Riley International Heart Missions

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Final Day!

leave a comment »

It was a late night for the team…  Packing up for the travel home this morning for most of the team and reflecting on an emotional and exhausting and yet successful week here.  This Riley team puts their heart and soul into these missions and wants to make everyone proud of this life-changing and life-saving work.  We might wear our “hearts on our sleeves” a little more by this time of the week and often tears flow to leave these beautiful kids who touched our hearts forever…

Dr. Anne, Dr. Riad, Sheila, And Mike left together Friday morning and Katy from COH left for London a little earlier.  

Dr. Mark has one of the last lectures of the day at the conference today.  We rounded on all the kids this morning before attending the conferene.  They all look just amazing!  

Eyad continues to improve and will likely go to the floor soon.

Rama looks good.  Will start feedings today.

Lamar’s sats are better.  Her parents are soooo sweet…  but she is still a little scared of us if we get too close!

Osama is doing great.  His mom wanted to snap all kinds of pictures with us this morning…  πŸ™‚

Sulakshi looks amazing!  Up walking about!  Smiling more as well!

Hawra’a looks great.  Up and about on the floor as well.


Miasar is looking good on the floor also!

Dr. Mark met up with a team from Sulamaniyah from the Kurdish region of Iraq at the conference .  He knew them from a visit there before…

Dr. Mark did a great talk about the Global Burden of Congenital Heart Disease and discussed the team’s work through missions in three very different parts of the world with different challenges in tackling CHD- Amman, Beijing, and Kampala, Uganda.  Very well done! I’m told Dr. Anne and Dr. Riad’s talks were quite the highlight yesterday as well!

Conference attendees at the end of the day.

We made one more trip through the ICU and Dr. Kal took this great pic with the ICU team and the two little ones in the ICU- Rama and Eyad!
Cannot stress enough how honored we all are to finish this incredibly successful week of 14 surgeries and 1 cath on our Adyan!  It is such a privilege to be welcomed to Al Khalidi to transfer skills with this receptive and hardworking team…  It is such a privilege to be welcomed to Amman to work collaboratively with the Amman Rotarians and GOLA… And it is such a privilege to help these beautiful children in any way we can!

Thanks to all who make this work possible- Chain of Hope, GOLA, Rotary D6560 Gift of Life (Indiana), Rotary International, Rotary Club of Greenfield, Rotary Club of Amman-Petra, Rotary D6560, other Rotary Clubs of Amman and D2452, Riley Hospital for Children, Al Khalidi Hospital, all the donors, and of course our families!  We are so honored to represent you all!

Until next time, “INSHALLAH”!

Written by stephkinnaman

March 12, 2017 at 2:56 am

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 7!

leave a comment »

We had a busy night of catching up with old and new GOLA friends! Another wonderful night of celebrating with our partners Wednesday’s 200th child helped by our partnerships!


Thursday we added on 2 more cases.  One adult congenital heart disease patient for Chain of Hope, and a tiny 6 month old with a PDA.  Dr. Riad and Dr. Anne gave two lectures each at the Annual Pediatric Review Conference hosted by Dr. Kal, so today was a different kind of “busy”!

We rounded on our ICU patients before going to the OR…Ruqayya was still on the vent, later successfully extubated and is doing so much better!

Osama is doing well in the ICU as well…


Lamar from Iraq is looking better and sats are up to the 70’s%, which is what we hope for…

Eyad is doing well, better overall.  


Sulashki is doing very well also.  She moved to the floor later that day.



Miasar is in the floor, doing great!

Marwa is looking better and will go home!   πŸ™‚


Hawra’a moved to the floor I believe that day as well.  The amazing thing about this sweet girl is that her pulmonary arteries have already doubled in size!  This is amazing great news for her!  A girl who was told she was inoperable…  πŸ™‚

These amazing pictures of super cute Yousef are thanks to Katy from Chain of Hope…  He has gone home!


This morning’s case was an adult male with a huge ASD.  Laith was born with this problem, but is now 29 yrs old and is Short of breath with any exertion and cannot lay flat at night.  He is at risk for a stroke with this large ASD as well.  Chain of Hope has agreed to cover one adult congenital case per mission, so he was an add-on today.  Dr.  Mohammad had gone home to Saudi Arabia for work, so I scrubbed in to assist with this huge, heavy heart compared to what we had been working with all week!  He is from Karuk and is here with his brother.  His case went very well and he was transferred to the ICU. 

The next case is a tiny little girl, Rama.  She is 6 months old with Pierre Robin Syndrome.  She had a very pale and almost gray color to her before surgery.  She has a cleft palate which needs repaired as well, so has to take her feedings via NG tube.  She is so sweet!  She has a Patent Ductus Arteriosus, PDA.  She is failing to grow well from that , so could use that closed.  It is not an open heart case and should be an “easy” add-on.  However, it wasn’t so easy.  The PDA was hard to access from the normal incision.  Her anatomy was just “different”, making it more difficult to access.  Dr. Mark was slow and steady and of course successfully located the PDA.  I didn’t get a preop picture…

We then checked on everyone in the ICU. Sheila was busy with all the new post-op patients and Dr. Riad and Dr. Anne were lecturing at the conference.  We got all the instruments accounted for and in the right cases to pack for home. Little Rama was successfully extubated once Dr. Riad came back from his lectures.  We then went out with Na’el and Ruba for dinner to celebrate an incredibly full and successful week!  14 cases and one cath by this team in 7 days!!  Dr. Mark and Dr. Anne went to dinner with the speakers from the conference while the rest of us were going out with Ruba and Na’el.  We were going to celebrate the March birthdays, but poor Katy was feeling a little under the weather. So, we let Katy blow out her candles at the hotel and then Ruba did it at the restaurant…


Everyone has worked so very hard this week!  It has been a FANTASTIC mission highlighting the work over 10 years between these growing partnerships with the busiest week in 10 years, 20 missions.  So much of you all to be proud of!!!

Written by stephkinnaman

March 11, 2017 at 7:02 pm

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 6

leave a comment »

We had a wonderful evening last night with all of our GOLA friends and Rotarians and GOLA supporters…  a few more lovely pictures to share now…




What a lovely evening honoring the work GOLA has done and prepares do for the little hearts!

Unfortunately, during this uplifting evening, Dr. Riad and later Sheila went to the ICU as little Khaled (the Czech mission’s patient on peritoneal dialysis) was really taking a terrible turn for the worst.  His family felt he had been through enough already…  All the family came in and he sweetly opened his eyes and smiled one last time to his family before he later passed away in the night.  So very very sad…

This morning, we rounded quickly in the ICU…  Ruqayya (AV Canal defect) was still on the vent and looking comfortable.  Treating with some meds to try to help get her off the vent soon…

Miasar looks great!  Awake and alert this morning!

Harwa’a’s sats are coming up a little more and she was awake and alert this morning also… 

Love this!

Eyad looks like he is kicking back and relaxing!  

Sulakshi looks much better today and her mom was smiling.  Much improved!  Of course, she is not even 24 hours since her surgery!


We headed to the OR to start fairly early.  It was before 9 when we started the case!
While we got started on the morning case, Dr. Anne and Sheila and Dr. Kal saw the patients on the floor…

Yousef will be discharged today!  He seemed to like this picture of himself that Katy had on her phone…



Hasan, our first case of the mission, will go home as well.


Muntathar will go home as well!  All are doing great!


Mwar needs to get up some more today and get around, then she will likely go home tomorrow as well.



Little Osamah is a 4 year old boy from Iraq with Tetralogy of Fallot.  His case goes well and we had him back up to the ICU before noon!

Dr. Riad and Sheila have been working with Ruqayya again on her vent settings and heart rate and blood pressures…  They have been hopping all week!!

Dr. Anne messaged that an old friend was in Dr.Kal’s clinic, so we headed over to find little Farrah!  She was just a baby on the first mission when she was first operated and then came back in a year for her completion Fontan.  She is now 12 years old, has 12 brothers and sisters, and is doing great!  She greeted each of us with a handshake and kiss on each cheek and the most beautiful smile!



That was a lovely reunion for Dr. Mark and Dr. Anne!

They were ready in the OR again after a quick look at the kids in the ICU…

Lamar is a 2 year old beautiful little girl from Iraq.  She is sooooo cyanotic!  Room air sats are about 60%.  Preop TEE was going to help decide the operative plan for this complex heart problem…  She has a hypolastic tricuspid valve (or tricuspid atresia) and RV which may have needed a Glenn shunt.  TEE helped to see it all better and a plan was made for a Right Ventricular Outflow patch.  However, Dr. Mark was not convinced at the end of that repair on TEE that it was quite how things needed to be…  So, he then did a Left-sided Glenn shunt as well.  Oxygen sats vastly improved (80’s room air).  She will still need another surgery later down the road…

This beautiful little Lamar is the Riley Team’s 200th case here in Amman at Al Khalidi!!!  How perfect that she is wearing a darling little dress sent from the US by a founder of GOLA, Marikay Satryano!  It is a special trip here indeed, marking this team’s 20th trip, 10 year Anniversary, and now the 200th case!

She was transferred to the ICU and we had a late lunch about 4…  Adyan was here again today for a cath as well.  Dr. Kal did a balloon angioplasty of her right pulmonary artery to get more blood flowing to the lungs…  


Another cath followed by Dr. Kal that he wanted consultation with Dr. Anne and Dr. Mark as well…  Considerations for a future mission.

Riad has shared some Riley Critical Care Walk-a-thon shirts with the wonderful ICU nurses.


Possibly a case tomorrow while many of the team will be speakers at Dr. Kal’s Pediatric Annual Conference.  Dr. Mohammad is flying back home to Saudi Arabia tonight and will be on call for the weekend, poor guy!

Tonight, we will meet with some old friends and founding Board Members of GOLA before possibly our final day of operating….

It has indeed been a momentous day!

Written by stephkinnaman

March 8, 2017 at 1:56 pm

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 5

leave a comment »

Another big day today in Amman!  We met up with Matt Cook, president of Riley Hospital for Children and Dr. Elaine Cox, Infectious Disease specialist and Co-Administrator Riley’s CV Services last night…  Then, after we had a very late dinner, Rob Raylman, CEO of Gift of Life International, happened to come down to the hotel lounge/restaurant as well!  The gang is all here now!

We had our usual breakfast, but joined by Rob and Katy this morning and then headed to the hospital.  Dr. Kal said it was a quiet night, which is great!

The team rounded on the kids in the ICU and I’m told all were doing well.  I was waiting on our visitors in the lobby of Al Khalidi, so I missed rounds and morning pictures…

The Chain of Hope sponsored children from Iraq arrived late last night.  Katy brought them from the airport and checked them in to the hospital. 


They met us in the ICU for echos with Dr. Anne and for the team to meet them all.  They are just adorable!  Osama is 4 yrs old and has Tetralogy of Fallot.

  Lamar is a 14 month old girl with tricuspid atresia, VSD, pulmonary stenosis who will need a Glenn procedure.  Everything looked ok on echo for surgery tomorrow as planned, thankfully!


We made it down to the OR for first first case.  Eyad is a sweet little “blueberry”…  :). Such a sweet 9 month old Syrian boy who has super complex heart disease and is obviously cyanotic (hence the “blueberry” comment, stolen from Dr. Anne) with sats in the 70’s%.  He was stented twice by cath in the PDA/PA to try to continue to allow mixing of the blood to get some blood oxygenated…  his Right ventricle is hypoplastic (small), the tricuspid valve leading into it is hypoplastic, and multiple other lesions (HRV, HTV, multiple ASDs, VPS, PDA- with stent).  After checking some things in the operating room, Dr. Mark decided to do a Hemi Fontan which will create more mixing of blood.  This makes the next stage some 1-2 yrs later the completion Fontan and finally separates circuits for the venous and arterial blood…  One of the things I love most about these trips (besides seeing the amazing, life-changing surgeries for these wonderful families!!!) is to learn…  I’ve had more time the last couple days to “read up” on these complex lesions and the repair a little more thanks to wifi in the OR (thanks Mo!!! 😊). I hope that has added a little more for the non-Cardiology people like me reading the blog!

Things went well and we had multiple special visitors watching!  Dr. Cox and Matt Cook joined in on the fun!  And Hannan is back in the OR!  Yay!  Issam and the other scrub nurses have been absolutely fabulous, but we probably have the most history over the years with Hannan.



Matt and Elaine on the right while Amjad is circulating sporting his Riley scrub hat on the left.  Perfect!  “Mumtaz”!

Eyad was moved to the ICU.  He needed to be extubated as soon as he woke up because he appeared to have a good leak around his ET tube…  Poor Sheila, as if she wasn’t busy enough, was holding the ET tube in just the right spot to keep his sats reasonable until he woke up enough to extubate.  We learned when we went up to the ICU that little Ruqayya did not tolerate extubation this morning and was pretty quickly reintubated.  She is stabilized now back on the vent.

Hawra’a, the central shunt twin girl from yesterday is doing  well and posed for a sweet picture with Dr. Riad!


Sheila was busy this morning handing out more Riley tattoos before her “shift” even started caring for the patients!  They are a HUGE hit with the men and women! She has been bringing special Riley bags and goodies every day for the staff and patients!


When we came up from surgery, little Shadi from the Syrian refugee camp came for a visit after his clinic check with Dr. Kal.  He was a tiny little guy in September when the Riley/Rotary team operated on him and Chain of Hope arranged for his care. (See the rileymiddleastmissions.wordpress.com blog by Dr. Anne in September 2016). He has grown so much since the team last saw him!  Amazing!

Claude (seen lower left in the above picture) is such a blessing to us and so many of these patients!  He has helped with access to the camps (to visit Shadi and Basel in November), to get the Iraqi families their visas, and helps arrange food at lunch often for the hardworking team!  Thank you, Claude!

We headed back down to the OR for the second case of the day.  Sulakshi is a sweet 6 yr old girl from Sri Lanka who had Tetralogy of Fallot/ absent pulmonary valve and was operated at 3 months of age by Dr. Mark in Amman.  She now has some pulmonary insufficiency and a dilated right ventricle.  So, Dr. Mark and Dr. Mohammad did a pulmonary valve replacement with a Contegra and Pulmonary arterioplasty… Takes a little longer as a “redo”….  and finding the right size Contegra for this sweet little gal required some discussions as well.  Complex stuff going on today!!!

Between TEE and taking Dr. Cox and Matt around as well as consults with Dr. Kal, Anne found the time to see Harwa’a awake!  She’s so adorable!

And Muntathar is up walking and transferred to the floor!

And Mwar is walking…

Sheila and Riad were busy with getting the new patients from the OR stabilized and insisted on staying while the rest of us went on to get ready for the GOLA Fundraising Gala.  They somehow got in and ready in such a short time and we all were all ON TIME for the event!  Wow!  

It was a lovely night sponsored by COH.  Na’el and Rob both spoke eloquently about the importance of this 10th anniversary of our team’s missions and the importance of GOLA in the lives of 360 children since its inception well over 10 years ago!  The organization has had many vibrant leaders through the years, but the goal remains the same- to help these little hearts!  Jood from our November mission was a special speaker as well as another Jordanian boy Dr. Bassam operated.  


Well done, Ruba and Na’el and all of GOLA!  What a fun night! 

Written by stephkinnaman

March 7, 2017 at 7:31 am

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 4

with one comment

We were counting on a busy Monday…  Three cases planned, more visitors coming from the US to join our team, and clearly more patients in the ICU.  I think we all felt a little more rested today, which has to help as well…

We started in the ICU to check on the kids…  Khaled (the Czech team’s patient), is still very sick, but thanks to dialysis, many of this numbers have vastly improved.  Potassium has come down to normal and renal function numbers are improving as well.  He might need a pacemaker placed before we leave later this week…

Hasan, our first patient of the mission, is doing great!  He will move out of the ICU today…


Yousef is doing well also.  He will likely move as well.


Joury looks amazing!  She surprised us when she walked around the corner as we checked on the X-rays!  We thought it funny that she was carrying her shoe cover/booties as if she was saying, “You want me to wear THOSE?!”  I would love to call her a diva to be funny, but this sweet little gal actually lives in the Palestinian refugee camp of Jerash….


Muntathar looks typical of Postop Day 1, no smiles yet, but we’ll get there!  Vitals look great and he is plugging right along…

Mwar was definitely not a happy camper this morning.  Her numbers also look great and she will continue to be monitored in the ICU today as well.

We then checked on a 24 yr old complicated congenital heart disease patient.  She was somehow only diagnosed about 3 years ago.  She is Syrian as well.  Her oxygen sats are only in the 60’s. A sign of this going on for so long is that her fingers are so clubbed.  She needs surgery, but needs some dental work done first and some more studies perhaps to determine the type of repair that will help her.  Without repair, she will suffer more and more.  So very sad.  Hopefully, Dr. Mark and the team can help her on a future mission!



Anas is another possible case for this mission or another upcoming mission.  He had surgery some time ago here at Al Khalidi, but likely needs at least one valve replaced now.  He was smiling through the entire echo.  Smiling and waving.  Just adorable!


After all of this, the super-efficient OR team had been waiting on us to start the first case of the day…  We started with little Ruqayya.  This is Ruqayya from 2 nights ago when Dr. Anne did her echo:


Ruqayya is a tiny 8 mos old girl whose family is from Pakistan.  She has a Complete AV Canal defect with a PDA.  This is the most common heart defect in kids with Down syndrome.  She is tiny for her age and her sats are a little low most of the time as well- 85-87%.

Ruqayya’s case went quite well.  The TEE by Dr. Anne looked great.  Our dear friend Mo who is the head of the OR came back for old time’s sake to do the perfusion with Mike!


Ruqayya moved to the ICU and the OR team prepared for our next case, a shunt. In the meantime, our ICU team and also Dr. Kal came from clinic to help a different patient in trouble in the ICU (not a mission patient).  Dr. Anne was left in his clinic to do some echos and check out some possible patients for missions on her own for a bit.  They have all been so busy, working hard for our mission patients and others!

After a brief lunch for the OR part of our team, we were off to the OR again.  Miasar is an almost 10 month old from Jordan with a complicated complex of problems with her heart causing her to have low oxygen sats- 70’s%(ASD,VSD, pulmonary atresia, hypoplastic PAs).  She will need a set of staged procedures to grow some more sizable pulmonary arteries to get blood to her lungs for oxygenation.  Today, we placed a central shunt.  This will help to grow the pulmonary arteries to work with later down the line and may help her with her oxygenation now.  Dr. Anne did her echo last night.  How cute is she?! (… until she screamed bloody murder throughout the echo, she said! πŸ˜‰)



Miasar’s shunt went well and rather quickly.  We were notified in her case that we could indeed do the third case… and even better, we would have another room to get started right away!  Harwa’a’s case was a little iffy for multiple reasons since last night.  Although Dr. Kal and Dr. Anne did her echo and told the parents she was considered for surgery in his clinic this weekend, when called for admission, her father was out of the country.  He apparently must sign consent, so that could’ve been a problem….  That was worked through and she was admitted.  This morning we were told that she didn’t have any “papers”, which would cause problems getting blood products.  Thankfully, all that worked out for her and the OR team was ready for Dr. Mark and Dr. Mohammad as the second case finished.

Harwa’a is a 6.5 yr old girl from Syria.  She has the same complicated set of defects as Miasar (VSD, pulmonary atresia, ASD, hypoplastic PAs…).  However, because she is older, she has more collaterals and so her sats are a little higher.  Her family has been told there was no hope for surgery or any repair for her, but Dr. Mark felt she could be helped, so would do a central shunt for her as well and try to grow some pulmonary arteries.  Truly amazing that she has lived this long with her defect as it is….  Dr. Anne found out later she is a twin.  How scary and sad to think for this family that one of their twins had no hope for adult life… We certainly love the idea of giving this and all the families renewed hope!  Her shunt case went well also.  Dr. Mark made good use of the new Scanlan instruments thanks to the Ferlands and Appleton Medical’s assistance.  Here they are in action:


Dr. Anne and Ruba found Marwa awake and feeling better!  We didn’t have a good picture from the morning, so Dr. Anne wanted to snap a good one as she is in better spririts…


Marwa took her phone and just started snapping away!  So, Ruba and Dr. Anne taught her how to take a proper selfie!  πŸ™‚


After Harwa’a’s case, we went to the ICU to check on everyone.  Sheila and Riad and the Al Khalidi team were super busy with all three of these new patients operated today!  Working on extubating all of them and getting things stabilized…



Discussions again ensued on the possible surgery line-up for tomorrow…

Finally, we saw some recorded images of another patient for further discussion and decided on two cases tomorrow.  One is a shunt and a second, longer case with follow with a Tetralogy of Fallot with no Pulmonary valve. Tomorrow night is the big GOLA Fundraising dinner.  We must finish and get to that on time for our GOLA friends who are our partners in making all this work possible for the children!  Rob Raylman, CEO of Gift of Life International, and Matt Cook, President of Riley Hospital, and Dr. Elaine Cox, Co-Administrator of the CV Service Line at Riley have joined us this evening in Amman.  They will also be there to see the children tomorrow.  It’s a big day!

So, off to the hotel we go to prepare for a full long day tomorrow!  Goodnight, friends!

 

Written by stephkinnaman

March 6, 2017 at 3:11 pm

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 3

leave a comment »

We had a lovely dinner of Arabic food last night thanks to Ruba and Na’el and finished early enough to get them out in time to pick up Katy from the airport.


Dr. Riad and Sheila after our dinner went back to the hospital to check on little Khaled who had started peritoneal dialysis.  They were there until about midnight checking that this all started well.  They told us that the Czech team was there as well checking up on their patient.  They were relieved that despite his setbacks, he is in good hands with Dr. Riad and Sheila with the Al Khalidi ICU team.  They came back this morning as well just before their departure.  They are a great team who operated on 12 Syrian patients in 6 days!

Na’el with our Riley Team, Dr. Kal, and the Czech team and some of Khaled’s family

Khaled’s potassium is a little better today after starting dialysis last night, but his renal function is improving and he has made a little urine and epi drip is coming down.  All good signs…  Sheila is determined to have him “eating candy” by the end of the week…  πŸ™‚

Dr. Riad with the Czech team’s Cardiologist/Intensivist discussing little Khaled

Hasan is doing very well.  Nursing well and heart rate is better.  We turned his pacer off and will watch him one more day before transferring him out of ICU.

Hasan gave us a few smiles!

Yousef is doing well also.  He is eating well, vital signs look great and he is moving along nicely for postop day 1.

img_5473

Dr. Riad and Sheila and Al Khalidi ICU nurses with Yousef

Joury looks great as well.  She is having some liquids and vital signs look great…  She isn’t necessarily happy about all this just yet of course, at postop day 1!

Joury, Postop Day 1

Our first case of the day, Muntathar, is 8 years old and originally from Iraq.  He had a VSD repair when he was just one year old here at Al Khalidi.  In follow-up, he was found to have aortic insufficiency that has over time worsened.  It was thought he may need a new valve, but with a closer look on echo last night, it appeared it may be repairable.

Muntathar with the team, (Dr. Anne took this one)

He was in the OR and ready, but we were waiting on blood products to come to the hospital before we could really get started.  He is a redo, so that takes more time to get down to the repair…  We started at 9 and were all done by 12noon.  The case went so well, with everyone chipping in and doing what they do best to repair Muntathar’s valve.  He had a sizable hole in one of the leaflets of the valve that Dr. Mark and Dr. Mouhammad repaired with a carefully prepared piece of pericardium. The valve closed so nicely when all finished with no residual leak at all!  Beautiful!

img_5458 Dr. Anne teaching Dr. Luna TEE- Dr. Luna did the post-repair images with Dr. Anne looking on!

We had several visitors in the OR today as well.  GOLA had some great publicity as a local station interviewed Dr. Kal as well as Na’el live, then a cameraman came to the OR as well with Na’el to film a little.  Ruba visited as well.

img_5468 

(Mike overseeing Muntathar’s surgery, all ready to throw in the right kind of patches for the repair!)
All the while, Sheila and Dr. Riad are handling things in the ICU and Katy arrived!  So excited to have Katy join us this week from our partner group Chain of Hope out of London!  Katy went straight to work to meet the families after catching up with the team.

Katy and Sheila on a brief coffe break

Dr. Anne has been busy with consults in Dr. Kal’s office between TEEs.  She said so many sad cases needing help, yet all complex.  We may be operating some of these kids on following missions.  Dr. Kal will continue to follow up with them, of course.

While the OR team prepared the patient for the next case, we ran down for a quick lunch in the hospital cafeteria.  We were quite surprised when Dr. Anne messaged and met us down there with some special visitors- Noor, Adyan, and Rnad!  Many of you will recognize these sweet faces from past Amman missions and most recently, their longer stay in Indy 2015 for her last two surgeries.  They live in Baghdad now, but can come to Amman for Adyan’s appointments.  She will get a cath this week by Dr. Kal to possibly open up one of her pulmonary arteries Dr. Mark so carefully created over several stages and years of surgeries…  They look amazing!  Rnad says she misses her school she attended for a short while in Indianapolis.  She liked it better than her current 1st grade in Baghdad, she said.  They are overall doing well.  Adyan and Rnad both are doing well in school and looking adorable, as always!  Can you believe Adyan is so much bigger than Rnad now?!

Adyan is getting SO much taller!

Noor, Dr. Ann, Adyan and Rnad

Rnad, Dr. Mark, and Adyan

Off to the OR we went for Marwa’s case… Marwa is a 13 year old girl with Down Syndrome from Syria.  Despite her apparent complex Tetralogy of Fallot, she has not had any cardiac interventions at all.  Her family moved from Syria to Jordan 5 years ago.  Her diagnosis was established at birth and was followed by a cardiologist regularly in Syria, but has been told there was nothing that could be done.  However, a friend 2 mos ago referred her to Dr. Kal and here she is getting her heart fixed!  She will certainly function better daily with her repair… Two mos ago and for 13 years, this family had no hopes or sweet Marwa, but here we are!  She will really be running and skipping down the halls here at Al Khalidi even more!

Dr. Anne with Mwar

Dr. Anne sent me a picture of Muntathar already looking fabulous in the ICU!  Sheila brought so many gifts and little treats for the staff all week!  She will likely have an empty suitcase for all the gifts she is unloading here!  She is amazing!

img_5492After Mwar was moved to the unit and did well after extubation, we headed to Dr. Kal’s office to work out some details for the cases for tomorrow and perhaps the rest of the week.  Two patients from Iraq were attempting still to get visas that we had slated for surgery this week, or at least evaluation, but still do not have official word on their status to travel.  We only have 3, maybe 3.5 more days to operate, so time is getting short…  Everyone is doing their best!  It was an earlier night to the hotel as we all need some rest for THREE big cases tomorrow!  Five cases done now and we are not quite to the halfway point of our proposed number.  The Riley and Al Khalidi team are doing just an amazing job… making everyone proud!

Written by stephkinnaman

March 5, 2017 at 11:02 am

Posted in Uncategorized

Riley/Rotary Vocational Training Team with Chain of Hope Mission- Amman, March 2017- Day 2

leave a comment »

The evening was busier than planned… The newly-arrived team members had little time to rest and recoup from the long travel to Amman…  Dr. Kal came to take the entire team out for a bite to eat. We enjoyed a brief, somewhat chilly walk for Shawerma and the some Syrian Kanafe.

 As soon as we arrived back to the hotel, Kal received a call one of the Czech team patients was doing very poorly in the ICU.  Most of the team jumped in Dr. Kal’s car and rushed to the hospital where at least 2 hours of work resulted in an improved status…  What a way to start the week for our weary travelers!  They were fabulous in stabilizing this patient with the Al Khalidi team, but he is certainly in critical condition.

Saturday morning brought a breakfast all together…  It was a nice time of around a big round table to catch up on the happenings of the evening at the hospital for those of us who stayed back and plans were made for the day.  We knew the day would be full.  The plan was for a VSD in the morning and a TOF repair in the afternoon.  Dr. Kal brought us to the hospital and caught us up on the kids.  The Rastelli patient, Khaled, is the boy with the troubles last night.  He continued to need an awful lot of epi and some calcium, but the team was thrilled to see his eyes open and responsive (although still on the vent, of course).  He would continue to be work for today for Dr. Riad and Sheila while Dr. Kal is in his clinic.

Dr. Anne doing an echo on Khaled in the ICU

Our little Hasan, the VSD from yesterday was overall doing well.  He was more awake and pleased for Ruba as she visited later.

Our first patient of the Mission- Hassan

Dr. Anne did an echo on our second planned case for the day, Joury.  Joury is a 2 year old Palestinian with Tetralogy of Fallot.  Sats are 87-90% as recorded…  she is just beautiful!

Joury

After plans were made for Joury, we proceeded to the OR.  Little Yousef is a 22 mos old Down syndrome sweetie with a pretty sizable VSD for his small frame.  He is Syrian and came late Thursday night because they had to await a Police escort from the Refugee camp where they live.  The amazing Al Khalidi team had things moving right along and waiting for us when we arrived to the OR…  Turns out I had spoken too soon and Dr. Mouhammad arrived to Amman very early this morning, about 3 AM, so Dr. Mark would have to wait for a real surgeon to assist him in the afternoon.  All went well for little Yousef. His VSD was closed beautifully and the new instruments made Dr. Mark smile with glee with his new, wonderful Scanlan instruments made possible by the generosity of the Ferland family.  For 10 years, he has been using old instruments that were put aside for missions only because they were somehow deemed less than ideal for use at Riley.  These new instruments actually hold the needles and tissues as they should and they are amazing- saving so much time and frustrations and stress!  Thank you to the Ferlands and Scanlan and Appleton Medical!!


 Just a few of the awesome new Scanlan instruments thanks to Ferlands’ donations!

Yousef was moved up to the ICU to the capable combined team of Al Khalidi and our Riley ICU team.  Plans were made settling him in nicely…

Dr. Mark, Dr. Riad, Sheila, and Mike discussing iStat readings and ICU care

Little Khaled was still struggling…  not tolerating weaning the epi and in some apparent renal failure.  He will be dialized this afternoon.  Blood pressures are labile…

We visited with Ruba in the ICU who was here to see the kids and joined us some in the OR some for Moh’d’s case as well.  We also checked in on all the kids in the ICU and then it was time to start the second case.  The tall, thin surgeon who I was starting to think was only a figment of Dr. Mark’s imagination actually arrived in the flesh!  Dr. Mouhammad was of course a very welcome sight meaning I can blog and watch surgeries from a little father off!  :).  Dr. Mouhammad is Jordanian, did his medical school training here in Jordan and trained some in the US as well.  He is now a Pediatric Cardiac Surgeon in Saudi Arabia.  He helped Dr. Mark during the September 2016 Amman mission as well. Thank you to Dr. Mouhammad for making the trip to Amman for our team and the beautiful children!

Issam, Dr. Mouhammad, and Dr. Mark

Joury, 2yrs old, as noted before had Tetralogy of Fallot and is Palestinian.  Her case with Dr. Mouhammad assisting (clearly a little height difference to adjust for…  πŸ˜‰) went well.

img_5431

Much discussion with Dr. Anne over the post-repair TEE

After Joury’s case, we were able to catch up with Sheila and Dr. Riad who were still working diligently getting the epi drips turned down on Khaled.  He is passing some urine now, which is good…

Yousef was awake and extubated and not happy about his empty bottle, but finally settled down for his mother and drifted to sleep.

img_5433

Yousef

Dr. Anne brought up proposed cases for tomorrow for echo…  Three patients were checked out, 2 arranged for tomorrow and the other should be done Monday.

Marwa is a sweet Syrian 12 year old Tetralogy of Fallot patient who has not been previously operated for her heart at all and never formally diagnosed with any genetic disorder, but certainly appears to have Downs Syndrome.

Marwa


Ruqayya is a tiny 7 month old with an AV Canal who is Pakistani.

Ruqayya


…. and then Mr. Personality shows up πŸ™‚ …  Muntathar is a small 7 year old patient who had a VSD repair when he was just 1 year old, but now has severe Aortic Insufficiency.  By echo, it appears perhaps Dr. Mark and Dr. Mouhammad could repair rather the replace this valve, which would be great for him.  His mother was encouraging him to use his English with our team.

Muntathar


Muntathar and the whole team!


Our first full team pic with our proposed first patient tomorrow, Muntathar!

Sheila and Dr. Riad are already planning on coming back after dinner for the peritoneal dialysis for Khaled and following back on Joury who is doing well extubated so far…

Joury


We anxiously await the arrival of Katy from Chain of Hope this evening after dinner arranged by Ruba and Na’el!

Written by stephkinnaman

March 4, 2017 at 12:09 pm

Posted in Uncategorized