We obviously were Grandma's favorites

I tried to post this once before but apparently I did something wrong...so here we go again. 

My Grandma had six children.  When she was in her 60s she was diagnosed with a bicuspid aortic valve which was replaced with a Bjork-Shiley.  She died at the ripe old age of 89 of cancer.  We loved her more than words can say and miss her everyday.

I would have been honored to inherit the traits that were so characteristically "Granny Fanny".  She always remembered names, birthdays, and anniversaries (although her pronounciation was sometimes off...my then fiance-now husband, Collin, smiled even though she called him Colon...like part of your GI tract or Colin Powell).  She was a devout Catholic who never missed a day of saying the Rosary.  She was active in her Church and social group up until a few months before she passed away.  You couldn't pull her away from the TV or radio when the St. Louis Cardinals were playing ball.  THOSE were traits that made Grandma, Grandma.

Typical of Grandma, she didn't want to keep anything to herself.  She encouraged my sisters, brother and I to: "Share and share, alike".  She believed in equal portion sizes for all and fairness in play.  In the spirit of sharing, Grandma passed down a trait that didn't define who she was when she was alive, but plays a huge role in our lives now that she is gone...she passed on to my sister and I, her bicuspid aortic valve.  Well, not her ACTUAL valve.  It's not sitting on the bookshelf in my office, although that would be a good conversation starter, wouldn't it?

My name is Karen and I am 28 yrs old.  I got married in October 2002 and we all lived happily ever after...well, at least until January 2004.  My sister, Amy, (who will also be blogging on Girl Valves) was diagnosed with a BAV.  Her diagnosis led to some serious action on the heart surgery front but that is her story...I will let her tell it.  After Amy's diagnosis, my mother, siblings, and I were all given echos to test for a BAV.  Fortunately for my mother and siblings, but unfortunately for me, I was the only other family member to have a bicuspid aortic valve.

After my TEE which showed mild/moderate regurg and an aortic root diameter of 3.5, my husband and I decided to try and have children while my heart was still in decent shape.  We met a few days later with a high-risk OB who assured us that pregnancy with a bicuspid aortic valve should be a piece of cake...relatively low risk and completely managable by my regular OB.  Just for fun, he ordered a thrombophilia panel.  A week after our meeting, we found out I was pregnant.  My husband and I high-fived all around the house and thanked God for our blessing.  Surely, a baby was part of the divine plan for us...or was it?

I miscarried that pregnancy at 6 weeks.  A probable ectopic though no one knows for sure.  As irony would have it, I was released from the hospital on Mother's Day.  I celebrated with a couple of cold ones (okay, so maybe it was 6 or 7...whose counting?) surrounded by my family.  Shortly thereafter, the high-risk OB called to tell me that I had tested positive for homozygous MTHFR.  Basically, my Mom and Dad each passed on a mutated gene that predisposed me to multiple miscarriage, placental abruption, stroke and other blood clotting issues.  Wow, thanks, Mom and Dad...couldn't I have inherited Mom's great love of cooking or perhaps Dad's handiness around the house?  As it stands, I can't cook to save my life (but I can pick some great restaurants to eat at!), and the only handiwork I'm good at is handing someone else tools.  On a good note, MTHFR is easy to treat with high doses of folic acid and baby aspirin.  So, it really is an afterthought for this story.

Six months after our miscarriage, I became pregnant again...and overcome with fear.  My mind raced between thoughts of miscarriage and bad hearts.  Was my heart okay?  Was the baby's heart okay?  If we fast forward through a couple of uneventful months, it brings us to today.

I am currently 27 weeks pregnant and all seems well.  My last cardiology appointment showed no change between my echo last year and this year.  The baby is scheduled for his or her fetal echo in two weeks.  The docs say there's a 10% chance of passing on ANY heart defect to the baby.  I am praying that we have a baby with a great heart (and as a sidenote to God, I am praying that if the baby does have a defect it's not life-threatening).

The big dilemma now is this:  Both my cardiologist and OB seem to think that a vaginal delivery will be just fine but have agreed to a c-section if I so decide.  While I would like a vaginal delivery, I'm concerned about it's effects on my heart.  And no one can seem to give me solid answers on that.  I want statistics. I want studies (although you won't see me volunteering for the study that asks for almost healthy women with heart defects to determine whether pregnancy and vaginal delivery damage the heart further....in fact, I think that would be a violation of some kind of code of ethics...either way, a study would be helpful).  Since apparently there aren't statistics or studies on this kind of thing, I am offering up a prayer to my devout, caring, Cardinal loving Granny for her to help me with this decision.  I hope she hears me.

I realize I've been long-winded and if you've read this far, you are far more patient than I...but thanks.  My story is different than the many stories I have read on this site but I'm hoping it will help others.  Be on the lookout for Amy's post.  It should be a good one.  Thanks, Michele for allowing me to post on your blog.  What a great idea.

Comments

[Michelle]

Hi Karen and thanks for posting. There are studies that I've found but they are few and far between ... and I don't even know if they focus on the method of delivery. I'm not a doctor but from what I read (which is just basic google researching), the concern with BAV and pregnancy is in the hormonal changes during the third trimeseter, so vaginal delivery shouldn't effect that. But there may be a need for antibiotics ... same as any other procedure with blood.

That's just based on what I found and read ... but I agree with you that common sense and logic would suggest that c-section would be easier. Just haven't found anything written that says that.

I'm so glad you posted. Gives me hope ... I'm a BAVer too. Haven't tried to get pregnant yet. Trying to enjoy newlywedhood. Keep us posted!!!

[Jill]

Hi Karen! You and I have different heart issues (I have mitral regurg), so I don't know how helpful I can be, but, I am offering my two cents anyway. When I was pregnant, my doctors were not terribly concerned with the delivery. They were more concerned with how my heart would handle the extra blood that your body produces during pregnancy (which peaks around 30 weeks). Anyhoo, the doctors never seemed to think that a c-section was even something I needed to consider (any more than anyone else anyway). One doctor suggested a "shortened second stage," which basically means that I would not push - they let the baby come through the birth canal on its own and then pull it out with forceps. But, the other doctors did not agree that this was necessary and they all decided to just "wait and see" how I was doing during labor. In fact, my high-risk OB even decided not to give me antibiotics during labor unless I got an infection (which I did). (My cardiologist, by the way, was not thrilled with this approach, but it ended up being fine.) I ended up having a vaginal delivery - although I did need help from the forceps, but only because after pushing for 2 1/2 hours, Colin's giant head was just not budging!

Good luck with everything! Have you had the fetal echo yet? I hope all is well with the baby!