Melissa Grunden

 Peripartum Cardiomyopathy Support Network

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My name is Melissa Grunden.  I am 36, and I am still very much in the early stages of my story.  It took my husband and I three years to conceive.  I was diagnosed with PCOS (polycystic ovarian syndrome) two years ago.  I weighed 205, had insulin resistance, and was very close to becoming diabetic.  I was put on metformin and began to ovulate.  We were able to conceive in February after undergoing an IUI.  I went back in for my first pregnancy appointment in March.  I was only 7 weeks but measured the size of someone who was 12 weeks along.  An ultrasound showed that I had 4 fibroids.  They were all growing rapidly because of the hormones my body was producing during the pregnancy.  I was considered high risk very early on.  I don't believe that my OB believed that the baby would make it far enough to survive, but we kept hanging in there.  In May, I looked like someone who was 7 months pregnant.  I was getting ultrasounds monthly and was on restricted activities.  I teach, so it wasn't too difficult to take things easy in the summer, and I already knew that I wouldn't be returning until after delivery. 

In June, my blood pressure started to skyrocket.  It had always been borderline-high, but now it was raging out of control.  Readings of 160/105 were very common.  My doctor put me on blood pressure medication and kept increasing it until I was at the limit.  It would get slightly better for a day or two and would start to climb again.  I went in for my bi-monthly appointment on August 1st (2006).  For the first time, my proteins were also high.  My doctor didn't order me to the hospital but told me that if I felt any worse, I should check myself in.  About a week before this, I had started to get out of breath and had a horrible time trying to sleep.  I was told that since I was so large due to the fibroids (now 6), I would probably have some difficulties and that sleeping in a recliner wouldn't be out of the question during this time.  In fact, in order to sleep, I usually had to prop myself on about 6 pillows.  Later that day I was feeling worse, so I had them admit me to the hospital.  I stayed for 2 days.  I was put on fluids and started to feel a little better.  I was still short of breath, but since I wasn't walking far and wasn't dealing with the August heat, I didn't notice it as much.  While I was there, I received steroid shots to help develop the baby's lungs. 

The day after I arrived home from the hospital I found that I had difficulty breathing when walking the 10 steps from my couch to the bathroom.  I was in daily contact with my OB regarding my blood pressure.  I told him about the difficulty and was sent to the hospital for chest x-rays.  The results were called into him right away, and he sent me directly to The Ohio State Medical Center.

It was there that my cardiomyopathy was diagnosed.  I am still uncertain as to whether my case is true PPCM or if it was a result of hereditary or viral issues.  My mitral valve regurgitates.  My grandmother has a similar valve issue, but it hasn't caused her problems until recently.  I remember getting out of breath and tired frequently about 3 months before I became pregnant, so I'm not entirely sure.  I spent 2 weeks in the high risk unit at OSU where I was evaluated daily and put on medication.  They were just to the point where I was going to be sent home for a couple of weeks when my membranes ruptured at 27 weeks, 1 day,  My son was born via emergency C-section.

Following the C-section, I developed an ilius.  Because I was unable to pass gas, I was put on an NG tube and had 2 colonoscapies.  It took 10 days for the ilius to resove.  During that time, I was mostly bedridden as my stomach was larger than it had been when I was pregnant.  My child was moved to Children's Hospital in Columbus.  I still had not seen him.

Two weeks after delivery, I was finally sent home, 60 pounds lighter than my weight before I became pregnant.  I finally got to see my child on my way home.  Two days later, I was transported by ambulance back to OSU.  I had contracted VRE and the infection had spread through my body.  It was literally eating through my uterus.  The doctors prepared to take me into surgery to clean up the infection.  During the prep time, I discovered that I had developed a blood clot in my leg.  Before I went into surgery, a filter was placed to catch the clot and a SWAN was placed in my neck.  It is fortunate that the filter was put in because the clot did break off.

I found out later that my EF dropped to 19% during the surgery.  The infection was so bad that the doctors also had to perform a hysterectomy.  Five days later, I was again at home.  I was on an IV for the infection, a wound vac for the hysterectomy, and Lovanox shots for the clot, but for the first time in 5 weeks, I was home.  Unfortunately my child was still 2 hours away.  Because of my infection and because I was so weak, it was another 3 weeks before I saw him again.

Five months later, we are both doing well.  My son was finally able to come home 3 weeks ago.  Despite his prematurity and a severe case of GERD, he is doing well and is devloping normally according to his adjusted age.  I do my follow ups at OSU where my cardiologist specializes in young people with heart problems.  In March I will return to see what damage has been done to my heart.  I currently take coreg, lisinopril, and lasix for my heart.  I also take warfarin for my clotting issues.

For the most part, I feel back to my old self.  I am able to exercise at the same level that I did about 5 years ago before I gained the weight.  However, I get tired much faster than I used to and often have days where my lungs still feel heavy.  I am lucky to have a family doctor who follows me closely and keeps in good contact with the doctors at OSU.

I feel very fortunate to have my son here.  Because of all of our difficulties, he is indeed our miracle baby.  I had no idea that so many problems could arise during a pregnancy.  I know that I caused my regular OB massive stress, but I am so glad that he had the foresight to send me to specialists who could handle my case instead of brushing off my symptoms.