Today Nora is 2 months old! It’s amazing how fast the time is going by. I keep meaning to post Nora’s birth story, but to be honest, I’ve had a really hard time writing it. Partly, because it’s so intertwined with my own health story, and partly because it’s been a really difficult season in our lives as a family, and I just haven’t had the same motivation to blog. However, despite it all, Nora’s birth should absolutely be celebrated, and this blog is not only a way for me to connect with all of you – but also a way for me to document and archive important moments in our life as a family. So, I’ve finally written the whole story down! I’ll warn you right up front – this is a long story, and it’s as much about my heart health as it is about Nora’s birth – I just couldn’t find a way to separate the two stories. So, as a result, I’ve written it in two parts, for better or for worse.
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I found out I was pregnant with Nora in February, 2018. Jeff and I had decided to go ahead and try to have one more baby, after being assured by my cardiologist in the fall of 2017 that I would be ok to go ahead with another pregnancy.
For those of you who don’t already know, I was born with a congenital heart condition – bicuspid aortic stenosis. Aortic stenosis is the narrowing of the aortic valve opening over time, which restricts blood flow; basically this means that my aortic valve doesn’t function properly, and so my heart has to work a lot harder to pump the blood throughout my body. I also have regurgitation of blood from the aortic valve back into the left ventricle, and because my heart has worked harder than most for so many years, my heart muscle is stiffer than it should be. Anyway – I had a balloon angioplasty (a surgery in which a balloon was inserted into my aortic valve to stretch out the opening) when I was 10 years old, and other than that, have basically lived life as normally as possible. For me, that has always meant avoiding extra strenuous activities, and monitoring my exercise. I knew from a young age that I wasn’t going to be an athlete, and to be honest, I was ok with that. This is something I have always lived with, so in some ways, I don’t know any better, and for the most part, I’ve been able to do all of the things that I’ve wanted to do.
Anyway – the reason this is relevant information to Nora’s birth story is because during my pregnancy with my third child, Molly, I had several issues, and it was suggested by other physicians at the time that it may be cardiac related and I should confirm with my cardiologist whether or not it would be safe for me to have more kids. So, in the year following Molly’s birth, I asked my cardiologist (at the time) to do whatever necessary to confirm whether or not I could have another baby, or if we needed to be done. In the fall of 2017, after a 6-month postpartum echo, my cardiologist gave me the green light and told me there was no reason I could not have another baby, from a cardiac perspective. Jeff and I were both very relieved to have this confirmation, because it had been our hope that we could have four kids.
When I found out I was pregnant with Nora we were both very excited and didn’t anticipate anything out of the ordinary with the pregnancy; after-all, this was baby #4, and we basically felt like old pros. And, though I’m not a person who enjoys pregnancy, I’ve always loved giving birth – so we were really happy to have one last opportunity to experience the miracle of bringing a new baby into our family. Little did we know the “adventure” that would unfold over the next nine months.
Shortly after finding out I was pregnant, I contacted my cardiologist to book an appointment. At the time, the earliest I could get in to see him was May 31st, which would put me at roughly 4 months pregnant. I would typically see my cardiologist 1-2 times during pregnancy, and have an echo. Other than that, there had always been very minimal cardiac presence during my pregnancies, and none during my deliveries – so I had always assumed that meant it wasn’t necessary.
However, I was a bit more concerned about my cardiac health in this pregnancy because of the complications of my pregnancy with Molly, so I wanted to stay on top of everything, despite the go-ahead to get pregnant. Unfortunately, a week before my scheduled appointment in May, I received a phone call from my cardiologist’s office telling me that he had stepped away from medicine “indefinitely”, and it would be up to me to find a new cardiologist. Now, for those of you not from Canada – this is a lot harder than it sounds. You can’t just go find a new cardiologist – you first need an appointment to see a physician (like a family doctor), who then refers you to a specialist, and this process can take weeks or even months in a lot of cases. So, needless to say, I actually felt pretty concerned; I was already four months pregnant, and completely without a cardiologist to check in and make sure things were ok.
I actually did not ending up getting a referral for a new cardiologist for another five weeks, and it was through an absolute miracle that we ended up finding an amazing physician who was willing to take me on as a patient. For five weeks we tried unsuccessfully, and it wasn’t until the end of June when my mom wound up at an event in Ottawa, Ontario, where she was randomly introduced to a cardiologist from our province, Saskatchewan. Although she felt bad mentioning my situation at an event, she told me afterwards that she just knew she had to say something, and thankfully, he was completely understanding and totally willing to help. Because he lived in a different city several hours from where I live, he couldn’t take me on as a patient himself, but he assured my mom that he could get me a referral to a cardiologist he knew in Saskatoon.
The very next day, the physician from the event contacted me, asking for my medical history, and the day after that, I received a phone call from my new cardiologist’s office asking if I could come in immediately for an echo. I was at work, but knew how important it was to jump at the opportunity. I took the rest of the day off and drove to the office for an echo, with a follow up appointment two days later. This was seriously an answer to prayer, and I know it was a total “God-thing” that my mom wound up at the same event as someone who was willing and able to help me. I can’t imagine how things might have turned out otherwise.
However, it was at that follow-up appointment that the severity of my situation became known to me. First of all, it has to be said, that my new cardiologist is truly an amazing doctor. In that one meeting I learned more about my own health and condition than I had in the many years prior. My new doctor went through my history with me, explaining exactly what was going on, and how things had become very severe. He had also done quite a bit of research into my situation – but there weren’t a lot of studies about pregnant women with severe aortic stenosis, because frankly the two just don’t typically go together. It became pretty clear to me that there had been a serious lack of communication between myself and my previous cardiologist, and I felt totally blindsided, and truthfully, really foolish for not having a better understanding of my own situation; I have learned so much about advocating for myself and my children through this experience. The fact is, I had just always assumed that my former cardiologist was doing what needed to be done, and that I was fine. Essentially, I believed that “no news was good news”, and the experts knew best.
Now, some of you may be wondering how I could have come to be in such severe condition without feeling the effects drastically, and basically the best way to describe it, is that it’s a bit like boiling a frog – it was a long time coming. I have been living with this condition my entire life, and things have been deteriorating over many years, so my body has adapted and compensated, and frankly, I’ve gotten used to not feeling great.
Additionally, a lot of the symptoms of heart disease are similar to symptoms of pregnancy: shortness of breath, swelling in the hands and feet, difficulty sleeping, light-headedness, etc. There are others, such as chest pain, irregular heartbeat, coughing, fainting spells, etc., but up to that point, I truly believed that all of my symptoms were due to other issues – pregnancy, or a bad cold; I was even diagnosed with adult-onset asthma at one point due to shortness of breath – so to find out that it could have been cardiac related instead was really a shock to me. And even scarier – I still had four months of pregnancy to go, and was finding out that the likelihood of going into cardiac failure, due to the added strain of the pregnancy on my heart, was very high. At that point, everything about my pregnancy changed. Suddenly, it wasn’t routine, and I understood quickly that it was not going to be like every other experience I had had in the past.
One of the first big changes was that it was recommended that we cancel all of our summer holiday plans, in order to stay close to home and a hospital, in case I went into cardiac failure. We had had several trips planned – including a road-trip to Pennsylvania, and although we knew why it was necessary to cancel, it was disappointing. The next big change in my pregnancy care was that I was transferred to a high-risk Obstetrics team that my new cardiologist worked closely with. I also met with an anesthesiologist to discuss potential birth scenarios and what kind of pain management would be put in place to limit the impact and strain on my heart. Additionally, I had been diagnosed with gestational diabetes in this pregnancy, for the first time ever, and met with a dietician to help monitor that. Apparently I was destined to experience ALL THE THINGS in this pregnancy.
However, a team of people was coming together to help ensure that both baby and I would be ok, and although it was a bit overwhelming, it was also very reassuring to know there were so many amazing people looking out for us. Truthfully, I think I was still in a lot of denial, but the blessing in it all is that despite the challenges and my own physical limitations, our baby continued to grow strong and healthy.
The month of July passed quickly, and it was a good thing that we cancelled the plans we had for the summer, because over the course of the month I became increasingly symptomatic. By the end of the month, I was essentially put on bed-rest; I wasn’t supposed to go up and down stairs, lift my children, do any kind of housework, or really do anything that would be even minimally strenuous for my heart. At the beginning of August I began seeing my OB once a week, and it was explained to me that because my symptoms were continuing to get worse, I would definitely be induced early; we basically just needed to find the “sweet spot” – the moment in time when I was still healthy and strong enough to deliver, and our baby was healthy and strong enough to be born. We were so blessed to have our amazing community of friends and family step up to help us throughout the month of August, with meals, childcare, house-cleaning assistance, to minimize the impact and strain on my heart; we will never be able to properly thank everyone who helped make our lives easier during that time.
The overall goal was to avoid an emergent situation, which would be much worse for both baby and myself. Originally we had hoped to make it to 36 weeks, but by the end of August, and after an episode that involved heading into the Emergency Room for an afternoon to be monitored, it was quite clear that that wasn’t an option, and so it was decided that I would be induced on September 5th, at 32 weeks gestation.
A part of me was wildly relieved that this extremely difficult pregnancy was coming to an end – my symptoms were leaving me absolutely exhausted physically, and emotionally I was constantly worried about going into cardiac failure or having to rush to the emergency room. But, on the other hand, I was so worried about our baby and the complications that can come from being born prematurely.
However, at the end of the day, we knew and accepted that this was the best-case scenario. It was explained to me that the best delivery plan for me and the baby was a natural birth. I originally thought that I would be having a c-section (something I was dreading, although I’m completely grateful the procedure exists), but my OB explained that a natural delivery would actually be safer for my valve because of the “auto-transfusion” that takes place in our bodies after a baby is born. Auto-transfusion is how the body absorbs all of the extra blood that we carry in our systems when we are pregnant; in a natural delivery, this process takes place slowly, over the course of about 24 hours. However, a c-section is a shock to the system, and all of that excess blood gets dumped back into our systems in the span of about 30 minutes, which my OB and cardiologist weren’t sure my valve would be able to tolerate.
As a result, a plan was made for induction, using a mechanic balloon and oxytocin, to hopefully bring our sweet baby into the world naturally. We should have known that nothing ever goes according to plan, especially after the complicated pregnancy we had already experienced, but on Wednesday, September 5th, Jeff and I headed off to the hospital completely oblivious to the challenges that were still before us, but so ready to meet our sweet babe.
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The bad news is that this story gets worse, before it gets better. The good news is that it DOES have a happy ending! So I hope you’ll read part two in the next couple of days! Thanks so much for your continued love and support.
Thank-you to Willows and Sage Photography in Saskatoon for these stunning family photos!