Belated update from Keith

Hi All,

Thanks for following along with us while we return to Uganda with our dear friends from DC Children's and UF Jacksonville. A special thanks to our former UNC colleague, Dr Gene Fried, now at UF Jacksonville, who jumped in at the last moment to provide cardiac anesthesia to the Ugandan children. Our trip over here was uneventful (mostly) but tiring (as usual). We had a wonderful rest at a Hotel on Lake Victoria Sunday night before getting on two buses Monday morning at 7 am for the trip in to Kampala. Despite having most of our supplies shipped over ahead of time by Samaritan's Purse (THANKS CYNDI AND JIM), we still accumulated 26 bags/boxes of luggage and supplies. The bus was packed. We had an interesting "off road" experience getting to the hospital since the main thoroughfare was blocked.

We arrived at the Mulago Guest House again (THANKS SO MUCH KATE and JOSEPHINE), where we are all staying. Such comfortable modest housing (except for the lack of hot water each morning...a terrible way I start each day). I continue to be amazed by our team. We so quickly converted the Cardiac ICU and Cardiac Intermediate Care units into fully functional (well mostly) units. we still have some work to do but it's OK...We have already operated on 4 children and each day presents itself with a new suprise. Day 1, was suppose to be a warm up for our first timers (Dr Mike Mill, CT Surgeon, Dr Gene Freid, Cardiac Anesthesia, Jenn Ditto (OR Scrub RN), PICU RN's Bren Sparling and Sandi Hawkins, and our loveable fellow, Dr Benny Joyner. But of course this changed. The first case, a PDA developed pneumonia and was canceled so we proceeded with another PDA ligation and added on a cardiopulmonary bypass (PUMP) case.

The team jumped right in and did a fabulous job. But we're always gerry rigging something or moving onto PLAN B (or as Spongebob's nemesis would say, PLAN Z). It's great to work with such resourceful, "CAN DO", "NO IS NOT AN OPTION", types....The second suprise came today when we added on a Coarcation repair that was seen at Tuesday's Clinic by Dr Sable. For some reason, they don't "see' coarctations here in Uganda, so we decided to show them.....AND the super suprise was a baby seen on monday with Transposition (and PS/SUB PS) who had O2 sats of 40...we put together the necessary equipment to bring him into the CICU, intubate, line him, and Dr Sable performed a life saving balloon Septostomy. While this buys him some time, surgery is the only long term survival option. Unfortunately, this is NOT something that can be done at this stage of the program here in Uganda. We're still working on options.

I'm here on call, swatting the mosquitos away thinking about my two beautiful children, Kyra and Connor, who I miss so much. Well the team will keep you up to date with events as the week proceeds. Tomorrow is independence day here in Uganda (YEP...they broke free from Britain too, sans the tea in the Harbour). So we will try to just operate on one child (and be half way done with our planned 10 cases.....), but who knows what tomorrow will bring.

Miss you all much.
Keith