Rickey Shumway Mission

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Grandpa and Grandma Shumway 50th Anniversary

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My Angel is 16! Dating and Driving

The Epistles of Spencer

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2012 Year in Review

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"Kath Lab" Shumway (Trevor's new nickname for me)

Dr. Cragun and Kathy (not quite out of anesthesia)

A little more awake, but still not completely.

Well, a few things have happened since my last post. After my stroke, I went to see my cardiologist, Dr. Cragun, about my PFO. A lot of people have PFOs, and evidence suggests that they can lead to strokes, but it is not totally conclusive yet.  Now that I've had a stroke, I am in a different category of risk, and Dr. Cragun suggested closing the hole in my heart and even said that if I were his wife, he'd close it tomorrow. He's an interventional cardiologist, which means that he does normal cardiology, but he also "intervenes" and does stuff with catheters, like closing PFOs, so we we scheduled the procedure with him for December 7, 2012.

It was a busy week leading up to the procedure and some days I was overwhelmed and over-worked--of course by my own choice.  The night before the surgery we were up until 1 am getting stuff done and ready, not necessarily for the surgery, but getting Christmas cards ready and photos printed and cut so that I could stuff envelopes while sitting around in the hospital recovering.  I also waffled back and forth about doing ginger bread houses, but decided to go ahead with tradition, so with the kids we rolled out the dough and cut out the houses late Thursday night.

On the morning of the 7th we arrived at the hospital at 5:30 am. They took me into the Cath Lab at about 7:40. The procedure called for a catheter to be inserted into the femoral vein in my upper thigh and groin (a vein big enough to allow them to go all the way to the heart). The catheter would then be pushed up to my heart, then the doctor would deploy two Gore-tex "umbrellas", called the Gore-Helex (about the size of a quarter), on both sides of the hole in my heart, then cinch them up to seal the hole (heart tissue will then grow over the Gore-tex implants and make it a permanent part of my heart). The procedure went well, lasting about an hour. However, the doctor discovered that the hole in the heart was bigger than they expected, so my hole was "upgraded" from a PFO, to what is called an atrial septal defect (ASD). PFO's only occasionally shunt blood where it is not supposed to go and are about the size of a pea, but an ASD is a hole big enough that it's constantly shunting blood back and forth.

I've been sad all week-end as I realized that I've had a heart defect all my life and that I've never even known.  I'm kind of in mourning. I also feel very weak and will take a little time to fully recover from the repair in my heart.  I looked up some details on ASDs and here are a few details about the research I've learned about the defect.  

"Atrial Septal Defect Complications

Over time, if an ASD isn't repaired, the extra blood flow to the right side of the heart and lungs may cause heart problems. Usually, most of these problems don't show up until adulthood, often around age 30 or later. Complications are rare in infants and children.

Possible complications include:

Right heart failure. An ASD causes the right side of the heart to work harder because it has to pump extra blood to the lungs. Over time, the heart may become tired from this extra work and not pump well.

Arrhythmias (ah-RITH-me-ahs). Extra blood flowing into the right atrium through an ASD can cause the atrium to stretch and enlarge. Over time, this can lead to arrhythmias (irregular heartbeats). Arrhythmia symptoms may include palpitations or a rapid heartbeat.

Stroke. Usually, the lungs filter out small blood clots that can form on the right side of the heart. Sometimes a blood clot can pass from the right atrium to the left atrium through an ASD and be pumped out to the body. This type of clot can travel to an artery in the brain, block blood flow, and cause a stroke.

Pulmonary hypertension (PH). PH is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. Over time, PH can damage the arteries and small blood vessels in the lungs. They become thick and stiff, making it harder for blood to flow through them."

As I ponder the last 3 weeks and all that's gone on with my health, I am just VERY grateful that I was able to discover the heart problem and get it repaired so quickly and that the Lord has blessed me with no lasting side-effects from the stroke.  I do worry about all the years that I've pushed myself physically, and hope that I don't have any of the other side-effects (like pulmonary hypertension or arrhythmias). But I will be under close follow-up with my cardiologist. I will find out there are different levels of ASDs, and where mine fits into the spectrum of bad to mild.  The doctors are having me wear a 30 day pocket ecg monitor that will check for arrhythmias. 

I slept a lot in the hospital after the procedure was over. Jeff stayed with me for a few hours, then went home to be with the kids, who helped him finish raking the leaves in the back yard. Mikelle came and stayed with me for a few hours in the evening before Jeff came and picked her up. I also got visits from some other family members. I came home Saturday morning. The doctors said I could start walking around right away, but that I should not do vigorous exercise or lift anything over ten pounds for a few weeks. They don't want my catheter site to start bleeding but mainly they don't want my Gore-tex umbrellas to shift position.

So, when I got home, the house looked pretty good, but my instinct took me down to the laundry room where I started cleaning up and lifting clothes bins. Jeff immediately got after me and ushered me to bed where I quickly fell asleep for about three hours and basically rested the whole day through--missing 3 of the kids activities I'd originally thought I'd be fine to attend. I felt weak and tired all day, but I felt better on Sunday and enjoyed church, a nap and then we had a ball as we decorated the ginger bread houses with the kids (see photos below).

I am so grateful to the Lord for our family's blessings. I feel blessed from my 2 sons and their missionary service.  Family and ward members have also been so generous with bringing food and helping with the kids etc.  I am thankful for all the prayers and fasting offered on my behalf. The Lord is watching over our family and we are so aware of His hand in our lives and ever so grateful.

Kathy's Thanksgiving in Hospital

On Tuesday, November 20, 2012 we were getting ready to leave to Grand Junction, Colorado, for Thanksgiving with Jeff's sister Emily.   All the kids were at school and Jeff was working on getting one our cars started.  Before he left to work we went to say our morning prayer.  I was sitting at the computer desk and quickly turned my head to kneel down by him.  When I turned my head, something went "swoosh" in the right side of my head and it felt really weird.  As I knelt with Jeff and tried to say the  prayer,  I couldn't speak except for a few mumblings.  Jeff gave me a strange look, and I looked at him with panic.  My speech came back, but I told him my tongue was numb and my face, arm, and leg were going numb as well.  I kept saying that something was wrong.  I walked to the couch and lay down for a minute.  Jeff gave me a blessing, then insisted that we head right to the hospital.  I was hesitant and told him to wait a minute and see what was happening.  "Maybe we should just go to our regular doctor," I told him. He would have none of it and he helped me into the car.  I didn't resist because I knew these were stroke symptoms.  I also remember hearing about how women many times delay going to the hospital and how it hurts them in the long run.  If Jeff had not been home, I would have just gone to lay down and rest though.  I would not have taken myself, nor called someone to take me to the hospital.  I am so grateful that he was home.

The symptoms persisted and I felt very weird.  I wasn't in any real pain, but I felt very strange.  As we drove I was so worried about losing consciousness and no one knowing about our neighbor's girl who I was supposed to pick up from kindergarten with TImothy at 11:40am.  Her  parents were going to be inside the temple and no one would know how to reach them.  I kept telling Jeff to get the text off my phone of our neighbor's sister's address so he'd know the aunt's address of where to drop her in case something happened to me.  I also noticed big beads of sweat all over my forehead that were so out of the normal, since I rarely sweat.

I had a hard time walking when we got to the ER.  I still felt very weird as I walked in and the immediately took me and started my vitals.  I had high blood pressure, which I normally never do, but that's common occurrence during a stroke I learned.  They took me immediately back and started asking questions and checking my ability to feel on my right and left sides.  They did a CT scan and found abnormal results, so they immediately ordered an MRI.  They also discussed a miracle "clot busting" drug called tPA which, if used within the first 3 hours of a stroke, can prevent further damage and help damaged brain tissue recover.  There were some risks in using the drug.  Because it is a powerful de-clotter, it can cause other kinds of bleeding in the brain and body.  Once this drug is used, the patient has to be evaluated very closely in the ICU for 24 hours.  We weren't sure about using it but once they started the MRI and confirmed that it was a stroke, which means they saw evidence of a blockage in the brain, and they could see that some tissue was at risk.  The doctors were hoping that it might be a variation of a migraine, but the scans showed that indeed it was a stroke.  They immediately  pulled me out of the MRI machine and asked if they could administer the anti-clotting drug, tPA.  I gave them a thumbs up, knowing it meant I'd be getting checked in to the ICU for at least a day.

I was so glad that the neurologist on call that day was Trevor and Aaron's good friends' dad, Kevin Call.  He is one of the nicest men and an excellent doctor.  He is in the same ward as Jeff's parents and sister Angela, and he also just got made Angela's home teacher and his wife is Angela's visiting teacher.  Dr. Call's wife was the first one to offer dinner to our family that night and I took her up on it, gratefully.  Many more offers came in later as people heard about the day. It was a great comfort to have Kevin Call as my Dr.  I trust him and told him to do for me what he would for his wife, if she were in this situation.  During all of this time, I was stressed, but never too scared, by the way.  I didn't really believe anything was happening. My numbness symptoms subsided after a half an hour and my speaking difficulty didn't last long at all--just long enough to scare me and make me get to the hospital.  One blessing is that we got the medicine started so quickly.  I was in a very serious situation, but the medicine helped, and when when we finished the MRI, it showed that there didn't appear to be any permanent damage to any parts of my brain, which means no lasting effects from the stroke.  We asked if this might be a TIA (stroke-like symptoms, but no evidence of a stroke in the scans), but they said that this was a stoke, even though my symptoms lasted only about an hour.  Perhaps it is because TIA's have no visible evidence in the scans, but since they could see evidence of blockage in the brain, then it is classified as a stroke.

Of course I was wondering what caused the stroke in the first place, and what I could do to prevent it from happening again.   The last thing I remember doing is turning my head, then I felt the "whooosh" and the numbness.  I was scared it would happen again.   I also wondered if I would always be afraid of having another one of these again.

I actually knew that I have some small heart problems that made me a more likely candidate for a stroke.  I have what is called a "patent foramen oval" (PFO) which means the hole in my heart (that everyone has in the womb) never fully closed after my birth.  I found this out when me and my whole family had echocardiograms after Timothy's 3rd open heart surgery.  The doctors at Primary Childrens were doing a study to see if there was evidence in other family members of a child with hypoplastic left heart syndrome like Timothy.   Everyone was fine, except they discovered a PFO in my heart, as well as an atrial aneurism.  I didn't like the sound of either of those, but the cardiologists said they were both minor, and they did not suggest taking any action.  I learned that a PFO causes an increased risk of stroke so I saw a cardiologist a few years ago who suggested I start on an aspirin a day, which I did for a year or so, but then stopped for some reason.  I started the aspirin therapy and will be doing it for the rest of my life.

One problem is that a small stroke, even if caught and treated early, can be a precursor to a larger stroke.  The doctors decided to keep me for 2 days in the hospital to keep a close watch on me--one day in the adult ICU and the second day in the recovery wing.  I  also will be monitored for the next few weeks and am wearing a pocket holster heart monitor for 30 days.  It's awesome to see me with 4 devices hooked to my belt, as I always carry the home and cell phone on my person.   They said they wanted me staying close to UVRMC in case any symptoms return.  They also said I should call 911 next time because  paramedics can start the IV's and have all the vitals checked and have the stroke team gathered and ready in the ambulance by the time I arrive.  I was SO disappointed that it meant we couldn't go to Grand Junction for Thanksgiving to be with Jeff's sister Emily and Jon Pfeifer, like we'd been planning.  Emily, her kids, and our kids were all disappointed.  All the other Shumway's were going to Doug and Jen's in Bountiful for Thanksgiving, and they invited us there, but that would have put us an hour away from UVRMC, so we knew we were staying home.   How happy we were when Emily and Jon decided to come to our home for Thanksgiving dinner.  Jon dropped work, they loaded up right then and came to do their shopping, cooking and all the Thanksgiving preparations at our home.  We had a great time relaxing, eating, and watching some of the Horatio Hornblower series.  The doctors told me to take it easy for the next many days.  Jeff has had to order me out of the kitchen a number of times.

After running a lot of thorough tests and taking blood draws and ultrasounds, CT scans etc my stroke was declared a "cryptogenic" stroke, which means its cause is unknown.  My blood pressure was low if anything, cholesterol was fine, no clots in the legs, all blood draws normal etc.  To me, it points to the PFO as a probable cause.  However,  there is a lot of debate about whether closing the PFO really helps stop a stroke recurrence.  I know that having the atrial aneurism in addition to the PFO raises the risk of a repeated stroke.   One reason the PFO causes strokes is that, apparently, if we have little clots in our blood, they can be filtered when they pass through the lungs.  But with a PFO, there is a hole between the two atria of the heart, and blood can jump from one atrium to the other, which increases the chances that a clot could get through and go up to the brain.   Closing the PFO used to be done in open heart surgery, but now within the last 5 years, they've been doing it in the "Cath lab" (they insert a catheter through a vein in the groin and they go up to the heart and fix things).  It's a lot less invasive, but it also entails putting little metal "umbrellas" in the arteries to enable the catheter to get to the heart, and the long-term effects of those umbrellas are not clear.

The doctors and nurses kept telling me that I need to be VERY grateful that I'm doing this good, and that I have zero "deficits" (no physical or verbal problems).  They said that 2 weeks ago they had a woman about my age come in with similar symptoms and before they could start the medicine she had a bigger stroke that they couldn't stop.  She ended up dying.  WOW!   All the nurses kept saying the same thing, adding that they were surprised that I didn't need physical therapy to re-learn things. I know strokes are not to be trifled with and that they are deadly, but I just didn't know how grateful I should be.  It's so easy to take things and life for granted and we can easily get into a rut.  I get so caught up in the crazy schedules that sometimes I don't take the time to be thankful and grateful for the MANY MANY blessings I have.   Please let it be known to you that I am so thankful for the gospel in my life.  I am so grateful to Jesus Christ and His Atonement. I am so eternally grateful for my husband.  He is the BEST man in the world and I can't imagine life without him.  I am so grateful to be blessed to be a mother to 7 wonderful children and look forward to years of fun together with them and their spouses and grandchildren some day. I am so grateful that I have 2 sons out serving the Lord on full-time missions (in South Dakota & Chile)  I am also so thankful for my parents and my in-laws and siblings and in-laws on both sides.  I'm so thankful for dear friends and ward members and just want to express my love and gratitude for each of you and thank you each.  You mean so much to me and I appreciate the many offers for help that we've received.  I hope you all had a happy Thanksgiving and I hope you enjoy this wonderful Christmas season already upon us.

Both Kathy's

Dr. Call with Kathy and Jeff