Friday, March 4, 2016

A Time for Celebrations and Farewells.

The team has finished up the final day of surgeries. In our short time here, the CSI team performed 56 surgeries. This morning the surgeons made their final rounds and signed off to the local Urology and ENT Departments who will follow the children In the hospital for a few additional days, as is their typical protocol here. 

Vietnamese nurses providing follow-up care.

Dr. Yuri Reinberg, Urology.

Dr. Siva Chinnadurai examines a young patient. 
A few CSI team members toured different areas of the hospital during the course of the week, including the NICU, pediatric ICU and the emergency department. 

The CSI team has been honored to care for the families and children of the Thanh Hoa region this week. The children's sweet smiles and the grateful eyes of the parents make the work a pleasure. 

Adminstrators, surgeons, physicians and nurses from Thanh Hoa pediatric hospital invited the CSI team and our translators to a farewell gala to celebrate the week of collaborative work on behalf of the children. It was a festive night filled with friendship, laughter, toasting, speeches and, of course, Vietnamese karaoke!

Dr. Hung, Hospital Director, Tom Fansler, CSI board chair,
Father Joseph, and Dr. Hai, Hospital Vice Director.

Dr. Hung and Tom Fansler.
Dr. Hung, Hospital Director.

Ellen Reynolds, PNP, celebrates with hospital nurses and staff.

Drs. Petersson and Chinnadurai. ENT represents.
Here's a fine example of the karaoke, performed by Dr. David Vandersteen, urologist, left, and Leon Randall, biomedical support.

A special shout out goes to a very enthusiastic and dedicated team of translators who have been with us the entire week. 

Today was spent visiting a floating river village and Trang An, a national heritage park. Three generations live on this floating home. 

Celeste and Wyn fell in love with the youngest family member.

The children enjoyed dollies and bubbles.

The team will disperse tomorrow. Some head home to the U.S. while others extend their stay to explore Vietnam and Thailand. 

Wednesday, March 2, 2016

Settling in and enjoying successes.

Jet lag, 12-hour workdays, exhaustion, and sometimes a rumbling stomach are "part of the deal" on a surgical mission. But what is so very wonderful is that every morning I wake up thinking about the kids we cared for yesterday, and remembering the smiles, the tears, the parents' expressions of hope, worry, and ultimately gratitude. I can't wait to get back to the hospital to see how the kids fared during the night. Did her labored breathing settle down, did he drink some fluids, did the bleeding stop, is her pain under control, did the parents get some rest? 

The weather has been beautiful this week, sunny and 75 degrees. The morning walk to the hospital is filled with the sights and sounds of the city. Walking into the bustling Thanh Hoa Pediatric Hospital gives us renewed energy. It's a large and very busy regional pediatric center, with 500 beds and currently about 800 patients. 

Today, the rhythm and flow of the CSI surgical day in Thanh Hoa were nice. The team members are all settling into their roles, finding their way around their work areas and the rest of the hospital, and getting to know their Vietnamese colleagues better. We are becoming more efficient and synchronized every day. 

The urology and ENT patients that are assigned to the CSI team stay with us in the Anesthesia Department for the first day and overnight. At that time they are transferred to their respective ENT and Urology Departments where they will be in the hospital for several more days. 

The surgeons, anesthesia and OR nurses (CSI and Vietnamese) have two cases going simultaneously in each room. With two ENT and two Urology surgeons with us, we are performing cleft lip and palate repairs, as well as the repair of a variety of urological abnormalities.  Some of these can be quite complicated and may require additional procedures in the future. 

Off to the last day of surgery. Stay tuned!

~ Linda Sedgwick

Tuesday, March 1, 2016

Long Days. Successful Surgeries.

Tuesday, March 1 - A beautiful morning to start the day in Thanh Hoa. The teams are starting to hit their stride. We are seeing great collaboration and information sharing among our surgeons, pediatricians, anesthesiologists and nurses as they work a busy slate of urological and maxillofacial cases. The ENT team has been working through seven cases today, mostly cleft palates, and there has been an opportunity to work side-by-side sharing ideas and procedures with our Vietnam colleagues. 

The urological team had a rare epispadias case this afternoon, something which our surgeons had only seen five times in their 50 years of combined experience. It’s estimated to occur at a rate of 1 in 250,000. We were well-equipped, and working with our Vietnamese colleagues, the repair procedure went very well. During the day, anesthesiologists shared techniques on airway management and regional blocks. Pre-op and post-op nurses worked together on procedures and kept the whole system operating smoothly. The days are long, wrapping up around 8 p.m., but there has been strong engagement and support across the teams.

By Tom Fansler, CSI Board Chairman

Dr. Raj Petersson with a most grateful mother.

Jennifer Kreiman, RN, with Vietnamese ENT nurse and a happy family.

Our littlest patient of the week.

Drs. Yuri Reinberg and David Vandersteen. 

Monday, February 29, 2016

A Successful Day of Surgery for the Team and Families

The view from the hospital.
Successful cleft lip repair.

Urology surgeons collaborating.
Donna Schroeder, RN, with her Vietnamese colleague in pre-op.

And the families patiently and anxiously waiting:

Sunday, February 28, 2016

First Day at the Hospital for the Vietnam Team

After a meeting with our partners at Thanh Hoa pediatric hospital, we began evaluating the many patients waiting to be seen by urology and ENT surgeons. Many patients and hopeful families had traveled long distances to see CSI.

Because we had a team here six months ago, we have the ability to see some children in follow-up who weren't ready for surgery at that time. Returning after just six months also allows for more continuity in our education and training models, as well as streamlining and improving our processes with the hospital staff and administration.

It was a very busy but interesting and successful day. More than 100 children were evaluated for potential surgery. Some will be ready for surgery this week, while others may need further testing and diagnostic work. To a few families’ joyful surprise, their children had normal examinations and did not require a procedure.

While the children were being evaluated, our OR anesthesia and nursing teams spent the day setting up the operating rooms, assuring they had all the necessary equipment ready to provide safe and comprehensive pediatric surgical care, and meeting with their Vietnamese colleagues.

Our team is enthusiastic, resourceful, committed, hardworking and fun! CSI is thrilled to have a few nurses and physicians with us in Vietnam who are new to CSI. It really doesn’t take long for a group of passionate people to become a cohesive team. The children and families waiting for us here give us the energy and focus to give them our best.

As always, our focus is on education for local health professionals. We will be working alongside Thanh Hoa hospital surgeons, physicians, nurses and administrators every step of the way this week.

~Linda Sedgwick

Saturday, February 27, 2016

CSI Team Arrives Safely in Vietnam

Long travel days were the norm for the team traveling to Thanh Hoa. The journey included 28 hours+ flight times, an overnight in Hanoi and a bus ride to Thanh Hoa on Saturday. We enjoyed a welcome dinner with hospital physicians and administrators. Everyone is enthusiastic about getting started. Sunday will be spent screening children at the hospital in preparation for a full schedule of ENT and urology surgeries this week.

The CSI team in Vietnam includes 26 members from Minnesota, Virginia, California, North Dakota, Tennessee and Maryland.

A special thank you shout out to our guide Frederick, Father Joseph and our Vietnamese interpreters.

~Linda Sedgwick

The CSI team heads from Hanoi to Thanh Hoa.

Wyn Huynh, CRNA; Dr. David Vandersteen and his Vietnamese colleague, Dr. Thanh.

CSI board chair Tom Fansler with hospital director Dr. Hung and a local volunteer.

Cardiology Team Wraps Up Its Life-Changing Work in Ethiopia

Today we finished procedures and spent the balance of the day investing in teaching and knowledge transfer at the nursing, medical student, resident and fellow level.

We started our day at 8 a.m. with a lecture on ASCVD prevention and transitioned to rounding that went into the early afternoon. We had the pleasure of rounding with very energetic and bright medical students and residents as they were going on bedside rounds with the cardiology fellows.

The center caters to the underserved, and there are 14 beds in each room. The excess we take for granted in the United States is stripped down to the basics, where even the curtain and some extent of privacy between neighboring patients is now down to a few feet between beds in a large open space. Yet with no TV, no patients talking on the phone and no monitors beeping, these large rooms with their 14 patients were quieter than most single rooms I round in while in the U.S. Most of what could be heard was our large team of providers moving from bed to bed and room to room discussing each case in detail and teaching residents.

While the MDs were enjoying these bedside rounds, our multitalented nurse Colleen gathered up the nursing staff and took them through a series of lectures pertinent to cardiac care. The staff created a makeshift lecture hall for her in the middle of the ICU by moving a couple of the beds out of the way so the wall became the screen. (See photo below.) The ICU nurses did not want to miss out on the lectures, so nurses from other areas came over to the ICU and the class was good to go. Improvisation at all levels is the way of life for folks here and a remarkable gift.

Dr. Ben Johnson will do the last in our series of lectures. He will talk about atrial fibrillation, which is a condition common in our patients with valve disease.

I plan on having a series of meetings tomorrow that will hopefully facilitate the smooth entry of our items into Addis/Bahir Dar on subsequent trips.

~Dr. Woubeshet Ayenew, cardiologist at Hennepin County Medical Center and CSI volunteer