Heart Transplant Helps Cape Woman Overcome Rare Disorder
May 20, 2009, ST. LOUIS - Her pregnancy had been perfect. The birth of her daughter, Hallie, had been perfect. So Becky Stein was blindsided when her first night home from the hospital started a health nightmare that would end seven years later with a heart transplant.
"I honestly believe I'm a walking miracle," Stein said of her experience.
Stein, a Cape Girardeau resident, had been healthy her entire life. But the first night home after giving birth, she had difficultly breathing. She was readmitted to the hospital in Cape Girardeau, where doctors found she had an enlarged heart and blood clots throughout her body.
She was transferred to Barnes-Jewish Hospital in where doctors diagnosed a genetic clotting disorder and restrictive cardiomyopathy, a rare heart condition in which the heart walls become rigid and can't pump efficiently.
After four weeks in the hospital, Stein returned home.
At first, life was normal - raising Hallie with her husband, Robert, and working as a teacher at Nell Holcolm R-IV School. But she understood that she would eventually need a heart transplant.
"I did great for a couple of years," she said.
Although she took medication, ". really, I lived pretty normally," Stein said.
In December 2007, she had to have a pacemaker implanted to control an irregular heart beat.
About six months later, her condition suddenly worsened. She noticed a dramatic decline in her stamina. At school, she'd have to stop and catch her breath several times when walking the length of the hallway. Climbing stairs was exhausting, and doing chores at home left her winded. Stein was in heart failure.
In early October 2008, Stein was admitted to Barnes-Jewish to have a cardiac catheterization to evaluate her heart function. Doctors told her that it was time to be evaluated for a transplant.
She was put on a powerful, but potentially dangerous heart drug. Stein had an IV port implanted and carried an infusion pump in a belt pack that would administer the drug intravenously 24 hours a day.
Doctors warned her, however, that the drug was just a bridge to get her through until a donor heart was found.
Stein returned home to wait.
On Nov. 19, only two weeks after being listed for transplant, Stein got the call that a donor heart was available, and that she should get to St. Louis as quickly as possible. She and Robert immediately drove to St. Louis, and surgeons at Barnes-Jewish implanted her new heart.
The surgery went well. But shortly after the transplant, Stein developed rejection, a condition which, untreated, can cause a transplant to fail.
"Most of the rejection we see is due to specific forms of white cells in the recipient recognizing the donor heart as foreign and attacking it," said Dr. Ed Geltman, Washington University transplant cardiologist and head of the Barnes-Jewish heart failure program. "That for of rejection is treated with a variety of drugs and infusions."
In Stein's case, her body formed entirely new antibodies against her donor heart. Doctors treated her with plasmapheresis, a procedure in which the antibodies were filtered out of her blood and replaced with fresh plasma.
"We use plasmapheresis relatively infrequently on probably less than 10 percent of transplant patients," Dr. Geltman said.
The treatment worked and three weeks after receiving a new heart, Stein was home in time to celebrate Christmas with her husband and daughter.
Since then, she has been working her way back to a normal, active life and plans to return to Nell Holcomb School in the fall.
Stein credits prayer and her "huge support system," including her husband and daughter, parents, co-workers and friends, with helping her get through her ordeal. Friends cooked for the family, brought meals and made sure Hallie was cared for, while co-workers and students held fundraisers in her honor.
Stein has been in contact with the family of her donor, a 16-year-old boy who died suddenly of a brain tumor. She hopes to meet with them someday "to express my sorrow for them but also my immeasurable gratitude."
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