Wednesday, November 9, 2011

A Heart Condition


When I was 18, I had the privilege to study abroad in England for a year. As part of my preparation for that adventure, I was shuffled off to my primary care doctor for a physical. Due to some scheduling conflict, I saw the nurse practitioner instead of my normal doc.

She listened to my heart.

"Do you have a heart murmur?"

Yeah, I've had it like forever. Was checked out Pittsburgh Children's Hospital when I was like 8, and they said it was no big deal. I've never thought about it again, except to take antibiotics for dental work.

"It is really loud. You should have it checked out."

Mara shuffles off to the local university to see a pediatric cardiologist. Several tests and appointments later. I get an actual diagnosis. I'm textbook.

Textbook. Pulmonary Stenosis. With a gradient reading on the ultrasound that is right at the the threshold of do-we-intervene-or-not.

At age 18, my relatively healthy self choose no intervention. So on with life I went. Yearly updates with the pediatric cardiologist (pulmonary stenosis, a narrowing of the pulmonary artery is a birth defect, thus, the pediatric specialty) at the ripe young adult ages of my early 20s.

In 2000, as a young woman, pulmonary stenosis started to interfere with my adult life. It caused complications for me as I prepared to have a particularly agitated gall bladder removed. They wouldn't do the laproscopic surgery and thus, I was under the knife and out of commission for 6 weeks due to major stomach surgery.

Later that year I was in for a real shock. My OBGYN sat me down in his office post checkup.

"Mara," he said, "with your pulmonary stenosis, I would really advise caution about having kids. In fact, I would say that your chances for cardiac arrest during childbirth would be significant. I would recommend that you not consider (ever) having children."

THAT was NEWS to me. It wasn't like I was in the middle of my family planning but I had always just assumed that I would have kids some day. I left my OBGYN's office with a sense of "What just happened?" Why did this seemingly innocent heart condition that hasn't caused me any noticeable symptoms just thrown a wrench into my life plan?

I started talking to more doctors, more research, more time passed. I learned that when I wanted to have kids, I might consider having a catherization to widen my pulmonary artery. Time passed and I met Erik.

In 2005, I was referred to some amazing doctors at the Boston Adult Congenital Heart Clinic . There Dr. Sloss and Dr. Landzberg advised that since Erik & I wanted to have kids and the catherization risk so low, that I should have the procedure done to mitigate any risk I might have during pregnany. Without going into the details of the procedure, lets just say that this hospital experience was so positive, I would recommend these doctors and this facility to anyone looking for this kind of care.

What I won't forget is my post operation feeling. I felt like weight had been lifted off my chest. I ran up the stairs for the first time in years. I recall discussing this feeling with Dr. Sloss at my post operation follow up.

"Its not like I wasn't athletic. I was a swimmer all during high school."

"But, did you like to run?" he asked.

"Well, no. But I could if I had to."

He explained that I likely gravitated to a sport that was easier for my body and my condition to handle. Sort of a gravitation towards the path of least resistence. I realized that what I had done in my life was very much impacted by my asymptomatic heart condition.

At that time, I was a plus size girl. I went on to have two beautiful babies. Also as a plus sized girl. I remember being told that I should lose weight for my heart. I knew this. As I've blogged here, I dealt with complications during both my births due to my blood pressure. I never had blood pressure issues until preeclampsia hit in the 32 week in both pregnancies. My blood pressure was ranging around the 130/90 mark when I delivered both of my little girls a month early. Even with my corrected heart condition, my docs considered me high risk. In retrospect, I think this was due more to my weight than my heart.

My little girls were healthy. I was not. I had managed to make it thru the pregnancies but neither of them were ideal. They say that preeclampsia isn't caused by weight. All sorts of shapes and sizes get it. In my case, I feel like my body can maintain its health until I hit about the 300 lbs mark. At that point, all my systems (mainly my kidneys and my heart), don't handle the weight very well.

Why am I thinking about all of this on a rainy (and soon to be snowy) Wednesday morning?

I found a print out this morning from a couple of weeks back. I went into urgent care for a infection. While there, the nurse took my blood pressure and pulse. She was concerned. She was concerned for the opposite reason. My numbers were so low.

Blood pressure: 105/51
Pulse: 42

She took my stats twice. Then she looked at me and asked. "Are you an athlete?"

That nurse made my day.

Why, yes, I am an athlete. I am also a runner. I am a mom of two with a heart condition. Thanks to some amazing doctors and some hard work I've changed the path that my life was on. I no longer choose the path of least resistance. I have a heart condition. Now it is called healthy and happy.

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