An extra special Mother's Day
Heart-transplant patient celebrates health, simple joys of family
Michelle Lasater has spent the past year enjoying the first-year milestones of a new mom, including first birthday, first Halloween, first Christmas and first Easter. Her daughter, however, is 2-and-a-half years old.
On Mother’s Day last year, Lasater received a heart transplant, ending an intense battle with heart disease that began immediately after giving birth to her daughter.
“Since I spent much of the first year-and-a-half of my daughter’s life in the hospital, it caused our family to lose so much,” Lasater said. “This is our new beginning, the year of ‘firsts.’ My first year of being the mom I had always dreamed of and wanted to be, my husband’s first year of having his family together as a whole and our daughter’s first year of having both parents by her side.”
A difficult third trimester
Breathing problems during Lasater’s third trimester were attributed to common pregnancy-related issues, and early delivery was the recommended treatment. Daughter Aubrie was born via c-section at UC Davis Medical Center on Sept. 13, 2014. The symptoms, however, didn’t go away.
“I still couldn’t breathe well or exert myself in any way,” she said.
An echocardiogram showed she had a form of heart failure known as peripartum (or postpartum) cardiomyopathy, which can occur during the last stages of pregnancy or early stages of motherhood. The cause is thought to be the extra stress pregnancy places on the heart, combined with existing risk factors. It meant that Lasater’s heart muscle wasn’t pumping strongly enough to provide sufficient blood and oxygen to her body, leaving her weak, prone to blood clots and vulnerable to organ failure.
“Heart failure runs in my family on my father’s side, but I just wasn’t expecting it because I’m so young,” said Lasater, who was 33 at the time.
From then on, cardiologist Kathleen Tong, who leads the UC Davis Advanced Heart Failure Clinic, cardiothoracic surgeon Broadus Atkins, surgical resident Paul Perry and nurse Anca Rahman joined her care team and, as Lasater said, became part of her family. Their goal was to get Lasater a heart transplant, the preferred treatment for end-stage heart failure. In the meantime, they provided her with state-of-the-art heart failure therapies, but that proved challenging.
Waiting for a viable donor heart
“Michelle didn’t tolerate the oral therapies that are the foundation of care for most heart failure patients,” Tong said. “We needed to treat her differently before she developed multi-organ failure. Ultimately, we decided she should have a ventricular assist device as a bridge to transplant.”
The UC Davis Advanced Heart Failure Clinic links expert resources in cardiology, surgery, pharmacy, nursing and social work to provide comprehensive, evidence-based treatment based on the needs of each patient. To request a referral, call 1-800-2-UCDAVIS.
Lasater had surgery to receive first one and then a second ventricular assist device, a battery-operated mechanical pump that does work the heart no longer can. When the VADs became inadequate, she was prioritized on the organ wait list and transported to Cedars-Sinai Medical Center in Los Angeles, home of the largest heart-transplant program in the nation.
Coincidentally, Perry was there at the same time for transplant-surgery training.
“When Michelle arrived, I could see how debilitated she had become,” said Perry, who today has a faculty position at UC Davis. “We did our best to support her medically, but it was clear to our team that her only real chance of surviving meant finding her an appropriate heart, and quickly.”
Waiting and hoping was harder than Lasater thought. Two times a heart became available, two times she was taken to an operating room and anesthetized in preparation for surgery, and two times she woke to doctors telling her the organs were deemed inappropriate for transplant.
Her condition declined to the point where she was not expected to survive the night, and she was advised to say her goodbyes to Aubrie and her husband, Todd.
Third donor heart restores health
Then, a third heart became available. Lasater tried not to be optimistic, but somehow felt that she was meant to receive a new heart on this day. It was, after all, Mother’s Day.
She was right. The heart-transplant team, which was led by surgeon Alfredo Trento and included Perry, removed her diseased heart and gave her one from someone whose family, in the midst of grief following sudden loss, chose to give life to others by donating their loved one’s organs. She woke up this time on a ventilator, indicating that surgery had actually occurred, with Todd telling her she made it.
The change in her health was immediate.
“I couldn’t believe how many people said, ‘Hey, your face is glowing and full of color,’” Lasater said. “I was no longer pale and wasting away.”
Her energy and ability to be a parent also returned. While today she can do almost everything she could before pregnancy, she mostly enjoys basic things like watching her daughter play in the park, taking her to soccer with Todd and picking her up without struggling or being out of breath.
“We’re creating all the memories we should have created that first year, all the memories we thought we would never have,” she said. On Sunday, May 14, she added, those memories will include first Mother’s Day.
Lasater will continue to have follow-up appointments with Tong, but they will be less frequent as time passes — something she’ll regret.
“She and the team have spent so much time with us and been our advocates,” Lasater said. “Aubrie just loves them. And she is so comfortable with doctors now, especially Dr. Tong.”