Images and text by Jeanee Andrewartha.
When Jamie asked me to write about heart failure and pregnancy, I thought it would be easy. I have written so many articles about Peripartum Cardiomyopathy, surely this would be a piece of cake? However, I have struggled to write about it because I am pregnant and pregnancy and heart failure just don’t mix. While I am thinking about the new life that grows within me, I don’t want to revisit what happened in my last pregnancy and relive those memories again but I feel that in writing this article, lives may be saved.
I finally understand why no one wants to talk about heart failure and pregnancy because the two topics just don’t go together. If I who almost lost my life and lost a baby because of Peripartum Cardiomyopathy, find it hard to think about this disease while I am pregnant, well I can imagine, so many other people reading this, will want to stop reading and think it unnecessary and too stressful to know any more about this disease. I am sure, most people think, it will never happen to them, because they are young and relatively healthy.
I had never heard about PPCM and I don’t think doctors, nurses, obstetricians and midwives want to talk about PPCM because why stress a woman, who is pregnant with unnecessary information? However, Peripartum Cardiomyopathy is the leading cause of maternal death and injury and women continue to be misdiagnosed or diagnosed late of this cruel disease. It happens to women of all ages and races, in the first birth or after many pregnancies and the majority of women are healthy and often do not have any pre-existing conditions like high blood pressure, obesity, high cholesterol and all the things you associate with having a heart issue like smoking or drug use.
The saddest bit about PPCM is that women continue to die of this disease but most women who are diagnosed early make a full recovery.
The problem with heart failure is that it is often masked by pregnancy. In pregnancy, a woman naturally gets tired, feels heavier, finds difficulty lying flat, puts on weight, and can have swelling in the body. Heart failure is a silent killer. It creeps up like a snake and then strikes suddenly. I have had viral infections that have been worse than being in heart failure. Most women do have a sense that something isn’t quite right but they just don’t know what it is.
So how do you know if you are in heart failure?
The symptoms of PPCM include:
- Difficulty breathing while lying flat
- Shortness of breath on exertion
- Swelling (edema) above and below the knee
- Palpitations – awareness of heart beating
- Pink sputum
A woman may initially exert one or all of these symptoms, and many will have their symptoms dismissed as normal signs of pregnancy. There is a self-test on the homepage of www.myheartsisters.com but if you have any concerns, there are several medical tests that can determine if you are in heart failure.
- Blood test: C-reactive protein which is produced by the liver. The level of CRP rises when there is inflammation throughout the body
- Blood test: B-Type Natriuretic Peptide (BNP) blood test is used to help diagnose heart failure and to determine the severity of that heart failure.
- Echocardiogram (ultrasound of the heart) that determines if a heart is enlarged.
Unfortunately, these tests are not done routinely on pregnant women, so they need to be requested, if you suspect that you are experiencing heart failure.
It’s hard to revisit the dark days of my own heart failure. I can remember vividly being in denial, at the seriousness of my condition. My heart was only half working but I just wanted to be home with my family, who were grieving, because of the loss of our baby boy. My body had failed him and it was failing me but oxygen was also not getting to my brain and I really found it hard to think, and in my mind, my speech felt delayed and jumbled and I was being bombarded with new medical terms, test results and a working diagnosis of postpartum cardiomyopathy. I had to deal with the Coroner’s Court, medical investigation, police reports, and it felt like my whole world had shattered in an instant. I couldn’t rewind the clock, no matter how many times I did in my mind to create an alternative reality, where the baby was alive and I was still pregnant.
The doctors and nurses wanted me to get used to a new ‘normal’ and all I remember hearing was that I would probably be on medication for the rest of my life. For someone who ate organically, who wouldn’t touch an aspirin, it was a difficult thing to swallow. I was shown my leaky valves, my half working heart and the fluid around it, and none of it seemed real. I didn’t feel that sick but when asked how far I could walk without having to rest, it was about 200 metres, or even less if there was any slope. I reluctantly agreed to be admitted into hospital, when the local GP told me, in plain English that I was dying and I prayed about it, and God had told me to go, that He would heal me. How did this happen? How could I have got so sick, so quickly? We had just moved house. We were starting a new life, when everything turned upside down.
I spent a week in hospital, thinking a lot about what had gone wrong and over the course of the next few months, we dissected every aspect of our lives, to the point where there was so much regret and pain, it almost ended our marriage. I felt so alone in my thoughts, while the world kept spinning and I felt terribly lost. I prayed and cried out to God for help. I found strength from the Almighty in my greatest times of weakness, I learnt humility and became open to change, to seek truth and let go of the past. I looked at my life with a brutal honesty and knew a lot of things had to change.
I am currently six and a half months pregnant. I recovered after 11 months. I intended to stay on medication for a little bit longer but after developing a chest infection and hacking cough, and feeling terrible and losing memories related to being on medication, I felt that it was now or never and I weaned myself off medication. I spent over a year on an incredible health journey before getting pregnant, that saw me doing a lot of things that I never imagined I would have done from three 7 day water fasts, 30 day hot yoga challenges, infrared saunas, colonics, raw food and vegetarian diets, green juices and green smoothies, making and drinking kombucha and kefir, daily walking, meditation and prayer. I thought I was healthy, but I never really knew what healthy was until I embarked on this journey. It wasn’t enough that my heart was normal; I needed to feel healthy too. I don’t think many people realize how depleted the soils and our food are of nutrients, and how mislead we are about what it means to be healthy. We have exchanged health for convenience and no longer live in tune with the earth or the seasons. The incredible smells and black impacted waste that poured out of my body when detoxing was astounding. It is no wonder that many women suffer morning sickness, cravings and pregnancy complications because ‘unhealthy’ is the new ‘normal’ and until you push the boundaries of health, you don’t realize how healthy you can be. I lost 12 kilograms that I didn’t know I had and even fit into my engagement dress. My mind and skin are clear, digestive system efficient, and I feel younger and more energetic.
This has been an incredibly good pregnancy. I have had great energy levels, no morning sickness, no cravings, and no sickness. I normally have pretty good pregnancies anyway but all the care and dedication prior to getting pregnant is being rewarded. I try not to think about the previous pregnancy and focus all my energy on thinking positively and remembering how far I have come, not just in health but as a person.
I have a new found respect for pregnancy and the process of birth. A pregnant woman is sacred. She needs to be nurtured and loved, protected and rested, and be unstressed, so she can tune in to the needs of her body and the needs of the baby growing within. I religiously make a juice every day that has apple, beetroot, celery, spinach or kale, and orange, monitor my weight each day for any signs of unusual weight gain, eat lots of green vegetables, salads and fruits, have no processed foods, keep my magnesium levels high with homemade raw chocolate, am cautious to have adequate rest and good sleep, drink probiotics like kefir and kombucha, drink spring and mineral water, get fresh air and sunshine, and while there are many women who go through a pregnancy after heart failure without doing these things and get through without relapsing, for me developing heart failure has led to a transformation in how I see life and what is important in life. It’s not just about getting through this pregnancy but about a new way of living, of caring for both my physical, spiritual and emotional health, which are all interlinked. I am a better person, a more open, forgiving and compassionate person today.
It’s almost as though, my life prior to PPCM was an existence. I didn’t appreciate what I had. I was going through the motions of life, and had become weighed down with the cares and riches of the world, not breathing in life or being thankful for the love that I was surrounded by. I had become judgemental and focussed on running a business, and many negative aspects of the world and people entered in that suffocated my inner being and like most people, I didn’t put time into nourishing my body. I believed eating organic was the holy grail of health, which it wasn’t. It took me to losing a baby, to going to the lowest point in my life, to know the mercy of the living God, and his compassion towards me that created in me a new heart, a new way of seeing life and my relationship to the people and all living creatures around me. I value each day, and am grateful for my new life.
This pregnancy represents my faith in God, my hope for the future and the triumph of life over death. It is the fulfilment of a promise made to me that the baby I lost would be returned and my healing and journey continues, as I learn more about myself and the wonderful universe that we are privileged to live in.
Jeanee is the founder of www.myheartsisters.com a website that has been developed as a portal to raise awareness, provide support, information and stories about Postpartum and Peripartum Cardiomyopathy. She is also a Director of Passion Computing Pty Ltd, a website design, development, domain and hosting business located in Victoria, Australia. She is married with ten children and she is passionate about spirituality, natural living, home schooling, bushwalking, holistic health, raw foods, vegetarianism, yoga, reading and writing.