PAST SUCCESSES

Not only was our first surgery of 2012 a success, our first surgery of 2011 was a success ... just look at him!  We were graced by a visit from Evariste today - our very first patient last year came to visit us right after our first surgery arrived for 2012. What fate. It looks like both gentlemen are very happy with the result.

Have you ever seen such a handsome bunch of men? All fixed by Team Heart and HHNW.  Ernest, Jean Paul and Evariste. Ernest has graduated and will start University next year, Jean Paul has a successful taxi business and he interprets and educates our patients pre-operatively each year and Evariste is studying finance and banking. Not bad eh?

FIRST SUCCESS OF 2012

Our first day of surgery and post op recovery was a huge success in the CICU. This is Tanya, Bryan (KFH RN), Ashley and Dr. Atul tucking in our first patient - Angelique. I will use her as an excellent example of the difficulties that arise from choosing patients for HHNW surgery and then choosing valve types for each patient.

Our Screening Team (Cardiologist and Echo Tech) travels to Rwanda in February/March to perform Echocardiograms on 100's of patients. Then they narrow this list down to 40-60 patients. Dr. Hal Goldberg, our HHNW Medical Director, has set down excellent ground rules for patient selection, but our surgical team must narrow down this 40-60 patient list to 18 candidates and 5 alternates. You can imagine the difficulties they face - how sick is the patient?, would they tolerate the surgery?, do they have access to follow-up care?, etc.

Then, based on the Echos, the surgical team decides which valves need repair or replacement. Repairs happen with rings and replacements happen with either tissue or mechanical valves. (By the way, a big "shout out" to Edwards Life Sciences, Medtronic and St. Jude who donate all these rings and valves.) If a patient has a tissue valve they do not need to take Warfarin (Coumadin) post operatively, but they may need another valve surgery in the future. If a patient has a mechanical valve they will need to take Warfarin post-op to make sure their blood is thin enough not to form clots around the valve. Warfarin leads to several other decisions - will they be able to obtain Warfarin?, do they have a clinic nearby to perform their INR lab draws to determine Warfarin levels?, are females done with childbearing?

Which brings us full circle to Angelique. She lives in a Congolese Refugee Camp and has 3 young children. Angelique stated she was finished with childbearing - but was this because she felt so awful because of her mitral valve disease or was this her true heart's desire? What happens after we fix her Mitral Valve and starts to feel better?, will she want more children?, will she be able to obtain Warfarin?, will she have a clinic available to her in a Refugee Camp?

In the end we try and educate patients as much as possible so they can make an informed decision. This begins weeks before we arrive, thanks to the groundwork of the 3 Kigali cardiologists who manage our patients before and after surgery. Angelique chose a Mechanical Mitral Valve and is Post-Op Day 2 here, we will give her the first dose of Warfarin, per her decision. Then she will move from the CICU over to Telemetry. We wish her all the best, our first patient of 2012.

And so we begin...

After arriving on late Friday evening, we began undertaking the boxes. Remember all the hours we spent at the hospital packing, packing,and packing? Well, we had two days to get it all unpacked and organized before surgery could begin. Two really long days on Saturday and Sunday spent unloading, stocking and storing... We are ready to go!
Bright and early Monday morning, the real work began. The first patient was Angelique, a gorgeous 29 year old mother of three. Angelique had a mitral valve replacement that went vey well. The second patient of the day was Annociatha, a 23year old girl who had a mitral valve replacement and a tricuspid repair. Her surgery was a little more challenging but went very well also. 

One of the highlights of the first day was a visit from an old friend Everiste. Everiste was the very first patient operated on during the trip last April. He had an aortic valve replacement and is doing beautifully. Such a nice surprise to see his handsome, smiling face. The we're lots of hugs and a few tears going around. He was so happy and proud to show off his success. Seeing his face when he shook hands and hugged his surgeon, Dr. Neil, was priceless! Everiste visited with Angelique in the CICU just as she was waking from her surgery. He also visited with Daniel, a surgical patient scheduled for Tuesday morning. Daniel is just 11years old and despite his brave face, he was very happy to have someone reassuring him, especially someone who spoke his language!

After two successful cases, we finished and headed to the hotel around 6pm, tired and happy. It wasn't too long before we were all nestled snug in our beds, visions of valves dancing in our heads.
(we are having some problems with internet, we'll get pictures uploaded when we can)

WELCOME BACK

It began and ended with a toast, of course, to us and you and our families for allowing us to leave the country, finally!

And the long flights were just that. Thankfully they had great movie selections, so if you missed the Oscar Nominees, now is your time to catch up.

And, even those of us (Jamie and Ashley) who are plagued with lost luggage, were not so this time. All of the luggage and trunks arrived safe and soundly. This morning we are ready to greet our Berg Shipment and the Customs Officials at King Faisal Hospital (KFH) and justify all of our supplies. Wish us luck!