Kim Caroline

December 2003

Greetings,

My name is Kim Caroline. I’m 37 years old.

I grew up corn-fed and silver-spooned in Indiana, inheriting privilege and a persistent desire to reinvent myself. My father, “Heir Doktor” was a poor German immigrant who ripened into a neurosurgeon, champion tennis player and (unlikely) Civil Rights advocate. My mother, the daughter of an Indiana artist and business professor, is a Biologist-turned Interior Designer. (She has a penchant for knowing the names of anything living or gold-embossed). My brothers and sister have similar spirits of reinvention, focus and creativity that have wrought fortune or ruin.    

I earned an undergraduate degree in the Humanities from Indiana University and a graduate degree in American Studies from Columbia University where I lived adjacent to the silvery Twin Towers in Battery Park City. (What a memory!) After college, I worked on Capitol Hill for the US Judiciary Committee and two Midwestern congressmen. My most cherished DC memory: I pushed a bill that became law to fight telemarketing crimes targeting the Elderly.    

Last year, I retired young as director of a popular online company’s International programming division (where I briefly reported to the Chief Operating Officer). I lived an extraordinary life for my age – at least by American standards of money and mobility. My husband and I had “hot” jobs at one of the “hottest” companies during the .com boom, traveling First Class overseas and affording anything and everything, including an expensive home in suburban Washington, DC. (We didn’t feel the invincible energy of the new millennium, we were that energy!) God seemed superfluous. 

Then last year, I went to see a doctor for breathing pressure and strong pulsations in my neck. To put it simply, something didn’t feel right. After a quick listen with a stethoscope, I was misdiagnosed with Mitral Valve Prolapse and told to take antibiotics before dental procedures. And if my symptoms became “really bothersome,” he winked and said I could try Xanax.

I’m a blonde.

The symptoms did become “bothersome” and instead of reaching for the phone, I sought a second opinion from a cardiologist who really listened to my heart. To my surprise, he ordered an echocardiogram the next day.

I eventually was diagnosed with “significant” Aortic and Tricuspid Insufficiency. In the blink of an eye – a nanosecond in Internet time – I was "Kim with no heart disease" to "Kim with."

I felt like Spock on planet Earth.

I was also a few days pregnant with my third child when I got the news. One Sunday during the second trimester of my pregnancy, I noticed a prominent varicose vein on my right leg connected to a warm, purple mass on my knee. I thought it was inflammation from walking barefoot on the beach but called my OB and described what I had found. He told me to take a couple of Motrin and see him the next day.

When I finally saw him he said, “You didn’t tell me there was vein involvement!” and ordered an emergency sonogram of the arteries in my right leg.

I didn’t tell him? I most certainly did!

The hospital radiologist diagnosed me with Superficial Venous Thrombophlebitis – not Deep Vein Thrombosis – and warned that the blood clot in my knee could travel. I was instructed to keep my leg elevated, use warm compresses and wear support hose.

This was the same week that a young CNN reporter died from a pulmonary embolism in Iraq. Oh, the irony.

I felt caught off guard, trapped and anxious about the phlebitis, valve disease and health of my unborn child. And for the first time in my life, I drafted a Living Will and Last Testament. I also sought counseling from our church and began to recognize that I was going through the normal stages of grief:

Shock

Emotional Release

Depression

Physical Symptoms of Distress

Anxiety or Panic

Guilt

Anger or Hostility

Inactivity or Fatigue

Gradual Recovery

Adjustment

I began to educate myself about cardiovascular disease. I bought an informative heart book by the Mayo Clinic, researched health Web sites and learned to recognize the symptoms of a pulmonary embolism and heart failure. This world was unfamiliar and profoundly foreign to me. I really felt like I stepped off the USS Enterprise!

But gradually through the support I receive from family, friends and the amazing VR.com and local church community, I’ve learned to adjust to the unpredictability of my health and future.

After a couple of instances of pre-term labor and a prescription of bed rest, I finally made it to Term and went into labor fast – the contractions were a minute-and-a-half apart when I arrived at the hospital, which meant that I couldn’t travel to a larger tertiary center where I was scheduled for an induction the very next day!  

During early Labor, the night nurse at our small local hosptial, (a woman who traveled from another city for her job) neglected to take my blood pressure for several hours, although I was complaining of chest pressure. I had complained of the pressure throughout my pregnancy.

Then my anesthesiologist– a tall German who wore a bandana around his head like the nefarious Dr. Romano on television’s ER – walked into the Delivery room, picked up my chart and voiced surprise that I had Tricuspid and Aortic Insufficiency. He also cursed the nurse for neglecting to take my BP and asked how I was feeling. I said I felt cold. He went into crisis mode, triggering a commotion of BP and pulse ox readings. My husband anxiously paced in the background.

My BP was 58/27 and I was crashing.

Within seconds or minutes, the anesthesiologist administered Epinephrine (adrenaline) to stimulate my heart. Amazingly, the chest tightness went away along with the agonizing questions I had about whether or not the discomfort I had been feeling was heart or anxiety-related. Talk about learning to trust your instincts the hard way!

I received Epinephrine several times that night. I also fainted and was asked for my Living Will and whether or not I was an organ donor. Later, the nurse said, “Your lips had turned white,” when apologizing after I had recovered. (Thanks).

By the grace of God (and under the care of an alert anesthesiologist), I delivered a healthy seven-pound baby boy at 3:30am on July 23, 2003.

I still can’t believe how beautiful and wondrous he is.

The morning after delivery, my OB sat down beside my hospital bed and said, “What you have can kill you. It can kill you. I recommend going on antidepressant to help you cope.”

All of the sudden, I was shocked back into reality. Hadn’t I just successfully delivered a child, albeit the drama? Couldn’t my condition have been transient?

That night, I woke up crying from a nightmare, something I haven't experienced since childhood. I also went into the hospital nursery and held my tiny son, trying to understand my OB’s words. I didn’t want anyone or anything ruin the joy and relief I was feeling – we were survivors!

A week later, my cardiologist ordered a Stress Echocardiogram that revealed Markedly Abnormal Sinus Bradycardia, moderate Aortic and Tricuspid Insufficiency and a mildly dilated Left Ventricle.

Ironically, I was relieved to have “evidence” that all the symptoms I had been complaining about – debilitating fatigue, lightheadedness, arrhythmia and chest pressure – were not only due to the normal changes of pregnancy as my old (now fired) primary care doc and OB had theorized. (My OB later half-heartedly apologized, saying something to the effect that aortic insufficiency is rare).

Now, when I visit my cardiologist, he now quizzes me about the symptoms of Congestive Heart Failure: "Have you woken up at night gasping for breath?” and "Are you still exercising?" For someone who never set foot in a cardiologist's office until recently, his questions seem absolutely surreal.  

Bottom line, the last year was one of the hardest physical and emotional challenges I’ve ever had to face. (God bless those who face debilitating and life-threatening health challenges daily!) I am profoundly different than I was a year ago. I have confronted my mortality and found peace. I look at my children more tenderly, taking snapshots of their faces and every advantage of opportunities to teach them values like courage, integrity and compassion. And I love my husband more deeply. He stood up to the plate and swung multiple home runs for the team.  

A year ago I prayed, “Create a new heart in me and grant me peace.”

God answered both my prayers, but not in the way I had expected. I am grateful and in awe of His grace and mercy.

Peace,

Kim Caroline