Anna Jaworski: 0:00
After I had been podcasting for less than a year. I heard from a man with cc-TGA. We were Facebook friends and he was surprised to discover, after listening to Heart to Heart with Anna, that the two of us lived near one another. He reached out to me and we met face-to-face. This man was David Franco. The episode we're featuring in Heart to Heart with Anna this week is the very first episode I recorded with David. He became a close personal friend, the Host of Heart to Heart with Nicole and David. And when it went on hiatus, he became my producer and a sound engineer. David passed away on March 12, 2020. Heaven gained an angel when David passed away. My heart is broken right now, but I'm pleased to feature this very special episode with David Franco and Carol Raimondi
Opening: 1:05
Welcome to Heart to Heart with Anna, featuring your Host Anna Jaworski. Our program is a program designed to empower the CHD or congenital heart defect community. Our program may also help families who have children who are chronically ill by bringing information and encouragement to you in order to become an advocate for your community. Now here is Anna Jaworski.
Anna Jaworski: 1:32
Transposition of the great arteries, also know transposition of the great vessels, affects about 1250 babies each year in the United States alone, according to the Centers for Disease Control and Prevention. This means that one in every 3300 babies born in the United States is affected by this heart defect. According to an article on Medscape, by Dr. John R. Charpie, transposition of the great arteries (or TGA) is the most common cyanotic congenital heart defect that presents in babies during their first month after birth. The hallmark of the congenital heart defect is that the aorta and the pulmonary arteries are switched – thus blue, or unoxygenated blood, goes to the body and red or oxygenated blood goes to the lungs – which is why the babies are cyanotic (or blue).TGA was first described over 2 centuries ago but there was no treatment available until the middle of the 20th century with the development of the surgical atrial septectomy in the 1950s and balloon atrial septostomy in the 1960s, which allowed the blue and red blood to mix after doctors placed a hole in the baby’s septum. Those procedures were then followed by the atrial switch operation or the arterial switch operation. Today, the survival rate for infants with TGA is greater than 90%. There are a couple of kinds of TGA. L-TGA or levo-TGA is commonly referred to as congenitally corrected transposition of the great arteries or cc-TGA and is an acyanotic CHD because while the aorta and the pulmonary arteries are switched, so too the left and right ventricles are transposed so the baby does not present as blue. The other kind of TGA is d-TGA or dextro-TGA and it can be fatal if not treated early. As with many other kinds of heart defects, a person can be born with simple or complex TGA – meaning the person may have just that one specific heart defect or additional heart defects and possibly even other congenital birth defects.Our topic today is Living with Transposition of the Great Arteries and we have two outstanding Guests who will help us understand what it’s like to live with TGA. Our Guests today are Heart Survivors Carol Raimondi and David Franco. Carol Raimondi was born in 1975 with levo-transposition of the great arteries, pulmonary stenosis, atrial septal defect, ventricular septal defect (or VSD) and dextrocardia. Her first surgery at age 5, repaired her VSD and widened her pulmonary artery. Soon after that, she required a pacemaker. She has had 3 more open-heart surgeries – at ages 12, 21 and 31, and numerous pacemaker surgeries. Carol became a nurse, which had always been her calling, in 1998. She worked as an inpatient and outpatient cardiac nurse. She became pregnant and had a daughter in 1999. Unfortunately, due to physical decline, she quit working in 2005. Shortly after this, she had her 4th open-heart surgery to replace her tricuspid and pulmonary valve, repair her mitral valve and revise her pulmonary conduit.Still unable to work, Carol stays active in the CHD community, serving as an adult liaison for Mended Little Hearts of Chicago. Most recently, she started a support group for adult CHD patients in Chicago. Welcome to Heart to Heart with Anna, Carol.
Carol Raimondi: 5:06
Thank you for having me on the show, Anna.
Anna Jaworski: 5:08
Well, I'm so excited that you're here, and I am just shocked that you were able to survive until the age of five before you had your first open-heart surgery. The more I read about L-TGA or cc-TGA, the more I am amazed at some of the different birth defects that people can be born with and how some of those birth defects compensate for each other. So I'm wondering if you could tell us a little bit more about your defect and whether or not you had any other conditions that kind of complicated things?
Carol Raimondi: 5:38
Sure, absolutely. I was born with L-TGA or cc-TGA, in which my pulmonary artery and aorta weren't switched, it was just the ventricles that were switched. For my larger left ventricle is pumping to the lungs, and the smaller right ventricle has pumped the blood to the body. So that right ventricle is not built to do that type of job for a lifetime. I recently actually just asked my doctor about pulmonary hypertension because I had read that could have been an issue over time with my heart defect. And actually interestingly, she said, the pulmonary stenosis that I also had with the transposition helped to prevent pulmonary hypertension in my situation. She had said since it was the left ventricle pumping with the greater force, normally, that would have put too much pressure on the lungs, causing the pulmonary hypertension. But because I had the pulmonary stenosis that slowed the pressure, slowed the pressure of the blood going to my lungs so it wasn't as high of a pressure by the time it reached my lungs, I actually did have some cyanosis prior to my first surgery; due to the VSD there was some mixing of blood. I would have what they call 'Tet spells' where I would squat and kind of have to catch my breath, get the blood kind of circulating again throughout my body before I could continue. And back then, actually, though, the school of thought really was to try and wait as long as possible to repair any defects before you were able to have a surgery with the idea that the more that we grew bigger, the bigger the shunts that they could put in which they would hope would reduce the need for multiple surgeries. And actually that really has changed over the years. I was talking to many moms with kids who have the same defects, and the surgeries are done earlier and earlier now. You mentioned the double switch is the most common for congenitally corrected transposition. But during my first surgery, even though they had waited five years, they still did not put a conduit through my pulmonary artery to widen that - they just manually widened it. at that time. And also due to the abnormal location of my SA node there was some damage - there's not a great big sign there in the heart when they get in there saying where each little area of cells are at
Anna Jaworski: 7:45
right
Carol Raimondi: 7:45
- that was damaged during my first surgery because of its abnormal location due to the transposition. And that shortly thereafter I needed a single chamber pacemaker placed.
Anna Jaworski: 7:54
Okay, I was wondering what had caused the problem that required the pacemaker. So you were fairly young. Were you only five years old when you had to get your pacemaker?
Carol Raimondi: 8:04
I had just turned six when I got my first pacemaker, and that was a single chamber at that time.
Anna Jaworski: 8:11
And people have to understand that this happened in the 1970s. (chuckle) So a lot of things have changed. Like you said, the way that children are treated now is totally different. And it's interesting because I was just doing some research for an earlier show and they were talking about the philosophy that having children be cyanotic was not good for their brain development and that that could cause some other problems. And so that's one of the reasons why they encourage going ahead and doing some of these palliative surgeries earlier to reduce the cyanosis. Whereas like you said that the school of thought way back when was, 'Oh, let's let these kids get as big as possible.' I mean, so many things were being invented at that time, too, maybe there was the hope that there would be a more definitive fix,
Carol Raimondi: 9:00
Correct. Yeah. Absolutely. It's just so interesting now to see how these kids, because of people like David myself, what they've learned based on what they are doing with us 20-30 years ago.
Anna Jaworski: 9:13
Absolutely. Absolutely. You guys are pioneers, and it's so exciting to talk to somebody who really has helped shape the whole future for people who are born with the same heart defect that you were born with. I was so excited to see the picture of you and your daughter. And I hope people are looking at BlogTalkRadio's slide show so they can appreciate all the photos that are up there. It's such a beautiful picture, and I'm wondering if you can tell us if your daughter is heart-healthy and if maybe you can tell us a little bit about your pregnancy, because I'm sure that was something that probably terrified your parents.
Carol Raimondi: 9:45
Absolutely. Absolutely. Actually, yes, she is heart- healthy. She's 15 and 1/2. So she's a teenager with a whole new set of challenges, but she's a great kid and I'm very blessed to have her. I had a fetal echo during my pregnancy by my cardiologist because there's an elevated risk of having her have some type of a congenital heart defect. But fortunately, there was no defects of all. She was very healthy.
Carol Raimondi: 10:11
When I decided I wanted to have a baby, I had to have a conference with my doctor, my cardiologist, as well as a high-risk obstetrician. So once I got the go-ahead from my cardiologist that things were stable enough for me to go ahead and try, I did actually have some difficulty getting pregnant. So it could take some time. But once I was pregnant, they pretty much had to know right away because I was on Coumadin at the time. And that is not something that's encouraged during pregnancy. That's definitely a higher-risk medication that is known to cause birth defects. So I had to switch off of that and take heparin injections 2-3 times a day for the duration of my pregnancy
Carol Raimondi: 10:46
I was very closely monitored throughout my whole pregnancy as far as echocardiograms and visits with both the cardiologist and OB. I did have some complications. I did have two small TIAs during my pregnancy - one very early on and one at about 24 weeks. I did have, possibly related to the blood-thinners - I developed a blood clot in my uterus that put me on bedrest for the majority of my pregnancy.
Carol Raimondi: 11:13
I ended up actually having my water break at about 30 weeks. Since my cardiologist had said, because of my heart condition, they would not have let me go past 36 weeks anyhow - but it was the blood clot that was in my uterus (that) caused the water to break at 30. And actually, generally, I was very surprised to learn that the doctor originally said that he wanted me to try to go ahead and labor, and I really thought that would be counter-indicated with my heart defect. But the way he explained it was that with the big shift of fluid that goes on with childbirth, it's better to get your heart prepared for that with the work of labor versus with a C-section where you would go from having all this extra fluid to none in a very quick time and that having everybody kind of prepared for it. Unfortunately, though, I did end up having to have a C-section because I was not progressing with her and her heartrate was elevating and my heart was elevating. And I didn't fine. I didn't have any problems with heart failure or fluid retention right after the delivery, I did obviously deliver at a high-risk center; the only other kind of incidental complication, as far as my heart goes, was at the time my pacemaker was in my upper abdomen and of course as your stomach stretches everything kind of pulls and my pacemaker wire... Well, actually, I happened to be in the hospital during one of my TIAs. And I started feeling really light-headed and come to find out they did a pacemaker check. And because of the tension on my atrial lead, it stopped sensing actually.
Carol Raimondi: 12:39
We were very concerned that they'd have to do surgery while I was still pregnant. But fortunately, they were able to kind of amp up my other settings to get me through the rest of the pregnancy. And a few weeks after I had delivered her, everything was right back to normal. So it was definitely not something that we really predicted or thought about
Anna Jaworski: 12:59
Right
Carol Raimondi: 12:59
But my cardiologist was in the delivery room with me, even though he told me it was just to see the baby and not for me. But he was there and checked her out right away and did another echo so it was great.
Anna Jaworski: 13:11
Oh, wow. So you had a lot of support. How did your parents handle it? Were they really scared for you?
Carol Raimondi: 13:19
They were. They were very nervous. My mom went with me to a lot of my appointments which were very frequent, especially with the blood clot and things like that. I was being seen pretty much weekly through my pregnancy. So they were very supportive. Being on bed rest, they would come and help me out. Bring me groceries, things like that. And my in-laws, too, they always made sure that we had food to eat and that I was getting to my appointments. And they were all there...
Anna Jaworski: 13:41
This baby was very much wanted. And it sounds like it was a village approach. (chuckle)
Carol Raimondi: 13:47
Yeah, yes, it sure was.
Anna Jaworski: 13:48
How awesome is that? That must have been such a joyous occasion to have so many people together. And to see that your daughter's heart checked out perfectly and that both of you were okay.
Carol Raimondi: 13:59
Absolutely. It was a blessing. She is our miracle.
Anna Jaworski: 14:03
Well, that's a great way for us end this first segment, and we're going to have a short commercial break. But don't leave yet because coming up next, we'll have a man who was born with same congenital heart defect, cc-TG A. We'll hear how that heart defect has affected his life when we returned to Heart to Heart with Anna.
Baby Hearts Press: 14:20
Anna Jaworski has written several books to empower the congenital heart defect or CHD community. These books can be found at www.amazon.com or at her website, www.babyheartspress.com. Her best seller is "The Heart of a Mother," an anthology of stories written by women for women in the CHD community. Anna's other books. "My Brother Needs an Operation," "The Heart of a Father" and "Hypoplastic Left Heart Syndrome: A Handbook for Parents" will help you understand that you are not alone. Visit babyheartspress.com to find out more.
Anna Jaworski: 14:57
Welcome back to our show. "Heart to Heart With Anna: A show for the Congenital Heart Defect Community." Today we are talking with Heart Survivors Carol Raimondi and David Franco, and our show today is 'Living with Congenitally Corrected Transposition of the Great Arteries.' We just finished talking with Carol about being born with this very complex congenital heart defect and the birth of her beautiful baby daughter. So I'm very excited that we had a chance to have such a great first segment.
Anna Jaworski: 15:23
Now we're going to turn our attention to David Franco. David Franco is 48 years old and was born with a ventricular septal defect and congenitally corrected transposition of the great arteries. Six weeks after birth, David's pediatrician heard a strange sound in his chest, and he was referred to Montefiore Hospital and his catherization showed his complex heart anomaly.
Anna Jaworski: 15:44
David's parents were given very few options, and David was sent to the University of Alabama in Birmingham to have his VSD closed by Dr. John Kirkland. He received a pacemaker during that operation. David had a second open-heart surgery at 27 to replace his pulmonary valve and add a pulmonary conduit, allowing more oxygenated blood to go through his body. The surgery was successful, but David suffered a stroke during the procedure. He also received an implanted cardioverter defibrillator, or an ICD.
Anna Jaworski: 16:14
David is a father, a husband, and a stay-at-home dad. He exercises daily and participates in 5K races. He has a strong passion for music, and he plays guitar. Welcome to Heart to Heart with Anna, David.
David Franco: 16:26
Hi, Anna. Thanks for having me; (it's a) pleasure to be here.
Anna Jaworski: 16:29
Isn't it interesting how similar your story is to Carol's? And you were telling me in some personal correspondence that you also had your first surgery later in your childhood at the age of five? Is that right?
David Franco: 16:43
Correct. It's kind of ironic you could transfer my story to Carol's. I was diagnosed in early 1967 with my anomaly, and I was able to wait until I was five years old. It was April of '72 when they actually went in and corrected that VSD. So I was able to also last about five years before I had any major complications. Now this included the enlarging of the heart, the VSD getting bigger, and I also had some episodes of congestive heart failure at the time treated by meds, and the thinking was again - wait 'til the last minute, and that's what they did in my case.
David Franco: 17:22
I'm lucky to have made it through that surgery. Now, basically, the cc-TGA, in my case, is - you'll look at my heart. It looks pretty normal. I have four chambers like a normal heart. They're all closed up except for that little hole that I had in the bottom of my heart. And the circulation looks pretty normal, too, it's a little convoluted because of my anomaly; however, it looks much like a normal heart pumps systemically. However, the biggest problem that we have with ccc-TGA is the ventricular inversion, which means my right ventricle is doing the work my left ventricle should be doing.
David Franco: 18:03
The thing, as the previous guest had mentioned, it's the left ventricle is more muscular. It's meant to do the hard work of the body. It sends the good blood out to the body. And it's not doing that. My right ventricle is doing that, and that is taxing my right ventricle too much. It's not meant to deal with the higher pressures. And in this case, my problem is I've seen my cardiologists for about 12 years, and we do echo, ultrasounds on my chambers, and it's changing. It's not contracting as well as it did. And this is my right ventricle, which eventually may lead to some failure. So I suppose that's something I have to look at in the future. But as of right now I'm really asymptomatic and I'm just enjoying life. I couldn't be happier to explain.
Anna Jaworski: 18:53
Yeah, this is great. One of the things that I noticed when I was doing my research is that sometimes that right ventricle, which you're right, it looks different anatomically. It's not as muscular as the left ventricle is supposed to be because it doesn't have to do as much work. Well, when you force it to do a lot of work because of this cc-TGA, then in some people, it becomes thickened. When it becomes thickened, it doesn't pump as well. It is cardiac hypertrophy and that can be a real problem. And that was the major problem that I saw with this cc-TGA is that they really have to keep an eye on that left ventricle because it does tend to, after a while, start showing some problems because it is working so much harder than what God designed that ventricle to do.
Anna Jaworski: 19:38
But I'm just amazed that both you and Carol survived until the age of five, before you needed that first surgery. But it does sound like maybe she had some Tet spells under some periods where maybe she looked a little bit blue. Did you also have that happen to you?
David Franco: 19:54
I had no problems with cyanosis. I suppose when I was in congestive heart failure - my folks would know - but I was not a blue baby. There are pictures of me and I was never blue unless I came out of the cold ocean, if you will. So,
Anna Jaworski: 20:08
Well, yeah. Yeah, but that's normal for anyone.
David Franco: 20:12
The only thing I guess in our case is the wearing of that right ventricle. As you mentioned so well before, it's not built to do that job of the heavy lifting. So as adults, we're dealing with that. And as Carol mentioned before, we're hoping that they do invent a procedure or there's something that can be done, but maybe not. We will never know. But we'll see.
Anna Jaworski: 20:34
Well yeah, you will. You will know. (chuckle) Because we're seeing new scientific procedures all the time, aren't we? Isn't it amazing that the Internet has really helped us to be able to keep abreast of what is being created nowadays to help people? And you and Carol are the pioneers who are paving the way to let us see how long a person can last with cc-TGA and what maybe needs to be done. And it sounds like you're living a great life. I so enjoyed getting a chance to meet you in Austin just last week, and...
David Franco: 21:07
Oh, I had a blast. Thank you so much.
Anna Jaworski: 21:16
It was wonderful. We have to talk about your daughter Sarah. She was just simply gorgeous. And let's talk about Sarah for a minute.
David Franco: 21:17
She looks just like her mom. She's heart-healthy. During my wife, Pam's pregnancy, we did all the special precautions. We had the echoes. We had everything done. Nothing was shown that she had any cardiac problems. And when she was born, after they do that test, they also did the pulse ox. So we were pretty sure that there was nothing wrong with her. We did make sure that every precaution was taken. She had the high-risk OB-gyn. Every doctor that she spoke to, I was there saying, "I have a complex heart defect. Please, please be aware."
David Franco: 21:52
So I think that was more important than anything just following through. And even if I was a nudge to some of the nurses and to the doctors, I really just wanted to get the point across. And I think that's kind of what we need to be doing right now is doing a little bit more nudging. Maybe that'll get us somewhere.
Anna Jaworski: 22:08
Absolutely. I think that by us talking about this and letting people know there are survivors out there, you are kind of a very small niche. When I was doing my research. It was quite obvious that D-TGA is more common than L-TGA. And I thought, 'Wow, this is almost a little hidden group.' So we need to shed some light on this group of survivors and we need to talk about it. You're right. We need to nudge people forward to let them know that you all are out there. You all are survivors. But there are some complications.
Anna Jaworski: 22:40
When Carol said she had a TIA, I should have explained right away to all of my Listeners - what that is, is a little teeny, tiny stroke. And you also suffered from a stroke when you had one of your surgeries. I'm going to give you just a minute to talk about how that stroke has impacted your life.
David Franco: 22:57
Well, first of all, I have to explain. I was married for only three months before I had my open-heart surgery. I threw a clot, and that's how I had the stroke under anesthesia. My wife is still with me 21 years later after dealing with the person who had a stroke and congenital heart defects. So appreciation really is the biggest thing.
David Franco: 23:17
Now I've lost a lot. I suppose. A lot of this stuff I used to do - my little right-sided weakness, But other than that, cognitive issues seem to be a part of the equation. But I work a way around it and try and solve problems in a different way. I find more stimulus I receive - audio, visual, tactile, anything I could get my hands on - I absorb and hopefully it creates the new connections in the brain, so I can get back to normal if that's ever possible. So I really learned to appreciate life, also, I'm the luckiest man alive, and I know I'll have some arguments from some people, but I certainly am.
Anna Jaworski: 23:58
I think you're lucky, too. You have a wonderful daughter and such a supportive wife. Gosh, to be together 21 years when you've, almost from the get-go, had to battle so much together. That speaks very well for you and Pam. Well this has been a terrific segment. We do need to break real quickly for a commercial. And then we'll have David and Carol in the studio together and we'll hear their parting words of advice for TGA survivors. When we return to Heart to Heart with Anna.
Speaker promo: 24:26
Anna Jaworski has spoken around the world at congenital heart defect events, and she is available as a keynote or guest speaker for your event. Go to hearttoheartwithanna.com to learn more about booking Anna for your event. You can also find out more about the radio program, keep up-to-date with CHD resources and information about advocacy groups, as well as read Anna's weekly blog. Anna wants you to stay well-connected and participate in the CHD community. Visit HearttoHeartwithAnna.com today.
Anna Jaworski: 25:00
Did you know David Franco? Do you have a story you'd like to share about how he touched your life? When I return from David's funeral, I will be recording a Patron-Only program featuring Patrons of Hearts Unite the Globe who knew and cared about David. Visit www.patreon.com/hearttoheart and sign up if you'd like to join us,
Anna Jaworski: 25:23
Welcome back to our show. Heart to heart with Anna: A Show for the Congenital Heart Defect Community. Today we are talking with heart survivors Carol Raimondi and David Franco, and our show is 'Living with Congenitally Corrected Transposition of the Great Arteries.' I want to thank Carol and David so much for coming on the show today and talking with me about this really important topic because TGA is actually one of the more common congenital heart defects but you don't hear people talking about cc-TGA. So I'm really glad that we had a chance to shed a little bit of light on that. And I'm looking forward to hearing and keeping up with David and Carol as they get even older and see how things continue. But for our last segment, I would really love to hear what advice they would give to a parent who has a child today born with cc-TGA. And I will start with you Carol.
Carol Raimondi: 26:15
Sure, I really believe that the biggest thing that parents need to know is there is no cure, just as there is with other heart defects, there's no cure for congenital heart defects and especially in our situation, is that right ventricle does work over the years and start to wear down. Lifelong follow up is absolutely essential. There's so many people that have whatever corrective surgery when they were young for their transposition or other associated defects. And then they don't follow up until they're starting to feel bad in their adulthood thirties-forties. And by that point, sometimes whether it's a tricuspid valve, which becomes an issue as we get older, or complete heart block, which by the age of 25 - 50% of patients with cc-TGA will have heart black. So I think it's just making sure that they always have followup throughout the years with the correct type of cardiologists, so you can manage problems before they get out of hand.
Anna Jaworski: 27:09
I'm so glad you mentioned that, Carol. Not only is that a problem with cc-TGA, but we see that as a problem with so many heart defects where the children are lost to follow-up care. They turn 18 and I don't know if it's that they think they're fine, you know, or that they don't have the money or I don't know what it is, but we do lose so many of our children to follow-up care, so I'm really, really glad you mentioned that. That's really important. David, what advice would you give to parents of a baby born with cc-TGA today?
David Franco: 27:39
Well, I'll be blunt, and I'll say, "It's not a death sentence." My parents were very scared going through it. So please be persistent. Educate yourself, but don't overwhelm yourself. There's a lot to be learned, but not everything applies to every patient. We all are different, and we all react differently to different medications and procedures. So it's something I think that the parent really needs to follow up. And I agree with Carol 100%. We can't be lost in the system, whether it's because we get older and we think we feel good or because we move and we lose our doctors and don't follow up. There are a number of reasons, however, it's so important to stay on your meds if you're on meds and just and follow the care, because that's really part of our lifelong journey,
Anna Jaworski: 28:27
It really, really is. And I think, unfortunately, the name of your heart defect, If you go with the cc-TGA instead of the L-TGA - "congenitally corrected" almost makes it sound like, 'Oh, it's okay, it's fixed inside of you!' But it's not. It's better than the D-TGA; it's not as fatal. It's not often as fatal as the D -TGA, but it's not fixed. And I like what Carol said that there is no cure and parents do need to be aware of that.
Anna Jaworski: 28:58
But I also like what you said. David, I love what you said that 'it's not a death sentence.' When my son was born in the 1990s, which is a couple of decades after the two of you were born, he was also born with L-TGA, But he was also born with a hypoplastic left ventricle, and so they labeled him HLHS instead of cc-TGA because he had a whole a bunch of other problems as well. And unfortunately, I was told that his heart was a ticking time bomb waiting to go off. And that's not what any parent should have to hear.
Carol Raimondi: 29:31
No, not at all.
Anna Jaworski: 29:33
It's a really scary thing to be told that your child could just pass away at any time, and I like what David said that parents can empower themselves, they can educate themselves. It is easy to get overwhelmed with all the information on the Internet, but I think that information is power. You two are so wonderful at sharing this information with others who have L-TGA or cc-TGA. Thank you so much for coming on the show.
Carol Raimondi: 30:01
Thanks for having us.
David Franco: 0:00
My pleasure.
Anna Jaworski: 30:02
Well, I hate it that our time is up already, but that does conclude today's episode of "Heart to Heart With Anna." Please come back next week on Tuesday at noon Eastern time. Until then, find and like us on Facebook, check out our website hearttoheartwithanna.com and our Cafe Press boutique. Follow our radio show and remember, my friends, you are not alone.
Conclusion: 30:30
Thank you again for joining us this week. We hope you've been inspired and empowered to become an advocate for the congenital heart defect community. Heart to Heart with Anna, with your host, Anna Jaworski can be heard every Tuesday at 12 noon Eastern time. We'll talk again next week.