoms, but would need another surgery later. Once in the OR, however, the team decided it best to repair the VSD. There were some issues with the Oxygen sensors on the wall supply reading only 54%, so the UHI team brought other huge tanks of oxygen as backup as the entire hospital was going to switch to a different supply while the patient was in the OR. So, many large tanks of oxygen later, the anesthesiologists were ready! Her repair went well and Dr. Cordes did a TEE with the new Pediatric probe brought by Lucy (not Emma- my sincere apologies, Lucy!!). Everyone was satisfied with the repair and they started to take her off bypass.
We then went over to meet Priscilla, hoping we would do her surgery this evening as well. She has been here since the screening visits Saturday. She is such a beauty too! This morning, I had planned to check her over, but she was out of her bed. Then she emerged from the “Bath Room” with her mother, she had a towel wrapped and tucked around her with her bucket of supplies like a college girl coming from the dorm shower rooms…so cute! We caught them later less busy and checked her over. She has been on empiric antibiotics for a cough/”flu” of 2 weeks time, but no fever and no elevated WBC count. Her cough is better since starting them 2 days ago, mom said. Her mother Jennifer has 6 children, whom all live with her. Priscilla is the youngest of them all as her oldest sibling is 25 and the youngest 19! She is a sweet girl and we hoped to get to her surgery soon!
About an hour after the chest tubes and pacing wires were out for Patience and Barbara, the girls went for a walk with Sheila and Becca all the way to the ward! They are 2 days postop and these girls walked about 150 ft and back. Patience started out incredibly cautious and serious, but by the return trip to the unit, they had quite a spring in their step!
By this time, it was about 4:30 and it was apparent that little Priscilla’s surgery would not be today. She was given a meal after the news. This is her second day unfortunately of waiting and not eating all day to be put off… But tomorrow will be her day now! Princess came back to the ICU after the UHI team closed /finished the surgery at approximately 7:45 PM. She will remain on the ventilator overnight with Trina and Dr. Mastropietro.
Good thing he spent some quality time figuring out all the ins and outs of the ventilator. He is all over that! They arrived rested and ready for their full night’s work! Looking forward to hopefully 3 cases tomorrow, but for now….these boys look beat! :)
This morning is cloudy, breezy, and rainy in Kampala. Seems the streets are more clear and the hospital less busy this early morning…due to the rain perhaps or just a Tuesday, we are not sure. We arrive in the usual fashion to find Trina and Dr. Mastropietro bustling. They said their night was pretty unremarkable until this morning. The little 3 month old add-on emergency Pulmonary stenosis case made herself known as a true emergency this morning. She developed respiratory distress and they had been working to help her. We had not all even changed to scrubs yet when Trina carried her to the ICU for “transfer” and she was quickly intubated in the ICU by Dr. Mastropietro. The entire team worked together to try to stabilize her. It was decided it best to just get her back to the OR and get started. Dr. Cordes did another echo and surgical plans were made by Dr. Turrentine. We notified Frederick’s parents that his surgery would be delayed today. It was only after she was in the OR that I finally was able to find out more info on the baby. Her name is Shanel. She is from Kajjansi. Only one week ago, she started a nonproductive cough and shortness of breath. She presented to an outside hospital and was diagnosed with pulmonary stenosis. The hospital sent her to UHI for consultation with the cardiologists here. Critical pulmonary stenosis was diagnosed with significant Tricuspid Regurg. She needed urgent intervention.
Barbara and Patience in the ICU were doing well. Patience was a little sullen, but her dad says she is doing well. She got a little breakfast this morning and moved to the Step-Down Unit. That is a painful walk next door for these postoperative day one children.
Immediate Past President of Rotary Club of Greenfield Sara Joyner, Rob and I joined a press conference arranged by our Host Sponsors of the Global Grant, Rotary Club of Kampala North. It was well-attended by Rotarians, press, and Dr Omagino, Director of UHI and a Director from the Ministry of Health. The telemedicine room of UHI was rather full and well-used. Sorry no picture of the entire room, but a couple of some at the “head table”.
Barbara was moved in that time to the Step- Down Unit. Before her move, she was seen sleeping in her sunglasses… Her future is so bright she has to wear shades! :)
Shanel was brought back from the OR on the ventilator still with the idea that she would be watched overnight to see if she needed another operation in the near or more distant future. However, approximately 1 hour after her move, she was doing very poorly and then progressed to a full code. Sheila came to find Dr. Turrentine and told him the situation. She was sent as quickly as possible toward the OR, but Frederick, our next planned patient was prepped and all ready in the OR. So, the cath lab was quickly made into a makeshift OR, including bypass. The teams worked so diligently for approximately 6 hours, but 3 month old Shanel’s heart was just too sick for her little body. Her repair was done beautifully by Dr. Mwambu and Dr. Turrentine, but coming off bypass just did not work for her tiny body. At approximately 8 PM, after Dr. Mwambu had a long talk with her mother, Shanel passed. She may have overall lived a short life. However, she was not only loved by her parents, but shown so much love by the UHI and Riley/Rotary teams by working with everyone’s skills to give her the best possible chance at life. Apparently this was not the higher plan for sweet Shanel… May she rest in peace.
The team left quietly approximately 9:00 PM, knowing this was little Shanel’s only chance at life was the operation today…This certainly does not take the pain of losing a precious baby on the operating table. We will operate on Frederick tomorrow first since his surgery was delayed today. His parents were very understanding. He was able to have a dinner and share the step-down room with the fun girls, Barbara and Patience who were quite proud of their new hats from he Riley ICU nurses Becca and Sheila.
With the hope and excitement of Barbara and Patience, we look forward to lives SAVED tomorrow…
Riley/Rotary Vocational Training Team Trip 2014 to Uganda Heart Institute- Day #3 Operations Underway!
We start the day with the usual breakfast, but then an earlier departure to UHI. George, our faithful driver, is at the hotel ready before our requested 7 AM departure. We arrived at UHI, started preparing the OR and ICU. The ICU looks as pristine and ready to go as we have ever seen it! With new cords to match their monitors for EKG,sats, and Blood pressure cuffs all purchased with money from last year’s grant, they are all labeled and ready to go!
Anesthesia was soon out to to take our first patient of the day, Patience, back to the OR. She was in the room with her father Tony and seemed incredibly scared. She does not understand English we are told, so us talking to her certainly did not help. Sheila finally reached out for her and scooped her into her arms to take her back to the OR with Dr. Walker.
It should be noted with GREAT emphasis that the UHI team was all here and ready to go when we arrived near 7:30. The scrub nurses Ben and John, Dr. Joseph, the anesthesiologist, Moses (the Anesthesia assistant), and Murra of perfusion were in the OR and ready to go. Looking back to our first years, this is a really important improvement! With these efficiencies, the surgery was officially underway just after 9AM. What an accomplishment!
New equipment is utilized in this case from grant money as well… A new vaporizer is on the heart lung bypass machine (AKA the “pump”) which allows for delivery of anesthesia directly through the pump. This is a much more efficient and useful method of delivery on bypass. Rotary money again at work here!
Patience has an ASD and was repaired completely by the UHI team. Dr. Turrentine never even scrubbed in! He discussed with Dr. Mwambu and Dr. Oketcho certain aspects and gave pointers at critical points,, but the UHI team completed Patince’s operation completely as a team. With Murra on the bypass machine, Dr. Joseph at anesthesia, John as scrub nurse (Chass never scrubbed either), and Ben circulating, UHI had this covered. What an exciting sight for our fifth return trip!
Rob, our friend and Executive Director from Gift of Life International, arrived this morning from the most recent mission to Manila. Informal discussions and meetings ensued (because Rob’s presence creates meetings! :). We have found that there is no pediatric TEE probe, so anyone under 17kg cannot have a intra operative echo. This could create quite a conundrum and may change the schedule or the possibility of operating on 6 of the planned patients! Rob quickly called Chain of Hope in London and is still working on the specific arrangements for arrival of a proper probe ASAP.
In the meantime, Patience was transferred to the ICU with the new Lifepack monitor system purchased from grant monies from the 2013 grant. What a great addition to be able to fully monitor the patient during transfer. Previously, the patient came off monitor in the OR and was restarted once in the ICU. A lot can happen in approximately 30 yards, so this is a fantastic equipment addition!
Our longtime ICU nurse friend Anna is one of several prepared nurses who took back Patience with Sheila and Becca. Her parents soon were let in to see her and help comfort her. All goes well with her transition to the ICU.
Brenda was so excited to go back for surgery. She did not seem scared at all! She is a beautiful, glowing, friendly 9 yr old whom everyone instantly loves when they meet her! Dr. Schimmelpfennig checked her over earlier in the morning and was also the one to escort her to surgery….after posing for this fun picture!
Again, the UHI team cared for her alone until she was cannulated and on bypass. Dr. Turrentine donned his favorite headlight purchased by a District grant from the Rotary Club of Greenfield and joined the team at the operating table. Shockingly, Dr. Turrentine was even found to conform with our new gift for all the team members- the Rotary/Gift of Life hat! :).
(ok, so no picture yet of Dr. T in the hat, he evaded many…but here is our circulating friend Edith in her hat!, She was so excited she giggled and hugged me so tight!)
Brenda’s surgery went very well and the team recovered her in the ICU. In the meantime, apparently Dr. Cordes was asked to see with Dr. Lubega a 3 month old baby who is very sick with critical pulmonary stenosis. Plans were made to operate on this child between the two planned cases tomorrow.
One of our friends paying her own way to join us to observe (because it is not covered by the grant if not a working, medical, pre-approved Rotary International part of the team) is Rotary Club of Greenfield’s Immediate Past President Sara Joyner. She and I found our way to the RC of Kampala North’s meeting as well. Just when we were contemplating the straight road to the Hotel Afrikana in a 2 mile walk, Sara noted a man in a suit wearing what she thought was a Rotary pin. Soon after, I found him in the ward with the pre-surgical children and families. He introduced himself as Rotarian Sam from the RC of Kampala North, just 20 minutes before we would need to leave to go to the meeting! Prayers answered! Rotarian Sam was such a wonderful host transporting us to the joint meeting of all the surrounding clubs who meet on Mondays. They have this more informal joint fellowship every 5th Monday. It was a packed room of probably 150-200 Rotarians. WOW! What a vibrant group of Rotarians! Many familiar friends through the years to visit and we scurried out then for the hotel to meet the team.
It was fairly late to finish dinner, but overall an early night out of the hospital for the team… I am told Trina and Dr. Mastropietro
arrived in time for a shift change-over about 7:15, call phones were given, and all are ready. Tomorrow we plan 3 cases!
In the meantime, Rob worked diligently to arrange for Emma from Chain of Hope to transport a TEE probe for smaller children to Entebbe via a flight tomorrow morning. What a saint she is to abandon London in a heartbeat to fly to Entebbe for 2 days overall! The alternative unfortunately is to cancel 7 of the now 12 cases planned…not an option for this team, AND thankfully not an option for Emma from Chain of Hope! THANK YOU EMMA AND CHAIN OF HOPE!