The Gift of Life - Honduran Mission # 1

Honduran Mission #1 Wow, Its already Monday here in Honduras, all of us have been here since Friday, a few a few days before to set up and to start doing echocardiograms on some the first surgical cases. We have all been very busy since arrival so this is the first I have had a chance to sit and write, still at the hospital (its 5:45) and we have a few cases to go yet in the cath lab and at least one more open heart surgery. Its been an incredible several days, the doc.s have seen some things they don’t usually (if ever) see at home, many of them have been let go way too long, that’s why we’re here.
Its amazing to see the caring of the teams, doctors and nurses alike—wanting to help each and every kid if at all possible. We have seen some very difficult cases, some not even operable. Dr. Ngyuen has been doing his usual incredible job, started surgery yesterday, Sunday. They had some trouble with the first girl so it took much longer than it should have, but everyone stuck it out and by 8PM 3 surgeries were complete, 3 more lives saved! It’s a great feeling!

Saturday I spent a lot of time with Kevin Feely, the PA tech guy from St. Joe’s, working out suction and oxygen for a PICU meant for 3 patients and we want to set it up for at least 6 patients. Ran around to a medical supply house, an auto parts store and ACE Hardware to get tubing, connectors and such! Kevin seemed very happy with what we came up with. Dr. Bob Sommer and Dr. Fuad Kablawi, started doing catherization procedures, a few were diagnostic to give us more info for surgery but Sunday began repairs thru catherization, either inserting devices or doing balloon procedures to open up constricted arteries and heart valves. I am in the cath lab now, sitting on the back side of the protective glass for when they turn the xray tube on to locate the probe and such. Everyone in the room has to wear heavy lead lined aprons to work, I watched several procedures the other day and its just amazing to see how many people are working together to save one child’s life. When you think about it, besides the 6-10 people that are in the room at almost any one time, there are probably another 6-10 people at home that helped to pack all the equipment and supplies that we are using as well! One little girl we had in here yesterday, Melissa, is an extremely cute good natured kid in spite of her obvious poverty filled life, she had a large ASD and Pulmonary Stenosis, was very blue, turns out also has scabies and lice. Bob decides the best we can do for her is to open her restricted pulmonary artery, improve her O2 level, and then in December, when another team is coming to do heart surgery, she can have her ASD closed. It was very difficult to get the catheter into her left femoral vein so Bob finally decides to go thru the artery in her neck. It took a very long time to complete, but today she is much pinker, 02 saturations in the 90’s and is happy, smiling, and sent home by noon time!

At this point in the mission, the cardiac catherization team has already examined and/or treated 15 kids! One especially disappointing case was Belsy. Her echo showed a coarctation of the aorta with a restriction. Upon catherization exam, Dr. Sommer realizes that she has no operating corrated arteries to her brain! There are some smaller capillaries that have grown and the increased pressure in her aorta, because of the restriction, is necessary in order to keep some blood flowing to her head! This all explains why this beautiful 14 year old girl has been complaining of dizziness and seizures for some time now. There is most likely little if anything that can be done for her, and we all feel the mother’s pain and tears when she is told. It is also moving to see how one of the other mom’s comes over to pray with her and hug her.

Then there is Iris, yesterday was a long day, started out rough because we had what was thought to be an easy case to try out a new closure device for an ASD that a rep. from “Cardia” brought a bunch of here for us to tryout. They are not licensed to be used in the US yet but have been used in Europe for ten years, about 10,000 to date. Bob could not get that device to sit properly in a large ASD no matter what, her atrium was too small to allow for proper maneuvering. He then tried two other devices that wouldn’t work either and finally had to give in and put her on the waiting list for surgery. The good news is that we had another child, Angela-with long beautiful hair, canceled from surgery because of illness, so she was put in that slot today and is now doing great! I took a picture a little while ago of one of our nurses, Valerie, brushing her hair! Beautiful! So when they started the last case of the day- 15 year old Iris, they fully expected to just be confirming the echocardio report that she had tetrology of Fallot with several other severe complications and there was little or no hope that she would survive any surgery. After an extensive catherization study, it was determined that she most likely would survive surgery, there is a lot of work to be done on her, but there is a good chance for survival and a greatly improved life! Khan squeezed her into Wednesday’s schedule! We cant wait to see how she does, this morning when she was told she would have surgery, she cried with happiness that she has a now has a chance!

Everyone here is working together so beautifully, even when Ingrid or Alex blow up with their German way of responding to tension, the rest just take it in stride, knowing that its just part of how much we all care about what we are doing here!

There is so much to tell that has happened already, I realize I am jumping around the timeline here a bit, but that’s how it goes in the brain. Things like Fuad not being able to get on the plane on Thursday because he is from Jordan and needs a visa for Honduras, Alex and Ingrid from Germany, and we spend most of Friday sending them to the Honduran consulate in NYC, and calling everyone we know to convince them to give them a visa with no problems—obviously they all got their visas in just a few hours! Or the mountains of “luggage” that we brought with us, 28 passengers with 75 pieces-boxes, duffles, & two 6”PVC tubes I made for catheters so they wont be bent, the agent that first insisted,$100.00 per extra item, the supervisor that said “no” I saw an email about this and it is all fine! Or Ray and Reubens’ flight that tried three times to go from San Pedro Sula to Tegucigalpa before being able to land to pick up a car and all the supplies we shipped ahead of time! And yet we are here and everyone is working furiously, (or sometimes waiting furiously when things get held up for one reason or another!) Khan is working on the 6th surgical case and will hopefully be finished soon! 11 or 12 more to go before the end of Thursday. Beverly, Ruben, Ray, John and Joe are all keeping busy coordinating food, gift packs, toys, stuffed animals, payments of bills, etc, etc., all those things that round out what we are doing here so that we are sending everyone home feeling good in their heart, even if we were unable to provide heart surgery for those few. Well, I guess that’s it for now, this PDA has been successfully closed, 4 yr. old Keiglin is doing well and on her way to PICU in a few moments, this part of the team is on their way to the hotel for some much needed rest until tomorrow’s early hour to start all over again! Buenos Noches, hasta manana! 

Andy