Women who survive a heart attack caused by a condition called SCAD are usually told not to have children due to the risk of it happening again. Now the first babies are being born at the world's first clinic that helps heart attack survivors to have a baby.
Hayley Martin, 47, vividly remembers the morning her life changed forever.
"I woke up and I felt very, very poorly. I put my hands to my head and I was drenched in sweat. I knew straight away it was a heart attack," she told the BBC's Victoria Derbyshire programme.
She was a healthy 38-year-old when she had a Spontaneous Coronary Artery Dissection (SCAD), a rare and often undiagnosed condition.
It is the leading cause of heart attacks in women of childbearing age, affecting around 1,000 women a year.
It occurs when there is a sudden tear in one of the coronary arteries, blocking the flow of blood to the heart.
In hospital, Hayley, from Congleton in Cheshire, feared the worst.
"I can remember saying to them, 'am I dying?' And they just kept saying, 'we've tried everything we can, but nothing is working,'" she said.
'I felt less of a woman'
She survived, but like many women with SCAD, was told pregnancy would mean the risk of another heart attack.
"I think it was another thing that was stolen from me, so I almost don't allow myself to think about it, because it could take you down a dark path of sadness," Hayley reflected.
"I felt less of a person, less of a woman, more of a failure, like I was faulty."
What is SCAD?
- Spontaneous Coronary Artery Dissection (SCAD) is an under-diagnosed heart condition
- It affects mainly women, occasionally during – or soon after – pregnancy
- Menopause, extreme stress and exercise have also been associated with it
- During an attack, a sudden tear or bruise develops in one of the coronary arteries blocking the blood follow
- It can cause death, heart failure, cardiac arrest, and require heart bypass surgery
Hayley is the kind of woman who consultant cardiologist Dr Abi Al-Hussaini is trying to help, with her clinic at the Chelsea and Westminster Hospital.
Dr Al-Hussaini assesses the damage done to the heart by the SCAD and reviews the patient's medication, generally lowering the amount they are on.
She uses that information to advise the patient how risky a pregnancy could be.
This does mean sometimes she has to advise that the risk to health might be very high, but the key is the patient makes the decision, rather than the usual blanket advice not to get pregnant.
If one of her patients decides to proceed, they are referred to the pre-existing "high risk pregnancy team" at the hospital, who monitor them throughout the pregnancy.
"I have seen a lot of patients over the last few years who have come to me unhappy that they have been told they cannot have a child ever again," she explained.
"That's one of the reasons I established the clinic, to give these patients the correct advice and allow them to make an informed decision themselves."
She believes a lack of research into the condition is why most cardiologists prefer the blanket advice.
One of the first women helped by the clinic was Julie Murphy, 40, from Ruislip.
Shortly before her honeymoon in 2013, she started to feel unwell, like she had flu. While on holiday in Kenya, the symptoms got worse.
Then, while swimming, she had a sharp pain in her chest. When she got home, she had tests on her heart and, "the next day I found out I'd had a heart attack".
The days and weeks that followed were very tough.
"All the medication I was on really slowed me down so I couldn't even walk up the stairs when I came home from hospital. That was really difficult to get my head around," she says.
Like Hayley, Julie was initially told she would not be able to have children. But she became part of a research project led by Dr Al-Hussaini and had her first daughter, Holly, in 2015.
She then became one of the clinic's first patients when she became pregnant for a second time.
"I was worried that they would say there's no possibility or it would be too dangerous for us to try to have a baby, that it might mean that I'm putting my life at risk," she said.
Bella was born in April.
"They're such an awesome team that you felt so looked after," Julie said.
Despite the hope she is giving patients, Dr Al-Hussaini says she has encountered resistance from doctors around the world, in terms of what advice they give their patients.
"In America, they are against becoming pregnant any time after a heart attack, or having had a spontaneous coronary artery dissection," she said.
"But again, I think that's because there hasn't been a huge amount of research – but there is a growing amount of research at the moment that's been developed."
Officials investigating 252 possible cases of polio-like illness AFM
Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 con..
Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 confirmed cases in 27 states, according to the Centers for Disease Control and Prevention.
The number of cases under investigation by the CDC is up 33 from last week, and the number of confirmed cases rose by 10, Dr. Nancy Messonnier, the director of CDCs National Center for Immunization and Respiratory Diseases, told reporters Tuesday.
Acute flaccid myelitis is a condition that has polio-like symptoms such as partial paralysis. The virus mostly affects children and young adults. The CDC said they do not know why the condition is impacting these individuals, but many believe it is caused by viruses. The CDC emphasized it remains a rare condition and said there have been no reported deaths from AFM so far in 2018.
The typical symptoms of AFM are similar to those of a severe respiratory illness, along with a fever, but then progress into neurological symptoms. Some patients with AFM feel weakness in their arms or legs, a loss of muscle tone or slower reflexes.
Some patients may also exhibit facial droop or weakness, difficulty moving their eyes and drooping eyelids or difficulty with swallowing or slurred speech. The most severe symptom is respiratory failure.
Messonnier said the CDC doesn't yet have enough information to definitively say what causes AFM and are casting a wide net for information. Part of that is studying the long-term health of AFM patients. Scientists are also looking for a pathogen in AFM patients' spinal fluid, but haven't yet found a pathogen that's a clear cause, she said.
The CDC said it sees an uptick in AFM cases every two years, and so far, the curve of the cases being investigated this year looks very similar to that of 2014 and 2016.
Officials don't expect many more cases in 2018 compared to 2016 and 2014, Messonnier said.
The best advice available is to wash your hands regularly, which lowers the chances of getting sick or spreading germs from many of the viruses linked to AFM, and protect against mosquito bites by using repellent, in addition to staying indoors at dusk and dawn.
The CDC said the vaccines your pediatrician suggests are very effective and children should continue to receive them on schedule even though there is no vaccine for AFM. (more…)
‘Make-a-Wish’ wishes decrease trips to hospital for sick children: Study
A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in ..
A recent study from the Nationwide Childrens Hospital in Columbus, Ohio shows that participation in the Make-A-Wish program may give children better quality of life and reduce hospital visits and healthcare costs.
Patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients of similar age, gender, disease category, and disease complexity who would also quality for a wish but did not receive one.
What is the Make-A-Wish Foundation?
The Make-A-Wish Foundation is a non-profit organization whose goal is to provide children aged three to 17-years-old who have progressive, life-limiting, or life-threatening medical conditions, with experiences known as “wishes.” These wishes include “I wish to…” “go,” “be (someone for a day),” “meet,” and “have” (i.e. receive gifts.) The foundation is funded by contributions from individual donors, corporations, and other organizations.
What are the goals and mission of the Make-A-Wish Foundation?
The Make-A-Wish Foundation “serves a unique, and vital, role in helping strengthen and empower children battling illnesses.” And, “wishes make life better for kids with critical illnesses.”
How many “wishes” does the foundation grant?
The Make-A-Wish Foundation was founded in November 1980 and the first wish was granted in the spring of 1981 to Frank “Bopsy” Salazar, a 7-year-old who had leukemia. Bopsy had three wishes: to be a fireman, go to Disneyland, and ride in a hot air balloon — all of which were granted to him. Since then, more than 285,000 children in the United States and its territories have benefited from experiencing their wishes. The foundation granted 15,300 wishes last year alone; which means on average, a wish is granted every 34 minutes.
What are the potential benefits of receiving a “wish?"
There is a long-held belief that receiving a wish improves a childs quality of life and potentially improves their familys quality of life, enhances family bonding, reduces stress, increases hope and serves as a distraction from illness. (more…)
To curb STD rise, doctors treat patients’ partners without an office visit
This is a Kaiser Health News story.
If patients return to Dr. Crystal Bowe soon after taking medi..
If patients return to Dr. Crystal Bowe soon after taking medication for a sexually transmitted infection, she usually knows the reason: Their partners have re-infected them.
“While you tell people not to have sex until both folks are treated, they just dont wait,” she said. “So they are passing the infection back and forth.”
Thats when Bowe, who practices on both sides of the North and South Carolina border, does something doctors are often reluctant to do: She prescribes the partners antibiotics without meeting them.
Federal health officials have recommended this practice, known as expedited partner therapy, for chlamydia and gonorrhea since 2006. It allows doctors to prescribe medication to their patients partners without examining them. The idea is to prevent the kind of reinfections described by Bowe — and stop the transmission of STDs to others.
However, many physicians arent taking the federal governments advice because of entrenched ethical and legal concerns.
“Health care providers have a long tradition of being hesitant to prescribe to people they havent seen,” said Edward Hook, professor at the University of Alabamas medical school in Birmingham. “There is a certain skepticism.”
A nationwide surge of sexually transmitted diseases in recent years, however, has created a sense of urgency for doctors to embrace the practice. STD rates have hit an all-time high, according to the Centers for Diseases Control and Prevention. In 2017, the rate of reported gonorrhea cases increased nearly 19 percent from a year earlier to 555,608. The rate of chlamydia cases rose almost 7 percent to 1.7 million.
“STDs are everywhere,” said Dr. Cornelius Jamison, a lecturer at the University of Michigan Medical School. “We have to figure out how to … prevent the spread of these infections. And its necessary to be able to treat multiple people at once.”
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