Riley International Heart Missions

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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 drinking..in 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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Riley/COH/GOLA/GOLI/Rotary clubs of Amman and Greenfield VTT mini-mission Amman March 2019 Day #1

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Arrived at the hospital early to get Professor Tsang, Dr. Barsan and Dr. Wright familiar with the OR, Al-Khalidi Hospital and the patients for the day.

We decided to start our day with our 1 month old newborn Aged Ahmad Rabah, who has the coarctation of aorta.

Case went very well …Dr. Tsang and Dr. Barsan had a very easy and smooth assimilation with our Al-Khalidi OR staff.

Dr. Tsang and Hanan (one of the best scrub nurses!)

(Dr. Andrei Barsan assisting)

(Dr. Wright and the anesthesia staff)

He returned to ICU already extubated and did very well.

(Dr. Riad and Rami, head ICU nurse, caring for Aged).

Second case for the day, which started by 10:30am (because we were able to get a 2nd OR room!) was Mariam Abdel Wahhab, 10 month old with a PA band and apical VSD. Her first surgery was done in May, 2018 after she was born by the Czech mission team.

(Emily-COH with Mariam and her uncle)

L to R: Yousef (GOLA), Ameer and his father, Na’el (GOLA), Mariam and her uncle

We took the PA band off and closed the VSD that is in the apex (very bottom) of the heart.

Dr. Tsang and Hani (head perfusionist) discussing bypass machine and case

She did very well, no residual VSD and the pulmonary artery looks good with band off. She went back to ICU intubated but had her breathing tube removed a few hours as she woke up.

(Mariam –still giving us that same look she had beforehand right after waking up from surgery!)

The third case for the day is Ameer Abed Al Elah Abbudalah, a 5 month old Syrian boy with DORV (double outlet RV, essentially a large hole in ventricles and aorta comes off RV not LV).

(Ameer and his father)

His case started by about 2:00pm and went very well. He has no residual shunting across his VSD.

(Oroyo and Emily observing Ameer’s case in the OR)

Ameer got to the ICU and did very well. We were able to get the breathing tube out after several hours and everyone was stable before we left for the night! Excellent first day for the mission with already 3 cases done ! Great team effort by everyone !

We did pre-op on our 2 cases for tomorrow:

First will be Firas Adel Layeh, 6 yr old with DMSAS who we introduced yesterday!

(Firas -sporting his COH tee shirt with Dr. Tsang)

(Firas’s father with Firas and Dr. Tsang)

The second case will be a 16 month old Syrian little girl, Shaima’a Sayel Ghnaim who has Down syndrome and a complete AVC defect. She has developed pulmonary hypertension because of her age (being older than and infant), but we feel strongly that even though she is higher risk, she needs to be done now so she doesn’t become even higher risk or inoperable in the future. Her X-ray has a congested look to it and when we placed oxygen on her, her saturation’s increased, which means her lung vessels are reactive and can hopefully be managed after surgery with medicine and oxygen.

Shaima’a😀

Shaima’a and her parents -she has beautiful blond hair!!

The night ended with excellent meal at Leval -a traditional Lebanese/Jordanian/Syrian/Palestinian restaurant–and topped off with kenafe!

(Dr. Riad, Oroyo, Dr. Kal, Dr. Tsang -enjoying his first taste of kinafe!)

Written by drannefarrell

March 4, 2019 at 8:38 pm

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

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We are back for our 26th mission trip To Amman, Jordan with Chain of Hope and GOL- but this will not be our typical mission trip.

First of all, Dr. Turrentine…our fearless leader is on the injured reserve list!! He tore his quadriceps muscle shoveling the awful Indiana ice 3 weeks ago and needed surgery. He is doing fine-but needs at least 6-8 weeks to heal, keep his leg immobilized and cannot operate or travel…hence no Dr. T this trip.

We are, however, very fortunate to have Professor Victor Tsang, chief of pediatric cardiovascular surgery at Great Ormond Street Hospital for Children in London, where he has worked for 14 years. Professor Tsang has worked for Chain of Hope (COH) since 2002 and participated in 20 missions and will be our lead surgeon for our mini-mission.

We also have another new member, Dr. Andrei Barsan, a pediatric cardiovascular surgeon at Grigore Alexandrescu Hospital, (Clinical Hospital for Sick Children) in Bukarest, Romania who will assist Dr. Tsang. He has also previously worked on medical missions trips with COH and GOLI.

Dr. Tsang is accompanied by COH member Dr. Ian Gavin Wright, anesthesiologist and co-founder of Chain of Hope with Sir Mahdi in 1995 and has led some 30 overseas medical missions. He was voted chairman of COH in 2007.

Also returning is our good friend Oroyo Eubanks, communications manager for COH and new member Emily Miller, fundraising manager for mission from COH.

From Al-Khalidi Hospital, our amazing Dr. Khaled Salaymeh, Pediatric cardiologist extraordinaire, and the amazing ICU and OR staff.

From Gift of Life Amman-(GOLA) Board President Na’el Musharbash and his wife Ruba Karadsheh who organize and support the mission team, patients and their families. We would also like to thank the GOLA board members who are so generous with their time for the patients and families with their hospital visits and time spent on selecting patients for each mission,

From Riley Children’s Hospital in Indiana–Dr. Riad Lufti, CV cardiac intensivist and myself, Dr. Anne Farrell, Pediatric cardiologist.

We also thank the support of Dr. Stephanie Kinnaman and GOL-Greenfield, Indiana for their generous support with VTT grants and funding as well as GOL Amman Clubs for their fundraising and support of our missions trips.

We plan on doing 4-5 cases…mostly Syrian children in this mission.

We arrived at hospital today to look at the 5 children who have been admitted for possible surgical cases this week.l and perform their echocardiogram sand assessments.

First is Aghyad Ahmad Rabat, a 30 day old newborn Syrian baby, who was discovered to have a coarctation of the aorta 2 weeks ago. He has significant narrowing of his aorta, and will need to be operated on this week since he will likely become very sick if not repaired.

Next, we met Rimas Mahmoud Al Sa’eed, a 21 month old Syrian girl with Tetralogy of Fallot. She has significant neurological issues including hydrocephalus, developmental delay and severe failure to thrive. We need to evaluate her further possibly with head imaging and neurology to make sure she would be a safe candidate to undergo open heart and bypass surgery.

Dr. Riad assessing Rimas’s tone and neuro status

We next met and evaluated 6-1/2 year old Firas Adel Al Layeh from Syria. He has a discrete subaortic membrane (DMSAS) and some narrowing across the area below his aortic valve. He has no symptoms and plays soccer regularly. He was accompanied by his father. There is a chance his surgery could be delayed for a future mission as he is not having any problems, and his narrowing (gradient) isn’t too significant at this time.

Next is Mariam Abdul Wahhab, 10 month old from Syria. She has a large apical VsD and has a PA band placed at a few months of age by the Czech mission team in hopes to prevent symptoms, her her bigger and that the defect may get smaller. Our plan is to close her septal defect and remove the PA band.

Miriam is really not too sure about us yet-seen here with her uncle.

Last was 5 month old Syrian Ameer Abdul Ellah Ahma. He was born with DORV (double outlet right ventricle-essentially a large VSD/hike between the ventricles) he is so adorable and very sociable.

The team from COH arrived late tonight so we will reassess in the morning and make a plan for tomorrow’s operations.

L to R: Oroyo Eubanks, Na’el Musharbash, Dr. Ian Gavin Wright, Professor Victor Tsang, Emily Miller, De. Andrei Barsan, Yousef Batshon, (member of GOLA board)

Earlier this weekend a team from Riley Children’s Hospital was invited to give presentations at Dr. Khaled’s 14th Annual Pediatric Review Conference (APRC).

Riley was well represented by :

Dr. Elaine Cox-Chief Medical Officer Riley and infectious disease

Dr. Charles Vanderpool- Pediatric GI

Dr. Greg Montgomery- Pediatric Pulmonary

Dr. Riad Lufti- Pediatric Critical Care

Dr. Anne Farrell-Pediatric Cardiology

Our president of Riley Hospital, Matt Cook also accompanied the team to Amman and was awarded a special momento from the meeting for Riley Children’s involvements and co-sponsorship.

Written by drannefarrell

March 3, 2019 at 10:46 pm

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