First Day of Surgery 2017!!

The First Day of Surgery!!

Greetings Friends and Family of Team Heart!

My name is Bridget Colgan, I am a fourth year medical student from University of Vermont, and have been blessed with this amazing opportunity to volunteer with Team Heart for their 10th medical mission trip to Kigali, Rwanda.

Briefly about myself, I will be graduating from medical school May 21 and starting my general surgery residency at Tripler Army Medical Center in Honolulu, Hawaii on June 1.

How did I wind up in Kigali, Rwanda? Well, that story goes back a long time… when I was born… Just kidding. I will start when I met Dr. Bolman, Ceeya, and Dr. Leavitt during my third year of medical school. I have had a strong interest in cardiothoracic surgery and medical mission work for many years and during my third year of medical school when I first heard about Team Heart, I instantly knew I wanted to be a part of it. I will be forever grateful to Dr. Leavitt for telling me to talk to Dr. Bolman and Dr. Bolman for telling me to talk to Ceeya, and Ceeya for accepting me along as a volunteer for the trip.

Ceeya emphasized the value of being actively involved in the team to maximize my experience and I know without a doubt how right she was. I was able to help with inventory prior to the trip, receiving all the emails of supplies for perfusion, pharmacy, the supplies that were still in Kigali from last year and those that needed to be shipped - and I did my best to input them into FileMaker, the software we used to keep the inventory records. It was not until last Sunday, February 19, that I was able to actually put a visual to the weeks and months of emails regarding the inventory. To see all the supplies stacked up filling the closet of the Team Heart house wall to wall was very exciting - the trip was here! The 16 life-saving surgeries that required all these supplies would soon be happening!

The past week I have had the amazing opportunity to be a part of the screening team. We travelled to multiple sites in Kigali. The day before I got here, February 18, the team took a trip a couple hours away to visit Ruhengeri Hospital. While I was here from Monday, February 20 through Thursday, February 23 we went to three other sites: Kanombe, which is the Military Hospital, and Chuk, which serves as the city hospital of Kigali  also called Shiaska, as well as King Faisal, which is where we are currently doing the operations. Screening week was surreal. We saw so many patients, not just with rheumatic heart disease, but congenital heart defects, including corrected transposition of the great vessels and an ostium primum atrial septal defect, cardiac tumors, and many other diseases and pathologies. It was extremely challenging to not be able to help all the patients we saw, but the team did our best to collect the data we could on each patient and advise the local cardiologists on recommendations for further treatment, even for those we are not able to operate on and treat during this trip.

The screening meeting took place yesterday afternoon, February 26, at 1pm at King Faisal Hospital in the outpatient building. You can see pictures of the meeting below. We selected 16 patients and 5 alternates for surgeries. The selection was not without the challenge of wanting to be able to help everyone but being limited by time, resources, and disease burden. If the patients are too sick to tolerate surgery, it is a difficult but necessary decision to recognize our limitations as surgeons and medical professionals.

After finalizing the OR schedule for the week, we went out as a Team to Heaven, a local restaurant and favorite place of Team Heart where we were able to talk and reflect on the many life experiences that brought us together to serve in this amazing way. I had the privilege of sitting next to Dr. Bolman and Ceeya and hearing not only the story of how they met, but also the story of how Team Heart came into being. I am so amazed by their heart for service, their vision, and their ability to realize their vision in such an amazing way. They dream with their feet - putting their visions and hopes into action. They have inspired me not only as a future surgeon, but in the type of person I hope to become.

Dr. Bolman was going to read a quote last night at dinner from A Thousand Hills to Heaven by Josh Ruxin the owner of Heaven restaurant. He wound up not reading it, but he shared it with me and I wanted to share it with all of you because I think it sums up beautifully why we are all here on this trip:

"You cannot leave Africa and then expect to be satisfied by ordinary living. You will have to continue doing extraordinary things, because you know what can be done in the world, and you know what you are capable of doing, and you know that, wherever you go, many lives will depend on your willingness to exercise your privileges and skills on their behalf."

Today was the first day of surgeries - we had two single valve cases, one aortic valve and one mitral valve. Both cases went well and the patients are in the ICU now recovering. It was an exciting day for the patients and the team as everyone moved into their professional roles and worked together to make the day a successful one.

We all had breakfast in the morning and headed over to the hospital to get started. Zander, the UVM resident who is here with us, and I ran to the lab to make sure blood was available for the first patient - started the day off right with a yes! And the first surgery stayed on schedule. After checking into the OR to see how things were getting started, someone had brought in a coloring book, markers, a Dr. Seuss book, and play-dough for our second patient and I had a bunch of stickers to give each of our patients. I felt this sounded like a medical student task, so I brought it all up to our second patient and found him getting a lecture for eating a banana by the anesthesiologist because he was not allowed to eat before surgery. The nurse and the patient's sister were bargaining with the anesthesiologist to be able to give him some apple juice. I was happy to be able to distract our patient from wanting to eat with some coloring. It was color by number and he loved it - did an amazing job. While we were sitting there, the team walked in on morning rounds and he, being a little ham, soaked up the attention from his audience. His sister loves when we take pictures of him and she adopted my phone for a few minutes today to take some pictures herself and I taught her how to take a selfie - she was so enthused. It was overall a great morning and the day continued to go well.

We got the OR schedule finalized with a few changes and distributed to everyone. We got the patients for tomorrow all set up. And then I got the chance to scrub into the second case, which I was so grateful for the unexpected opportunity to be in a case on the first day. It was really awesome to be able to see a mechanical mitral valve replacement. I was able to actually see the old valve, how damaged it was, its removal and the process of the new mechanical valve being put in. Dr. Bolman had a camera attached to his headlamp so all the people in the room had the opportunity to see the operation on a small monitor in the OR. The cardiology fellows also had the opportunity to watch along with the anesthesiologists. It was a great case for everyone.

Tomorrow will be another full day and I know we are all looking forward to it as we are in the swing of things now. Dr. Oakes will be doing a mitral valve replacement in the morning, followed by Dr. Bolman doing a double mitral valve replacement and tricuspid valve annuloplastly in the afternoon. I will write more soon!

We are so grateful for all your support in this endeavor, we couldn't do it without you.

Urabaho!

From Bridget and the rest of Team Heart

The second case: an 11yo boy, single valve replacement