Thankful for the LVAD Bridge to Transplant

Vikas Mahajan is a heart transplant recipient who was fortunate enough to have the benefit of modern medicine to enable him to wait for 3 years for a transplant. Born with hypertrophic cardiomyopathy, he has had to endure the implantation of pacemakers, implantable cardioverter defibrillators or ICDs and a left-ventricular assist device (also known as an LVAD). His ultimate surgery, cardiac transplantation, has resulted in a much-improved quality of life.Vikas shares his medical history with us, how he came to need an LVAD and in the last segment he tells us about receiving the Gift of Life and offers some advice for others who might be walking the same path he did.

We appreciate it when people support Hearts Unite the Globe podcasts. Thank you to our newest supporters -- Annie Ulchak (Patreon) and Judy Miller (Buzzsprout)!

Transcript

spk_0:   0:00
way.

spk_1:   0:06
Welcome. I am Anna Gorski and the host of Heart to Heart with Anna. This is the 13th and final episode of Season 12. Our theme this season has been organ donation and transplantation. And I loved getting to meet all of these wonderful people that have been guests on my show this season. Today I am so excited to feature for cost Mahajan. Our show is entitled thankful for the l VAD Bridge to transplant. Kaz Mahajan is a 20 plus year I t professionals specializing in information security. He is married to Joe T. And he has two daughters, Aria and Sira, because has a genetic defect which has affected his heart. He has had multiple procedures and surgeries throughout his life. Born with hypertrophic cardio myopathy, he has had to endure the implantation of pacemakers, implantable cardioverter defibrillators, or I CDs and a left ventricular assist device, also known as an L VAD. His ultimate surgery was heart transplantation because will share his medical history with us. How he came to need in l've ad and in the last segment, he will tell us about receiving the gift of life and offer some advice for others who might be walking the same path he did Welcome to heart to heart with Anna the cost.

spk_2:   1:26
Diana very excited to be here.

spk_1:   1:29
I was so happy to have you here today. Let's start by talking about when you first discovered you had hypertrophic cardiomyopathy. Tell us about the symptoms that you had and how you knew something was wrong.

spk_2:   1:40
As a child, I was very active in sports. I remember playing soccer from about first through the fourth or fifth grade as well as basketball in baseball. I loved playing sports, and I discovered around fourth or fifth grade that I was really struggling to keep up with the other kids. When we ran laps and did practices or during games, I would often have to stop and catch my breath. And sometimes I would feel strong chest pains as well. These were the first signs that something was wrong, so we went to my family physician to get it checked out. You'll have to remember this was way back in the late eighties and very little was known about this condition. I was also growing at the time. Over the next few years, I grew taller than anyone in my family, my shoe sizes and balloon to a size 13. The doctors really couldn't find anything specifically wrong at the time. So she thought that perhaps I was simply growing so quickly that my heart was unable to keep up and it would eventually catch up and grow with the rest of my body and this would go away. That was the hope. But unfortunately, that never really happened. And I struggled through this period of time with shortness of breath and chest pains. And finally, around eighth or ninth grade, she referred us to a cardiologists. And that's when I was officially diagnosed with a condition called idiopathic hypertrophic sub aortic stenosis. I H S s, which later was revised to be known as hypertrophic cardiomyopathy, or HCM, the more common term used Today, HCM is basically a condition where there's muscle growth inside of the heart, and it's obstructing the flow of blood from the left ventricle. In my case, I had what's called in a large septum. The septum is the muscle that separates the left and right sides of your heart, and mine was growing so thick that it was preventing the left ventricle from being ableto pump out blood properly. And it was also blocking one of the valves, the mitral valve, and so it could not fully open and close under times of stress or rigour, such as running or walking up a hill or climbing a few flights of stairs. And this was the challenge, and it wasn't just playing sports. Unfortunately, it was literally every day I would struggle with this, just tryingto live, you know, walking to school, doing things like that. It was an everyday occurrence multiple times a day.

spk_1:   3:44
Did you ever faint?

spk_2:   3:46
There was one episode where I fainted, and this happened later towards my senior year and ultimately led to the next course of treatment for me, which was the pacemaker. I was actually running towards the school bus. The school bus had come early that day, and I pushed myself so hard trying to catch the bus that I pushed past the chest pains and eventually just ended up waking up flat on the ground because I had collapsed.

spk_1:   4:08
Oh, wow, that's scary.

spk_2:   4:10
It was very scary, and I was out for about not very long, maybe 10 15 seconds, and I got right back up and hopped on the bus. Of course, the kids on the bus were laughing over myself, but I had completely fainted and collapsed. And that was that was the one time I actually pushed myself so hard. There were several times where I came close. I was dizzy and play and stuff like that. But that was the one time where I actually completely collapsed.

spk_1:   4:33
Wow. You know, the first thing that is shocking to me is that it sounds like you were about six or seven years old when you first started to have symptoms and nobody recommended you goto a cardiologists, then that it wasn't for years. I mean, over a decade, right?

spk_2:   4:49
It took a while. I would say I was probably fourth or fifth ways. Maybe you're nine or 10 years old, and yet it did take several more years before it simply wasn't going away, That we've got referred to a proper cardiologists. As I said, this being in the early days, there just wasn't a lot known. There wasn't a lot of information about hypertrophic cardiomyopathy. Like the risk today, You know, it was just a challenge to find out what was going on?

spk_1:   5:11
Yeah. Did you have any kind of treatment in those early days?

spk_2:   5:16
I'm trying to remember at the time they may have put me on a medication. I know. Certainly. Once I was diagnosed, I was put on beta blockers and eventually onto calcium general blockers because for some reason, beta blockers or the traditional way you treat heart failure or eight cm as well. But it wasn't treating my chest pains. And so eventually we get switched to calcium channel blockers and that at least control the chest pain part of my problem. So those were the main treatment at the time, were just medication.

spk_1:   5:40
So you didn't have any surgeries as a child?

spk_2:   5:43
Not until I was 17 after they had collapsed. Um, we went back to the cardiologists and that sort of set in motion the decision to move beyond just medication and add a pacemaker to the treatment plan.

spk_1:   5:55
Oh, wow.

spk_2:   5:56
The idea at the time again, this was now the early nineties about 1993 is when I got the pacemaker in between my graduating high school and entering college. I was 17 at the time. The reason for the pacemaker the concept at the time was that they were trying to change the way the heart was beating. You know, traditionally, your heart sort of pumps left, right, left, right, very quickly. The two chambers of your heart pumping together What they were trying to do was slightly offset the pace of the heart such that it would go left, right, and a little slower fashion left, then right, left and right. And that way it would basically cause the heart to give a little more time to allow hopefully that left ventricle to pump more blood and that valve to stay open a little bit longer so that maybe a little bit more blood could flow through. That was that concept, the theory behind what they were trying to do? Unfortunately, that didn't really work. And that approach has since fallen out of favor in the medical community as well. And so, yeah, when you pump right toe left, it's going to contract differently. And so this was kind of where the challenge was with the heart. And unfortunately, the pacemaker by itself was not able to provide that functionality for me

spk_3:   7:03
takes this hot industry. We're offering us a mechanical hot, and he said, now that I've had enough to give it to someone who's worthy My father promised me a golden dressed world and held my hand and asked me where I wanted to go. Whatever strive for conflict that we experienced in our long career together was always healed by humor.

spk_4:   7:24
Heart to heart With Michael Please join us every Thursday at noon, Eastern as we talked with people from around the world who have experienced those most difficult

spk_5:   7:31
moments forever by the Baby Blue Sound collective. I think what I love so much about this CD is that some of the songs were inspired by the patient's many listeners will understand many of the different songs and what they've been inspired. Our new album will be available on iTunes. Amazon dot com. Spotify. I love the fact that the proceeds from this CD are actually going to help those with congenital heart defects Enjoy the music home

spk_1:   8:08
tonight forever.

spk_0:   8:17
You are listening to heart to heart with Anna. If you have a question or comment that you would like to dress down show, please send an email to Anna Dworsky at Anna at heart to heart with anna dot com. That's Anna at heart to heart with anna dot com Now back to heart to Heart with Emma Before

spk_1:   8:36
the break, we were talking about your heart condition and when you had your first medical treatment, which sounds like it was mostly medication and then finally a pacemaker. I know from your bio that in 2011 you went into congestive heart failure. So I'm guessing that the pacemaker was it good enough to keep you out of heart failure. So why don't you tell me about that time?

spk_2:   8:59
Sure, that was a little bit later in life. The good thing was, I enjoyed a good 15 plus years, pretty stable. Once we got the medication straightened out, the pacemaker was implanted and I graduated college. I started a career started a family settled down in life, was very good, but unfortunately my condition very slowly at the time deteriorated over several years, obviously, until it finally got to the point where it actually occurred. While we were on vacation, we had gone to Disney World with the family and we were staying at one of the Disney World Resorts and we were walking from our hotel room to the cafeteria, and normally that's a very straightforward walk. For me. It wouldn't have been a problem. But that day I was struggling to get to the cafeteria. I had to stop several times along the way and catch my breath and didn't really understand why we had just arrived in Florida. I thought, maybe allergies or something like that, and it ended up not going away, and I basically realized that something else must have been going on as well. We struggled that whole week in Florida with getting around the parks. Obviously, those parks are very large,

spk_1:   10:02
They're huge and it's so usually hot and muggy, which is probably not the weather conditions you were accustomed to you being from New England.

spk_2:   10:10
It was definitely a difficult time getting around, but fortunately my kids were small and we took our time and we were able to enjoy the parks. But we got home. I went right back to work the following day, and I was at the time commuting into Washington, D. C. Taking the subway. There's lots of walking, obviously when you take public transportation and I remember specifically trying to walk from the metro subway station to my office, and I could barely walk 10 steps or 12 steps without having to stop and catch my breath for one or two minutes 10 or 12 steps and do it again. And it was really challenging, even getting to the office. And that's when I went back to the cardiologists. Cardiologists took a look. Ransom tests did an echo cardiograms and a chest X ray, and they found that my lungs had filled up with fluid and I actually had to get my lungs tapped and they took out. I believe, about a leader fluid

spk_1:   10:57
from

spk_2:   10:58
one of my lungs. It had filled up so much. And that's also when the cardiologists looked at my condition and said, Your echocardiogram no longer shows that you have HCM. I'm not seeing that as being the problem. The large septum is being the obstruction you're now in congestive heart failure or C H f. And that's when we basically now got re diagnosed as having congestive heart failure. My hypertrophic cardiomyopathy had evolved and basically progressed into C H F, and that's when my cardiologists recommended I changed from having just a pacemaker to now getting an I c D.

spk_1:   11:32
Okay, so that's a big change for you. You're a father of two small Children. I'm sure that was really concerning to you.

spk_2:   11:41
Absolutely. That was a big deal for us. With two young Children at the time and obviously now dealing with hard issues all over again. I thought I had passed all these heart issues as things were so stable for so many years. And now here they were coming back up again. And it was it was obviously creating a lot of stress. But fortunately, you know, I agreed to do in the I c d. What? I understood the benefits. The main reason for this was twofold. One is they wanted to try and install this as what they call a bi ventricular pacing device, meaning a traditional pacemaker only works usually on one side of your heart. But with these newer I C. D devices, they could do what's called by ventricular pacing. They could actually put leads on both sides of the heart and control the way both sides of the heart brand. So they were attempting to do that. And of course, the icy gives you that emergency backup. In case your heart does go out of rhythm or fail, it can shock you back into a normal rhythm. So the doctor felt it was better to have that safety measure in place as well. Unfortunately, the Bible cricketer pacing they could never get installed properly when they put the pacemaker in. We couldn't get the second wire, so I ended up with just a traditional pacing. But at least I had the eye CD as that emergency backup in case my heart did have an issue and it needed to be kicked back into gear.

spk_1:   12:47
And don't the eye CDs also have a memory where they can keep a record of your heartbeat. So if your heart beats starts to be erratic, or you start to have certain arrhythmias that there's a record of it?

spk_2:   13:00
Yes, the eye CDs were technologically advanced. They could store all kinds of information, hissed a grams, and they could also monitor fluid levels in the heart and all kinds of things. So there were lots of benefits to having this more advanced device than just a traditional pacemaker that we were able to take advantage of.

spk_1:   13:16
So how many years had you had the pacemaker.

spk_2:   13:18
The pacemaker I had since 1993 through about 2011. And I had one battery change at that time. One device change.

spk_1:   13:26
You're kidding. It lasted that long.

spk_2:   13:28
The 1st 1 I had lasted about 13 or 15 years before I had to change it.

spk_1:   13:33
That's phenomenal. I kind of want to know what brand it was to give a plug to them because that's just phenomenal.

spk_2:   13:39
It was a Medtronic menu. It pacemaker. I actually still have it with me. I asked them if I could keep it when they took it out.

spk_1:   13:45
Yeah. I mean, that's part of your history. I would, too. And it saved your life. Probably.

spk_2:   13:50
It was definitely a one of a kind unit. Unfortunately, I CDs don't last that long. They typically last may be up to five years, maybe seven years, if you're lucky. So it was definitely nice not having to go through multiple surgeries frequently to change.

spk_1:   14:02
All right. I think the I CDs have to work so hard. Since they're gathering so much information, it doesn't surprise me that they don't last quite as long. But it seems to me that from your bio. Even the icy D wasn't good enough to take care of all of your problems. Tell me what happened when your health started to decline again?

spk_2:   14:21
Yes. So basically, what happened after the icy was put in? I definitely felt better. But we combined that with a number of other treatments. The primary one being the fluids. I had to now take a diary, Atticus. Well, to keep fluids off of my body and we also switched over time to a lower sodium diet, trying to buy just the way I ate. So I retained less fluid for anyone with serious heart issues. They'll often put you on this cardiac type of diet where you're trying to eat about 1500 milligrams of sodium per day, which is very little. It's about 2/3 of a teaspoon of salt. And so it takes a lot of adjusting and getting used to trying to find a diet that works,

spk_1:   14:56
right? I mean, forget eating out.

spk_2:   14:58
Yeah, exactly.

spk_1:   14:59
Because eating out people that fast food, restaurants and even nice quality restaurants they kick in a bunch of salt without even thinking about it.

spk_2:   15:09
You got it. That's what restaurant you're doing right there trying to play to your taste buds. And so they enhance the food with the lots of sweets, lots of salts. And so, unfortunately, that made eating very difficult. And I had to learn to start cooking on my own and preparing things and learning to do it, which I enjoyed and eventually picked up. But when I first went through, it was a big change and really took a lot of work and effort to learn how to do that. But, you know, those dietary changes along with the diuretics were meant to just keep the fluids off. The problem was, my heart was still getting weaker and weaker, and it was happening much more rapidly than before, whereas before it took 15 years for my heart to go from HCM to heart failure. Now, in the next two years, from 2012 to 2014 I was becoming much, much weaker. I could. By the summer of 2014 I couldn't even walk up a flight of stairs without having to stop and catch my breath. It was that bad. It had progressed so quickly.

spk_1:   16:00
So what options did they present you with

spk_2:   16:03
basically what we did at that time in 2014. Other parts of my body were having issues. You know, my simply wasn't getting enough blood to supply my body's needs. And my cardiologists finally said to me one day, Look, I've taken this as far as I can. I can't treat this anymore. I need to get you to heart failure specialists. And so he referred me back to Washington Hospital Center to the Advanced heart failure team there. And that's when we started looking at what to do about the heart failure issue specifically, and I went down there one day and they ran some tests and they immediately admitted me toe to the hospital in order to knock fluids off of my body. And they told me that day Look, they explained to me the four stages of heart failure and basically I was in the later stages. I was going from stage see, which was basically allowing you to get treated with medications and with diabetics to now evolving into the last and final stage, which is Stage D, which basically meant you needed a heart transplant or some other no serious medical invention Surgical that would ultimately fix the issue. And that's when it really, really hit me hard.

spk_6:   17:07
Anna Dworsky has written several books to empower the Congenital Heart Defect or C H D community. These books could be found at amazon dot com or at her Web site, www dot baby hearts press dot com. Her best seller is The Heart of a Mother, an anthology of stories written by Women for Women in the CHD community and his 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 baby hearts press dot com to find out more.

spk_4:   17:44
I am with origami L jewelry and we personalized lockets. It has helped me heal so much by having that locket. I've had other friends and customers who have created lockets. They'd love their lockets, and they gift lockets to people who are bereaved or they're celebrating somebody

spk_5:   18:04
to get your own origami. Our luck it Contact Nifc Jensen on Facebook for her website. Dancey dancey made dot origami owl dot com

spk_0:   18:14
Way.

spk_1:   18:20
Before we went to break, you were telling us that things were becoming dire. Tell us what happened next.

spk_2:   18:29
So this was the first time ever heard the term L that in my life, the doctor said simply that there weren't enough hearts available for me to get a heart transplant quickly and that there was this technology called a left ventricular assist device. That's basically a partial artificial heart that would take over the pumping of the left side of my heart, which is where all my problems were and would provide me to benefits. One was it would give me the time I needed to wait for the heart transplant, which he said in the D. C area was roughly at least two years on average for someone to wait for a heart at that time with my blood type. And he said, the other major thing was, it would greatly improve the quality of my life. Shortness of breath would become a thing of the past. For example, I could enjoy an excellent quality of life for as long as I needed to wait for the new heart. This was pretty shocking to me. I had already been through several sets of manmade devices in my body, none of which really fixed my problem. So I was very skeptical.

spk_1:   19:28
Sure, I would be, too.

spk_2:   19:29
Oh, yes. And so I did a lot of research. I went online, I found Facebook forms and groups and blog's, and I read about others who had gotten this l bad device, and most of them were very happy with it. And they indeed said it improved the quality of their life. And so I said, Okay, I'll go forward with it. And sure enough, in September of 2014 I was implanted with the L dad.

spk_1:   19:51
Now is this something that is a major surgery where you had to be hospitalized for a long time? Or was it like getting the pacemaker or the I C. D.

spk_2:   20:01
This was a major surgery, and indeed it's considered the tougher of the two surgeries compared to heart transplant, the L. That is the much more difficult surgery, and it was very much a big deal. I was in the hospital for about a month from the moment I got the L VAD to the time I was discharged from the hospital. It was about a month and it took a good three months after that, for me to finally feel normal, and I had to go through physical therapy, occupational therapy, you have to learn how to walk again and all these types of things. It was definitely a big deal, but the payoff was amazing. I can tell you, three months afterwards, I was up and about, and I was ready to get back to work.

spk_1:   20:36
Wow,

spk_2:   20:37
I felt energetic. I felt strong and most importantly, I was able to go and take my kids to school. I was never tow Walk my Children to school all those years and finally I had enough energy that I could go do that, and I loved every moment of it. That was the greatest thing in the world. Was taking my kids out and just walking them to school and spending time with them. The quality of life issues really went away. I could walk anywhere. I needed to walk and not be short of breath anymore.

spk_1:   21:05
So did this give you hope that once you got a heart transplant, you would resume a more normal life?

spk_2:   21:11
Absolutely. I I knew that this was meant as a bridge, but it would give me all the time I needed. So I was very patient, and I knew that I could just go back to living life. I didn't have to worry and think constantly about my heart. I could just go back to living, like normally for a CZ, long as I needed to. But we all knew at the end of the day that the ultimate solution was to get the heart transplant, because the quality of life after heart transplant for those who have gone through l've ad and transplant, all of them will tell you that the heart transplant is the better option in the long run. Because the biggest limitation with the L, that is you can't go swimming, for example, can't do anything in the water. My kids love to swim, and so that was a big part of it. That I would love to have back is being able to now go back in the bull with my Children and swim with them and do things like that. And again, I no longer have to wear a device around my neck and constantly change batteries and plug things in. So there's certainly a much higher quality of life that I'll be able to enjoy now with the heart transplant. Once I recover fully from this as well, it'll take another few months. I just had the heart transplant a few months ago, so I'm on the recovery stages just like I was with Yell bad. But I know that the hope and the optimism that I enjoyed from the L VAD carried over to the heart transplant, and I knew it was going to be successful in very positive, so I was very happy.

spk_1:   22:24
Well, tell us about how long you did wait with the l bad before you got your heart.

spk_2:   22:30
Sure, it was three years and 10 months at El Bad and then I out of the blue. I was very surprised. I gotta call July 16th. I got a call from the heart transplant coordinator of Johns Hopkins in Baltimore telling me that they had an organ available and they asked me how would take for me to get down to the hospital. It's about 50 miles away from my home. I told it would take about an hour and 1/2 to 2 hours for us to get there. You get things settled, you know, get my Children taken care of. And sure enough, my wife had just pulled into the driveway with the kids. They had gone shopping and I told her right away said, Look, we need to go back all the cell, bad stuff and take it to the hospital. They have a heart, a potential donor, heart available, and we need to get going now. My kids, they were completely shocked and they started crying and they were very

spk_1:   23:13
scared. I'm sure they were.

spk_2:   23:15
It was a lot for them, Thio, absorb. But I immediately took them when we hugged them. And we told them this was the ultimate journey, that this was actually a very, very good thing, and that now Daddy would no longer have to have the limitations he had. Now he could go back and go swimming with them, and he could no longer had to wear this bag around his neck all the time and all these wonderful things. We could enjoy life again and be free of carrying these devices. And they did an excellent job, really handled it well and understood. And eventually we were able to get them packed up overto our neighbor's house so that Mom and Dad could focus on getting dad to the hospital. And so that evening we've got to the hospital. They immediately got us into the E. R and through the procedures and had a room for us. When we got upstairs, they gave us some more information. They basically said There's a team of doctors that there now at the donor site and examining the organ itself and making sure everything was healthy and they felt very good about it. So they weren't concerned, and they thought the surgery would start around noon the next day. And then later on, they came back and informed us that actually, this particular donor did a wonderful thing. They were able to use many organs from this donor. This donor saved many, many lives, and it was able to donate several other organs. And when they do organ ex plantation like that, they do the heart and lungs last. So it ended up that my surgery occurred the following day towards later in the afternoon early evening time frame rather than at noon, because they had to take the other organs out first and harvest them And then finally they did the heart and lungs last. This this donor was wonderful and saved a lot of lives, including my own. And I'm very grateful.

spk_1:   24:46
I'm sure you are. What an amazing story. Because if somebody is listening to this show who has been dealing with congestive heart failure and they're being offered the l've at is a bridge to transplant, what would you say to them?

spk_2:   25:00
I would tell them. Take it, Don't hesitate. It will give you an excellent quality of life and allow you to continue living while you're waiting for that heart. And remember, you aren't just going through it to buy more time. The doctors are implementing this El vato let you enjoy life again. You'll be able to do things that you haven't been able to do in years, and the limitations are fairly minimal. As I said, you can't go swimming and you can't do physical sports contact things. But outside of that, you can do and resume pretty much all the things in life you were doing. I mean, there are some l bad patients out there who are bodybuilders and who are lifting weights and doing all the things they were doing before they got into heart failure. Whatever the cause of the heart failure was, they were able to go back and resume their lives. And there's no reason you should feel like it's going to hold you back. And even my family. We started going on family vacations again. We went this far. Oppa's Boston and Niagara Falls. We went down to Florida. We even went on a cruise. So we continued to live life while we were waiting for our transplant. And that's what the Elevate gave us the freedom to do. And this is very important to remember the key to getting through this all is let the doctors take care of the heart. They know how to do that. That part of the things is their responsibility, and they will do a wonderful job. Your job is to take care of your head, stay mentally strong, surround yourself with positive people and positive energy, and focus on taking care of keeping your mental state and in good health. And I promise you, you can get through this and come out of it much stronger.

spk_1:   26:26
Wow, I love it. That such perfect advice Thank you so much for coming on the program today the cost and for sharing your experiences with the l bad with us. I learned so much amazed at living over three years on this device. That is just amazing.

spk_2:   26:43
Thank you so much for having me on the show. I am truly honored to share my story, and I certainly hope it will help other spacing, heart failure.

spk_1:   26:50
So absolutely. This story is a miracle of modern medicine, wouldn't you say?

spk_2:   26:55
Correct? It really is. We're very fortunate to be living in these times.

spk_1:   26:59
We are, We really are. And I feel blessed to have gotten a chance to meet you and to share this story with the world that does conclude this episode of heart to heart with Anna. Thanks for listening today, my friends find us on iTunes and subscribe. And remember, my

spk_4:   27:13
friends, you are not heart to heart with Emma is a presentation of hearts, unite the globe and is part of the hug Podcast Network hearts unite. The globe is a nonprofit organization devoted to providing resource is to the congenital heart defect community to uplift and power and enrich the lives of our community. members. If you would like access to free resource, is pretending to the CHD community. Please visit our website at www congenital heart defects dot com for information about CHD, the hospitals that treat Children with CHD summer camps for CHD survivors and much, much more.

spk_0:   27:57
Yeah, thank you again for joining us this week way. Hope you have been inspired on Empowered to become an advocate for the congenital heart defects community. Heart to heart with Anna With your hose down, Jaworski can be heard every Tuesday at 12 noon eastern time.