Thirteen patients later!

It's been a couple of days since I updated but everythings well here! We have had a total of 13 patients, not including a few pacemaker placement patients, one of which was one of the first nurses here at Tenwek! There have been six more patients since I last updated. Charles, Chepkoech, Irene and Joyce were all mitral valve replacements and did well! Miss Chepkoech had a rough day due to some bleeding post operatively. She earned a trip back to the OR after dumping a liter, but after repairing the stitch she has done well! Our two other patients are little different. For my non-medical friends this may not make sense BUT it's interesting so I added it. Hillary came to us with severe aortic regurgitation and sinus of valsalva aneurysm.  The plan was to do an aortic root replacement but it was complicated by coronary ischemia which then required a CABG. He had an eight hour by-pass time during which the team contemplated calling it b/c his ejection fraction was 5. After his repair and a TEE we gave him an "optimistic" EF of 19 and he seperated from bypass easier than anticipated. Within 12 hours of this operation he was extubated and sitting up. I can't help but believe that in the states this just would not happen. There's something about these people. They're resilient, they have such a strong faith, and they are more than willing to do anything they need to get better. It's so clear to me God has his hand over this place.

Ron teach during Hilary's TEE in the OR! An optimistic EF of 19. Today we measured 28!

Another interesting patient was Dotto. He was a 12 year old (looked 5, Amy actually thought he was 4) from Tanzania. He showed up at our clinic on Wednesday and they pretty much immediately knew he was not well just by looking at him. His mom said someone from home heard about the Americans at Tenwek and they offered to pay their way here. You could tell by his appearance Dotto had severe ascites and his abdomen was HUGE; he could hardly breathe. They did an echo and found he had a huge pericardial effusion and large bilateral pleural effusions as well as severe ascites. The admitted him to our unit and tapped 3L off his belly. We discussed what to do about his effusions but were nervous he would decompansate. The following day we decided to evacuated fluid around his heart and lungs. Jenny put in a pericardial drain as Mary Taylor guided her with an echo. We got about 300mLs and he got pretty hypotensive and dropped his heart rate with it. Fortunately, we were able to volume resuscitate him pretty quickly. I'd be lying if I said I wasn't nervous during all of this! After that we drained his left pleural effusion and got about 800mLs...lets just say he could breath a lot better after that! He was such a sweet boy. He would call us "dada" over and over meaning "sisters". One of the Kenya nurses said he was praising God for "finding" us for him and was asking me to pray for him. That was a cool moment. He loved playing music on my iPhone and playing games on Sarah's iPad. Sadly, w don't know why he is accumulating all this fluid. It's kind of a mystery. We've sent several labs and test to try to find out so I'll keep you posted on Dotto!

Sarah playing games with Dotto! 

Jenny and I have been manning the ICU this morning. We started with five patients and are down to two! Charles and Chepkoech are moving along. Both sweet souls, very soft spoken, but getting better! They should go to the floor today. As we were rounding we found Julia, Agnus, Lilian, and my girl Peris basking in the sun with their incentive spirometers and gifts! It was AWESOME to see them laughing and smiling together. They've bonded this week. They each asked how long their surgery was and said they feel so happy. Peris said "I can even walk up the stairs now!" love it!! She has SUCH a beautiful smile, I wish you could all meet her!

Our sweet girls!! Julia, Agnus, Lilian(fist pumpin), Peris!

Sarah, Amy, Dr. Galat, and Luke are all headed back to the states today. I can honestly say I'm really sad to see them go! I spent a lot of time with Sarah and Amy this week so it's already weird without them. Luke is such an awesome guy. He genuinely cares for these patients and this whole mission. And Dr. Galat is an incredible surgeon and so willing to teach! Though I'm sad to say bye I'm super pumped Kristen, Brittany, Leah, Dave Bichell, and Lewis are en route to us! I think their smiling faces will be the perfect boost for round two!

Nez talking to Charles about his family back home over some lunch. 

Round two is pediatric congenital heart defect week!...aka what I actually do at home! I can't wait to see these sweet kiddos! I think our youngest is 3 months but we will discuss in conference tomorrow once the rest of the team arrives. Anyway, happy weekend to those of you at home and as a Kenyan just reminded me, tomorrows election day! She asked if I voted and I told her I've been here but my states red no matter what :) LOVE TO ALL!

"For it is God who is working in you, both to desire and to work out His good purpose. Do everything without grumbling and arguing." Philippians 2:13-14

My HotBox friend Rachel donated lots of soccer jerseys...Charles was eyeing this one!

"But let all who take refuge in You rejoice; let them shout for joy forever. May You shelter them, and may those who love Your name boast about You. For You, Lord, bless the righteous one; You surround him with favor like a shield" Psalm 5:11, 12