July 4th- a good day!

America’s birthday is not an official holiday here, so we operated today.  Both patients from earlier this week are doing great.  Carole has all of the monitoring lines removed and was able to walk today today.  She will be transfer out of ICU this afternoon.

Carole and me in the ICU

Our patient from yesterday had more severe heart dysfunction before the operation, and was on a lot of support last night.  But what a difference 12 hours in the intensive care unit can sometimes make.  She is making steady progress. 

Today’s surgery was a female patient in her mid 40’s with mitral stenosis and insufficiency, undergoing a mitral valve replacement with the On-X mechanical heart valve.    

On-X heart Valves

Patients with prosthetic heart valves require anticoagulation with Coumadin. It is extremely challenging for patients here to have their anticoagulation monitored on a regular basis.  The On-X heart valve is a promising mechanical heart valve that has favorable flow patterns across the valve, and that may reduce the risk of thromboembolism. 

Studies are underway to determine if patients can safely be managed with lower levels of anticoagulation. This will be a promising breakthrough for patients everywhere, if studies confirm this hypothesis.  

Holly volunteers in the neonatal nursery.  She has become quite attached to eleven-day-old twin sisters.  I'll call them Faith and Hope.  It requires filling and refilling a ten ml syringe attached to the tube with mothers breast milk.  It takes at least three hands to do this.  The girls gaze around the room occasionally making eye contact with Holly or their proud grandmother.

Faith, her grandmother, and Holly

It is amazing to watch Faith's tiny arms going every direction, grasping their ears, or squeezing Holly’s finger.

Faith 

Bonfire tonight to celebrate the Fourth. Signing off for now.