Archive | June 2016

Odessa June 28-30, then back to Kyiv….

Our overnight train to Odessa on the night of the 27th was interesting in that it was the first time I had been on a new train.  Actually quite nice…not so rustic as usual.

We arrived the morning of the 28th and checked into our Hotel….made pretty much a beeline for the Black Sea, which had many beautiful sailboats on it with spinnakers out.  We toured the downtown area as well….both historic and pretty.  And then shut it down pretty early as we had our Symposium the next morning.

This time Dan and I presented to the same audience….all Emergency Clinicians…doctors and physician assistants….so we focused again on the practical and the clinical…though Dan was able to give them an overview of EMS organization and Paramedic Training in the USA.

As they were an “all clinical” audience, I really loved the time spent in discussing Myths, EKGs and sharing a few Simulation Cases….which brought out many points.

Vitaliy now wants Dan and me to return next year latter part of May, first part of June to expand the prehospital care presentations and Simulation cases….in the context of a national and international EMS meeting northeast of Kyiv in “Sumyi”, north of Kharkiv.  There will be at least 32 teams of EMS providers from around Ukraine and some from neighboring countries like Poland.  Should be fun and more importantly helpful in our quest to both teach and collaborate.

As well, my dear friend Dr. Steve Raffanti, who founded and directs the HIV treatment center in Nashville, who joined me in 2008, has been requested to return to teach at the HIV Treatment Center in Vinnitsa….so we may have a lot going on, and he might also give a lecture or two on HIV Emergencies….a topic I lectured on in my Vanderbilt days, with Steve’s guidance.

So….as we wind up here in Odessa, we have had an amazing time in Ukraine….and the expansion of collaboration and of knowing more of this beautiful country are two goals well met.

Photos and wrap up to follow…..

Vinnitsa June 24-27

Truly, for me, Vinnitsa is a second home.  This, my 35th visit to Ukraine has included so much time and joy in Vinnitsa….working alongside physicians and dear friends Drs. Sergei Bolyukh and Irina Stefannenko and families and individuals we have been able to support in various humanitarian realms.

On this Saturday, we had a wonderful luncheon with families including Lyudmila Sinyavskaya and her husband Frank.  Lyudmila had her mitral valve replaced at Centennial Hospital in Nashville in May of 1997 and spent the summer with us.  Also present was Sveta Panchuk and her husband Maxim with their two kids and another on the way…Sveta spent the 10th grade at Centennial High School in Franklin, TN and like Lyudmila, joined us for a week in the Adirondacks at Camp Canaras in the summer.  After the luncheon, Sveta and Maxim took me to see her parents and the new home Maxim and Sveta built outside Vinnitsa.

Also at the luncheon were Dr. Marina Sizova and her husband Sergei and son Alexander….they are involved in the Messianic Jewish movement in Vinnitsa and help many people.

Galya Schpok and son Pasha and daughter Oksena were with us for lunch…and Oksena is now a Dental Nurse, and son Pasha’s affliction with cerebral palsy has long ago stabilized with him walking with crutches and communicating better than ever.

Lastly, we were joined by Anna Matichuk, now a University student in interior design, and her grandmother Olga Matichuk….widow of Grigoriy, who I had the joy of helping medically for years and through whom I learned of the need for Ukraine to adopt a uniform use of ACE inhibitor drugs in systolic heart failure…a discovered omission in their pharmacological approach to heart failure which helped Grigoriy, and others over time as they adopted some protocols I shared with local and regional doctors.

On Sunday, it was a visit to the Vinnitsa Nazarene Church service followed by a luncheon with Head pastor Roman Lebedyev and Associate Pastor Oleg Kuz.  Oleg and his wife Irina and kids and the family of Regional Nazarene leader Scott Rainey are moving to Lviv in July and will start a church in Lviv.  I am excited for them.  As with the Vinnitsa Nazarene Church, I am sure they will reach out to drug-addicted people and alcoholics among all others…offering and setting up Detox and Rehab Centers.  It was at such a Center run by the Vinnitsa Nazarene Church that I first met Oleg 10 years ago, when he was a patient.  Amazing man, transformed by faith in Christ and with a heart for his people beyond any norm.

That night I was taken to Nemia, to visit the Foster Home overlooking the Moldovan border, of Archana and Ruslan Tkachuk.  Their ministry, currently with 12 kids, is “Raising Hope Ukraine”.  You can Google it and learn much about a very precious ministry of true human rescue.

On Monday the 27th it was back to Vinnitsa for meetings at the Hemodialysis Center where colleagues from DCI in Nashville have previously helped and where they now are offering to send 15-20 refurbished precious dialysis machines.

As well, we visited the new and only Hospice in Vinnitsa, a project of Dr. Sergei, the Staregorod Hospital and the Vinnitsa Nazarene Church.  Inspirational to see, and to support this effort.

Then, another overnight train from Vinnitsa to Odessa, where we met up with our full team for presentations on the 29th after touring Odessa on the 28th.

Uzhhorod Symposium June 23 and a surprise visit before heading to Lviv

In Uzhhorod, we proceeded directly to the Hotel after the train ride overnight…then to our lectures.

Dan spoke to Administrative leaders, I to Emergency Medicine clinicians, both doctors and physician assistants.  The typical ambulance has one physician and one or two physician assistants as well as the driver.

My topic was “Medical Myths in Prehospital Care, or Mistakes We Have Made”….they especially liked the STEMI equivalent EKG portion of this talk, with EKGs to review and discuss.  Then we had 4 Simulation cases so that teams of 3 from the audience got up in front of their colleagues to run through, with a manikin, some scenarios that exemplified points I had made in the lecture.  Gracious and inquisitive group.

That evening we met up with an EM doctor from the US who lives in Prague, works in London, and serves as a collaborator in Ukraine….John Quinn, MD.  Also with his fellow collaborator, Patrick (last name I have misplaced), a Paramedic who lives in Kyiv.  These two are long time friends of Dan Smiley, so it was a joy to discuss the collaborative efforts we have undertaken for the past 20 years in Ukraine.  Different and yet in many ways very similar.  Along with Dan Smiley and folks like these, the EMS Protocols in Ukraine have been updated and revised and there have been several joint training exercises over the years.

The surprise visit was to a beautiful winery, in a town 30 km away, set in caves.  Quite good red blend and Riesling.  The winemaker was our hostess….and she was able to give us a lot of background of this site, which had entertained over the years many Soviet leaders and Cosmonauts, among others.  Interesting.

The day of the 24th we drove to Lviv through the Karpatian mountains.  Beautiful journey to the old and historic city of Lviv.  Dan and his translator, Dr. Svetlana, stayed in Lviv for three days and Dan lectured to the Lviv Police on Tactical Emergency Casualty Care….practical knowledge reinforced and expanded for them.


Ivan and Vitaliy headed back to Kyiv on an overnight train, while Sergei and I headed to Vinnitsa, arriving late evening on the 24th.

June 22 in Kyiv and then on the road to Uzhhorod

The day in Kyiv was started with meeting friends Paul and Vika Thorson and their 2 yo son Toviah. It was great to see them again, and to enjoy fellowship and update on their lives in Ukraine. Among the things they have done is worked with their church to support people in troubled areas by the Russian-backed and Russian-participated war in the Donetsk region of Ukraine.

Then I was happy to have Dr. Vitaliy Demyanchuk stop in on me at Bratislava Hotel to greet me with kind gifts, and to discuss the Heart Emergency Hospital at which he works…as a heart surgeon. We have known each other since his days as a heart surgery Resident at Amosov. In 2004 he visited me and Vanderbilt Heart Program with his wife Olga who is a perfusionist, and the Deputy Director of Amosov Heart Clinic, Dr. Vitaliy Maximenko. Vitaliy brought me up to date on his family, including his daughter Polly who is studying in the United States in Madison, Wisconsin.
As well, we discussed the possible renewal of the St. Jude Heart valve company in St. Paul, MN humanitarian donation of heart valves to his Hospital. St. Jude is likely the best valve manufacturer in the world, and they previously have donated valves for patients with no funds to acquire such.

Another meeting that will have legs was with Tatiana Tymoshenko, new with the Ministry of Health who oversees much of Emergency Medical Care for the nation. I hope and expect that this colleague, who is new to me, will be another fellow collaborator for progress. She is young and energetic.

Next it was onto an overnight train to Uzhhorod from Kyiv….which was a long ride, thought the west of Ukraine, through some of the Karpatian mountains into a beautiful small city at the extreme western edge of Ukraine, on the Slovakian border.

At this site, Dan would be speaking to the EMS and Disaster Medicine leaders of western Ukraine, while on a separate track, I was to speak to the emergency prehospital clinicians.

Arrival in Kyiv June 21st

All went smoothly, and my fellow lecturer and Ukraine Emergency Medicine collaborator, Dan Smiley, Deputy Director of California EMS was already in Kyiv.
It was a joy to be greeted by Drs. Vitaliy Krylyuk, Ivan Kuzminsky and Sergei Bolyukh.
We took the Metro into downtown Kyiv and had a sumptuous meal, after I got organized.
Mainly we discussed the upcoming Symposia in Uzhhorod and Odessa on June 24 and 29 respectively, and what Vitaliy felt would be the nature of our audiences.