Tuesday, April 19 (day #5)

Monday night:

Just as everyone got back to the hotel and started to think about showers, Anne received a call that Moh’d (our last case today) had declined. When they removed his breathing tube, he went into a sudden cardiac arrest about 20 minutes later. Mark and Anne immediately rushed back to the hospital soon to be joined by the team to start a long night.
The doctors did CPR on this little one for nearly an hour and then he stabilized enough to be taken to the operating room for exploration to see if there was a bleeding vessel or some other problem. When
Mark was satisfied that nothing else could be done in the OR, he
was returned to the ICU and we were all very hopeful that he might
turn around because his blood pressure and heart beat had returned
to somewhat normal. At nearly 1:00 am, Anne and Megan settled in to spend the night in the ICU to manage care on Moh ‘d
and everyone else tried to get some sleep.
He remained critical all through the night but with no significant
changes. However, by the time the team had all arrived at 7 am, Moh’d was again declining and had another brief episode requiring resuscitation.
There was a lot of consideration to returning him once again to the
OR to try a different operation but then grave neurological exam and a CT of his head revealed that he had severe neurological deficits as a result of his arrest.
There are no treatments that can reverse such a situation so most
sadly the hardest conclusion and decision had to be made which was
to end the resuscitation efforts on Moh ‘d. Throughout this whole
ordeal, the parents openly prayed and anguished and obviously were
devastated by this. But likewise, the father has also told Manal that
he feels that he gave the child the best chance. He says that “he
believes God wants him back and no one can rule above God.”. The
team has also suffered immeasurable grief and sadness. It is
horrible and sad and devastating. We keep reminding each other
that this is the reality of heart defects…. sometimes….. there are
times that no matter how hard you try or how much you do,these
kids are sick and thankfully not often, but occasionally their small
bodies just cannot deal with their defect or attempts at correction.
Clearly it is a blow to the team.

To the memory of Moh'd Sadeq

We only have a short time to regroup and then have to go on with their purpose so we start Tuesday:

The first case brought to the operating room is A. Rahman Husain Qandeel A. Aleem (Abud), a 1 year old Egyptian boy from Aqaba Jordan. He has a VSD (hole between the lower heart chambers). It is a straight forward, relatively simple repair done in just a couple of hours.
The 2nd cases Hiba Farid Khamis Mawad, who is an 11 month old child from Amman Jordan. This little one has Down’s Syndrome and a PDA (patent ductus arteriosus). Her surgery to ligate the ductus will be done as a thoracotomy and does not require the heart lung machine. It’s a quick case and by 3:30 she is out of the room.

Hiba after surgery

Update on Nour: she came back to the catheterization lab on Monday afternoon and with the help of an interventional radiologist, we were able to coil the rest of her collateral blood vessels on the left. We now hope this will allow her own small pulmonary arteries to grow better without competing with the extra blood vessels. We don’t feel surgery is needed at this time and hope for better and bigger pulmonary arteries for next year’s mission
To finally complete her surgery. She spent the night and this afternoon I find her, Maryam and Mortuda having a party in Their room. Kids from Iraq and Syria together..what an amaZing site, smiling, and much needed after just having lost another precious child. Nour will head home today and the other 3, including Hussain will all home tomorrow.

Zainab and Matti both arrived in clinic this afternoon, anne and Kal did echoes on them, they look great and will probably return to Iraq in the next few days.

Zainab in clinic after discharge

In the ICU, Hiba and Abdullah Rahman (Abud) settle in and look good. Abud get extubated shortly after returning to the ICU. Marah and Raneem are now roomates look great.

Raneem looking better each day

Marah is already asking for chocolate!
We want to thank all the Rotarians and people from GOLA that have come by and spent many hours supporting not only the familes and childre, by our team as well. They have constantly been at our sides, especially Manal Karasheh, translating, providing food for families, translatingmedical information, buying toys for the chidlren,. making trvel arrangements. None of this could be possible without the support of our friends here in Amman.

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