Tenwek Day #4: Kip

The second case of the day was my case so I was finishing up the 1st case and cleaning up when Dr. Jim one of our cardiac surgeons told me to come into the next room and meet our next patient for that day.  A 14 y/o boy with pretty severe heart disease from Rheumatic Fever, the reason most of our patients here at Tenwek require open heart surgery.  Rhematic Fever destroys the valves of the heart causing a variety of symptoms and debilitating issues for people who have had this disease.

I seem to have an affinity for patient's named "Kip" (see my prior post from 2008) and Kip is a very common name in Kenya. 

(Click Picture to Enlarge)

When Dr. Jim and I came into the adjacent OR where Dr. Malik (our anesthesiologist) and Dr. Agneta (surgical resident extraordinaire from Tenwek Hospital) were getting ready to put Kip to sleep and insert his lines for monitoring during surgery.  He was obviously very sick and very scared and my heart melted on the spot.  You just want to wrap your arms around all of these children and make everything "all better".

After Kip reluctantly agreed to let me take his picture we had to coax him with some well placed tickles from Dr. Agneta to get the second picture with his pearly whites!  I quickly went back into the cardiac OR to begin setting up the heart-lung machine for Kips surgery.  Kip was our first pediatric open heart of the trip so far and I was excited to be able to do my first pediatric case of our trip.

When I went back into Kip's room to check on him I was able to take the picture above of Dr. Malik and Dr. Agneta laying hands on Kip and praying for him to have a successful surgery.  Kip was a very sick little boy.  As you can tell, he was unable to gain weight as a normal child would because of his cardiac issues from the Rheumatic Heart Disease.  Our cardiology team started Kip on medication at the beginning of the week to get him as healthy as possible prior to his surgery later in the week.  I hurried back over to the cardiac OR to finish setting up as Dr. Malik began putting Kip to sleep...

There are a lot of changes to make to the heart-lung machine and the circuitry from the adult patient we just finished and the pediatric patient we were about to do.  One of the things that we struggle with on mission trips is that all of our equipment is donated and you never quite know what you have to choose from or maybe where it all is because there are so many packages of supplies to open in order to complete our set up.  While I was hurrying along in the the cardiac room, medical staff from Kips room started coming in and out of my room hurriedly for supplies.  The frequency of their visits and the number of people coming in and out to get supplies is never a good sign, especially when one of the things they're taking is a defibrillator.  I immediately started prioritizing my set up as an emergency bypass procedure for someone who had arrested... minutes later one of the Kenyan cardiac nurses came in and told me that Kip had arrested in the other room... twice... and Dr. White came into the room to see if we could push the heart-lung machine into the adjacent room to get Kip on bypass faster.
These children are so sick when we arrive, we never know how strong they are or if we will be able to operate on them in time.  One of the 19 y/o patients that our cardiology team evaluated on Monday hours after we arrived died that same evening in the ICU with his brother at his side.   Both he and his brother were orphans.  The older brother told our cardiology team that afternoon he needed them to make his brother better so he could take him home since he couldn't afford to transport his brother's body back home if he died.  You all have no idea how much a cardiac team is needed in these parts of the world and it is by the grace of God that we arrive when we do for some of these children.

Kip was brought into the cardiac room and we put him on heart-lung bypass urgently because he was so unstable and our team proceeded on with his operation.  The surgery went very very well in every perspective.  I was able to use some specialized techniques on bypass that we use back home at Vanderbilt that allowed us to not transfuse him with any blood and also helped to decrease post-op bleeding.  Our whole team was doing everything they could optimize his outcome, as we do for all of our precious patients.

The picture above shows our team moving him from the operating room table onto his ICU bed for transport to the ICU just around the corner.  Our ICU team is in the picture getting report from the anesthesia team and preparing to take over his care in the ICU.  It is just after 10 pm and we're all very excited that his surgery has gone so well.  We will know more in the morning after he is through the initial 8-12 hours post op.

The following morning (this morning) I was able to sleep in since Hoang was doing the first open heart and Eric was assisting her.  On my way into the OR, I stopped by the ICU to check in on little Kip and was very surprised to see him sitting up in a wheel chair with an iPod in his ears and a MI hat on his head.

This little guy had had a pretty rough day yesterday and this morning he was chillin' in the ICU with his MI hat on, listening to some 'tunes and being waited on hand-and-foot by our ICU team.  The nurses told me when he was extubated (the breathing tube removed from his throat) the first thing he said to them was, "I want to play football!"  Our team brings the patients gifts each year, so their gift to Kip was a shiny new bright red soccer ball.  They said he held on to it all day long just patting it... all day.  After a while he quietly asked them if the ball was his to keep or is he could only play with it today? 

Doesn't that just make you want to save all your latte and movie and "everything else" money to make a difference in all these children's lives?  If you're so moved by Kip's story or any of the story's you read about on any of our teams blogs (see "Kristen's Tenwek Blog" and "Anna's Tenwek Blog" link on my blog sidebar on the right to hear more about our time at Tenwek) please consider a donation to the Tenwek Compassionate Surgery Fund via World Medical Missions that is described in bright blue font on the right hand side of my blog when you sign in.  If you are able to donate as a result of reading my blog, please write my blog address in the memo line of your check and they will let me know how much money we've all been able to raise so we know we've been able to make a difference in the cardiac care at Tenwek Hospital.

And finally, tonight when we were finishing up our second open heart of the day, Dr. Luke and I stopped by the ICU to check on little Kip before going back to get some sleep.  The video below will show you just how well little Kip is doing tonight.

2 more open hearts tomorrow everyone... please keep us in your prayers!  It's 1:40 am, it's going to be another short night, but that's really OK  ;)