GLOBAL – at Heart!

Besos (kisses) from the Zumba Instructors Convention in Orlando Florida where Kat, I and 7,000 plus global fitness instructors, our brothers and sisters, are dancing, sweating, engaging, and expanding our professional skills in the company of our global Zumba Tribe. Huge THANKS to the three Albertos who created and continue to evolve and empower the international Zumba community (180 countries, 15 million people, 200,000 locations). Zumba is committed to creating health, fitness, peace and love and for that we are joyously grateful.

Within the world of Healthcare communities, countries, and continents collide, connect, intersect, and merge to develop and transform individuals, resources, systems, processes, and medical solutions.   A perspective in healthcare that attempts to be isolationist is not only myopic, it is not viable. Let’s travel with curiosity and open minds; keeping our eyes, ears and hearts open……

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Cardiac Conditions and Preterm Birth Close to our Hearts

Come walk with us through a bit of the history of pediatric cardiac surgery…. and celebrate the Global personality of healing, health and medicine.

Living and working in Guatemala resides a brilliant pioneer in pediatric cardiac surgery, Dr. Aldo Casteneda. Born July 17, 1930 in in Nervi, Italy to a Nicaraguan mother and a Guatemalan father, Aldo entered elementary school in Munich, Germany. When World War II began in 1939, his family, Guatemalan citizens, became “enemy aliens” and they were not allowed to leave Germany.  Eventually, Dr. Castañeda received his MD training at the University of Guatemala and completed his training as a surgeon through the University of Minnesota. At 86 years of age, Dr. Casteneda continues to provide cardiac surgeries to the neediest children in Guatemala, Honduras, El Salvador, Nicaragua, Belize, Haiti and the Dominican Republic.

We initially discovered Dr. Casteneda in a short video provided by Hearts for Life Across the World-World Society for Pediatric and Congenital Heart Surgery (Every child born anywhere in the world with a congenital heart defect should have access to appropriate medical and surgical care) at:  http://www.wspchs.org/index.php/interviews/78-interview-with-dr-aldo-castaneda-intro).

Walking around Greenlake in Seattle WA. one beautiful evening last week we located and listened to (one ear bud per person, nerdy-we know!) a more recent YouTube interview with Dr. Casteneda. The intro to the YouTube (below) itself presents a story of global and national medical significance. Please enjoy this short read:

Published on Dec 9, 2015

“Aldo R. Castañeda is a pioneer in pediatric cardiac surgery. He has been a vigorous supporter of early correction of complex cardiac malformations in infants and newborns. These efforts culminated in the successful repair of transposition in neonates, giving rise to the modern era of neonatal cardiac surgery. Under his mentorship William Norwood developed the Norwood operation for hypoplastic left heart syndrome.”

Dr. Castañeda received his training at the University of Guatemala and the University of Minnesota. Upon completion, he remained at Minnesota as a faculty member. In 1972 he accepted an appointment as Cardiac Surgeon-in-Chief at The Children’s Hospital in Boston and Professor of Surgery at Harvard Medical School. From 1981 to 1994 he served as Surgeon-in-Chief at The Children’s Hospital. Dr. Castañeda’s many contributions to pediatric cardiac surgery are remarkable and well documented in his more than 400 scientific articles and two books.

Dr. Castañeda’s work has spanned the globe. Upon retirement he returned to Guatemala and developed one of the most successful programs for pediatric cardiac surgery in Central America. More than forty of Dr. Castañeda’s trainees have served as chiefs of Pediatric Cardiac Units at institutions across the globe. In 2006 he was appointed to the Pediatric Cardiology Hall of Fame”.

Now, for the SHOW: Please enjoy Dr. Casteneda’s answers the questions posed. His unique personality really shines!

WSPF – “History of Medicine Series: Cardiac Surgery” with Dr. Aldo Castaneda, for OPENPediatrics”-

Funding for the medical treatment the communities Dr. Casteneda serves is provided through the US Based Non-Profit Organization “Friends of Aldo Casteneda” at http://saveachildshearttoday.org/Friends_of_the_Aldo_Castaneda_Foundation/Home_page.html

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Home Sweet Home:

U.S. News & World Report has ranked Boston’s Children’s Hospital Heart Center # 1 in the Nation – Cardiology and Heart Surgery – 2016/17.  Frank Pigula, MD, Director of the Neonatal Cardiac Surgery Service at Boston Children’s Hospital, discusses how the Heart Center team cares for the most complicated prenatal congenital cardiac diagnoses. This video provides a personalized look into the world of neonatal cardiac surgery. 

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Local Flavor Shout Out ……and forever thank you’s to Kat’s Cardiac Surgeon, Margaret Allen M.D. – A National Library of Medicine Local Legend. Kat would not have survived her preterm birth if not for the skill, courage, and genius of her cardiac surgeon, Margaret Allen MD and her surgical and after care team.  A pioneer in cardiac and transplant surgery, Dr. Allen’s legend continues to unfold through her research (tissue engineering, stem cells, and autologous cardiomyocytes for repair and regeneration of cardiac muscle).  Dr. Allen’s inspiring biography can be found at: https://www.nlm.nih.gov/locallegends/Biographies/Allen_Margaret.html

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WARRIORS:

Medical research exploring cardiac issues that challenge preterm birth survivors is relatively new. While preterm birth infant survival rates in the USA have dramatically improved over the past few decades, developing research reports that preterm birth has been identified as an emerging risk factor for arterial hypertension, diabetes mellitus, cardiovascular disease, and stroke in later life.

The following article in Forbes Magazine AUG 12, 2013 is interesting and provides us with an opportunity to explore related ongoing medical research.

Preterm Birth Linked To Adult Heart Problems – Robert Glatter, MD

“Based on results of new research, babies born prematurely may be at risk for structural heart abnormalities which can lead to additional cardiac risk factors such as high blood pressure as they age.  This may ultimately impact individuals who are at risk for coronary artery disease, making early screening for high blood pressure particularly important for those who were born prematurely (< 37 weeks)”.

The article cited research in which investigators studied 102 premature infants from birth into their mid 20’s.  The article stated “They compared their findings to 132 individuals who were full term, and found that progressing into adulthood, the right lower chamber of the heart (the right ventricle) was smaller in size, but had walls which were significantly thicker with a pumping mechanism which was less efficient compared to those born full term.  They also found that the more premature the birth, the greater overall decrease in size as well as function of the right ventricle”.

Dr. Paul Lesson, the lead investigator from Oxford University’s Clinical Cardiovascular Research Facility in England stated “Up to 10 percent of today’s adults were born prematurely, and some have an altered higher cardiovascular risk profile in adult life”.

Dr. Adam Lewandowski, the Lead study author, agreed, explaining,  “We are trying to dig deeper into what’s different about the hearts of those born preterm”.   He added, “The potential scientific reasons why their hearts are different are fascinating and our study adds to the growing understanding of how premature birth shapes future heart health”.

http://www.forbes.com/sites/robertglatter/2013/08/12/premature-birth-linked-to-adult-heart-problems/#7d414f6b3c58

Preterm Birth and the Shape of the Heart – Mikael Norman-Circulation – January 15, 2013: Preterm Birth and the Shape of the Heart: http://circ.ahajournals.org/content/127/2/160

The article begins with the following summary “Preterm birth, that is, delivery >3 weeks before term, affects an estimated 13 000 000 newborn infants annually, and rates are increasing. In only the United States, ≈500 000 infants are born preterm each year, and of these, 80 000 are delivered very preterm (>8 weeks before the expected date). Without effective care, the number of deaths among very preterm infants would equal that of major causes of death in adults such as Alzheimer disease or essential hypertension. Although mortality after preterm birth was high until a few decades ago, advances in perinatal medicine have resulted in almost universal survival, so the concept of prematurity nowadays is shifting from a pregnancy complication to a common developmental basis for a whole new generation of young adults. Although this progress is very welcome for women delivering preterm, their infants, and their families, there is an increasing concern because preterm birth has been identified as an emerging risk factor for arterial hypertension, diabetes mellitus, cardiovascular disease, and stroke in later life”. The article shares the following suggestion  “The most obvious clinical implication of this new knowledge is that young people born very preterm need continued and tailored follow-up, taking the total cardiovascular risk factor burden into account”.

If these articles spike a bit of interest, you may also want to review this December 10, 2012 thought provoking article in Medscape Multispecialty “Premature Birth ‘Should Be New Risk Factor’ for Cardiovascular Disease” which offers interesting research/findings.- http://www.medscape.com/viewarticle/775950

The developing research into preterm birth and cardiovascular disease is new, exciting, and perhaps, for some, concerning. Further research may allow our preterm birth family to understand and promote our own health and well-being as we experience adulthood. Access to emerging medical research may inspire us to discuss questions and concerns with our personal health care providers as we responsibly choose to empower our own well-being.  Aloha Warriors!

 

Author: Kathy Papac and Kathryn Campos

Kathryn (Kat) Campos: Hello, I am a former 24 week gestation NICU baby. I lost my twin brother Cruz at birth and encountered open heart surgery with no anesthesia at 3 weeks old weighing 1pound 3 ounces. I served on the University of Washington Medical Center Advisory Board Neonatal ICU Council from 2013 to 2015. I am passionate about assisting and supporting our Global NICU Community. If your a Preterm Birth/NICU survivor this blog is dedicated to you, your family, and all members of the NICU Community. Together lets support other NICU Grads, NICU babies, NICU families, NICU staff, and NICU facilities. We have stories to share and NICU journeys to help empower! Kathy Papac: NICU mom of surviving (Kathryn) and a deceased (Cruz) 24 week gestation twins. Neonatal Womb journeyer, counselor/legal expert with an MA certificate in Spirituality, Health and Medicine from Bastyr University. Passionate Global Community participant. Our goal is to recognize, honor and empower the Neonatal Womb community and shine light upon the presence and potentiality of the preterm birth survivors as vital community participants.

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