This week was a bit tiring, as we had some very sick kids in ICU and we also worked to graduate some of last week's cases who were giving us extra work to do!
This boy was the very first case done on the day we arrived in Najaf. Now 8 years old, he should have been operated as an infant, and he experienced significant complications from his system essentially being shocked by his suddenly corrected heart. He was very sick for a few days and spent extra time on the ventilator, but he made a full recovery! It was really encouraging to see him steadily improve, though he did keep us very busy while he was in ICU!
Here he is off of the ventilator. He left ICU a few days after this photo, walking and doing well! 
This little guy was my favorite baby while we were there. (there's always one!) He was operated on the last ICHF trip, and was recovering well but then suddenly became sick and was admitted to another children's hospital in Najaf, where his condition was rapidly worsening. When our team arrived, he was transferred to our ICU in severe respiratory distress. Both of his lungs had filled with fluid, which collapsed his entire right lung and most of his left. We placed him on a ventilator, put in chest tubes to drain the fluid collecting around his lungs, and he quickly improved. He came off the ventilator the same night and was doing well for awhile, until one chest tube stopped draining and his right lung collapsed again. He needed surgery to clean out his lung and have a new chest tube placed, but there was already a case in surgery, so he had to wait more than 8 hours. I'm really grateful to all my RT friends back home who donated some supplies to me in May - they definitely saved this little guy! I was able to put him on a form of NCPAP that relaxed him enough to breathe on his own for a few more hours until he got his surgery.
For my RT friends - how to make emergency nasal CPAP with just a flow generator: Use a HFNC adapter to connect oxygen tubing directly to the flow line. Pry a disposable manometer off of an Ambu bag (pull HARD - it will come off!) Attach a pressure line or cut O2 tubing and create your own, the manometer fits perfectly. Connect your O2 tubing to a flow source, or wye an air line and O2 line together to make a blender, and - voila! NCPAP for the third world!
This baby was too unstable immediately after surgery to have her chest closed, so her sternum was covered with a special bandage and her chest was left open for 2 days until she stabilized. Then, the ICU became an OR and the surgical team closed her chest at the bedside! She tolerated the surgery very well.
Ready, set, levitate! Some of our local Iraqi nurses in action, lifting a patient so his bedding can be changed. Go team!
Remember the jumper? He came back to ICU on the last day so he could have his pacer wires removed. He didn't really like us very much, but he did like the two DumDums he got as a reward! 
So, sad news - the rest of my second week photos got accidentally deleted when I arrived in Tanzania - I thought I had already transferred them to my computer - FAIL! In total we operated on 13 children in 8 surgical days. 5 were still left in ICU when we left, which was really hard - please keep them in your prayers. Two were stable and going to discharge, but three were still sick and needing continued care. Pray that the local team is able to put their new knowledge into action and that these children recover well.
Until next time....=)
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