Serena N. Welsh

 Peripartum Cardiomyopathy Support Network

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In December of 1999, I visited a cardiologist to have a full cardio work-up. Call me paranoid. My mother had just gone into heart failure (and eventually had her mitral valve replaced along with a double bypass), my then 4 year old daughter was diagnosed with dilated cardiomyopathy when she was almost two years old. And My grandmother, who was then 93, had an enlarged heart, along with other heart issues, probably related to age. I was told that I was fine, but due to family history I should probably follow up every 5 to 10 years.

In December of 2001, I was put on terbutaline in the hospital to stop preterm labor with my second child, Jack. He was due in late February. My Obstetrician sent me home with a prescription and instructions to keep an eye on my pulse. If it ever got above 120, I should call her immediately. Upon taking my first dose at home, my pulse raced to around 150. When I spoke with my OB she told me not to worry about it, and take it again at the next dose time. After calling her for the same reason after each of the next doses over a 2 day period, she finally told me that some people just have that reaction to the drug and I could stop calling.

In early January I presented to my OB with shortness of breath and mild palpitations. My symptoms were not investigated and were written off as "severe acute pregnancy." On February 13, 2002 my labor was induced. During this very long and hard labor, my breathing became more difficult and my blood pressure (historically low) dropped to concerning levels, but my obstetrician decided that we should "just keep an eye on it." A few hours post partum, I was almost unable to sleep lying down at all. I was propped up on four pillows and still felt like I was suffocating. No one ever listened to my chest and I was told this was normal. Five days postpartum, at home, I finally called the OB on call. It was President's Day, so she wasn't keeping office hours. I told her my lips were blue, and I felt like I was suffocating. She sounded agitated that I had bothered her, and told me it was not an obstetrical issue and I should see either my regular doctor when they were next in the office, or go to the ER.

In the Emergency room with a 5 day old baby, the doctor's immediate concern was ruling out a blood clot, which he did. A chest X-ray of my lungs revealed fluid. They told me I had bilateral pneumonia and sent me home with antibiotics.

Fast forward to early 2004. My third child, Cate is due in July. I'm having palpitations and shortness of breath. My new obstetrician (we'd moved since the last child was born) told me it was just normal pregnancy, though she also never investigated the symptoms. I felt I was being ignored and neglected, so I changed doctors. My new doctor immediately recognized that I should be on a blood thinner for a past history of clotting issues. My other OBs had ignored this piece of medical history.

A week later I was in the Emergency Room because I'd had palpitations so severe they knocked me to the ground. I was dizzy for about 30 minutes, and could not breathe.

They first did an EKG, which they said was normal. A cardiologist came in and explained that he'd like to run some tests to rule out a blood clot, but there were risks to the baby, so I needed to be really sure that I wasn't imagining my symptoms. He successfully ruled out a blood clot, sent me home and told me to follow up with my OB.

Following up with my new OB saved my life. He sent me to a cardiologist to be thoroughly examined. On March 10th, I was diagnosed with congestive heart failure due to Peripartum Cardiomyopahty. My ejection fraction (EF) was 5%-10%. "Normal" is considered to be around 55-60%. On March 17th I was admitted to UNC Hospital Labor and Delivery floor. There, the doctors tried to stabilize me on what heart medications they could, taking the safety of my baby into consideration. Many meetings were held between the OB staff and the Cardiology staff to determine the best course of action for me. Continuing the pregnancy to full term was too risky. Delivery alone at any stage was too risky. The wonderful OB staff allowed us to take all of the information they had compiled and make our own choice.

On April 12, 2004, Cate Teagan Welsh entered the world at 28 weeks gestation via C-section. Besides the normal OB staff present, I also had a cardiac anesthesiologist, and a wonderful team of doctors and nurses from the NICU. There was also a cardio-thoracic surgeon on the stand by - just in case. Luckily, we didn't have to get to know him.

Today, I'm followed by Duke University Medical Center Heart Failure and Transplant team.  My EF is in the 20% range.  In November, 2005 I was fitted with an ICD, or implantable defibrillator.  This little device will save my life if one of my frequent runs of Ventricle Tachycardia doesn't correct itself.

I founded this organization and website in October 2004 to combine member support with my effort to raise awareness and funds for research.