A loving mother will go anywhere if the trip could save her child's life.
For Katerina Zalenskaya, that meant traveling 5,000 miles from Minsk, Belarus, to Omaha, Neb., with her ailing 9-month-old son so he could undergo a life-saving heart operation.
Looking at him today, you wouldn't think that Vsevolod (pronounced SEV-uh-lud) Meleshchuk ever was very sick. The bright-eyed, rosy-cheeked potential future wrestler crawls across the floor at a respectable speed, pausing and smiling back at his mom to see what she thinks of his skills.
Weeks ago, though, his face was about as white as a blank piece of paper. Which actually was an improvement over the blue he had turned when he couldn't breathe.
Vsevolod — or Seva, as an American might spell his nickname — was born with a heart condition called tetralogy of Fallot.
In such cases, the blood flow from the right ventricle of the heart is diminished because of a narrowing of the pathway to the lungs and a hole between the left and right ventricles.
The narrow pathway forces some of the unoxygenated blood in the right ventricle to mix with the blood going out to the body. Unoxygenated blood is bluish in color, so the skin of children with the condition can have a bluish discoloration.
Early in her pregnancy, during an ultrasound, Katerina, 31, learned that Seva had a heart defect. After what she said were many sleepless nights and desperate consultations with the physicians, tetralogy of Fallot was diagnosed during the 22nd week of pregnancy.
The condition affects about five out of every 10,000 babies. If left untreated, it usually is fatal before age 20.
After Seva was born March 2, he spent more than a week in the intensive care unit, where parents are allowed only limited access to their children. He spent an additional 18 days in the pediatric wing, where Katerina was able to be with him.
The baby had to endure injections, IVs, needle pricks in every finger and toe and a catheter in his head, which he managed to pull out.
Seva's Belarusian doctors said they could perform open-heart surgery to repair his heart defects, but it would have to be done in two stages.
They described his prognosis as bad to very bad and said he would be in the intensive care unit after each surgery for at least two weeks. That was if no complications arose. Some children in Belarus stay in the hospital for months after surgeries, Katerina said.
The young mom couldn't bear the thought of two surgeries and prolonged separation from her son, the second of her and her husband's two children.
She started looking around for other places that could do the surgery in one stage and could offer a better prognosis. She looked for doctors in Moscow, then in Germany and Israel.
She contacted a childhood friend who is the daughter of Dr. Eugenia Raichlin, a native of Belarus who is a cardiologist and associate professor at the University of Nebraska Medical Center in Omaha.
Raichlin's daughter, who lives in Israel, told her mother about Seva. Raichlin thought she could help. She contacted a colleague, Dr. James Hammel, a cardiothoracic surgeon at Children's Hospital & Medical Center in Omaha, who said he could perform the surgery.
Officials at Children's negotiated an affordable price for the operation that was lower than the normal fee. Hammel also wrote two letters to the U.S. Embassy in Minsk to encourage the approval of visas for Katerina and Seva.
Hammel has performed heart surgeries on medical mission trips to Central America with the International Children's Heart Foundation and operated on children from Mexico who come to Children's through the Los Cabos Children's Foundation.
Raichlin said that while Belarus has good, ambitious surgeons, American hospitals are better equipped to deal with such heart surgeries.
Hammel noted that Children's has pediatric cardiac anesthesiologists, pediatric perfusionists who run the heart-lung machine during surgery, pediatric intensive care nurses and others.
“I don't want to make it sound like a commercial,” he said, “but the point is that pediatric heart surgery is not something I can do just by myself.”
Katerina and her son flew to Omaha, arriving on Dec. 2, and stayed at Raichlin's home in far west Omaha.
Hammel performed the surgery on Dec. 6. He closed the hole between the ventricles and made incisions to open up the artery above the narrowed pulmonary valve and the ventricle beneath the valve. He then enlarged the artery and ventricle by sewing patches into the incisions. He also enlarged the valve.
Hammel had to go back in a few days later to widen the heart valve a little more, but otherwise was satisfied with the results.
“We expect his heart function to be basically normal,” he said.
Hammel said the procedure should make Seva's heart function more normally over the long term and may eliminate the need for another operation to implant a valve later in life.
Katerina was thrilled. Her son was out of the hospital in a week.
Before the surgery, she said, “I was worried about him all this time. Our doctor (in Minsk) said that in any minute, he can have sudden death. So you just live and you don't know, 'Will it be tomorrow?'”
“When they came,” Raichlin said, “she couldn't sleep. She was very anxious about it. She was very scared. She didn't smile. Now, she's smiling.”
Seva has a doctor's appointment on Thursday before he and his mother fly home Friday. First, though, the two will celebrate Christmas with some of Raichlin's friends from Siberia who live near Raichlin's house.
When mother and baby return home, they will celebrate the new year and the Orthodox Christmas with Seva's father and 6-year-old sister.
Doctors in Minsk will check Seva's heart in about six months to make sure everything's working.
His mom acknowledged that her son won't remember his December in Nebraska. But she said she will encourage him, when he's older, to express his gratitude.
“I will tell him he should say 'thank you' to Dr. Hammel, to the Children's Hospital and to Eugenia.”
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