Riley International Heart Missions

Riley/Gift of Life/Chain of Hope Lebanon Humanitarian Mission #2 -Day 5

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Not as much success extubating yesterday’s surgery patients, but they have all had a good and stable night. And actually recovering as expected. We have one more case today, but first a few pics of our kids from earlier in the week who are out on the general cardiac floor unit.

Adam our patient with bilateral bidirectional Glenn’s from Monday. Not too happy to see us but doing very well

Nour who had Tetralogy of Fallot repair on Monday looks amazing on post-op day 3!

Madien who had VSD closure on Monday is also doing great

Heather with Fatima who had a Glenn procedure on Tuesday

Mouhammed and Sheila with Marwa. PA band done Wednesday who still needs a day or two before being ready for extubation

Hammoud who had a Glenn procedure Tuesday, waiting to be transferred out of the ICU

Our last patient of the mission was Maram Ismail. She is a 2 and a half year old from a suburb of Aleppo, Syria. Her family moved to Saida early in the war. According to her parents there is currently a battle occurring in their home town. They have 4 other daughters but Maram is certainly the most spoiled. She will be our 4th patient to have a Glenn operation. Her heart defect is a form of single ventricle called double inlet left ventricle. Her pulmonary valve did not form, and when she was an infant she had a BT shunt performed. Her case went very well, and Dr. Al Rassi came in at the end of the case to help close.

Dr. Amanda and Dr. Mark with Maram

Kristin and Mike our perfusionists with Maram

Hammoud OR team members helping us with every case

Dr. Al Rassi, scrubbed in to help finish the case

A local 6th grade class raised money to help pay for one of our patients this week. They came to visit and were fascinated by everything.

Mouhammad about to explain some of the medical care being provided to one of our post-op patients

Later taking a photo with our team. Appearing more relaxed out of the view of tubes and monitors

Afterward, we packed our trunks and bags and headed to Beirut. Some of our Riley team are heading back to Indianapolis tonight (2am Friday). The others will travel over the weekend. We have a few meetings and events scheduled with leaders from AUB.

We have had a very successful Humanitarian Mission with all of our shared patients progressing well. Our interaction with the everyone at Hammoud Hospital and our colleagues from AUB has been wonderful. We are honored and humbled by the kindness and generosity everyone has shown us.

We again want to thank the generous support we received from our primary sponsors:

The Josh Linblom Foundation

Gift of Life International

Gift of Life Indiana

Chain of Hope

Gift of Life Lebanon

And our hosts:

Hammoud Hospital

American University of Beirut

Saying Farewell to Lebanon

I also want to acknowledge the help of our own Dr. Riad Lutfi who provided the brief background stories of our patients – helping to bring home the impact of these missions.

Written by tcordes757

May 3, 2019 at 12:15 pm

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Riley/Gift of Life/Chain of Hope Lebanon Humanitarian Mission #2 -Day 4

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All of our patients who had surgeries yesterday did well overnight. The last of them was extubated around 11 PM. Today we are helping them deal with their postoperative pain and start feedings.

Nour Jomma with chocolate still on her face – a powerful analgesic indeed

Hammoud struggling to hold his bottle as he drifts off to sleep

We began with three more cases for today. First was the most challenging – Zeinab Abdullah 15yo from Lebanon – due to the fact that she was a repeat surgical case with a pulmonary conduit that had adhered to the inside of her sternum. This proved impossible to avoid while Dr. Al Rassi tried to open her sternum, so she needed to be placed on bypass from her femoral vessels. She had a successful pulmonary conduit replacement, and arrived in the CVICU in stable condition, although requiring support with IV medicines.

Our next case was a 12 day old baby – Omar Al Wawi – who came to us from a nearby hospital. There a new pediatric cardiologist who had moved back to Lebanon after 17 years of practice in France, diagnosed her with a severe coarctation of the aorta. He had this repaired from the left side and did quite well.

Finally our third patient was Marwa Maarouf, who is a 2 month old with double outlet right ventricle and the need for a pulmonary artery band to allow her to gain weight before a complete repair when she is a few months older. Prior to this operation she was always breathing fast and working too hard to breath. She was gaining weight very poorly. She also did very well.

Dr. Tim and Dr. Mark with our friends and colleagues from AUB, Dr. Ziad (left) and Dr. Issam (right)

Our combined OR teams from Riley and Hammoud Hospital

Although we only had one patient today that needed to be on heart-lung bypass, it was a long day. We returned to our hotel around 5:15 in order to get ready for a sunset dinner in old Saida. At this dinner all of the people who helped to make this mission possible including the doctors, nurses and many other support individuals at Hammoud Hospital, our friends from American University of Beirut, and our Riley team were honored and thanked.

The restaurant we went to is dedicated to empowering woman and the old recipes and food traditions of Lebanon. This an appropriate photo in this place of our own awesome women teammates: Heather, Emily, Brittany, Sheila, Kristin, and Amanda.

Tomorrow we finish with one more surgical case. Then we pack our trunks and bags and move to Beirut.

I’ll add some more photos and background stories to this post tomorrow. It’s late and time for sleep.

Written by tcordes757

May 1, 2019 at 7:26 pm

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Riley/Gift of Life/Chain of Hope Lebanon Humanitarian Mission #2 -Day 3

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Our patients all did well overnight.  The 4th patient, Fteim was extubated around 8 pm.  One by one we anticipate these patients will be moved out of the CVICU today.

Madien feeling much better today on post-op day 1!

Today we plan on 3 more patients. The first patient is Hammoud Allou – a one year old originally from Aleppo, Syria. His family moved to Lebanon 2 years ago. He has 3 siblings, with one who also has significant heaLth problems too. He is here with his mother and grandfather as his father is also at home with chronic health problems. Hammoud was diagnosed since infancy with severe tricuspid and pulmonary stenosis, hypoplastic right ventricle and previous right BT shunt. This a form of single ventricle, and today Dr. Turrentine performed a Glenn operation with BT shunt takedown. His previous operation was done from the front, and the scarring made it challenging to get safely back to his heart to do this procedure. However, it all went well. Due to some post-op bleeding we likely may keep him intubated tonight.

Dr. Amanda and Dr. Mark in the operating room with Hammoud

Heather, Sheila, and Riad in the CVICU

While this operation was proceeding, Dr. Al Rassi was operating on an eight month old patient named Fatima Farhan. She has tricuspid valve atresia with a very small right ventricle and another version of a single ventricle. Dr. Al-Rassi also performed a Glenn operation, as well as enlarging her left pulmonary artery. She is also from Syria but her family moved to Lebanon 4 years ago after the family’s home was destroyed. She did well with today’s operation and was expected to be extubated shortly after surgery.

Dr. Issam Al Rassi with Fatima

Our third case was with Nour Jomma. A nearly 3 year old with a large VSD. Her family left Syria 6 years ago and live in northern Lebanon. Her grandmother is with her and described living under Isis for 3 years. She has many stories about their brutality. She escaped her home and traveled by foot and car for 6 days to reach Lebanon. She shared how much suffering the Syrians have gone through in the areas controlled by Isis. Nour clinically she seemed to be in congestive heart failure. But a cardiac catheterization suggested high pressures in her lung arteries that could make her situation much more risky. Fortunately in the OR things appeared much more favorable, and her VSD was closed without complication.

Nour Jomma with her dad – not so sure she wants us to check her sats preop

After our cases, we had a wonderful and informal gathering with many of the patients we cared for on our first Lebanon Mission last year. They are all well, and appear as happy and beautiful as we all could hope.

Of course they all lost their smiles just as we took the picture. And the 2 on the right are heading for the food table. 😂

As always, we are tired by the end of our days, but having an amazing time partnering with the great people from Lebanon to provide heart operations for these deserving children.

Dinner at our hotel. Well, …soon. The amazing food is on its way.

By the way – I will go back and add some family details on our patients as I am able to. Just working through my language barrier. So please go back to see today’s and previous days’ posts if you’re curious.

Written by tcordes757

April 30, 2019 at 8:08 pm

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Riley/Gift of Life/Chain of Hope Lebanon Humanitarian Mission #2 -Day 2

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I realized that yesterday I forgot to introduce our team. So without further ado…

OR Group:

Brittany Mote OR Scrub Nurse

Emily Saunders OR Scrub Nurse

Mike Horner Perfusionist

Kristin Ewen Perfusionist

Amanda Stram Cardiac Thoracic Resident

Cardiac ICU group

Sheila Rocchio CVICU nurse

Heather Dornbusch CVICU nurse

Riad Lutfi Pediatric Cardiac Critical Care Doctor

Mouhammad Yabrodi Cardiac Critical Care Docto

Here and There Group + blogger

Tim Cordes Pediatric Cardiologist

Here and There and Team Leader

Mark Turrentine CT Surgeon

One Team!

And so we began Our first day of surgeries. Our first patient was Nour Kassem, a 7 year old with tetralogy of Fallot. She was already in the operating room when we arrived to the hospital so we don’t have our typical picture prior to surgery. However she did very well and was extubated quickly. She was adorable holding onto her Barbie doll which we brought with us as part of her gifts. Her family is from Idlib in Syria and she and her family moved to Sour Lebanon seven years ago, due to the war. She has eight siblings and her family describes her as very shy. All she wants is mai (water in Arabic). Throughout her life she’s been cyanotic with significant clubbing of her nails. As soon as she woke from surgery today she asked for mai.

Brittany, Amanda and Mark at the start of Nour’s operation

Noir resting after surgery with her Barbie

Our second case of the day was Adam Kanaan. He is a one and a half-year-old boy who had a complicated form of single ventricle known as an unbalanced AV Canal. Today he underwent a bilateral bidirectional Glenn. He also did very well and was extubated shortly after returning to the cardiac ICU. Adam is the oldest child from his Palestinian family. He was born in Sour, Lebanon – about 45 minutes south of Hamoud Hospital. He was examined in the United Nations office after birth, and because of their exam findings he was referred to cardiology. An echocardiogram was done by one of UAB’s pediatric cardiologist Dr. Ziad Bulbul. And this referral for repair was made.

Adam sleeping after his operation also with a doll from Sheila’s bag of gifts.

Madien (9 yrs old) was our 3rd case today. He was diagnosed since birth in Syria with a VSD. He was scheduled to have this repaired at the Childrens Hospital in Damascus in 2011, but was unable to due to the war. He is the 3rd of 5 children. The family moved to Lebanon 2 years ago but could not afford the operation and were referred to this mission opportunity. His operation went well and he was recovering well in the CVICU.

The fourth case today was Fteim Chehadeh. A 10-year-old who was discovered to have a severe discrete symbiotic membrane with a very high gradient. She had previously had a coarctation repair as an infant. Recently she has had worsening fatigue with activity. Her family is originally from Al Raquel, Syria. They moved to Lebanon a few years ago to escape the war. She is here with her father while her mother is back home with their other children.

Emily in the foreground and Mike in the background, helping with perfusion and circulating duties.

The main reason we are able to do four cases today and still be back to our hotel by 6:15 PM is due to the fact that we could run two rooms with the help of Dr. Al Rassi and the team from Hammoud hospital. It is a very productive partnership and we will be splitting cases this week.

We are looking forward to a quiet evening at the hotel tonight with dinner near the sea. Then back to Hammoud Hospital tomorrow for four more successful cases.

Written by tcordes757

April 29, 2019 at 5:09 pm

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Riley/Gift of Life/Chain of Hope Lebanon Humanitarian Mission #2 -Day 1

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Preparing to load ourselves into the vans to our hotel

A few of our new members for the Lebanon Mission-Emily, Heather, Kristin, and Brittany

We arrived to Beirut Saturday afternoon after an uneventful trip from Indianapolis, and were greeted by our friends from Hammoud Hospital and American University of Beirut. We were taken to our beautiful hotel on the Mediterranean Sea to clean up quickly and then travel to Hammoud Hospital for a brief orientation tour.

Dr. Mark Turrentine, Dr. Issam El-Rassi with Dr. Ghassan Hammoud (founder of Hammoud Hospital University Medical Center – HHUMC). Dr. Hammoud had the original vision for developing a joint humanitarian mission for pediatric cardiac surgery in Lebanon in Saida.

After a good nights sleep we gathered in our hotel conference room and reviewed our cases for the week. The pediatric fellows from American University of Beirut did a great job presenting the echoes and Cath data, and our plans were settled.

We reviewed 13 cases from simple to very complex and decided on 12 for the next 4 days!

Our 11 member team with friends from Hammoud Hospital, Gift of Life, and American University of Beirut. Ready for an amazing week.

Our trip this year has several amazing sponsors. It is only through their efforts that we have this incredible opportunity to help the children in this region on this trip.

The Josh Lindblom Foundation – supporting team expenses and surgery cases

Gift of Life International – supporting surgery cases

Gift of Life Indiana – supporting surgery cases

Chain of Hope – supporting surgery cases

Gift Of Life Lebanon – mission host

Hammoud Hospital – mission support and hosts

American University of Beirut – pediatric cardiology & pediatric cardiac surgery support

Written by tcordes757

April 28, 2019 at 5:12 pm

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Riley/COH/GOLA/GOLI/Rotary clubs of Amman and Greenfield VTT mini-mission Amman March 2019 day #3

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Dr. Tsang and Dr. Riad beat everyone up early this morning to get to the hospital before Victor’s departure to the airport to see all the children and their families one last time.

The rest of the team arrived to the hospital around 8:30 and made ICU rounds.

Aghyad cannot wait for his first bottle. Normally his mother would breastfeed him, but since his effusion is looking chylous, we need to give him formula that is fat free. He really didn’t seem to care what he got once he tasted the first drop !!

(He’s telling his mother thank you for the food!)

(Dr. Gavin examining Aghyad)

Miriam is doing better today-sitting up bed, seems happier, eating, chest tube and lines out. Probably will go to the regular floor tomorrow.

(Miriam, her grandmother, Ruba and her mother)

Ameer also is doing very well–remember his parents told us that he never sleeps, only 1-3 hours/day. He slept last night !!! In the noisy ICU…his parents thought something was wrong with him! There is …his heart is fixed….he is no longer uncomfortable and breathing fast. So happy to see this because mom handles all 4 kids (boys!) ages 12 and under in her own !!

Firas is doing very well post-op day #1. He’s some pain but very stoic kid. His family also fled Syria in 2015, he has 3 siblings (2 sisters and a brother) and his parents live in Amman. His dad works construction. He had a murmur heard a regular check-up and the DMSAS was discovered.

And finally, Shaima’a did well overnight …no significant pulmonary hypertension issues so we extubated her first thing this morning after we arrived. She was so excited to be able to see her parents and they are so loving with her…was really heartwarming to see. Hopefully her course will continue to be a smooth one after we leave and know that she will have a very healthy life now!

We were able to get in our annual picture with the team and all the ICU staff. This is also becoming a tradition we do at the end of each mission.

We packed up our equipment and said our goodbyes to the families and staff.

(Emptying out our “unofficial” office -head nurse Rami’s office 🤣)

We were able to get in our last tastes of our favorite Jordanian /Syrian food before we headed to the airport. Falafel at AlQuds and Syrian ice cream at Bekdash!

We want to thank everyone involved in our successful 26th “mini-mission”.

Riley Hospital, Dr. Mark Turrentine for always leading our cause -even if was from his couch this year 😉, and our colleagues for covering our work back home.

Chain of Hope, Dr. Victor Tsang, Dr. Gavin Wright, Emily Miller and Oroyo Eubanks for participating and helping us staff our mission on last minutes notice. Was a wonderful opportunity to work with some amazing physicians and organization as always.

GOLA, board and committee members and president Na’el and his wife Ruba. Gracious hosts, chauffeurs, meal planners, and all around amazing people and organization to support the families, patients, team members and fundraising ( the gala was a remarkable success!)

Rotary Clubs of Amman and Greenfield, Indiana, Dr. Stephanie Kinnaman, for your continued support of fundraising, global support and VTT grants. Missions could not be possible without these philanthropic efforts.

GOLI, Rob Raylman, we appreciate you always supporting our team and missions-often times in person as was the case this week!

Dr. Khaled Salaymeh, his wife Rania and the staff of the ICU, OR, nurses, anesthesia, Dr. Sami at Al-Khaladi hospital. Our partnership has remained strong for 12 years and hope it continues to remain for years to come. You are family to us…and we are grateful for the relationships we have developed with all of you.

Last but not least…our families..for supporting and cheering us on during our work here from afar. Couldn’t do what we do without your love and support …

Until our next visit…in’shallah…shookran, shookran.

Written by drannefarrell

March 6, 2019 at 7:23 pm

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Riley/COH/GOLA/Rotary Clubs Amman and Greenfield VTT mini- mission Amman March 2019 day #2

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Arrived at the hospital at 8:00am today and Shaima’a was already back in the OR to get prepared for surgery !! (Good start to the day)

We made our ICU rounds…chest X-ray and echo shows Aghyad has an effusion. He is having a bit more trouble breathing this morning so we will put a chest tube in this morning.

Mariam did well overnight…she had a fever but is looking good this morning. Still very wary of our group.

Ameer finally got some food this morning and is a much happier boy!

Wanted to give more background on the Children and their families stories:

Aghyad was born in Amman, Jordan, 1 month ago. His mother is from Homs, Syria and his father is from Deer Alzour, Syria. They met in Jordan in 2015 and got married. They have another boy who is 2 yrs old. Father studied Arabic literature and was a teacher in Syria but escaped Deer Azour and never finished university. The pediatrician heard a murmur at 2 weeks of age and diagnosed with coarctation. His mother said this child makes her “feel like a mom” because he knows when she’s there vs. her 2 year old who doesn’t care and when she leaves treats her like a second wife !! (Wow that sounds familiar 🤣!)

Mariam was born in Irbid, Jordan. Family is originally from Dara, Syria and moved to Jordan in 2013. She is their only child and the mother lives with her mother and brother. Mariam’s father works in Kuwait. Mom cannot visit him because of Visa reasons, and he usually visits every 8 months. She was diagnosed with a murmur at age 2 months, and then had surgery with a PA band right afterwards by Czech mission team in May, 2018. She has had symptoms of breathing fast and not gaining weight. Her mother says she is very good-but spoiled and picky eater.

Ameer was also born in Irbid, Jordan and his family is also originally from Dara, Syria (south where revolution started). They moved to Jordan in 2012. Dad works in Kuwait and is visiting now for the surgery. Mom cannot visit due to Visa issues as well, and dad visits every 6-8 months. He has 3 other brothers, ages 6-12 and the grandmother watches the children . The parents told Dr. Riad last night that he never sleeps -only 1-3 hours a day and very active!! He was diagnosed with a murmur at 6 weeks of age and then his heart defect was found. He has had significant failure to thrive. Hopefully that will now change and he’ll gain weight easily!

Shaima’a is a 16 month old Syrian girl with Down syndrome and a complete AVC defect, essentially a very large hole between the lower chambers and smaller hole between the upper chambers. Her family now lives in Irbid, Jordan and is also originally from Dara, Syria and moved to Jordan in 2012. She has 3 older sisters ages, but her father said he loves her the most 😊

(Pre-op Echo of her large AVC defect)

(Dr. Tsang and Dr. Barsan working on Shaima’a)

Things went very smoothly in the OR…and her repair looked great. No shunting across either her VSD or ASD patch, and her mitral valve had minimal leakage. She will need some medications and support on the ventilator , at least for the next 24 hours to have manage the Pulmonary hypertension that she has developed. But her operation went as well as could be expected.

(Echo showing the patches closing the VSD and ASD).

We were able to get a second room for the Second case today so we moved along quickly —Firas Adel Layeh, 6 yr old Syrian boy with discrete membranous subaortic stenosis (DMSAS). Essentially he has a membrane of tissue that has developed below his aortic valve and is obstructing blood flow through the aorta. He can also develop leakage of his aortic valve due to the membrane-so it is usually removed before that happens.

His surgery went very well-a large membrane was removed and the valve now has no leakage or narrowing.

(Picture shows the valve opened -and the membrane (white tissue seem in opening) below the valve.)

Firas arrived back to the ICU extubated and doing well.

(Even gave us a peace sign with Dr. Kal and his father!)

After we left the hospital… we got ready for the annual GOLA fundraising dinner. We were honored to be guests at this wonderful event hosted by the Na’el and Ruba and the GOLA board and committee members. Rob Raylman from GOLI arrived yesterday to attend and speak at the annual event-which is always great to hear from him. There was fundraising, great food and dancing –but most importantly , camaraderie for one common goal – to help little hearts ❤️

(Honored guest patient Joana and Dr. Kal)

Written by drannefarrell

March 5, 2019 at 11:10 pm

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