A Third Chance on Life: Heart Failure after Surviving Cancer
When Stephanie Zimmerman was 8-years-old, she battled Ewings Sarcoma, a rare form of childhood cancer. Being so impacted by her experience, she became a pediatric oncology nurse practitioner with a special interest in the late effects of therapy. While doctors told her she may have some heart damage from the radiation and chemotherapy, Stephanie, now 38, continued to live a normal and productive life.
Knowing there were risks to having a child, she and her husband, John, welcomed their son Abel into the world five years ago. Thankfully, mom and Abel were doing just fine.
But as the years went by, Stephanie began experiencing increasing fatigue. Upon evaluation by her doctor in Atlanta, Georgia, she recommended a mitral and aortic valve repair, and she successfully received treatment at Cleveland Clinic in December 2007.
After returning to Atlanta, it became clear Stephanie's condition was much bigger than the valve repair, and she found herself back at the doctor with intolerable fatigue, shortness of breath and fluid retention.
“The repair unmasked the fact that the chemotherapy drug I had as a child did damage to the left ventricular muscle,” Stephanie recounts. “Once the valves were repaired, the left ventricle did not have a ‘pop off’ valve so to speak, and I spiraled into heart failure.”
Unfortunately, Stephanie was told she was in heart failure and the only option looked to be a transplant.
Her husband, John, knew this was a major surgery and recovery would take a long time given how very sick she was entering into the transplant. Their preference would have been to have the transplant in their home city; however, after John had thoroughly researched the top transplant centers in the nation and desiring the very best for his wife, they concluded that the Cleveland Clinic was THE center for them based on reputation, outcomes, and clinical experience with complex cases.
They needed to act quickly, and Stephanie was soon transported to Cleveland via life flight. Randall Starling, MD, head of heart failure and cardiac transplant medicine at Cleveland Clinic, was on call when she arrived and informed the family that she may only live a few hours – she must be put on the transplant list immediately.
“At that point, I was very scared. I knew things were going quickly,” Stephanie recalls. “I also knew there might not be a heart available.”
Because of the damage radiation had done to her chest as a child, traditional methods of putting her on extracorporeal membrane oxygenation (ECMO) to provide oxygen to her heart and lungs were impossible. But, not giving up, cardiothoracic surgeon Gonzalo Gonzalez-Stawinski, MD, tried a revolutionary ECMO approach through the groin, and it was a success.
Within 12 hours, they found a heart that was a perfect match. Cardiothoracic surgeon Nicholas Smedira, MD, performed the successful, nearly 12-hour transplant surgery.
“When I woke up, I could feel the heart beat and it was so strong,” Stephanie recalls. “Before the transplant, I couldn’t feel my heart beat because it was so weak – an inefficient.”
Experiencing highs and lows, Stephanie spent 12 weeks at Cleveland Clinic. Today, she and her family are just over four months out from her transplant surgery and doing very well. Ultimately, she credits the love of family and friends, the hard work of all the doctors, nurses and everyone else their daily encouragement. While recovering, her son Abel would pray, “Dear God, please let my mom speak again and let her give me hugs.”
Stephanie is currently doing both as often as possible. “I’ve been doing great and I’m up and walking and doing things that are normal again – like last week watching my son learn how to ride his bike without training wheels. I’m so thankful I didn’t miss that!”
Stephanie also plans to get involved with organ donor families or recipients and work to raise awareness about future health complications for survivors of childhood cancer.