The Surgeries, part 3 -

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19 February 2015

Our third day of surgeries and everyone did great. K. is 12 yo, is 4’7″ (139 cm) and weighs 52 lbs (24 kg). The surgeons repaired her mitral valve with an annuloplasty ring to fix the leaking around it and some some artificial chordae to help hold the repaired valve in place. Chordae are your literal heart strings- they connect your valves to your heart muscle.

We brought gifts for the kiddos. My heart was so happy to see the Lisa Frank.

These kids get it, why can’t adult Americans get it? The IS.

D. was not amused. I laughed and laughed at her. She still wasn’t amused.

The second surgery was our little Avatar, G. Money. He’s 16 yo, 5’6″ (167 cm), 88 lbs (40 kg), and he doesn’t need a governess. But he is incorrigible. Actually, he’s very polite and smiles all the time, even though he has no idea what we’re saying to him.

Seriously, doesn’t he look like an Avatar?

He had his mitral valve replaced with a mechanical one and also had his triscuspid valve repaired with an annuloplasty ring.

For those of you wondering what I’m talking about: Hearts= four chambers: right and left atriums (on top), right and left ventricles (on bottom). Four chambers = four valves: the tricuspid valve between the right atrium and right ventricle, the mitral valve between the left atrium and left ventricle, the aortic valve between the left ventricle and the aorta/body, and the pulmonary valve between the right ventricle and the pulmonary artery/lungs.

Overnight I read through all the pt’s charts, which had a lot of personal info about the kids. All of them that had their diets on them only listed three or four food items- bread, rice, pasta, or injera. All of the children come from two-parent households and in all the charts that listed the parents’ occupation the fathers were farmers and the mothers were housewives. If listed, all the pts’ economical standards were ‘below average’.

20 February 2015

The last day at the hospital we only did one surgery. I worked all night (with a nap), but didn’t want to miss my chance to see one so I started on my coffee early (or was it late?) and stayed in surgery all day.

D. was our previous mitral and tricuspid repair, 15 yo, 5’2″ (158 cm) and 79 lbs (36 kg).

Wires hold her chest together after her previous repairs. See her valve rings?

Part of the trouble with going back for additional operations is that the heart likes to adhere to the chest wall, so getting the sternum open without cutting into the heart can prove a difficult task. The surgeons weren’t always able to use a sternal saw for that reason, so Tahta held the chest open while Cattaneo attempted to cut through her sternum with scissors.

The American nurses- Sandy, Jamie (me), and Adessa.

Wells’ 17 yo daughter, Adi and his parents came to Ethiopia for the last few days of the mission and Adi sat in on her first open heart surgery. She may or may not have been the queasy one.

Sterile processing. Yes, some of those are paper towels.

There was no blood shaker available so everyone had to take turns rocking the blood baby to keep it from clotting. The two Africans and Wells are the perfusionists. Perfusionists manage the heart-lung bypass machine that allows the blood to be oxygenated and circulated through the body while avoiding the heart so it can be stopped for surgery.

The Ethiopian nurses are super smart, super competent, and they love to laugh. They’re just wonderful. And one of them was ready to burst.

I kept going back to ICU to check on the other pts, and socialize with the nurses. D. was sweating so I tried fanning her off. Per usual, she was not amused.

Cattaneo brought all the kids teddies, which they used to splint their sternal incisions when repositioning and coughing, etc. And for cuddling of course.

A Canadian, an Argentine, and an Ethiopian walk into an OR. The patient says “What is this, some kind of joke?”

Adessa tries to comfort K. She was having a tough morning.

The Ethiopian CV surgeon, Dr. Fekadesilassie. We just called him Fekade.

Anesthesia used spinals on everyone with propofol for sedation, and aside from the first D. everyone came out of the OR extubated, which made life much easier. After this surgery D. even came back doing her own chin lift. Jen couldn’t have been more pleased.

The Mission: