It was Mother’s Day, and Shellie Ulven was ready for a day with her family. She was starting to feel better after a drawn-out seasonal cold. Heart disease was not on her mind.
She was young, healthy and felt absolutely fine. But suddenly, after coughing and blowing her nose, Ulven started seeing double. Confused by what could have brought on this seemingly random symptom, she decided to wait and see if her vision would return to normal.
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But when the double vision hadn’t completely cleared by the following day, Ulven went to Sanford Urgent Care Clinic. After hearing about her symptom, the provider knew immediately that something was not right. Eventually, it was discovered that Ulven’s double vision had been the result of a small stroke in her brain stem.
Ulven was fortunate to not experience long-term residual effects, but that didn’t satisfy her or her care team at Sanford Health. The team wanted to know why Ulven had the stroke in the first place.
“Because I’m 46 and healthy, having a stroke didn’t make sense to the medical team,” she said. “So over the course of the summer I had tests and scans from the tips of my toes to the top of my head to figure out why I had that small stroke.”
Measuring only a half-inch in diameter, the brain stem controls all basic activities of the central nervous system, including breathing and motor control. A brain stem stroke can have complex symptoms — ranging from double vision to vertigo — which are not always present in strokes occurring in other parts of the brain. The most common symptoms associated with strokes are facial drooping, arm weakness and slurred speech.
In the middle of the summer, all the testing and scanning finally revealed an answer for Ulven’s mystery. She had been born with a small hole in her heart.
“I didn’t show any signs that I had a hole in my heart,” she said. “And apparently my heart sounded really good when you listened to it.”
According to the American Heart Association, more than 1.3 million Americans have some form of congenital heart defect. Roxanne Newman, M.D., a cardiovascular and thoracic surgeon at Sanford Fargo Medical Center, recommended that Ulven have the hole in her heart closed before it could contribute to or cause any future health problems.
Open heart surgery
But closing the hole meant that Ulven needed open heart surgery — a complex operation even for someone with an otherwise healthy heart.
“That was not what I was planning on,” she said. “That’s when it got scary. Nobody should be doing that in their 40s, but I knew it was the right thing to do.”
Although the surgery recommendation was unexpected, as a mother of two young children, Ulven wanted to invest in preventing future heart disease and any further strokes. Dr. Newman assured her that the surgery would be rewarding, providing a more secure foundation for her heart health into the future.
“To be a mom and to tell your children that you need to have open heart surgery, that was probably the worst,” Ulven said. “My kids are amazing. They asked great questions, were sad, scared, just like my husband, Jon, and I. We shared that my surgeon thinks this is going to make my heart even better. They were courageous through it all.”
After the open heart procedure successfully repaired the hole in her heart, Ulven committed herself to working with Sanford Heart’s Cardiac Rehabilitation team. Exercise physiologists and nurses developed a customized heart disease prevention program for her.
“It was a gift to be hooked up to a heart monitor and to walk on a treadmill and know that my heart was pumping fine,” she said. “It was so reassuring. You just know your heart is doing what it’s meant to do.”
After a procedure like open heart surgery, cardiac rehabilitation is important for many reasons. With support and encouragement from rehab staff, patients learn how to be more active and make changes that can lead to a stronger heart.
“The heart is a muscle, and just like any other muscle it needs exercise to get stronger and work more efficiently,” said Sierra Lien, an exercise physiologist at Sanford Cardiac Rehab. “This allows patients to return to the activities they love and will help prevent future heart events.”
In addition to exercise, cardiac rehab focuses on educating patients about healthy lifestyle changes. The education focuses on all aspects of a healthy lifestyle — stress, diet and exercise, as well as other risk factor modifications.
“They’re so motivating and patient with you, yet they push you,” Ulven said. “I don’t think that I could have tested these waters on my own, of taking on exercises and weights. They build a confidence in you to know that you’re OK.”
Stronger than before
Rehab helped Ulven understand what she could and couldn’t do during recovery. By following an exercise program designed to help rebuild her strength, she could plan to return to an active lifestyle of exercising, golfing, gardening and playing with her family.
“She always had a great attitude and a willingness to try new things,” Lien said. “She was constantly working toward achieving her personal goals of returning to yoga and starting a strength training program.”
The cardiac rehab team emphasizes that exercise is important at any age. For women specifically, maintaining weight-bearing exercises after menopause is key.
“Now I’m back to the person I was before, and probably stronger,” Ulven said. “I have the strength and the energy back — and I have the confidence to know that my heart is OK.”
As she approached her graduation from cardiac rehab, she emphasized that women, and especially mothers, should keep a preventive mindset to be aware of warning signs and diligent about addressing them. Because she was more willing to investigate problems with her children’s health rather than her own, Ulven encourages others to take charge and advocate for their own well-being. Investigating her double vision may have ultimately saved her life.
“I want to be healthy for myself and my family, and preventing heart disease is one way,” Ulven said. “Women need the courage to ask questions for themselves too. If something doesn’t feel right — go ask the question.”
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