Riley International Heart Missions

Amman Mission #15- Thursday, our Final Day

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We enjoyed a great dinner with Dr. Kal and Dr. Abass last evening after a quick stop at Dr. Farrell’s favorite local store for a couple souvenir gifts.  Mijana was a beautiful restaurant with a gorgeous view of Amman in the evening.  We enjoyed wonderful food and great company with Dr. Kal and Dr. Abass.  Thank you!


  

We unfortunately missed an evening visit by the Rotaract group from Amman Cosmopolitan.  They visited the children and saw GOLA and Rotary’s recipients of this “Service Above Self”ongoing project and collaboration.  Thank you Rotaract of Amman Cosmopolitan!
  
Rotaractors with Raihana

This morning was a quick start…we rounded on the ICU patients, but the OR already had our first patient back to the OR!  

Sham (from the mission before us) was not able to come of the vent last night as she spiked a fever and has been breathing fast.  She has started her IV antibiotics as of yesterday, so that part is good.  She will continue to be monitored closely.

Rusul (postop day 2 VSD) is doing well.  She will likely get some lines and tubes out later today and transfer out of the ICU. 
 

Rusul eating an apple

 
San (postop day 2 TOF) is doing well also.  Will stop his oxygen which he had only been on routinely, also get some lines out and transfer as well.
 

San

 
Wesham (postop day 2 Glenns) is looking great.  Quiet and sweet, chewing on his finger as we checked him out this morning.  He is nursing well and was anxious for us to leave so he could get to that! 

Wesham

 

Fatumah (postop day #1 PA patch and valvotomy) needs some medication adjustments to get some extra fluid off and will work to get her up today.   Dr. Kal sayid that yesterday she had thought he did the surgery, so she was anxious about seeing him.  He pointed to Dr. Turrentine that HE did this to her and she smiled a really big smile!  She may not feel tons better yet in her early postop course, but she will!  Her lips look so pink compared to before when her sats were in the 40’s!
  
Fatumah

Dr. Turrentine and Dr. Farrell (who will be assisting in surgery again this morning!) went to the OR then.  TEE was done by Dr. F on little Hasham as they continued to prepare for the procedure.

I had the pleasure of doing a mostly social visit on the patients on the floor.  Abdullah(POD #3 ASD), though has moist cough that is really bothering him and he spiked a little fever last night.  He does not look like he feels up to going home today as we might have planned.  He has been slow to get up and around and today is no exception.  We ordered a chest Xray and will see how this looks and how to proceed.  His breathing sounds very good.
 

Abdullah

 
I only recognized Farjenya (POD #3 TOF) as I walked past her room because of her mom!  She looks AMAZING!  You would never guess this girl just had surgery 3 days ago!  She was up toddling around in the room and offered me the Kleenex her mother gave her.  She is no longer “a little bit crank” like she was in the ICU!
 

Farjenya

 

Raihana (POD #4 VSD) is sharing a room with Farjenya.  The mothers were sitting and chatting with Hasham’s mom as he was back in the OR when I visited. It was undoubtedly reassuring for her to visit with these girls who look great so soon after surgery!  Raihana was taking a bottle with mom and looking pretty chill!
 

Raihana

 
Hashem is our first case this morning.  He is an 8 month old little sweetheart with Tetralogy of Fallot.  His oxygen sats are close to normal at upper 80’s/ 90’s.  He is from the Amman area and his lovely mother speaks great English.  She was asking the team member’s names and seemed to be taking mental notes of it all this morning.  Dr. Farrell got some great pictures of Hashem yesterday as she checked him over with echo.  
 

Hashem and his sweet mom

 

Hashem with Dr. Farrell

Hashem’s surgery went very well.  Dr. Farrell scrubbed in the assist and scrubbed out to do the post-repair TEE.  Before Dr. Turrentine even had his paperwork finished, they super-efficient staff had transferred him out of the OR and to the ICU.  

We caught a quick lunch during which Sirene from GOLA and RC Amman Cosmopolitan came to visit.  We were quickly joined then by a group of visitors to see the children from ABC Bank and GOLA.  Simons and Rusha from ABC Bank were welcome visitors given Simona’s continued generous contributions to GOLA throughout the years for ABC Bank.  They were so kind to have huge ballon bouquets for each of the children as well.  The kids absolutely loved them- especially San who was giggling and smiling like we had never seen him while looking and playing with the gift!
 

San just LOVED the ABC Bank Balloons!

 
We were also joined by Dr. Noor from GOLA as well.  They visited each of the children and were moved by their stories.  We are so appreciative of Simona and ABC Bank in contributing so generously to GOLA to give the Gift of Life to these children. 

 

the team with Sirene, Simona, and Hashem’s mother

 
 

Simona, Dr. Noor and Rusha from ABC Bank with Hashem and mom

 

 

Simona with Dr. T as he expresses our gratitude for ABC Bank contributions

 
While we toured the ICU, Dr. Turrentine started with the last case of the trip…
Jana is a sweet 4 year old with a coarctation of the aorta.  Her defect was discovered at 2 years and 2 months by her physician when they heard a heart murmur and she was referred to Dr. Kal.  She has been pretty healthy thus far and no high blood pressure issues, but this could soon become urgent with no access to affordable care if we don’t fix her coarctation now.  Her pulses are very diminished.  

 

Jana and her mother

  

Jana- all ready to go! How sweet is she?

 
Just as Dr. Farrell and I were going back to the OR, we were able to see the parade of patients and families to their new rooms on the floor from the ICU.  With their ballon bouquets, they are quite a sight!  The other parents were excited to see their friends come down to greet them!
 

The big Move!

 
Jana’s case went very well with Dr. Osama assisting again.  He has been a wonderful help this week and I for one am so thankful that I did not have to assist!  Dr. Farrell was happy to fill in, but it was such a great help with Dr. Osama!  Thank you Dr. Osama!

We checked on all the patients one last time and said good-bye to all.  What an incredible week of beautiful children all at the right stage in their recovery!  Will post a few last pics of some of the children before we left…”In Shallah” they all go home from the hospital and live long, healthy, and prosperous lives!
 

Farjenya with her full family! Adorable!

   

Dr. T with Jana’s parents

  
We have a lot of re-packing to do…surgical instrument pans, iStats that have been so helpful in the OR and the ICU all week for bedside lab results, saving money and time (thank you RC of Greenfield and Rotary D6560 for these items purchased with a District Grant!).   Thank you also to Abbott for the cartridges used in these time and money-saving iStats!  Thanks also goes to Gore for donating Goretex patches used in many of the surgeries this week!  What an amazingly successful week this has been for a team of only 3 to work with the dedicated and thorough Al Khalidi Hospital staff and of course Dr. Kal!  This amazing collaboration between the Riley Heart Team, Al Khalidi Hospital, GOLA and Rotary D6560 Gift of Life (with many supporters, but most generously by Rotary Club of Greenfield), has now resulted in 15 trips over a span of 8 years and countless children’s lives forever changed!
And thank you to Dr. Kal who works tirelessly day and night for these children and these missions- not just when we are here, but year-round!!
  

Written by stephkinnaman

April 16, 2015 at 9:14 pm

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Amman Mission #15- Wednesday

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We had a great, casual evening at Sirene’s when Dr. Kal took us straight to her beautiful home after leaving late from the hospital.  Light, but scrumptious Jordanian food and fantastic company of GOLA board members and Rotarians.  Thank you Sirene and GOLA!
 

Lively discussions over dinner at Sirene’s lovely home

  

 


It is a sunny and finally warmer day in Amman this morning!  Feels more like Spring. Some gorgeous views from the hotel window as well as a sample of the patients’ views out their ICU room windows…
 

Sunrise at the hotel

  

  

some of the views from the ICU!


We made the rounds to check on all the patients in the ICU.  Unfortunately, the hospital is having difficulty obtaining the Tetracycline antibiotic that Sham needs.  She will get her wound vac this morning placed, but she really needs the antibiotic to clear her infection.  She is holding strong however.   


San (TOF) is doing well.  His parents do not speak Arabic or English, so language is a difficulty all the way around with nursing and this American team, but his parents’ smiles say it all!
 

San -fast asleep


Rusul (VSD) is doing great!  She was falling asleep with a bottle on rounds.  So very sweet…
 

Rusul

 

Wesham (bidirectional Glenn) is “Mumtaz” as Dr. Farrell says- excellent!  His oxygen sats on room air are 85%- exactly what we would expect and over double what his little body was getting before!  He will start on some aspirin today and remain on this until his next surgery in the future.
   

Wesham and his young parents (with grandparents in yesterday’s pitcure)

 
Riahana (VSD) is doing well and will certainly move to the floor today. She put on quite a show of some acrobatics for Dr. Farrell yesterday!  She looked like a little gymnast doing an ab workout!  
 

Riahana yesterday

 
 
 

Riahana today, nearly asleep!

 

Farjenya (TOF) tried so hard not to cry as soon as we moved to her side of the room, but you could see it coming in the worry on her face the entire discussion about her. :). She finally let it go when Dr. Farrell moved in closer for a picture.  She is so beautiful!  She has her mother’s curly hair.  Her room yesterday was decorated like a big mobile above her bed with many of the gifts sent by the Riley Child Life group.  Quite festive!
   

Farjenya and her mom, Noor

Abdullah (ASD) moved to the floor last night.  His mother was concerned about his cough, but he needed to get out of bed and move about more.  We hoped to catch him in the halls later.  

 

Abdullah- not too eager for Dr. T to check his wound!

 

Reem (ASD/PS) is ready to go home today!  She looks great. We took some pictures with the family and said our goodbyes.  She will do very well.  They were so sweet and gave us an Easter gift to thank us (Orthodox Easter was the day of her surgery). 
 

Reem and Dr. T- she is ready to go home!

 
 

Reem’s family with the team

 
  

Our afternoon patient was hanging out in the hallway as we came to visit Abdullah.  He was walking about, blowing bubbles, blowing kisses, and giving the biggest, best hugs ever for a little guy!  He was being nosy to check on Abdullah in the next bed over from him as well when we went in…he was standing on his tippy toes to check him out… Saa’ed will steal your heart- look out!  More to come on this little sweetheart…
  

  

Sorry- I just can’t get enough of this guy!

 
   

After a hug and blowing me a kiss!❤️.

 
We then made our way to the OR for a challenging case this morning… Fatumah is a beautiful 13 year old girl you met yesterday with recently discovered Tetralogy of Fallot.  She is Pakistani living in the Jordan River Valley.  She is very sick from her sick heart.  Dr. T is going to do something to try to make her life better, but she is not a candidate for a total correction of her defect.  Her family was aware this was risky, but she will die soon if nothing is done at all…and a miserable, short of breath-sort of slow death.  He was not sure exactly what he would patch or do once in the OR, but would assess her heart’s responses when in there.  Her heart is very sick and acted like it from the start of the case, heart rate dropping to 40’s-60’s it seemed with any activity around it.  After much discussion, Dr. T decided it best to do a pulmonary valvotomy, do a bicuspid valve and patch her pulmonary arteries.  She came off bypass well and post- repair TEE showed her right ventricle was contracting better!   Her oxygen sats then were 99% on the vent!  Wow!  Once in the ICU and she awoke, her sats were 88%!
 

Fatumah right after surgery in the ICU

 

Next up was sweet Sa’eed.  He is such an adorable 3yr old boy who is the only child of his young parents.  He is from Amman.  In fact, we were told that our friend Fares Shaddad referred this family to Dr. Kal and GOLA and local Rotarian Samer Aklouk made the donation for Saa’ed’s surgery.   He has a supracristal VSD.

Saa’ed and his parents

Saa’ed ‘s surgery goes very well.  His VSD is quite sizable for this little guy!  Here is the size as you can see below where the patch was cut out.  Dr. Turrentine always tries to give these to the parents so they know…

  

During this surgery, Dr. Farrell was able to see little Sham with her eyes opened as attempts will be made now to wean her off the ventilator.  Her wound vac is on and the nurse said her wound looked much better! 

Sham- hoping to get off the vent for the first time!

 

Dr. Basam comes to visit and discuss the case with Dr. T

Still using this awesome Battery-powered headlight from a District grant from RC of Greenfield and Gift of Life D6560!

 

Dr. Farrell in the meantime found Abdullah up and moving!  

Abdullah looking great, up and on the move!

Now we are back at the hotel, earlier than last night!  Kids are tucked in and doing well.  Last day of operating tomorrow!  Many technical difficulties again with the blog today, so sorry I cannot delete this duplicate last pic of Saa’ed, but as I said, can’t get enough of him!  :)

 After a hug and blowing me a kiss!❤️.

Written by stephkinnaman

April 15, 2015 at 3:42 pm

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Amman Mission #15- A Full Day Tuesday

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After the wonderful dinner with our Rotary and GOLA friends last night, it seemed unfathomable that it was time to eat again this morning at breakfast!  It is a beautiful sunny day today, but still a little chilly for Spring.  First, I have to share a picture of our GOLA friends from arrival (I had thus far been unable to post on the blog) and dinner last night.  They are always such welcoming and warm hosts to our team and the patients and families!
  
Lamia and Sirene, our amazing hosts!
  
First Night planning session with Dr. Kal and GOLA ladies with our team.
 

Dinner Monday evening with Rotarians and GOLA

 
As usual, Dr. Kal drove us to the hospital and briefs is in the car.  Sham, our little 9 month old from the previous mission had some respiratory acidosis on her morning ABG, he made some adjustments on the vent settings and we would check that out for a source.  When we arrived to the ICU, so many welcoming smiles from the parents….
Sham has warmed up nicely and her antibiotic infusion of her wound looks to be working great.  Her wound culture is growing out the same bacteria as from her sputum culture last week (Klebsiella for you medical folk) and her blood culture looks to be the same.  We later discovered from the ID specialist that her bacteria is only susceptible to Tetracycline.  This is not typically used at all on children as it stains the teeth terribly, but clearly saving her life is most important!  Once she is on proper antibiotic coverage (usually for 6 weeks), this should improve.  

Raihana has another day in the ICU as with her defect and some pulmonary hypertension before surgery, she needs to be watched a little more closely for longer than some of the other patients.  Her parents are such lovely people!  She was crying throughout her exam and discussion about her because she was hungry!  Her mother quickly fixed her a bottle as we finished and she was instantly quiet!  Adorable!

 

 Raihana


Farjenya is doing well.  We seemed to be upsetting all the patients on rounds this morning.  She cried throughout her exam also…crying, “Momma!”  She seemed to be just anxious by our presence, because she stopped pretty quickly when we moved on to her roommate!  :). Some medication adjustments for her little swelling and for her heart anatomy (beta blocker as she has a small annulus)…and she should be good!

 

 Farjenya

Abdullah gave a big smile after Dr. Kal greeted him.  As we commented he saved his big smile for Dr. Kal, we hear that Dr. Kal was called about 9 PM last night that Abdullah was really mad and making quite a big boy fuss about needing more water.  Dr. Kal then just asked to speak with him on the phone, so the ICU nurses put Abdullah on the phone to be settled by Dr. Kal himself!  This morning Abdullah thinks that is pretty funny…and we did too!  He is doing great overall…  His mother is really pleased.

 

 Abdullah

We then went down to visit Reem who had moved to the floor.  She is doing fantastic and Dr. Kal thought so well she could go home today!  But, Dr. T says not so fast… She may be a rock star, but Postop Day 2 from an open heart surgery for ASD/PS may be a bit quick!  She looks adorable and healthy in her Rudolph flannel PJs.
   
Dr. Kal and Reem

 

Reem looks a little scared of Dr. Farrell and me!  :)
So, we then headed off to the OR… Dr. Farrell completed the preop TEE on little San. He is an 11 month old from Kurdistan, Iraq.  Dr. Aso, a Pediatric Cardiologist in Sulaminyea, Iraq has sought help for this family and made all arrangements with Sirene from GOLA to get them here.  San has Tetralogy of Fallot and even at his young age, has had a couple of Tet spells (passing out).  

 

 San

Dr. Farrell showed on the TEE why this would happen.  This is a narrowing where the blood passes through the valve to the pulmonary arteries to the lungs.  With intense activity, or in his case intense crying, this narrows and he is not getting enough blood flow to the lungs or anywhere, so he passes out.  Here is a picture of his echo with the arrow pointing to his thickened infundibulum- one of the four defects of Tetralogy of Fallot.

 

 TEE- arrow points to the infundibulum stenosis (thickened are there)

 

Dr. Farrell teaching a pediatric resident during post-repair TEE.

Surgery went very well with postop TEE showing an excellent repair and he was moved to the ICU for recovery.  We then followed San to the ICU to check in on the patients and consider a very sick 13 year old girl who was just diagnosed with Tetralogy of Fallot last Fall!  Fatuma is a Syrian refugee who is thin and frail and very blue.  Room air sats are 71%.  She walks slowly as she is so weak.  She has been worked up and considered by the Italian surgeon here before us, but needed more studies.  Her left ventricle function is incredibly poor and the thought with that is would she even survive the surgery (particularly coming off bypass). Dr. Farrell does an echo for Dr. T to see it for himself.  He decided with Dr. Kal to admit her to the ICU to see if some Dobutamine or Dopamine (IV medications) would improve her heart squeeze at all and if so, she may be considered for surgery.
   
Fatuma

 

Henna tattooing of her hands, but notice the significant clubbing of her fingers!

The other patients are doing well.  Abdullah is still working up a smile, Riahana is much happier and sweet as can be, and Farjenya is, we are told, “a little bit crank!”  I think this was her nurse’s way of saying, “Please, for goodness sake…Don’t wake her up!”

Next in the OR is Rusul.  When we visited her this morning, she was sleeping soundly, although haphazardly in the bed!  She is actually 16 months old and has a VSD.  She was assisted by GOLA founding member Marikay Satryano who remains a faithful and hardworking member of GOLA even though she no longer resides in Amman. She was also assisted in getting here for surgery through Dr. Wassim who identified her problem.  Mom says she started breathing hard at 4 mos of age.  She sought medical attention and found that she needed an echo due to her murmur.  This found her defect (VSD).  Mom says traveling here from Iraq was not terribly difficult, although it is hard to tell if she is downplaying this as she is thankful to have help for her only child!  She is so beautiful!
   
  
Rusul

Last planned for the OR is little Wasim.  He is a tiny 11 month old Syrian boy with Tricuspid atresia and severe pulmonary stenosis.  Clearly not getting good blood flow to the lungs for oxygenation as his resting sats are in the 40’s, wow!!  After a little oxygen since admission, his sats are up to 70% so he doesn’t look as blue as when Dr. Kal and Dr. Farrell saw him in clinic 2 days ago!  He is only about 13lbs due to his defect.  He will need a staged procedure starting with a Glenn to shunt the blood for better oxygenation and he will feel (and grow)  soooooo much better!  This will be completed then ideally about 2 yrs of age with a Fontan procedure.
  
Wasim and his parents

Before Wasim was ready in the OR, we checked on the ICU patients again.  San is doing well and Rusul was quickly able to be ecru bated.  She was bright and alert and ready to go!  We found Sirene and Lamia visiting the patients as well.  Many many smiles all around shared by these GOLA leaders and the grateful patients And families!

 

 Sirene and Lamia visiting with Riahana

The dedicated OR staff stayed late for Wasim’s case.  It was rather quiet all around as Dr. Turrentine opened and started the surgery alone.  Dr. Osama had other obligations and Dr. T was ready to go solo.  However, Dr. Farrell indicated from the preop TEE that there may be a double SVC.  Her CT images did not get to the OR fast enough before Dr. T got in and verified this was true.  That made things a little more complicated and decisions were made to proceed with a Bilateral Glenn (this creates a connection betweem the pulmonary arteries taking blood to the lungs from the SVC (deoxygenated blood).  One of us had to scrub in to assist at this point and Dr. Farrell won!  
  
Once the first Glenn was finished, the Sats immediately rose from 50% to 70%.  He briefly went into atrial fibrillation that might have needed us to get out the paddles, but Dr. T had the magic touch ultimately and no paddles were needed.  This brought him to 85%.  The right side Glenn was finished then and the sats came up to 99%.  Oxygen was decreased then as the goal is approximately 85% Sats.  His parents may not recognize him this pink!  :)

We are still in the planning stages for tomorrow and at the time of this post will be heading up to the ICU for echo on two patients planned for tomorrow.  Then we will have a casual dinner with our GOLA friends at Sirene’s house before hopefully an early bedtime!  Here’s to hoping!!


Written by stephkinnaman

April 14, 2015 at 4:19 pm

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Amman Mission #15- Monday

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We awoke to another unusually chilly morning for April in Amman.  Dr. Kal transported us to the hospital after breakfast.  It was an uneventful night thankfully for him with very little calls regarding our patients in the ICU.  He discussed some more cases that we may consider for this week.  There are so many needy patients awaiting surgery, how to choose even 10 for the week is so difficult!  


When we arrived in the ICU to check on Sunday’s patients Reem and Raihana, the smiling families were at their bedside.  Raihana had a good night and her mother says she is hungry!  She was resting comfortably when we rounded.  


 

 Raihana


Her father was eager to tell Dr. T and Dr. Farrell about their friend’s daughter Rand who was operated here in Amman in 2008.  She is doing so well and Raihana’s father shared an updated picture of her and most importantly a kiss from Rand’s mother!  :)


 

 After “the kiss” from Rand’s mother via Raihana’s father :)

 

 Rand and her mother in 2008


Reem was not a happy camper as we rounded, perhaps with the crowded room or in anticipation of Dr. T stripping her chest tube… Her sweet father was singing to her and offering her a stuffed caterpillar friend…she just wasn’t having it!  Big crocodile tears…


 

 Reem in ICU


We had a full day to include exploring little Sham’s mediastinal infection in the OR as well as Farjenya’s TOF and Abdullah’s ASD surgeries.  So, we hurried to the OR and Dr. Farrell completed the TEE on Farjenya.  This helps Dr. Turrentine make plans for his surgical approach.  Dr. Osama was thankfully present to assist Dr. T and all went efficiently to start her case.  Her case went well and he was able to do the repair while sparing her valve, which is ideal.


Farjenya is a sweet little 20 month old from a Christian city outside of Mosul, driven out by the violence and now living in Jordan.  Dr. Samir referred this patient, like many other Iraqi patients in the past to Dr. Turrentine.  He is a great collaborator for these patients in planning and arranging their travel to help these sweet families.  Farjenya has been short of breath since birth apparently and Dr. Samir identified her congenital heart defect and made arrangements ultimately for this trip for her repair.  Again, amazing collaborations by so many to make this Gift of Life possible!


 

 Farjenya at preop echo


The OR staff felt it was best to do the ASD first before exploring the mediastinal wound of sweet Sham.  So, they proceeded with preparing Abdullah in the OR.  Dr. Turrentine checked on the ICU kids, including newly transferred Farjenya before meeting at Dr. Kal’s office to discuss the plan for the rest of the week.  So many patients have been identified as needing help that we must narrow down to the specific plan at this time. 


Farjenya’s parents met us outside the ICU and were so smiley and full of “Shukron” (Thank you in Arabic).  They insisted on taking some pictures of the team and with the team with their sweet Farjenya, fresh out of surgery.


  

 Farjenya and parents with the team in ICU


We had passed Abdullah’s father as we hurried across the street to Dr. Kal’s office, he was tearful as Abdullah had just been taken back to the OR.  He was indicating that he will be praying…we of course told him we will take our very best care of sweet Abdullah, as always.  Abdullah is a 10 year old boy whose family is Palestinian but have lived in Jordan for long before Abdullah was born.  His parents told us yesterday that he has two sisters at home.  He is very small and tired easily with exertion.  As it was said before, he is more the size of a 6-7 year old boy.  His ASD is very large.  He will grow and play and just live so much better now!  


Abdullah preop

  


Abdullah’s surgery went very well.  Dr. Farrell came in to confirm the repair looks “Mumtaz”- excellent!  He was moved to the ICU to his very very thankful and emotional parents.  

We visited with the ICU patients and found Reem ready to move!  She had a lovely walk with her father and was all dolled up in her pajamas and slippers.  Her twin Maria visited later and we captured a pic of this adorable pair!

  

Reem and her father

  Reem and her twin sister Maria

At that point, we ate a late  Jordanian lunch in the cafeteria- in the bowels of the B-2 (second level basement of the hospital).  Mo from the OR arranged this for us and although the lights were turned on for us, we are served by a young man in a bow tie!  :). We then came up just in time to the OR to find little Sham with the evening OR team prepped and ready to go to clean out her infected chest wound.  This was truly ingenious, creative, old school medicine with no Infectious Disease consult or a special wound vac (although this is in the works)…just old fashioned surgeon cleaning out a wound and fashioning an antibiotic flush/ drain setup.  See Dr. Farrell’s wonderful drawing explaining Dr. Turrentine’s creative antibiotic wash of Sham’s wound:

  

Sham was moved back to the ICU and plan is for her to continue this ingenious antiproton flush for about 24 hours, then hopefully have a wound vac placed as well as continuing antibiotics and staying on the vent for at least 48 hrs.  Her faithful and loving young father was updated in the ICU.

We then met tomorrow’s patients, both from Iraq, both arranged by a web of incredibly helpful hands (Dr. Aso and Marikay Satryano).  First, we did an echo on adorable Rusul.  She is a 2 yr old from Baghdad, Iraq.  She is only 22 lbs and has suffered initially at admission from a GI virus of some sort.  She has been hydrated as an inpatient the last couple days and is doing much better- ready for surgery.  She has a perimembranous VSD and was arranged for assistance through our longtime friend and GOLA founding member Marikay Satryano (even though Marikay no longer lives in Amman, she works tirelessly to continue to help children here!)
  
Rusul and her mother 
We next rechecked an echo for Dr. T to see of Aso’s patient San from Khurdistan, Iraq.  He is an 11 month old boy with Tetralogy of Fallot.  His Sats range in the upper 80%iles.  He will be the first patient in the morning.
  
San and his mother

By this time, it is just after 7PM and we are to meet Rotarians and GOLA members for a dinner at 8PM.  Dr. Kal kindly drops us off to the hotel and we quickly ready for a meal thanks to Rotarian and new GOLA member Thuraya.  She treated us to an amazing Iraqi meal at what Rotarian Wyel says is the best Iraqi restaurant you will find anywhere!  It was truly an amazing meal, including Masgoof- a traditional Iraqi fish cooked over a coal fire vertically on a stick.  Dr. Farrel and I even took a quick kitchen tour to see how it all starts!
   
Yes- these are the fish cooked, right in the kitchen!

 

This is the open fire the fish are cooked over.  Seriously, the most flavorful fish I have ever eaten!! Masgoof= amazing!

A wonderful night with Amman friends, all bound by the purpose of giving the Gift of Life!  Thank you to our Amman GOLA/Rotary friends and partners!!

Written by stephkinnaman

April 13, 2015 at 9:36 pm

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Amman Mission #15!- Day #1-  Sunday, A Day to Start Our Work!

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Another “April showers” sort of day this morning in Amman… After breakfast at the hotel, Dr. Kal picked us up and brought us to the hospital.  We checked on a little 9 month old recovering in the ICU from a previous mission and proceeded with echo on several of the children planned for operations this week as the OR prepared the first child for surgery.

We first met Rihanna, a little 11 month old Downs Syndrome girl from Basra, Iraq.  She has a VSD, PFO, and PDA.  She is very small for her age of course.  Very sweet and thankful parents… Dr. Farrell confirmed the echo and plan for surgery with Dr. Turrentine and then some photos of course of sweet Rihanna who slept through most of the echo.
   
Dr. Anne Farrell with Rihanna

 

Rihanna with her parents

Next up was Fargenya, a 20 month old sweetheart originally from the Christian cities outside of Mosul, Iraq.  The family fled to Jordan not too long ago.  Fargenya was not too fond of the echo process and turned quite blue with all of her crying.  She has Tetralogy of Fallot.  Her mother is Noor and was quite helpful throughout the echo with unhappy Fargenya.

   

 

Fargenya and her mother

Next we examined Abdullah, a very small but polite 10 year old Palestinian boy who lives in Amman with his parents and two sisters.  He has a large ASD making him short of breath and tire easily when he plays.  Of course, it is adversely affecting his growth which is why he appears barely older than my 6 year old daughter!  He was very cooperative with Dr. Farrell’s echo, of course.  His father was very interested to see the ASD defect on echo as he had never seen this before.  They obliged us with more photos of course as well….

  
Abdullah and family

Then we were off to the OR for little Reem, a 4yr old from Amman with a large ASD. She is apparently a twin.  Her defect was discovered at birth as she spent some time in the NICU.  She too is small for her age at only about 30 pounds.  She was already under anesthesia and ready for preop TEE when we came in the OR.  Dr. Usama is a surgeon who planned to assist Dr. T, but he would not arrive until approximately 10 AM, so one of us would need to help.  Dr. Farrell was just the right person to play assistant surgeon for the day!  She did a fantastic job assisting Dr. T through Reem’s case, of course!  Dr. Usama came in to take over for Dr. Farrell just as she was coming off bypass. Dr. Kal came in for TEE after the repair.  All looked great, so the case was finished out and little Reem was taken to the ICU.  Her family was updated and we went to Dr. Kal’s office to meet up with Dr. Farrell as well.  

   

 

Dr. Farrell and Dr. T operating on Reem

Just have to share with our GOL friends that Jill continues to be with us and continues to provide supplies for our surgeries…  

 

Dr. Farrell and Dr. Kal had been quite busy in the short time they left the OR.  An 11 mos old child, a Syrian refugee presented with severe cyanosis (oxygen sats only 41%!).  She is a tiny approximately 12 lb baby with Tricuspid Atresia.  Discussions ensued as the whether we may be able to add her in this week as well…

When we walked through Dr. Kal’s waiting room, we were immediately greeted by smiling, sassy, familiar twins- little Adiyan and her twin sister with their lovely mother Noor.  You may remember that Adiyan had NO pulmonary arteries and was in dire straits when the team first met her in 2012.  She had her second stage of her surgery in March 2013 on a mini mission and now awaits her final stage.  She looks ready by echo today for her completion and plans are still in discussion to bring her to Indianapolis for this surgery.  Given this is her third surgery, Dr. T feels it would be safest and most ideal to operate her at Riley.  Sirene is trying to help find financial assistance for her and Noor’s airfare while GOL D6560 (Indiana) will cover the cost of her hospital costs and stay in Indianapolis.  We will most likely need funding for her Contegra conduit as well….all these little complexities that affect timing, etc.  the Tom Deierlein Foundation have funded her surgeries thus far in Amman.  To say the surgeries have been life-changing would be an understatement as we look at this beautiful, active little gal with sats now in 95% range! but many hands have played a part in getting her this far and will require more to come together to see it through.  The beauty of this Gift of Life work!

 

Dr. T with Adiyan’s twin, Adiyan, and Noor- their mother

  

 Adiyan’s twin is no stranger to the stethoscope!

A couple other patients of Dr. Kal’s were discussed and examined with echo and we  proceeded back to the OR for little Rihanna.  The super efficient OR team has her ready to go… Rihanna is the little Down’s baby with VSD, PDA, PFO from Iraq.  Rihanna’s case goes very well and we were out of the OR quite efficiently.  Dr. Osama has been a huge help, and yet we just discovered that he has been 2 nights in a row on call!  What a trooper!  He left to have an early dinner with his mother with our strong encouragement…
  
Dr. Farrell doing TEE with Dr. Osama and Dr. T looking on.

At this point, we went up to the ICU to check on the little 9 month old cared for by a previous mission.  She has been doing quite poorly and thought to be “brain dead” in the last week.  However, this morning she opened her eyes when we talked in her room and cried and moved her arms with removal of her chest bandages.  This evening, Dr. T noted the leaking of pus from her chest wound.  We opened her chest wound under sterile technique and found severe mediastinum is or infection through her lower part of her sternum.  This was cultured, packed, and left open to likely need full flushing/debridement in the OR tomorrow.

We then waited in Dr. Kal’s office while he findings his private clinic and joined our Rotarian friends DG Mustafa, Lamia, Sitene, and Usama for a great discussion to plan an upcoming VTT for a full team with teaching and even more broad range from which to pull patients in May 2016.  Very exciting!!  Two patients planned for tomorrow- A full day, but more work to do!

Written by stephkinnaman

April 12, 2015 at 9:10 pm

Posted in Uncategorized

Amman Mission #15!- Arrival

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The small team of Dr. Turrentine, Dr. Anne Farrell and Dr. Stephanie Kinnaman arrived Saturday early evening for another round of Gift of Life surgeries in Amman this week.  The flights went well, although a tight connection in Chicago and we were welcomed at the Queen Aaliyah airport as always by the lovely Lamia and Sirene from Gift of Life Amman (GOLA).  After a 2 hour visit there while waiting for our luggage, we found that Dr. Turrentine’s personal bag didn’t make it, but the trunk of medical supplies did!  Sorry, Dr. T, but that does mean the show can go on as planned tomorrow since we have the trunk!

Once at the hotel, Dr. Kal met us there for planning of the surgeries for the week.  He has a valiant goal of 10 surgeries in our 5 operating days here…we will do our best!  There are 4 families traveling from Iraq for surgeries this week.  Dr. Kal has plans for 5 others already as well, and we are sure one more will be planned by the end of the week if all goes as we hope.  Plans were discussed over dinner and we headed for an early bedtime to ready to get to work tomorrow!

Written by stephkinnaman

April 12, 2015 at 8:44 pm

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Riley/Rotary Vocational Training Team Trip 2014 to Uganda Heart Institute- Day #9- Saying Goodbye

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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.
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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!
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Fredrick

Ukasha is doing great. He should get some new roommates today as Princess should move over.
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Ukasha
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Princess

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!)
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Priscilla

Aaliyah was sleeping the entire time we were in the unit. She is doing well also.
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Aaliyah

Benita is doing just fine! She was not in the mood for visitors today! :)
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Benita

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! :)
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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!

Written by stephkinnaman

October 5, 2014 at 10:05 pm

Posted in Uncategorized

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