Sometime last year, I started having heart palpitations--often skipped beats with an extra heavy "catch-up" beat. I went to the doctor, he did an EKG which looked normal, and I got bloodwork done. We discovered my vitamin D was low, so we increased it with mega supplements. My D levels are still lower than they should be, but the incidence of the palpitations has decreased significantly, so I considered the issue behind me. All good.
Then, sometime last month, I started noticing that I was having chest pain when I lay down at night to go to bed. Since it didn't happen every night or last too terribly long, I assumed it was heartburn--even though it didn't feel like the heartburn I had when I was pregnant.
With my 40th birthday on the horizon, wanting to lose some weight, and knowing that physical activity can help release pent-up emotions, I got a membership to our local wellness center and began working out. I began to feel nauseous during one of the classes I was taking, so I stopped doing those and went to just doing the elliptical. Well, last week, I began having chest pain during my workout that didn't go away until I was done working out. It's not horrible pain, but it's sharp and nagging. Still, I convinced myself it was nothing.
Then I got emails, Facebook posts, radio and television commercials, all over the course of two days, discussing how the signs of heart attacks in women are different than for men and include things like back pain, nausea, and what not. My mind began to wander and wonder--was this a message for me? I thought about the fact that both of my kids had CHD and that there appeared to be a genetic component. That would mean there's at least a 50% chance that the issue is from my genes, in which case there could be something going on with me. I've had high cholesterol forever--even in college when I was 18 and weighed 150, my cholesterol was 206. I'm certainly overweight, and I've had my ovaries removed. All of these things increase the chance of heart attack.
I also have a family history of heart disease. My grandmother was convinced something was wrong even though all her tests came back okay. They finally took her in for a heart cath and couldn't even get the angioplasty balloon in, so she had quadruple bypass surgery; but she never had a heart attack thanks to her persistence. I began to worry. Still not enough to go to the doctor, but it was in the back of my mind.
Not until I woke up today with a sinus headache, mucus for days, and a general blah feeling, did I decide I needed to go to the doctor about this. After antibiotic and steroid shots for the bronchitis, I had an EKG. The good news is, it was completely normal. The bad news is that all of my symptoms sounded very cardiac to the doctor. And, given my grandmother's history, I was not reassured by the EKG. So, the doctor sent an ASAP referral to a cardiologist, and I am waiting to hear back about when I can get in.
It is unlikely that anything is wrong. It is highly likely that it's stress, on top of stress, on top of grief, on top of stress. But, my family has already been through enough, so I'm getting it checked out. I don't want to find myself in the hospital, or the great beyond, thinking "woulda, coulda, shoulda." It's time to step-up the taking care of myself stuff. Better safe, than sorry.
Showing posts with label family history. Show all posts
Showing posts with label family history. Show all posts
2.18.2015
8.02.2013
Don't Know Why
As we have shared the news of Jellybean's heart issues with people, we've have two main questions:
1) Is it the same thing Lil' Bit has? No. If it was, doctors would be writing this up in medical journals right now.
2) Do they know why both your kids have heart issues? No. There are lots of factors that can play a role in children getting congenital heart defects (CHD). Below is our best understanding of some of those risks and why don't seem to be applicable.
Family History
This is generally the biggest factor, hence the big jump in probability of Jellybean having a heart defect once we discovered Lil' Bit had one. However, to the best of our knowledge, there are no cases of a CHD anywhere in either my or Phil's family. So, although Lil' Bit's having one increased the chance Jellybean would also have one, Lil' Bit had no increased risks.
Anti-depressant Use
First, an interesting fact: The fetal heart is fully formed by roughly 7 or 8 weeks gestation, which is generally long before most people know they are pregnant. Thus, things that occur later in pregnancy have no bearing on whether there are CHDs. However, because I was taking my anti-depressant prior to and during that time period, and there is a link between the anti-depressant I have been taking and babies having CHDs, we were concerned about this. However, the drug I took (my doctor just switched me to something new) is linked to a very specific type of defect which Jellybean doesn't have, and I didn't take any anti-depressants during my pregnancy with Lil' Bit. I have had at least seven different doctors reassure me that this was not the cause.
Uncontrolled Diabetes
Children born to women whose diabetes was not well-controlled are statistically more likely to have a CHD. However, because my diabetes is gestational, it is less-likely to be the cause of any issues. My doctors reassured me this is generally applicable to women who are diabetic pre-pregnancy. In addition, my A1C test at 3 months gestation revealed a nice low average blood sugar level of like 5.5 (well in the normal range). Because this test provides an average blood sugar level for the prior 3 months, to the extent that there was any chance I had diabetes prior to pregnancy, it could not even remotely be considered out of control. This was not the cause of either child's CHD.
Chromosomal Abnormalities
There are lots of chromosomal abnormalities that are associated with CHDs and, because I was 34 at the time the embryos were created, my kids were at a slightly higher risk of such abnormalities than if I had been younger. Because we are unwilling to risk a miscarriage to have an amniocentesis done, we won't know until after Jellybean is born whether he has any such abnormalities. We do know, however, that Lil' Bit doesn't have any and, because her embryo and Jellybean's were created at the same time, there is no additional risk for him based on my increased age during his pregnancy--the risk is calculated based on the age of the egg, which was the same for both kids.
IVF
This is the biggy, and it's somewhat controversial. Initially, there was a fair amount of research that indicated a link between IVF, particularly with the use of ICSI, and CHD. Subsequent research indicated that the increased correlation could be because of the increase in multiples (twins, triplets, etc). Other research has shown that although there is an increased incidence of CHD among IVF users, it is because there is an increased incidence for couples who suffer infertility, regardless of the fertility method used to conceive. Thus, whether Clomid, IUI, IVF, or natural conception after years of infertility, the incidence rate appeared correlated with infertility, not IVF. We had seen this research and thought that since our infertility issues were largely structural--the result of blocked tubes from a ruptured appendix--rather than genetic or hormonal, we had a lower risk. Guess not. In any event, the current understanding is that children conceived using IVF do not have an increased risk of developing a CHD.
So, there you have it. The only risk factors for CHD that might have some application in our case appear not to be the cause. And, in truth, I'm not sure it really matters what caused it. If it turns out I did something to cause it, would being able to beat myself up about it change anything? No. Would pointing the finger at IVF help? No. I think we would have made the same choices because the odds of any child having a CHD are just so darn small. So, to the best of our ability, we're setting aside the need to know why it happened and just focusing on what we do from here. It seems like a much better use of our limited physical and emotional resources right now.
1) Is it the same thing Lil' Bit has? No. If it was, doctors would be writing this up in medical journals right now.
2) Do they know why both your kids have heart issues? No. There are lots of factors that can play a role in children getting congenital heart defects (CHD). Below is our best understanding of some of those risks and why don't seem to be applicable.
Family History
This is generally the biggest factor, hence the big jump in probability of Jellybean having a heart defect once we discovered Lil' Bit had one. However, to the best of our knowledge, there are no cases of a CHD anywhere in either my or Phil's family. So, although Lil' Bit's having one increased the chance Jellybean would also have one, Lil' Bit had no increased risks.
Anti-depressant Use
First, an interesting fact: The fetal heart is fully formed by roughly 7 or 8 weeks gestation, which is generally long before most people know they are pregnant. Thus, things that occur later in pregnancy have no bearing on whether there are CHDs. However, because I was taking my anti-depressant prior to and during that time period, and there is a link between the anti-depressant I have been taking and babies having CHDs, we were concerned about this. However, the drug I took (my doctor just switched me to something new) is linked to a very specific type of defect which Jellybean doesn't have, and I didn't take any anti-depressants during my pregnancy with Lil' Bit. I have had at least seven different doctors reassure me that this was not the cause.
Uncontrolled Diabetes
Children born to women whose diabetes was not well-controlled are statistically more likely to have a CHD. However, because my diabetes is gestational, it is less-likely to be the cause of any issues. My doctors reassured me this is generally applicable to women who are diabetic pre-pregnancy. In addition, my A1C test at 3 months gestation revealed a nice low average blood sugar level of like 5.5 (well in the normal range). Because this test provides an average blood sugar level for the prior 3 months, to the extent that there was any chance I had diabetes prior to pregnancy, it could not even remotely be considered out of control. This was not the cause of either child's CHD.
Chromosomal Abnormalities
There are lots of chromosomal abnormalities that are associated with CHDs and, because I was 34 at the time the embryos were created, my kids were at a slightly higher risk of such abnormalities than if I had been younger. Because we are unwilling to risk a miscarriage to have an amniocentesis done, we won't know until after Jellybean is born whether he has any such abnormalities. We do know, however, that Lil' Bit doesn't have any and, because her embryo and Jellybean's were created at the same time, there is no additional risk for him based on my increased age during his pregnancy--the risk is calculated based on the age of the egg, which was the same for both kids.
IVF
This is the biggy, and it's somewhat controversial. Initially, there was a fair amount of research that indicated a link between IVF, particularly with the use of ICSI, and CHD. Subsequent research indicated that the increased correlation could be because of the increase in multiples (twins, triplets, etc). Other research has shown that although there is an increased incidence of CHD among IVF users, it is because there is an increased incidence for couples who suffer infertility, regardless of the fertility method used to conceive. Thus, whether Clomid, IUI, IVF, or natural conception after years of infertility, the incidence rate appeared correlated with infertility, not IVF. We had seen this research and thought that since our infertility issues were largely structural--the result of blocked tubes from a ruptured appendix--rather than genetic or hormonal, we had a lower risk. Guess not. In any event, the current understanding is that children conceived using IVF do not have an increased risk of developing a CHD.
So, there you have it. The only risk factors for CHD that might have some application in our case appear not to be the cause. And, in truth, I'm not sure it really matters what caused it. If it turns out I did something to cause it, would being able to beat myself up about it change anything? No. Would pointing the finger at IVF help? No. I think we would have made the same choices because the odds of any child having a CHD are just so darn small. So, to the best of our ability, we're setting aside the need to know why it happened and just focusing on what we do from here. It seems like a much better use of our limited physical and emotional resources right now.
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