Her deadly diagnosis made pregnancy risky But this Houston woman took the leap Garcia - Bindu Akkanti HEAD TOPICS

Her deadly diagnosis made pregnancy risky But this Houston woman took the leap

10/22/2022 9:45:00 PM

In September 2021 Garcia learned she was pregnant For months she was healthy

Garcia Bindu Akkanti

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Houston Chronicle

After being diagnosed with pulmonary arterial hypertension, this Houston woman didn't know if she'd be able to have children. At 27, she did. But it took several months in the hospital, and weeks in the NICU for her child. In September 2021 Garcia learned she was pregnant For months she was healthy Show LessMORE FROM LINDSAY PEYTON:But that was not the last Garcia would hear of pulmonary arterial hypertension.Then, Garcia signed up for the genetic test, which confirmed that she also carried BMPR2, the gene mutation responsible for the disease. Simply having the marker, however, is not a guarantee of developing the disorder, Akkanti explained. Patients require frequent visits to the clinic and echocardiograms. “They need to be on top of it, so they don’t do anything that makes it worse,” Akkanti said.She was especially hopeful because her aunt with the disorder had two successful pregnancies before the gene was expressed. Read more:
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Covid was a contributing factor in 25% of maternal deaths in 2020 and 2021Pregnancy-related deaths have spiked nearly 80% since 2018, according to a new government report. What 😷💉💉💉💉 could possibly be causing this? Just FYI, 1/4th is a lot... Scary. Police Board Member Votes For Evidentiary Hearings For Officer Who Fatally Shot Adam Toledo in 2021Following a recommendation from the Civilian Office of Police Accountability, the Chicago Police Board has voted for further review for officer Eric Stillman, who fatally shot 13-year-old Adam Toledo following a foot chase in Little Village on March 29, 2021. Suicides in the military decreased by 15% in 2021, Pentagon report findsThe suicide among active duty service members decreased by over 15% in 2021, but there is still a gradually increasing trend in suicides in the military over a ten-year period. The government would rather give billions to Ukraine then help veterans And the military isn't at 60% of their 2022 recruitment goal... 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That’s how America apologizes $$$$ COVID was a contributing factor in 25% of maternal deaths in 2020 and 2021Pregnancy-related deaths have spiked nearly 80% since 2018, according to a new government report. of 10 Brooke Garcia, a pulmonary hypertension patient, takes her 6-month-old son, Luca, to her check-up appointment with her doctors Tuesday, Sept.Bitcoin trading flat Thursday, with little movement over the last 24 hours.pandemic stress has intensified depression , a common condition during pregnancy.22-year-old Anthony Alvarez in Portage Park, also in March 2021. 27, 2022, at Memorial Hermann in Houston. Yi-Chin Lee/Staff photographer Show Less One of Brooke Garcia’s earliest memories is of her mother in tears. Bitcoin's 30-day volatility has dipped below that of the S&P 500. “I remember her sitting at her vanity in her bedroom and thinking, ‘Why is mom crying?’” she said. “Mental health is the greatest complication in pregnancy that we don’t understand,” she said. Garcia, now 27, was only 3 the day her mother, Lee Ann Doskocil, was diagnosed with pulmonary arterial hypertension, high blood pressure in the vessels leading from the heart to the lungs, which can cause cardiac arrest. Oct 20, 2022. MORE FROM LINDSAY PEYTON: She mistook an aneurysm for a panic attack. During that chase, one of the two responding officers, Eric Stillman, opened fire, fatally striking Adam in the chest. Now, this Houston woman is using her platform for good. The maternal death rate is particularly stark for Black women, who have long faced worse maternal outcomes than their peers. Doskocil was told that her condition was so severe that she would not likely live to see her twin daughters’ sixth birthday. With the help of pulmonologist Dr. Adaani Frost at Houston Methodist, Doskocil lived until Garcia and her sister, Briana Saenz, turned 13 in 2009. White women had death rates of 26. But that was not the last Garcia would hear of pulmonary arterial hypertension. Initially, COPA said that bodycam footage of the shooting would not be released, citing Adam's age as the agency could not publicly release video involving a juvenile without a court order. Her grandmother also had the diagnosis and eventually received a double lung transplant. One aunt succumbed to the disease, before her family learned that she had the condition. Death rates among Hispanics had been on the decline, but they swelled again during the pandemic from 12. Another aunt is currently living with pulmonary arterial hypertension, while two more carry the gene. “It’s mind-boggling to me how one disease can affect a family like this,” Garcia said. “It’s just crazy. Black and Hispanic people have also died at higher rates from Covid-19, in part because they have less access to medical care and more often work essential jobs that expose them to the virus. Elizabeth Toledo, Adam's mother, told police he left the home again in the overnight hours of March 27-28, and she had not seen him since then. ” In 2018, Garcia’s twin sister was diagnosed – and started seeing pulmonologist Dr. Bindu Akkanti, with UTHealth Houston Division of Pulmonary and Critical Care and director of Heart and Vascular Care at Memorial Hermann. Akkanti had been trained by Frost. More than half of rural counties didn’t have a hospital offering pregnancy care as of 2018, the review found. Then, Garcia signed up for the genetic test, which confirmed that she also carried BMPR2, the gene mutation responsible for the disease. Simply having the marker, however, is not a guarantee of developing the disorder, Akkanti explained. Adam appears to pause near a fence bordering a parking lot at the end of the alley and turn toward the officer with his hands up. “It increases the susceptibility,” she said. And if you have the gene, it’s important to keep an eye on it to see if it becomes expressed. “Once you develop pulmonary arterial hypertension, it can be deadly,” Akkanti said. “That’s if you’re not diagnosed on time or if you’re not on the right therapies.” Patients require frequent visits to the clinic and echocardiograms." Read more. “They need to be on top of it, so they don’t do anything that makes it worse,” Akkanti said. Heading to Houston The stress to the body during pregnancy and labor can result in mortality in mothers with pulmonary arterial hypertension. Still, Garcia’s OB-GYN told her a healthy pregnancy was possible, since she had no symptoms. “My labs were normal, so we thought, if we’re going to have a baby, this would be the time,” Garcia said. She was especially hopeful because her aunt with the disorder had two successful pregnancies before the gene was expressed. In September 2021, Garcia learned she was pregnant. For months, she was healthy. “Everything was going great,” she said. That changed in late December. If anyone could detect the warning signs, Garcia thought, she would. After all, she works as a night nurse at the intensive care unit and ER in a hospital in her hometown of Beeville. Still, when Garcia arrived at work dizzy and out of breath one night, she did not suspect the cause. Her supervisor sent her home. But it happened again – and again. Garcia would show up for work, then struggle to catch her breath, find it difficult to talk to her patients or make her rounds. Her heart rate was increasingly high. Her OB-GYN recommended she see a maternal-fetal physician, a specialist in complicated pregnancies. Finally, Garcia was sent to a cardiologist for an echocardiogram. She was pulling into her driveway after the test when she received a call one Thursday. “You have severe pulmonary arterial hypertension,” the doctor said. “You need to contact your Houston doctor immediately.” Garcia texted Akkanti’s nurse-practitioner with the news. They told her to come in on Tuesday. With her baby shower scheduled that weekend, Garcia did not tell anyone she would be heading to Houston in a couple of days. She did not want anyone to worry. After the party, Garcia packed a bag. Her husband, Ryan, asked why she needed a suitcase, when they were just going for an appointment. “In my head, I knew that I would not be coming home,” she said. Riding a seesaw Garcia was 27 weeks pregnant when she arrived at Memorial-Hermann in the Texas Medical Center. Akkanti was waiting. MORE FROM LINDSAY PEYTON: “Immediately she got an ultrasound,” Akkanti recalled. “It was very evident how much worse it was. It was to the point where she had signs of right heart failure.” Garcia’s liver was also affected. Akkanti was well aware that as the pregnancy progressed, Garcia’s condition could decline. “We knew that the baby was going to put more strain on her heart,” Akkanti said. “We sat down and explained how dangerous this could be.” Garcia needed to stay at Memorial Hermann until delivery. She was placed on medication to build up her heart strength – and to lower her elevated pulmonary pressures. In the meantime, a team of caregivers was assembled from UTHealth Houston Heart and Vascular and Memorial Hermann. Akkanti was joined by cardiologists Dr. Maria Patarroyo and Dr. Sukhdeep Basra, cardiothoracic and vascular surgeon Dr. Ismael Salas, maternal fetal specialist Dr. Sean Blackwell and obstetric anesthesiologist Dr. Barbara Orlando, as well as Dr. Yafen Liang with cardiovascular anesthesia. Each brought in their teams of physicians and nurses. Also coordinating the effort was Sandra Uribe, nurse navigator at the Women’s Center at Children’s Memorial Hermann Hospital. “We would meet on Zoom at least once a week to make sure everything was in place,” Akkanti said. The goal was to wait as long as possible before performing a C-section for the safety of the baby, she explained. But the further along Garcia moved through her pregnancy, the more the stress on her body increased. Akkanti described it as a seesaw: Finding the right balance was crucial for timing the delivery, to protect the welfare of both mother and child. At 31 weeks, in March, it was go time. “This would be the safest time, the best-case scenario,” Garcia recalled. She knew a high level of risk remained. Before heading into the operation, she kissed her husband goodbye and started to cry. “I really thought it would be the last time I'd ever see my husband,” she said. She said a silent prayer, asking God that if he had to take her, to at least let her hear her baby’s cry first. Then, she was wheeled back in for the operation. Time for operation A multidisciplinary team was at the ready – complete with an extracorporeal membrane oxygenation (ECMO) machine outside the room manned by Basra. The neonatal intensive care unit was also standing by with an incubator. “If she had a cardiac arrest during the surgery, we wanted to do everything we could to support her,” Akkanti said. “We deal with heart failure on a daily basis, but there is limited experience at any center in regard to patients with pulmonary arterial hypertension and high-risk pregnancy.” Still, Garcia provided them with more than enough inspiration. “Her strength gave us strength,” Akkanti said. “We have the experience and skill – and you combine that with a whole lot of faith. Then you do the very best you can, what you would do for your own daughter or mother.” When Garcia’s heart began to race during delivery, the team was there with a planned response. Then, baby Luca was born and taken to the NICU, while Garcia rapidly stabilized. She could hear her son cry after taking his first breath and thought, “Ok, God, you can take me now.” Instead, she quickly recovered, hitting one milestone after another. Nurses helped her visit Luca in NICU each day until she was released March 14, just in time for her 27th birthday. “What those nurses did for me to see Luca, I will never, ever be able to repay them,” she said. Luca was discharged April 15, after 46 days in the NICU. “He’s been great ever since,” Garcia said. Still, her battle with pulmonary arterial hypertension is not over. She goes with her sister to appointments with Akkanti and Patarroyo every three months. Garcia will continue with medications administered through an IV pump in her chest, the same pump as her mother and grandmother had. “There is no cure for pulmonary hypertension,” Garcia said. “The treatment is to slow the progression of the disease. The goal is to put off a lung transplant for as long as possible.” Akkanti explained that pulmonary arterial hypertension is considered an “orphan disease,” meaning it affects fewer than 200,000 people in the U.S. “They are neglected diseases,” Akkanti said. “And if you don’t develop treatments for them, more will die.” MORE FROM LINDSAY PEYTON: Garcia, who was inspired by her mother to pursue a career in medicine, is optimistic that more advances will come. “If you have faith, and you have hope and a good medical team, the possibilities are endless,” she said. Her sister also graduated as a registered nurse in 2020. Both women exemplify why being proactive with health is important, Akkanti said. Many individuals could be out of breath and never search for the cause, assuming they may simply be out of shape. “With pulmonary arterial hypertension, that kind of mistake can be fatal,” she said. Genetic testing and specialized clinics have made it easier to diagnose – and Houston has resources available for top-notch care, Akkanti said. “There really is a village to support them,” she added. When the twins come for an appointment, especially now with Luca, Akkanti said, “my heart is absolutely filled. ” Garcia has the same feeling whenever she gazes at Luca. “I look at him, and I am in awe,” she said. “We have come so far in six months. We really have.” Lindsay Peyton is a Houston-based freelance writer. .