Kara with Marisa Cevasco, MD, MPH, her transplant surgeon
Kara DuBois lay in her bed in an intensive care unit at the Hospital of the University of Pennsylvania (HUP) one day last month, connected to a balloon pump which was helping her weakened heart push blood through the veins and arteries. Earlier, she had received “the call” that her new heart was coming. The transplant was moving ahead.
DuBois was both excited … and scared. From where she lay — she couldn’t leave her bed — she could see a little of the outside world from the room window. As she gazed out, a rainbow appeared, right above HUP’s helicopter pad. “It gave me a sense of peace. It’s the right donor and it’s going to be ok.”
But it had been a long road.
A History of Heart Conditions
DuBois suffered her first heart attack in 1999, when she was only 27 but it was misdiagnosed as an anxiety attack; she received no treatment. The damage was picked up five years later during a physical exam. The following week she underwent a quadruple bypass.
DuBois’ next heart attack came in 2011, and then she suffered another three last year: one in June and then two within three of weeks of each other in November and December. Genes — from her father’s side — played a large role in her cardiac issues. Indeed, many relatives on her paternal side died by age 40.
By this time, she was suffering shortness of breath, chest pain, and fatigue. “It was the start of a slippery slope,” said cardiologist Paul Mather, MD, professor of Clinical Medicine at the Perelman School of Medicine, telling her that evaluating her for a heart transplant would be the next step. The decision to transplant is not a simple decision, Mather stressed. “You have to look at all the patient’s organs and body systems to make sure you do no harm,” he said. “And the patient needs both the right mental fortitude and a support structure. Kara and her family met all spot on. Other than the heart and vasculature, she’s a young woman.”
The transplant process began in January but her day of testing, set up for March 19, had to be cancelled because of the pandemic. “We all thought COVID would make it impossible for Kara to get the transplant,” said Georgette, DuBois’ mother. But COVID did not stop the transplant team. “You can’t put transplants on hold because of coronavirus. These patients are hanging on by a thread,” said transplant surgeon Marisa Cevasco, MD. ”We worked through COVID, testing donors and recipients, keeping socially distanced, and wearing appropriate PPE.”
At home, DuBois slept on oxygen every night but still suffered breathing attacks and hyperventilated. Her husband, Chuck Elliott, would lie awake listening to her struggling, knowing that another attack could come at any time. “He slept in his clothes,” she said, just in case. “It was a terrifying time — I was immunocompromised and there were COVID cases at HUP.”
Kara with her husband, Chuck and mother Georgette
DuBois underwent the rescheduled day of testing on April 23 and then returned to HUP on May 11 for a right heart catheterization, part of her transplant workup, but her weakening condition kept her in the hospital until the end of the month. She was discharged with a PICC line (peripherally inserted central catheter), through which she could receive medication that would dilate her blood vessels and make it easier for her heart to pump. DuBois was on the PICC line 24/7 and with the help of Penn Home Infusion, she learned how to infuse the drug herself.
The drug kept her heart pumping — and supported her other organs — but she was not improving. And she didn’t know if she’d get on the heart transplant list — or a transplant — in time. “I was afraid of dying every second, every day. It was the hardest part of the process.”
She returned to HUP — and the ICU — on July 13 for another cardiac catheterization. While she was still scared of being exposed to COVID, once she came to HUP, “the fear subsided. I felt safe. This is where I need to be.”
On July 29, when DuBois turned 48, Georgette bought in her favorite cupcakes from a bakery shop and they celebrated. But the anxiety was never far away. “The whole time we never knew whether she’d make it out of there alive,” her husband said. “Things would look good and suddenly she became worse.”
On August 10, DuBois was added high on the heart transplant list; two days later, a donor heart was found.
DuBois’ transplant surgery — performed while reggae music played in the background (per her request) — went well and so has her recovery. She said that, although originally planned for August 13, she was taken to the OR after midnight, on August 14, her mother’s birthday! She was discharged to home and “is getting her strength back. Her age and her spirit helped,” Cevasco said, “and she’s a fighter.”
DuBois calls the ups and downs of her cardiac journey a “wild ride,” which she said has impacted her mental health as well. She has suffered from bipolar depression and anxiety for most of her life. These conditions, combined with the stress of COVID and not knowing if the transplant would come in time, was “torture at times.” But social media helped. “I told my story on Facebook and people were so touched and inspired.” Her good friend, Kathy O’Connor, had t-shirts made up that say “#Team Kara” with a beautiful graphic of a lion, and the mantra she lives by: DON’T GIVE UP BEFORE YOUR MIRACLES. “Now everyone is sending me pictures of themselves wearing the t-shirts,” she said. “That support, and the amazing care I’ve received at Penn, has gotten me where I am today.
DuBois and her transplant team, as always, are also grateful to the generosity of her donor’s family for offering her a new lease on life. “Donating an organ is the ultimate gift of empathy and compassion,” Mather said. “It’s an innate goodness in people.”
“My future is so bright. I get to live the life I wanted to but never did,” DuBois said. “I lived in total fear all the time but I’m not living that life any more. I want to inspire people — I have a reason now and a way to do it!”
DuBois credits her personal good luck to her father’s spiritual presence. Although her father had not been a part of her life after her parents divorced when she was 3, “I feel like he’s been in my life every second here. For me to see the rainbow, it had to be lined up perfectly. What a magic trick my father performed!” she said, smiling. She added that two months before receiving her heart, she posted on Facebook that her heart would be at the end of a rainbow. When she saw the rainbow on the helipad, it made an impact. “I have an even stronger belief in miracles than I did before.”