Riley International Heart Missions

Rotary/Gift of Life Lebanon VTT #1 -day 5

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All week long we have been trying to figure out the schedule for Thursday – our originally anticipated last operative day here. We had planned to do one or two cases, then leave around noon to Beirut. But there are many different activities that need our attendance. So a quick change of plans and we are doing 4 cases today – and none tomorrow. Tomorrow we can round, do some echoes, say our good-byes, pack our trunks and head out to Beirut. Elaine Cox (Riley Chief Medical Officer) and Matt Cook (Riley President), arrived last evening. Today they are seeing our activities and friends in Saida at Hammoud Hospital. Tomorrow they and Dr. Turrentine are meeting with leaders at American University of Beirut. Tomorrow night the Gift of Life Lebanon is having their annual Gala in Beirut. So a pretty busy day ahead today and tomorrow.

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Dr. Elaine Cox (Riley Chief Medical Officer) and Matt Cook (Riley President/CEO)

 

Our first patient today was a late add-on – Atef Samir Al Souweidani. He is a 2 and a half year old with a diagnosis of tetralogy of Fallot. During the operation, Dr. Turrentine realized that we could not save the pulmonary valve, so the repair required a patch to close the VSD and another patch across the pulmonary valve and into the pulmonary arteries. This went very well but it is a big operation with a significant chance for some post-op issues overnight.

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Dr. Lola and Dr. Turrentine operating on Atef

 

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Souad and Mike working together in the OR

 

Our second patient today was Abbas Jalil – a 10 month old male from Syria, with a large paramembranous VSD and small PDA. Dr. El Rassi closed these defects. And everything looked good afterwards.

We then moved on to Mohamed Jaber also from Syria. He also has a paramembranous VSD with a significant amount of blood going toward his lungs – large enough that it needs to be closed. Dr. El Rassi and Lola began this case after lunch. The operation went well and, he should recover nicely over the next few days.

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Dr. El Rassi and Dr. Lola closing Mohamed”s VSD

 

Finally, we performed the 3rd VSD closure of the day on Safa Chemali -an 8 year old female with Down Syndrome. Her VSD was somewhat complex and she had a small residual VSD seen at the end of the operation when we did the transesophageal echocardiogram. This will not be a significant problem and she should do well.

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Dr. Lola assisting in the last case of the day/mission

 

These were our cases today, and they were done with the hard work and high efficiency from our combined Riley and Hammoud teams. A pretty amazing synergy developed in a short time.


We again learned more details of the trials of our patients and their families, exemplified by Atef above. He is one of a set of twins, from a family of 8 children who have lived in Lebanon for 5 years. They came here after their home in Dora was bombed. They receive some support from the UN, but there lives here are hard. Atef was diagnosed after his mother began noticing that he was having blue spells – a problem that can gradually worsen in a child with tetralogy of Fallot.

Throughout this week we have enjoyed using a new GE Vivid IQ portable echo machine and pediatric transesophageal probe – purchased with a generous donation through Riley Children’s Foundation. And realized by amazing effort and support from GE who delivered the machine, set it up and trained us in record time just before departing last week for this mission.

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Echo rounds this morning before we left for Beirut

 

After these cases were finished, we enjoyed several small and large ceremonies of appreciation for the trip.  New friendships and collaborations have been formed, and there is excitement about the future.

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Our post mission celebrations – the bottom image includes almost everyone involved in the mission from Riley, Hammoud, GOL, Rotary and COH.

 

Sheila and Riad stayed at the hospital tonight with a full CVICU and several children still on the ventilator.  The rest of us were treated to a cocktail and appetizer gathering with Rotary Club of Saida.  Their support and generosity have been wonderful.  And to add to the all of these celebrations, it was Lola’s birthday!

I will add more photos to this post Thursday morning after we see all of the children…..Here they are:

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Morgan with Hala who was out for a walk this morning

 

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Amira doesn’t want to smile for us, but she is so adorable we don’t even mind

 

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Mohamed was not so happy after we changed his dressings.  However, he is reovering very nicely and will be moving to the telemetry unit soon.

 

We are all in Beirut now except for Dr. Yabrodi who is watching the patients today and overnight.  Tonight there is a big Gala that Lina has been planning and coordinating for Gift of Life Lebanon.  Tomorrow a little sight seeing for the team, and then we begin the long journey home.  It is always hard to describe the very strong friendships and bonds that we make on these trips and in such a short time.  And how many children along with their families who we are able to help.  On our rounds this morning we confirmed that all of the kids we performed operations on are doing well. We already miss everyone and the kind and beautiful country of Lebanon.

Thank-you to EVERYONE who made our trip so productive and enjoyable!

Written by tcordes757

May 10, 2018 at 4:54 am

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Rotary/Gift of Life Lebanon VTT #1 – day 4

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A few of our team are getting better, a couple still have a day to go they think. But our enthusiasm is strong. Dr. Turrentine has named the affliction “Lola Virus” as she seemed to be one of the first to be affected. And so we began day 4. Rob Ralman – President of Gift of Life International, and Katie from Chain of Hope arrived yesterday afternoon/evening. Riad said the night was good with all patients stable and behaving. After checking out to us and Mouhammed, he left to go back to the Hotel for a meal and sleep.

more friends

Dr. Ziad  (AUB), Rob Raylman (GOLI), Dr. El Rassi, Lina Shehayab (president and founder of GOL Lebanon, Nadine Sakakini (Liaison for everything), Katie from Chain of Hope.  These are the tireless friends of this mission, helping it all work so smoothly.

Our first patient today was Abdelrahman Salem – a 21-month-old from Yemen, with Levo-transposition of the Great arteries, a large VSD, and pulmonary valve atresia. He had a central shunt placed in his first year of life, but has become progressively more blue with saturation in the 50-60% range. You saw his picture from our day two post when we were touring through the hospital. He had catheterization yesterday that was not too surprising but revealed a significant and discrete left pulmonary artery stenosis. All of those diagnostic terms above basically mean he has very complex heart disease. At the time of the operation Dr. Turrentine and Dr. Rassi will directly measure the pulmonary pressure, and if they are low enough they will perform a bidirectional Glenn (connection of the superior vena cava to the right pulmonary artery) plus patch the left PA narrowing. This went very well, and now he will need to recover.

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Drs. El Rassi and Turrentine working together on behalf of Abdelrahman

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Abdelrahman later in the day drinking water from a syringe and very happy about it.

I mentioned above that Abdelrahman was from Yemen.  A country currently embroiled in a devastating war.  To reach Hammoud Hospital required a 5 day journey – much greater in effort and time than usual.  After his operation his saturations are 89% – a huge improvement to before.  Perhaps in the future a more definitive surgery can be attempted to help this beautiful boy.

The second patient was Noha Awad – a 19 year old female from Lebanon born with Pulmonary atresia with a VSD. She had had a previous shunt, and later repair with a pulmonary valve replacement. She also had a history of a post-operative mediastinal infection which will make her surgery more difficult. She needs another pulmonary valve replacement, and enlargement of the right pulmonary artery. Although her surgery was very challenging, Dr. El Rassi was able to succeed in the valve replacement and proximal right PA enlargement.

Our third patient of the day was Amira Kachak. A 6-year-old Syrian girl with a somewhat late diagnosis of an isolated cleft mitral valve that had a significant leak. This heart defect usually is in combination with other atrial and ventricular septal defects which is why we specify “isolated”. Left untreated, this would eventually create many problems. Her repair also went very well and we anticipate a good recovery.

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Amira sleeping comfortably right after surgery.  She was extubated shortly after this photo and doing well.

Every day, we are doing the surgeries and post-op care that we have been trained to do, and which for us are somewhat routine.  But the extraordinary trials and long journeys of these children and their families is not.  One of the patients I have reported on already grew up in Daraya Syria.  Sadly a city in the middle of the Syrian civil war conflict.  The rebel and Syrian forces have battled there for years, and this child’s family had to leave their home.  They have been displaced within Syria multiple times, and finally 3 years ago traveled to a Lebanon refugee camp.  There, this patient’s heart defect was discovered and she finally found her way to this place and time. Thanks to Rotary Club of Greenfield Indiana and Saida, Gift of Life International and Lebanon, Hammoud Hospital, Riley Hospital, American University of Beirut, University of St. Joseph in Beirut, and the many kind and generous people working on and supporting this mission, she was helped.  Her home city was recently completely destroyed in a major battle to win control from the rebels.  So her family does not have a home to return to.  Her family of brothers and sisters still look to a day when they can go back to Syria.  But perhaps her experience here has brought a piece of hope towards that uncertain future.

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That darn ship has been anchored there for days.  But the sunset was still truly amazing.  Perhaps another sign of good things and hope.

Written by tcordes757

May 8, 2018 at 8:59 pm

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Rotary/Gift of Life Lebanon VTT #1 – day “3”

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I realize that it is actually our 4th day here but we were off yesterday for the Lebanon National Elections.  The first in 9 years and under new rules.  And it was a Sunday.  So we laid low at our hotel. Happily the elections went off without any significant problems – so things seem back to normal.

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Most of our team (not sure where the others went for this pic) having dinner at the hotel on our off day.  Thanks Lina for sending me the picture.

And so…today we began with our first cases.  The Riley team was very anxious to begin, and we headed to Hammoud Hospital at 7:30 am.  A few of the team were suffering with upper respiratory illnesses but would not let this slow them down.  Positive thinking and physical fortitude were the primary therapy – plus some cough lozenges and ibufrofen.  Before the surgery detail, we want to say, “Happy Nurses Week!” to all of our nurses in Indianapolis and here.

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Sheila and Morgan – our fearless CVICU nurses

Case one is a 6-year-old girl named Reina.  She has a moderate ventricular septal defect (VSD), a second smaller VSD, and developed very complex muscle bundles and scarring in the area below the pulmonary valve.  She needed the VSDs closed, the scarring and muscle bundles cut away, and a patch placed below the pulmonary valve.  Her heart looked great after the operation. In the second operating room the next case was being prepped. 

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Mike (our perfusionist) working with the Hammoud perfusionst to learn their equipment and share our approach for CV bypass.

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Reina waking up after surgery with her parents.

Omar is 17 years old and was born with tetralogy of Fallot which was repaired earlier in life.  Later he had a pulmonary valve replacement.  Over time this valve has become very narrowed and also leaks.  So he needs to have this valve removed and a new pulmonary valve replacement placed.

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Dr. El Rassi working on Omar (his patient) to lead in the valve replacement. His work with the assistance of some Riley resources.

Our 3rd patient of the day is Hala.  An 11 year old with a late diagnosis of Partial or Transitional AV canal defect – a specific type of atrial septal defect, a unique form of leaking mitral valve and a very small VSD.  She also did very well and is expected to be extubated shortly after she moves into the CVICU.

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Hala bravely watching Tony (Hammoud Anesthesiologist) start her IV in the OR.

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Besides our own Angie, we were helped by the experienced Hammoud Surgical Scrub Nurses. Here with Dr. Mark and Dr. Lola is Souad Fneich.

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and here in the foreground right – Moussa Abbas.  Their assistance helped make the first operative day of this mission a success.

All 3 cases went very smoothly.  The Hammoud team is skilled and confident and our presence here allows for a sharing of experiences and techniques, plus an addition of resources and capacity to address the great need of the refugees here.

Our team still needs a really good night of rest to recover from this cold.  But another good day lies ahead.

Written by tcordes757

May 7, 2018 at 8:12 pm

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Rotary/Gift of Life Lebanon VTT #1 – day 2

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Day 2 – Welcome, Hospital Tours, Seaside Lunch, and Surgical Planning

We all got to relax and some able to sleep in comfortable rooms here at the Golden Tulip. I think we could get used to the sound of the sea outside our windows. But a full schedule of activities awaited. Trunks were taken to Hammoud hospital and readied for the week ahead. Then we had a welcoming gathering and tours of relevant areas of the hospital. We were treated to a delicious lunch at Saida Rest House. Right on the sea and next to an ancient Crusader Castle.

After lunch we returned to our hotel and the Pediatric Cardiology Fellows presented the 11 planned cases and 3 backup cases. They did a great job and we had many excellent discussions about various approaches to complex heart defects. Then Dr. Turrentine and Dr. El Rassi set the schedule. Three cases between 2 OR rooms Monday, Tuesday and Wednesday, and 2 cases on Thursday.

The day ended around 6 pm. Lola went to the airport and retrieved everyone’s luggage and the TEE probe. We’re heading out to dinner later to a restaurant recommended by Lina – our GOL Lebanon host. Tomorrow is election day here and we have been told traffic will be even worse than the Lebanon usual (which is famously terrible). So we are staying at the hotel. Maybe a walk on the beach …..before the real work begins.

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Lina and Banda Kalash (Rotary Club of Saida past president) with one of our patients for the upcoming week

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Blended in with our Riley team – the Hammond Hospital doctors, nurses, administrators, coordinators, liaisons, plus GOLL and Rotary of Saida. Wonderful new friends here.

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13th century Crusader Castle next to our lunch locale

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Lunch at the Saida Rest House

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Surgical case reviews by the AUB Pediatric Cardiology Fellows

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Mediterranean Sea from the Golden Tulip Hotel

Written by tcordes757

May 6, 2018 at 10:49 am

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Rotary/Gift of Life Lebanon VTT #1 – day 1

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Day 1, first mission to Lebanon.

Thursday, May 3 another Riley pediatric cardiac surgery team began their journey to Lebanon. Indy to JFK, to CDG, to Beirut in a mere 18 hours. Unfortunately about 9 bags didn’t get through Paris, including our pediatric TEE probe.  Air France says we will have them by tomorrow afternoon.  But all of our trunks made it. Our plan is casual dress day tomorrow 😁

This is our first trip to Lebanon, where we plan to operate on disadvantaged children from southern Lebanon and from nearby Syrian refugee camps.  We will be working at Hammoud Hospital in Saida, about 30 min south of Beirut which is closer to these patients than Beirut.  The staff there and the pediatric heart surgeon from American University of Beirut Dr. El Rassi , are excited to work with us and be our hosts for this mission.  All of our great friends and support from Rotary Clubs in Greenfield Indiana, The Rotary Club here, GOL International and GOL Lebanon, and Chain of Hope from London will be here to help in this inaugural mission.

We begin tomorrow with a welcoming meeting to introduce ourselves to each other, go over cases for the week and unpack our trunks at the hospital. The small “scout” team that visited last November already know how beautiful the country and people of Lebanon are and are eager to get started.  So tonight we need to sleep.

Our Team:

Dr. Mark Turrentine

Dr. Tim Cordes

Dr. Lola Chabtini

Angela Hawn – scrub nurse

Michael Horner – perfusionist

Morgan Lamping – CVICU Nurse

Dr. Riad Lufti – Cardiac Critical Care

Sheila Rocchio – CVICU Nurse

Dr. Mouhammed Yabrodi – Cardiac Critical Care

 finally at t he hotel

Our Team along with Lina, George and Joe from GOL Lebanon, relaxing at our hotel before we get a bite to eat and head to bed.  Dr. El Rassi took the picture.  Lola was whisked away by her mother and sister for a mini reunion.

Written by tcordes757

May 4, 2018 at 7:27 am

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Amman Riley/Rotary GOLA final updates

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Wanted to share with everyone these updates and pictures from the children last week ..especially Rua’a who had the most difficulty all week so I didn’t have much to post about her. (Photos all courtesy of Ruba Karadsheh)

Well..she was extubated yesterday and looked good today with saturations 84%!! Hoping she is able to start feeding and then get out of the ICU soon. So happy to see those gorgeous big eyes again!

Khadejeh, Adam and Yaseen were discharged from the hospital on Saturday!

Above: Adam

Above: Yaseen

Khadejeh escaped before they could get her picture !

Noralain, Joury, Maher and Ahmad were all discharged yesterday! They were playing with balloons and gifts the GOLA members brought them for their farewell party!

Above: Joury and Noralain becoming friends ❤️

Noralain and her aunt Magda

Above: Joury

Above: Noralain trying to walk her way out of the hospital

Above and below: Maher

Above: Ahmad

Karar went home today (he was our last case on Thursday before we left)

9 of the 10 children have been discharged …and hopefully Rua’a is not far behind

Thank you for following this mission’s blog❤️

Written by drannefarrell

March 12, 2018 at 9:55 pm

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Amman Riley/Rotary VTT with COH and GOLA final goodbye

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Maher

Adam

Noralain

Joury

Ahmed

Our Riley Heart Team just finished the 6th Trip under the current Rotary International Global Grant (co-sponsored by RC of Greenfield and RC Amman-Petra, local Rotary Clubs of Jordan, Palestine and many clubs in Cyprus, UAE, Armenia, Sudan and supported by GOL Amman and overseen by GOL International) and finished operating on 10 children from the region including Iraq, Syria, Yemen and Jordan. So many more lives have been saved because of Chain of Hope’s partnership in these missions. This was our 23rd trip for the Riley Team to Amman over the last 11 years and we are so thankful this amazing partnership.

We want to give special thanks to all our partners:

GOL Amman (GOLA) and the board members, especially chairman Na’el Mushrabash and his wife Ruba.

Special thanks to Laila and Diala, Ramzi and all the board members for their hospitality to our team.

GOL International and CEO Rob Raylman for all his support and arranging to come to the fundraiser and mission in person.

Chain of Hope and their amazing partnership thank you to Oroyo Eubanks and Katy Woolley, Emma Scanlan and Lucy Osaack. Thank you to Melissa Cortizo for your work in filming these missions and sharing these children and their families’ stories.

RC Greenfield, Indiana and RC Amman-Petra for your work and support of the global grant ; Dr. Stephanie Kinnaman for your guidance and work on these mission trips.

Al-Khalidi Hospital and the staff of the OR, ICU, pharmacy and nursing staff. Their time, commitment and talent to these mission trips is invaluable.

Dr. Khaled Salaymeh, he has worked tirelessly for 11 years on this partnership and work and we cannot thank you enough for everything you do.

Our families, friends, work colleagues for allowing our team time away to perform this important work -we couldn’t do any of this without your support.

And lastly …I want to thank our amazing Riley team…

Dr.Mark Turrentine for his leadership, passion and commitment to this important work …your skills and healing hands are magical and have given life back to so many broken hearts.

Dr. Kamal and Dr. Samer for giving us a glimpse of what it’s like to return to your native countries to give back care and passion to these families …what a gift to watch you work amongst families that are not given access to care that we are used to here

Melissa and Kristin…for being seasoned veterans in providing your expertise of care and skills ..even though this was a new culture and environment for both of you ..thanks for giving your hearts and souls to this mission and the families

Thanks for following on our journey and the blog…until next time

Written by drannefarrell

March 10, 2018 at 4:10 am

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