Thursday, February 14, 2013

ICU-Docs! The best!



Meet our behind the scenes team caring for patients after surgery. The intensivist is a physician coordinating and providing care for patients in the ICU following surgery. They can be boarded certified in critical care but also have back ground in anesthesia, Internal medicine, pulmonary medicine, surgery or Pediatrics. Working closely with the nursing team and the surgical team they are the glue who keeps us together and focused during the most critical time.  These two, shown here with Chip have been exceptional to work with and provide care for our patients.

Dr. David Morrison is returning for his third Team Heart trip. An anesthesiologist from the Gundersen Clinic, in LaCrosse WI. He traveled with CARDIOSTART on a cardiac surgical  trip before we met.

Dr. Norm Yunis is a pulmonary medicine intensivist and works at North Memorial in Minneapolis, MN. This is first Team Heart trip.

They received the highest complements from the ICU nurses this year--which given the incredible nurses we have,  great praise!

Monday, February 11, 2013

A few thoughts from the Stepdown Ward...

In 2009, I came to Rwanda for the first time. I had previously done mission work as a nursing student in Kenya, but cardiac surgery and Rwanda were new to me. I was excited to learn about this beautiful country and to work with Team Heart as we changed the lives of several very sick Rwandans suffering from Rheumatic Heart Disease. Flash forward to 2013, and my 5th trip to Rwanda. I continue to be in awe of this country, it's landscape but more importantly the people. In the last five years, I have been fortunate to have provided nursing care to nearly 60 Rwandans ranging from 15 to 45 years old.  Their stories of struggle and illness preoperatively are profound and their recoveries after life saving cardiac surgery (specifically heart valve replacement/repair) is miraculous. Last Saturday, about 40 of our former patients travelled to Kigali for a reunion. Some travelled by bus for 8hours! Seeing these patients healthy and happy is overwhelming. I can remember how sick they were before surgery, and their daily progress in the Ward after surgery. Now, if not for the chest scar peeking out of the top of their shirts, you would not know how near death they all were at one time. They have returned to school, gone back to work, gotten married and some have even had babies. It is remarkable to see them all together, hugging and catching up. It is such a privilege to be here doing this work. This year I was fortunate enough to have my husband Justin join me for the first two weeks of our mission. He worked hard with the preoperative team, screening potential patients and helping prepare them for surgery. At the end of his two weeks, he was finally able to understand why I return to Rwanda year after year. Pictures don't do this experience justice. It is the best thing we as medical professionals and people can do. The 40 or so Team Heart volunteers are all such special people, donating their vacation time, money and time away from their families to be here for almost 3 weeks. Today is our last day of surgery, the step down ward is booming with 11 patients and 5 more expected to move over in the next two days. They are all amazing individuals, aging 16 to 45, from all different parts of the country, but now all bonded by this shared experience of heart surgery. I am already looking forward to seeing them all next year, a year post op with stories of renewed hopes and dreams.  Thanks for supporting Team Heart and following our story...

Sunday, February 10, 2013

Slideshow!

First batch of pictures! Saturday morning, 2/9, in the OR at King Faisal. Check out the slideshow through the link here:


More to follow!

-Mackenzie

Getting to Know You: Part I


As one of the only non-medical members of Team Heart here in Rwanda this year, I can’t say I know much about the details of heart surgery.  I’m grateful that we have a whole group of really smart, thoughtful people who ARE experts on the subject and are anxious to share their stories—I promise to leave that part of Team Heart ‘s day-to-day in their expert hands. 

Before arriving in Rwanda, I wondered how I might find a way to really connect with Team Heart—and how our supporters, followers, friends, families, donors, and general Boston fans might do the same without the benefit of a medical background. It became clear pretty quickly that these patients are something special, and they all have a story. To me, that’s the hook.  These patients have names, faces, families, dreams, some amazing curiosity, and now, bright futures.  What does it look like when they start to feel safe again after the surgery? When they realize they’re not going to die, and they allow themselves to feel hopeful? When do they lower their guards? These patients have been given back their lives…what will those lives entail going forward? 

Over the last week, I have watched some of these stories unfold.  Some stories are in their infancy; some are second hand; some started with Team Heart at the beginning and are incredible to see today.  There is one gentleman who is currently in the step down unit at King Faisal. He was the first surgery of the 2013 trip, and he is just amazing.  This patient is older than most of the people we see, but at 39, he has a beautiful wife, a new baby, and a good job at the Ministry of Defense in Rwanda.  This past Monday, he had a successful single valve replacement operation, and just 2 or 3 days later, he was like a new person.  I first met him in the ICU recovery room after his surgery, and soon after that, I found myself looking forward to seeing him each day.  Many of the patients speak a minimal amount of English, and when they are weak and tired in the days after surgery, it’s hardly a surprise that they don’t feel like saying much in a secondary language.  This man, so soft-spoken and warm and smart, surprised me with his mastery of the language and seemed to go out of his way to engage us every day.  “Good Morning, Mackenzie” was the simple greeting that I looked forward to.

I could gush forever about his sweet personality, but it was one particular conversation with this man that will stay with me.  As I sat next to his bed chatting and sharing pictures one afternoon, he politely asked if he might ask me a “complex question.” He explained that, to him, Team Heart seemed like a military operation. He wanted to know how the whole thing worked, and I was struck by his thoughtful questions:  Team Heart is so organized, how did that happen? (The answer to that one was easy: Ceeya!). How do we pay for all the medical supplies? How do we get them here? Do we leave our families behind in the United States to come to Rwanda? Is that hard for us? How do we pay for the trip? How do we get so much done in so few days? How do we take time away from work for the trip? Are we working together with the government in Rwanda?  How will the program go on once we return home? Maybe I shouldn’t have been surprised by his questions, but I was.  These patients come to us in need of help, feeling quite vulnerable, and Team Heart heals them. That’s enough for anyone to try to process. But he had thought so much about the program beyond what he was seeing first hand, and I realized that he truly cared beyond the scope of his own experience.  It was a meaningful reminder that these surgeries change the lives of the patients, but they also change the doctors and nurses and team members who become part of that story; in the big picture, this project forges deeply strong bonds and connections among people—and even though we are the caregivers, the patients care for us too.



- Mackenzie 


Patient Reunion 2/9/2014

Patient Reunion -Each year we plan a reunion for our patients and attempt to do follow up of as many as possible. We keep Marilyn and David  Of the 60 patients we have done in previous years, over 40 returned!
It was emotional for both patients and team. Recalling those we thought would never survive and seeing them vibrant and healthy was wonderful. We celebrate a wedding for Delphne and meet her husband, we see Anastasie pregnant and proud. in turn, the patients love meeting Justin Pitman, husband of Sara.

Several are in University and several are in high school. It is a tough economy to be entering the work force, but they encouraged each other and celebrated the Rwanda way with community and sharing. The patients performed a wonderful song in our honor and LOVED "Hearts of Courage" a film, by Michael Fasciano, premiered in Rwanda a few nights before.



Suellen and Laetitiia

Sara and Suzan

Sara and Sufa


Emmanuel, Shabani, Erneste
Patient Reunion 2013

Thank you to Jean Paul I, President of the Rwanda Heart Foundation who notified each patient. Thank you to Deborah Rekundo, Team Heart Rwanda Administrator who made all the arrangements, selected the food and did a fantastic job.
Ashley Kleinkauf, RN from  Ft. Lauderdale, Fl and Boston  area is returning for her second year. Here she is with John, 15 years of age in ICU before transfer. This year she brought co-workers with her, Hanna Isenstein,  photographed below and Patty Weist featured in a later entry. Ashley Hanna and Patty all work at Holy Cross,  and their hospital is one of THREE  of the 16 hospitals that support the commitment of the employees to donate their vacation time and travel with this team. 
Diane Gay, MGH, Boston,  Bonnie Greenwood, BWH Boston, Ashley, Hanna. Connie Fail, MGH and Dr. Norm Yunis, North Memorial, Minneapolis, MN

A note from Chip, February 10, 2013

February, 10, 2013, Team Heart surgical trip number six. 

As always, the team has exceeded all expectations. This is not easy, as expectations have become quite high during our past trips. The coming together of this disparate group of individuals, from 8 or 9 different states and 18 hospitals, united by a desire to help those less fortunate, manifests itself in ways expected and totally unexpected. Everyone works incredibly hard and without complaint. A 17 yo patient had some problems in the middle of the night, and, when I threw on some clothes and ran out, there was the Top Tower bus full with OR nurses, anesthesiologists, surgeons, at 3 a.m., all not just ready, but eager to help. All ended well, fortunately.


We hope to do sixteen heart operations, and one pacemaker insertion in our eight days of surgery. All has gone well up til now.



In reflecting on our now six years of experience with having the privilege of doing this work, I think I can sum it up by saying: "If not this, what? If not now, when? If not us, who?
Thank you to all who are here with us, and to all who are supporting us back home. Our success is your success, and it has been the highest honor of my life to do this with all of you.
Chip


Chip, Cardiologist Patricia Come, Jeanne DeCara at the Premier showing, Courage of Hearts, a film by Michael Fasciano

Surgical Team Bobby Oakes, Chip Bolman and Terra Lawson, work with theater nurses from King Faisal Hospital in Rwanda. 



I