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Heart Mission


In this blog, Deaconess heart surgeon Dr. Lee Wagmeister updates his team's heart mission to the Dominican Republic.  The team of eight are performing life-saving heart surgeries to Dominican citizens.  This incredibly impactful endeavor is  sponsored by the Heart to Heart Mission.  Check back each day as Dr. Wagmeister shares his stories and pictures.

Day 7 - October 18, 2019

Last day.

One and a half years in the planning. One week of work. This has gone by so fast. We probably spent more hours in the planning and prep than we actually spent here in the Dominican. But obviously worth it.
 
Today, was the last day to be able to teach. I gave a lecture to medical students, residents of various specialties and to some of the medical staff about surgical lung cancer. I believe that it went over well. The final equipment and supplies in the operating room and ICU are put in storage. Then it was off to say goodbye to staff that we met and more importantly to the patients that we operated upon. All are doing well from both teams. It is hard to say goodbye.
 
When the head administrator at the hospital wants Dr. Bob’s mission trips to continue to come back and both teams to a person says they also want to come back without reservation, this demonstrates the importance and good of this endeavor. I was worried when i was here 2 years ago that the utility of this mission over time would not be as much a necessity because of multiple reasons. The opposite is so much true. The need is actually growing. The skill will be how to harness that energy and lead the path to continued success. I am sure Dr. Bob will know what to do.
 
Unfortunately, time to say goodbye to new friends from Rochester and to Dr. Bob and his wife, Joan. We are such a small part to this large mission machine. I know that the Evansville team are happy to be a part of this process.  As said before, lives have changed on both sides of the knife.
  
  

Day 6 - October 17, 2019

As fast as it started, the operating comes to an end. There were 9 individuals operated upon this trip, 5 by the team from Evansville and 4 from Rochester. There may not have been hundreds of individuals that were treated medically, but there were more than one hundred people that were touched on this trip. It is not just the operation, it all the people that we come in contact with. Obviously, the patient gets some of the greatest benefit but then there is the family.

Also, there is all the teaching of residents and staff. During the last case there must have been at least 10 people in the room at one time asking questions, listening, placing lines, intubating, trying to understand the bypass machine, or scrubbing into the case to see or feel what critical aortic stenosis can do over time to the human heart. Everyone participated in the process. Hopefully, the lessons learned will effect hundreds to thousands in the future. Again, we did not just operate on 9, we affected so many more.
   
 

  
Day 5 - October 16, 2019

Each day we are reminded why we are here. Of course, one aspect is the surgery and helping individuals who otherwise may not get the operation they need because of financial limitations. However, there are the many people that we see on the streets or the homes that cannot be missed. One of our friends here in the Dominican who was a medical student last trip and is now trying to get a residency in the US takes our extra food at dinner when he can to a place where young Dominicans congregate. As he tells me, these individuals just never have had the opportunity to break the cycle of poverty. Yes, what we have in the states is not perfect but it is far from here and other places in the world.
 
On a lighter note, today, was a long day. The process of doing two cases is an ordeal. It is not the operations, it is everything around doing the procedures. The first operation was a straightforward cabg that went nicely. Then there is the hurry up and wait process. Since we only have one set of instruments, we have to wait for the sterilization process that takes a few hours. Then there is losing the next patient in the elevator. You can’t make that one up. Once we got going, things again in the operating room move efficiently as the team has the process down like at home. As quickly as we get used to the process, tomorrow is the last operating day. All this preparation over these many months to be over so quickly. Well, as said before, today, was another very good day.
     
  


Day 4 - October 15, 2019

Today, was a very good day. All the miscues and delays were a thing of the past. The routine that we have established as a team over the many years and brought to the Dominican were in full show today. Things went very smoothly. If heart surgery can ever be considered routine, today, was an example made possible by all the preparation. A very nice lady of 56 years old got a mitral valve repair. The patient from yesterday is walking the halls with a new aortic valve. Again, a credit to the team.
 
With all the hard work, there is some fun. We get to enjoy each evening at dinner talking about the day and past. More importantly, we get to learn about the other team making new friends in the process. Just as funny, I learned about a new term called ‘Facebook jail’. One of our team members shared on Facebook many of our pictures and experiences with some of them being in the operating room. I guess that some of these pictures are considered graphic in nature. Obviously nothing grotesque to us, but I guess there are limits that I don’t understand. Well, no Facebook for our team member for 24 hours.
 
Tomorrow, brings a test to all. We will be doing two operations which should take pretty much all day. Each day brings a new challenge. One patient has an extremely tight aortic valve with coronary artery disease. The other is a cabg. Whatever it is, we will do it and look forward to making someone’s life better. Well, today was a very good day and tomorrow will hopefully be better.
   
 


Day 3 - October 14, 2019

Today is the start:

Today is the day we began operating. However, it definitely had its challenges. Even though we have been here before. Even though we had everything checked. Even though we had everything set aside. “The best laid plans of mice and men often go awry“ (John Steinbeck).

Today, was a straightforward aortic valve replacement so the harder operations will go smoother. We as a team are glad that it was only one case and just the valve. At first, the pump stopped working when testing it before the patient came into the room. We went through 5, yes 5, sternal saws until we had one that worked. One of our teammates had some residual gastric difficulties but recovered quickly without problem once the case started. It took almost 3 hours to get the patient in the room, getting a saw, placing lines, overcoming the language barrier, time to teach anesthesia and surgical residents, and a few things more.

Most importantly, my team was working hard and feverishly. I had nothing to do but run errands and support their efforts. Then it was time to operate. Then everything clicked. It became routine and usual. The operation went without difficulty, nor complication. She left the operating room having received a good operation, extubated and talking to us just one hour post op. This was excellent team work overcoming difficulties and obstacles.

Tomorrow is another day and we all look forward to helping another person. As mentioned before, i am proud of our team both here in the Dominican and back in Evansville.
 
     
     

Day 2 - October 13, 2019

The second day is upon us. We are ready. After a long day of travel, we started the day nice and early. The majority of the day was spent preparing the operating rooms for surgery. We took a shell of a room and turned each one in just a short time to a functional cardiac room. There was much supply movement and testing of equipment. Fortunately, with some adjustments, we are ready. Everyone spent hours unloading boxes or going through instruments or preparing the pump for the eventual patient encounter. Yes, i say again, we are ready.

There is a second team here from Rochester, NY. Dr. Peter Knight has been here before 2 years ago, but the rest of his team are new to this adventure. All of us are meshing well and look forward to the  next several days of intense surgery and the improvement we are about to bring to these patients and their families. There is a strong element of professionalism that is quite evident in all that are involved. All want to make a difference and i am sure we all will.

Tomorrow, the hard stuff begins. We get to hear about the patients and meet them. Why we are here is upon us. And yes, we are ready. I am so proud of the team from Evansville. Again, it is quite evident that we have the skills and training to match any group in the country. Little old Evansville. Thanks to the staff here in the Dominican and the many we left behind. We are ready.

Getting to closer. Yes, today we learned about the patients that need cardiac surgery. The cardiac residents did a fantastic job presenting the information to make critical decisions. There were ten patients, but one did not require surgery at this time.  One other needs some additional testing that hopefully can be done in time for surgery this week. It’s hard to say no to someone but cardiac surgery is not a procedure to obviously be taken lightly.

The patients range in age from 20 years old to 70 years old. There is a variety of cardiac pathology from aortic valve to mitral valve to coronary artery disease. The patient that most will remember is a young man of 20 who has rheumatic valve disease involving his mitral and aortic valve. At the end of meeting him, tears of either concern about having heart surgery were very evident or tears of the knowledge that his life is going to change for the better. Probably, both. This is what this mission is all about.

Tomorrow, we start operating. Maybe it is not as many patients as we planned to operate on, but it is not the number but the quality. Both teams are ready. The team from Rochester has 2 cardiac surgeons helping each other. Dr. Knight has been doing cardiac surgery for more than 30 years. The other, Juan Lehoux, was trained at Rochester but went into congenital cardiac surgery. Dr. Lehoux is from Santiago, Dominican Republic and was involved with this mission trip at its beginning when he was a medical student. Interesting, how things come back around.
 
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Day 1 - October 12, 2019

Here we go again:

2 years ago we did this trip to the Dominican Republic to perform open heart surgery to help a few that need this life saving procedure. This is done through Heart to Heart Mission run by a retired Florida cardiac surgeon. We are privileged to be asked again to participate in this very heart fulfilling endeavor. This is the 42nd mission trip for this organization and the 2nd for us. Most of what we do is valve surgery but one never knows what we will encounter. 

The team comprises 8 members in order to do what we have to do. We have 4 members of the team that went last time which includes myself, Kelly Talbott (operating room nurse team lead), Jessica Edwards (perfusionist), and Rebecca Wonning (team lead scrub tech). The 4 new members include: Dr. Ryan Neal (anesthesiologist), Kyla Knies (physician assistant), Elsie Reed (ICU nurse), Jeran Marshall (ICU nurse). It would not be possible to even think about doing a trip of this making without each individual’s support. This really is a team endeavor. 

Today is a very long day of travel starting out as early as 3:30 AM for some of the members leaving their homes to get to the airport to catch a 5:30 AM flight. It has taken 3 flights to get to Santiago, Dominican Republic. That is 18 hours of travel time for most. One really has to want to do this and there are no beaches where we are going. Not much to report other than time spent on getting to our final destination. Tomorrow we prepare the operating room for the upcoming surgery. We will be taking a shell of a room and in one day making it ready to do whatever we need to do over the following week. 

I know that this would not be possible without the support of the team going but also all those we left behind that had and have a part in this mission. The support from the top at Deaconess in Mr. McCoy and Ms. Lingafelter, to the operational staff of the heart unit and operating room who helped gather up and pack supplies, and includes the security guard who helped load up the boxes. And a special thanks to Barb Rogers in purchasing who helped get all of our supplies sent out and made cookies the day before we left to wish us well. We do this because we know that this does make a difference in the world no matter how small. And so do all of you. Thanks.
      

 
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