The Magic of a 10-Year-Old
I have always had a special place in my heart for 10-year-olds. It’s a magical age. They’re not so young that they need a lot of supervision, but they’re usually not old enough to be rebellious. And I’ve long aspired to be a grandparent. Since our marriage three decades ago, my husband, Dell, and I have dreamed of having a 10-year-old grandchild. Four years ago, that seemed very doable.
At 50, I had three children in their early twenties. I led an active, healthy lifestyle: exercising, no drinking, no drug use. I got the flu vaccine and a mammogram every year. I had never been on a prescription other than an antibiotic in my life. I had normal blood pressure and enviable cholesterol levels, and no risk factors or family history of heart problems.
In fact, I had a medical evaluation and was told I had less than a 3% chance of ever developing heart disease. Three weeks later, on Nov. 27, 2015, I almost died from heart failure brought on by a virus, severe idiopathic dilated cardiomyopathy.
I have often looked in the mirror over the past four years and wondered, “How did I get here?” But perhaps the better question is, “How am I still here?” At least three advances in the treatment and understanding of heart failure have preserved or prolonged my life. The first is awareness of how sodium affects the heart.
Lori Ann Wood
I loved cooking for my family. We almost always ate balanced meals at home, but I wasn’t tuned in to sodium. Right before Thanksgiving, I was nursing what I thought was the flu with canned soup, saltines and sports drinks. But I didn’t know my heart was failing and that these remedies were overloading me with sodium, putting my weak heart into deep, almost irreparable distress.
My primary care doctor hospitalized me to drain the retained fluids. I remember being surprised and upset that after being sick for a week and missing Thanksgiving dinner, I had actually gained weight. I felt strangely vindicated when they drained 12 pounds of fluid, almost 9% of my body weight. Much of that was due to sodium overload on a very weak heart.
I was moved to cardiac ICU with an ejection fraction of 8%. (Normal is around 55-70%.) I spent most of my 14 days in the hospital in ICU. I was given less than a 10% chance of surviving six months. I was emergency flighted to the Cleveland Clinic. Even after returning home, I remained my doctor’s most critical patient for a year and a half.
Once I was stabilized in the hospital that Black Friday, my doctors worked to find a drug that would help my heart without lowering my blood pressure too much. Medications are the second critical piece of my ongoing treatment. The first few drugs sent my heart into a lethal rhythm, but they finally found one that my heart could handle. We spent the next nine months slowly increasing the dosage.
Today, I am on a regimen of 16 pills a day. I will be on these drugs for the rest of my life. My primary drug, the beta blocker, was first used to treat heart failure in 1975. Over the first few months of treatment, this drug, along with expert dosing by amazing medical professionals, would work to save my life.
Medical devices are the third prong of innovations that have prolonged my life. After leaving the hospital following my heart failure diagnosis, I wore an external defibrillator for nine months. My doctors wanted to give my heart every opportunity to function on its own without more drastic measures. But by June of the following year, they were becoming increasingly concerned that my heart would need long-term help.
Eventually I had a device implanted to help boost my heart’s pumping power. My Cleveland Clinic doctor explained that a special three-lead biventricular pacemaker called a cardiac resynchronization therapy with defibrillator had recently been approved for use in heart failure cases that do not respond well enough to medication alone.
I was hesitant, but my doctor was thankful we had the option. Ten years ago, I would’ve been taken straight to transplant. So, three years ago, on my wedding anniversary, I had surgery in Cleveland to have the defibrillator placed under the skin on my left upper chest. The wires were run through a vein to my heart. Although it was heart-related, it was not the most romantic anniversary trip we’ve ever taken.
The Wood family — back row (l to r): daughters Emily and Maggie, Lori Ann and husband Dell; front row (l to r) son-in-law James and son Joel with four-legged friends Buford and Pearl
My ejection fraction improved dramatically. For now, I am holding my own, despite some ups and downs over the past three years. My doctors believe I might someday still need a heart transplant, which is another medical miracle that has become widely available in my lifetime.
My doctor put me on a low-sodium diet. The most difficult part of my daily battle is working diligently to stay under 1,000 mg of sodium. I’ve discovered that it involves so much more than passing up the salt shaker, as much of what we eat is packed with sodium. I have learned to meticulously read labels. And I have learned how to cook all over again. We make many foods from scratch, including bread and condiments, and we rarely eat in restaurants. Research on sodium, which started as early as the 1940s, saved my life and brought these simple (but not easy) changes to my lifestyle.
Despite all the innovations, heart failure is considered a chronic, progressive disease. There’s no cure, but most people can manage their symptoms and possibly slow the progression. Statistics say that my life expectancy is about 10 years after diagnosis — so six for me now — using all the current medical advances. If you’re doing the math, you know that won’t get me that 10-year-old granddaughter.
Still, the magic of the 10-year-old transcends this story. Somewhere, on what seemed like an ordinary day around the time my mother was a 10-year-old girl, someone discovered the harmful effects of sodium in heart failure.
Then in 1975, when I was 10, someone was working on the drug that would keep my heart beating. Amazingly, in the early 2000s, when my youngest daughter was 10, someone engineered the biventricular CRT-D I received to help my weak heart survive.
I am looking forward to the next miracle in this wave of constant innovation: a new and more effective drug, a leadless pacemaker, a new kind of artificial heart. Hopefully, we won’t have to wait until my granddaughter is 10 to see them. In this case, I hope the pattern is broken. I hope the magic happens much earlier.