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Lucinda's Journey: Mitral Valve Repair, Tricuspid Valve Leakage, and Diastolic Heart Failure
Episode 8214th January 2025 • Open Heart Surgery with Boots • Boots Knighton
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Hey Heart Buddies! Boots Knighton speaks with Lucinda McDermott about navigating heart health after discovering a severely leaking tricuspid valve. Lucinda shares her journey, from initial chest pain and fainting to being diagnosed with a heart murmur by her OB GYN. After mitral valve replacement in 2017, Lucinda faced additional challenges, including fragmented healthcare and dismissive cardiologists. Both Lucinda and Boots stress the importance of patient advocacy, support networks like WomenHeart, and having a “heart doula” during medical appointments. The episode highlights key issues like secure insurance, patient empowerment, and the significance of clear communication with healthcare providers.

Want to contact Lucinda? Email her: lucimc2319@gmail.com

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**I am not a doctor and this is not medical advice. Be sure to check in with your care team about all the next right steps for you and your heart.**

How to connect with Boots

Email: Boots@theheartchamberpodcast.com

Instagram: @openheartsurgerywithboots or @boots.knighton

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Transcripts

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Six years later, you know, I think I'm doing well, and

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then I'm told I have a severely leaking tricuspid

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valve. Welcome to Open Heart Surgery with Boots,

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where we explore the journey of heart health through the eyes

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of those who live it every day. I'm your host, Boots Knighton,

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and in season five, we're focusing on what it truly means

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to thrive. We'll dive into cutting edge medical

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advances, share powerful stories from both sides of the

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stethoscope, and learn how to be better advocates for

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our own health. From candid conversations with cardiac

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patients to insights from dedicated healthcare

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professionals, each episode brings you closer to

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understanding the complex world of heart health. Whether you're

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navigating your own cardiac journey or supporting someone who

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is, you're in the right place. So let's get to today's

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story. I thank you for being

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here, for supporting this podcast, for

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showing up in the world and shining your bright light.

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It is not easy being a heart patient, and if you are new

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to me and this podcast, I welcome you with open

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heart and open arms. I started this

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podcast for all heart patients worldwide, and

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as of this recording, I have now been downloaded in

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65 countries, which is just really

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astonishing to me. And so thank you.

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I love you. I see you, I hear you. I am here

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for you. Please send an email

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bootsheheartchamberpodcast.com that was the

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original name of this podcast and I want to hear from you if

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you're just now finding this podcast and tell me what you need to hear

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more of what you need support with, and then find us on

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Patreon at Open Heart Surgery with Boots.

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And that is a great way to support the show and

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get involved with the community that I'm slowly getting going

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as I still continue to navigate my own heart

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story. But today I am excited to bring you

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a new friend of mine, Lucinda

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McDermott Pirro. And

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Lucinda and I met through

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Women Heart, which is an incredible

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national organization in the United States

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that is for women with heart disease. And

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Lucinda and I met in Rochester,

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Minnesota this fall, 2024, and

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I am so grateful. I hopped on a plane as a heart patient and

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navigated missed connections and a broken

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bathroom on the first flight. It was all worth it,

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too. Even after I took a diuretic, it was all worth it

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so I could meet Lucinda. And by the way,

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I had to pee in a cup. But that's another day, another

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podcast, another. Story for another time.

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So, Lucinda, thank you for saying yes. Welcome to Open Heart

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Surgery with Boots. Oh, thank you, Boots. It's a pleasure to be

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here. An honor actually. And I'm looking forward to hearing

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that story in detail. Yeah. Because that's, that's the

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girl I am. Hanger. Nice.

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Nice little teaser. Lucinda is an amazing

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musician. She's got some crazy ninja skills

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and the acting and production world and she's

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also a ninja in the health care space because she,

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like a lot of us heart patients, have had to navigate the health

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care maze and is doing it with

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grace and dignity. And that is one of the reasons why

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I brought Lucinda on today. She is a

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very young 63 year old woman. I need to

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do what she does, dance and sing because apparently that's working.

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So Lucinda, you have a brand

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spanking new valve and you are

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continuing on your cardiac confusion

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journey, which, those are your words. And so

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I, I invite you to give us the

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50,000 foot view of you and your

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journey. What's worked and what hasn't. Oh,

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wow. Okay. Well, to kick it off, the, the little

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piggy valve is about 6 years old. And so in 20, actually

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in 2017, fall of 2017, I was in, living in

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Richmond, Virginia. I was a couple months out of having hip

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replacement surgery. Again. Yes, too young. Hip

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replacement surgery. And so something may have happened there, but

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I never been told I had an heart issue. And I

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started having chest pain. Chest pain, feeling really

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tired that I chalked that up to panic

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attacks or anxiety. I was in a very

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stressful job which eventually was let go

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from. So it was a high stress time. There

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was one point in there where I actually fainted in my driveway,

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but behind the wheel of the car. So luckily I hadn't pulled out

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yet. Still I'm like, oh gosh, did I just not eat

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breakfast? You know, not paying any attention. I had

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my, my heart was being listened to. I had doctor appointments, no one said

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anything. And at the end of May, we had moved back to where

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we are in the, in the Blue Ridge mountains of Virginia from, from

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Richmond. And just because I like my

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previous OB GYN nurse practitioner, I went to see her to

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check everything under the hood. She listened to my heart and immediately looked at

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me and she's a friend with tears in her eyes and said, have I or

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any other doctor told you you have a murmur? And I was like,

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oh, everybody has a heart murmur, come on. And she said

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with all seriousness, yours is really loud and I'm very concerned

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and you need to get an EKG and do all the things. And I was

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like, well, so I did get said EKG

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and at that point, my pcp, who'd been my former

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PCP three years previous, also said, that's the same

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thing. She said, I sent you a perfectly healthy. You come back to me with

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this. What's going on? And it just. So a series of

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tests that was in beginning of June,

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actually, and by August six, they went in to

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try and repair my mitral valve, and it was too far gone. And so they

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replaced it. We had a previous discussion. If I needed to have it

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replaced, I got a porcine valve. And so then it was all the things that

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you deal with coming out of heart surgery. Now I will say I'm going to

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kind of try and give you the Cliff Note version. Six years later, you

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know, I think I'm doing well. And then I'm told I have a

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severely leaking tricuspid valve. When I first had my

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mitral valve, everything was moving so fast,

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and I really felt like a deer in the headlights. And I

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was just going from test to test and doctor to doctor. I didn't have

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a secure insurance at that point. So tests that I thought

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were covered, I was then told they were not covered. They were considered out of

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network. That's a whole other issue for another

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episode, I suppose. But I was very happy to

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be just told what to do. I had a good friend. I reached

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out to my friend Teddy, who had had similar

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surgery, and he said, if you. He talked me through some things.

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He said, I can tell you what's going to happen if you want to know.

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I said, I don't want to know. I said, I don't think I can handle

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it. And he said, okay, I won't tell you and don't look

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it up. So in terms of what the surgery was going to do,

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all the details, he wanted to know. So. So I had to. I just

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depended on the. I felt I found a good surgeon. My

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cardiologist was about 45 minutes away at the time because there was no one

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close. And so for that procedure, I went

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in really not knowing. Knowing very little about the heart,

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maybe close to nothing. And so, you know,

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fast forward to this past March or April,

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actually. I had the echo done. And

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in April. March, sorry, March and the previous

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year, I'd be going through different tests because I started having atrial

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fib, a flutter and some pain and feeling

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short of breath. And my cardiologist started doing tests. So

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it took over a year from the time I said, something's not right. In April

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of 23, April of 24, that was in March. So around the

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end of April, I get these results about, you have a

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severely leaking tricuspid valve. And I was like,

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oh, well, I expected you, him to say, like, oh, you're

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doing fine. Towel on, off, and we'll do this echo again in three years

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or whatever. And so I like, well, what does that mean? He said,

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well, you know, we'll, We'll. We'll check it out

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in. Again in six months, we'll do another echo. And, you know, if

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something needs to be done, well, now they can, you know, do things through the

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vein and you might not have to be opened up again.

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That's all I got, and that's all I

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absorbed. And because I'm. I've been taking

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courses towards being a mental health coordinator, on my way

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home, I knew that I was flooded and

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in some kind of emotional state because I wasn't paying attention to the traffic, and

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I almost got hit. And so that's when I realized,

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wow, you're really having a rough time

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with this information. I'm just hearing this. Very dysregulating.

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Yeah, it was out of the blue. So I

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determined after that that this time around,

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whatever this was going to be, I was going to do, learn as much as

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I could. Put myself through a 101 about how the heart

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works, read everything I could, read up on what this

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thing is, what my options are, and I will not

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go to a doctor by myself again. And started

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finding out where I can go. Where's the best place for me, whether it's in

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Virginia. Cleveland Clinic, which I ultimately went to. And

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so I started doing all the research. And that set me on a path to

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becoming what I call a fierce patient advocate and eventually also

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finding. Finding women heart. Because my second question to him

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was, is there any support for heart patients

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here in Blacksburg, Virginia? No. How about

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the New River Valley, which is our region? No. Roanoke,

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which is the closest big. What we call our big city

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shopping. 40. 40 minute, 45 minutes away?

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No. And I went online. What's in Virginia? Nothing, except in

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Hampton Roads. And if you think of the state of Virginia and how that's shaped.

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Oh, it's a very long way. It's a long way away. We're in the mountains.

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Hampton Roads is the coast. So five hours.

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So. And eventually it's when I found women heart and realized kind

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of what. When we were there. Boots. The, The. The. We heard

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lots of really wonderful scenes. But I think the thing that stuck with me the

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most was I first asked, why me? And

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then I asked, why not me? Wow. Okay.

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Say more about that. Well, I have known for

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myself, maybe through the first heart issue and just, you know,

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other things in my life. I think it's been kind of a find it

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out by doing is that if you're stuck in

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something, you can either, you have a choice, you can either stay stuck,

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you can either feel sorry for yourself, or you have a choice. And I think

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the only way out of something is through, or the

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only way through something is out and through helping

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either helping others or doing something where you. You got to get outside

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of yourself. You got. You got to get over yourself, and you got to get

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outside of yourself. It's not to ignore yourself. But if,

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you know, no one's been able to tell me how long I have, you know,

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and with the new diagnosis that I have, no one's

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been able to say, well, here's your life expectancy. So I guess part of

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it is, well, if it's going to be shorter than

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I had hoped, then I damn well going to make

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sure that what I do, at least I feel that

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I have spent my time in a good way, that it's been

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worthwhile. Well, that's a really good, like, existential

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sidebar. The pros and cons of

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wanting to know how long. Right. Yes.

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Yes. Yeah. Like, what are. What is the benefit of asking that

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question and what is the drawback? Well, the

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drawback is. Well, let me back up,

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because what I. What I hear in my head, my mother is yelling. In my

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head, my mother passed away in 2010, and my mother is saying in my head

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right now, you either live to live or you live to die. And

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I think maybe that answers both questions.

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And, you know, I have. I have two children, adult

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children, 28 and 30. And if

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there's something that I need to do to make things easy

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for them, I want to do that. And so I'm not going

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to wait around. You know, things are in order.

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A will is done that was actually done when they were toddlers, you know, all

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those things. And it's funny because I don't get depressed

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about that. If it did, I think I'd stop and I'd shift gears in

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my. In my brain. But I've been through lots of instances

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where, whether it's my husband's parents

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or my parents or other folks didn't plan well,

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and they made hell on earth for their people, and I don't want to do

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that. Gotcha. Yeah. And I. I think it's normal, too,

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for us to hit Dr. Google

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and, you know, look up Life expectancy. Because

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like when I think of life expectancy and asking that

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existential question, I think of cancer

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diagnoses, als, you know,

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some of these like bigger, well this is big too. But like those really

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big hitting diseases that are just

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on their own level of hard. I'd like to think of

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heart disease. I personally, I look at it as having a few

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more options and, and more easily

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fixed than you know, unwanted cells growing

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at fast paced in a human body. It's also just a normal

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human curiosity of us to know what, wanting

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to know what this means for our longevity or lack

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thereof. You know, and it's funny because you mentioned als. So

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for me, I guess maybe the thing is that why I'm able to

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say I don't. You know, when I first did Dr. Google with

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it, I wasn't seeing such great stuff and that was a little

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emotional. And then I remembered my father was diagnosed with

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ALS when I was four years old and we were told he had two years

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to live and he lived for 27. Wow. He lived for

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27 years to the ripe old age of 86. It arrested in his

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arms and hands and ultimately they weren't sure what

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that was. So my takeaway from that is

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they don't know everything. And even if they were to

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say this, this long, this blah blah, blah, I am not going to allow myself

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to be defined by that. And in fact it may just be a

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thing of. Well, that's what I'm going to bypass, you

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know. While you dance doing it. Yeah, exactly.

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So you have this, this severe

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tricuspid leakage. Yep.

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How is this impacting your day to day? And, and then

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also. And then it took you to Cleveland Clinic, right? It

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took me to Cleveland Clinic in August. I had, was able

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to get a three day workup and going there. It was

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my intention to. My goal was to see if I was, was

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going to be a candidate for the trans tricuspid valve

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repair where they do this cute little thing where they go through.

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Did I really just use the word cute? Where.

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Yes. Okay. So where they go, you know,

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it's, it's non invasive and. But it is cute. If you look

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at the video, the little thing is kind of cute. It almost looks like a

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little mush. It looks like a video game in my

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mind, in my brain. Anyway, it's, it's

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new. You have to be considered high risk for them to do

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it. So I went and I was tested

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and within, after a couple of

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tests they said number one, you're too young. Which of Course, you

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know, I loved. But it's because this has only

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been around. It was just approved by the FDA in April of

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24. So they said we don't know how long. What we don't know

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because it's so new is how long it will last.

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And you're only 63 and

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we don't want to have to put, you know, put them on top of each

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other. And he literally said like Russian nesting dolls

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or to have to go in and do the invas open you up anyway

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to take it out. And so that was the first reason,

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not knowing how long it's going to last. The second reason is they did not

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know if the tricuspid valve issue was a

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primary issue or secondary. Primary, meaning the

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valve is messed up. Because it's a messed up valve.

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Secondary if something else is causing the

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leakage. So I was sent home, told we'd

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have a follow up on October 2nd. So, as you know, I had that follow

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up on October 2nd and I was still a deer in the headlights

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from the news I got when I saw you basically the next weekend.

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And so what I was told is the tricuspid valve

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leakage is a secondary issue and that I have

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diastolic heart failure. And again,

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deer in the headlights, because what I'm hearing now is

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I have something that is no longer acute

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and potentially can be fixed. Now I have something

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that is chronic and can't be

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fixed, will be managed by with medication for the rest

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of my life. And this is so the shortness of breath

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is because my left ventricle, diastolic

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in that mode, does not relax. It is

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stiff. So that's what I got. And it was really,

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really, really hard to hear. And I didn't

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feel like through all of this I haven't felt like my

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current cardiologist did due diligence. I

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had to keep asking for things to be done. And I

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get that he is overworked, but

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I feel like he dropped the ball. So I

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have been looking for another cardiologist. I do have one. I will have an appointment

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actually on November 13th and we'll see how it goes. The other reason

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is it's a different health system.

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So the current health system I'm in their portal does

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not speak with Cleveland Clinic's portal. So I was doing things like print

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this out here. I'll go to the library and fax it. You fax this. Did

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you get the fax? You didn't get the fax? Okay, I will call them again

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and make sure that they send the fax. And so

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as one of the docs from Cleveland Clinic said, I've had a fragmented care

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team. So part of my job now as a patient

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advocate is I am addressing the fact that I've had a fragmented

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care team and I'm trying to clean that up. All while

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trying to manage your heart, your symptoms and self care

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and. Yeah, yeah. And be a gig worker. Freelance gig

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worker. Yeah, yeah. I hear this more than

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I don't. And I don't doubt it. Yeah, that's the,

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the hidden price we pay. We don't have the

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luxury like life keeps happening around us heart

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patients. Life doesn't stop. Right. And so not only are

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we having to advocate fiercely for ourselves, we

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are also keeping up with the laundry and you know,

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maintaining our homes and our jobs and our relationships

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and then, you know, dealing with world current events. It's

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like so much for the nervous system to

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handle. There's just so much more to our stories than

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what you see on, in the scar in our chest.

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Yeah, for sure. For sure. And when I started on my

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journey as a, as an intimacy director, you know,

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I had to take a lot of. This is going to sound like it's out

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on left field, but I had to take a lot of cultural competency courses.

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And in one of them, one of my teachers who is a

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black woman said, you know, the thing, one of the things that's different and

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for your, for your listeners, I am a lily white

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woman and I should have said before pronouns, she, her. One of the,

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that she, she. What she said was black people don't

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have the privilege of making themselves

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victims and, and whining for too long. You know, we don't have the

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privilege we have of just kind of wallowing. We have to get on

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with it. And sometimes in those moments where it's

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like, and it's not to say that you were not allowed a day or a

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time to do whatever you need to do, mourn, stay in

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bed, you know, watch Netflix, do whatever you need to. Because

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sometimes that is simply self care. But we also

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have to realize that the only person who is accountable for moving on

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and, and getting the done for ourselves is

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ourselves. We cannot rely on the doctors. We can't rely

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on somebody else. We have to, we have to drive our own ship

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simply, you know, no. One'S coming to save us. No,

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no one's coming to save us. No. Night on White

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horse. Yeah. And I, I can hear

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real little curiosity bells going off for people. Can you just

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spend one minute explaining a little bit More about your

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intimacy coordinator role that you've had. Sure, sure.

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So I think the, the. So I'm in theater arts. That's my, that's

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my field as a. And have been

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actor, playwright, director. And four years ago,

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I found this new function in the entertainment

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field of intimacy work. And what that is is someone.

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So on one hand, if you, you're probably familiar, most familiar with what a

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state a fight choreographer does for film and for,

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for theater is that they, they

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choreographed and simulate fights to look real, but they're not

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because it would be impractical for an actor to actually

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get stabbed with a sword. Right. Or to get smacked. You know, so

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we choreograph it, we make it look real. So we do the same

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thing with intimate scenes is. And it used to be that you'd have a

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director say, you know, if there was a kiss or blah, blah, blah, or whatever.

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Oh, just go for it, you know, get into it. And so

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there was a lot of harm being done. There was no consent, there were no

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boundaries. So in the training of this, you,

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besides just learning how to choreograph a really good, you know,

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a scene to look like, wow, that's good.

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You're also realizing you still have to tell the story, the

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story arc. But we also take a lot of courses and understanding, you

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know, cultural competency, trying to be consent

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forward, boundary awareness and to, to reduce

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harm in those workspaces. Fascinating.

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Boom. So, yeah, for those who have

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curiosities now, you know, and that's a thing. And, and

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you're doing this as a heart patient, and

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that's amazing. So speaking of, that's kind of a

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great segue of, of consent and

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boundaries with our health care providers.

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You have obviously had experience with

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being dissatisfied with healthcare providers that you

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have interacted with and even some recent

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stories, and we're not going to mention names, but, you know, there's, there's

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a way we heart patients need to be

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seen, heard and validated by our

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providers that we're trusting our stories with. Yeah.

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And you and I and many other people I've had

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the privilege, privilege of interviewing for this podcast have all

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experienced moments where we have

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not been heard, where we have not been seen. And can you

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share with us your experience and what you've learned? Yeah.

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First of all, so as you know, we're both empathetic people.

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As a playwright, I try and

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I automatically think of what's the other character feeling, you

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know, because you want to paint 360 degree characters. So

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sometimes this is a detriment to myself because. Because I almost give the other person

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too much leeway in real life. So I

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understand that cardiologists are.

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There's not enough of them. They have too many patients, their time is

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important. They are trying to

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balance their patients as well as trying to stay up on

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current stuff. You know, I remember, I remember

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you asking that question of, of some of the cardiologists

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we were with, of how do you stay up with current

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research so understanding all that. But we are also

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people who, when we come to a cardiologist who has opened the

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door to say, you know, you can ask me questions, ask me anything.

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I think maybe sometimes they forget how

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vulnerable, raw and

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tired we are with trying to figure this

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out. I mean, it's like if I was asking a

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question about my child, I am all in. I

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am viscerally connected to

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trying to find out what's happening with child. Well, I'm viscerally connected to my

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heart. So when I'm asking you a question about my heart, it is not

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frivolous to me. And when I'm asking questions about,

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you know, I said cardiac confusion, I thought, oh, I have this, I have

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this diagnosis by stolic heart failure. So when I

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hear someone mention diastolic heart failure

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sometimes is an umbrella diagnosis for something

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else. It could be blah, blah, blah. And if I didn't quite catch that

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because they're using an acronym, you know, just the

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initials of this very, very long thing. If in a

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follow up I ask them, hey, I heard you say that

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it could be something else, what is that? And this

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particular cardiologist responded, well, I mean

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that's like heart failure. And then looks at another cardiologist kind of

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chuckle and say, well, that's just a, that's just, it kind of can be a

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trash can diagnosis. And to tell you the truth, after trash

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can diagnosis, I didn't hear anything else. Yeah.

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Because I felt like I was

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in inside of that camera

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technique where the camera is on you and everything

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in the background recedes. And

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I heard it was like hearing wow. And

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I'm sure there's some term for that

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dysphoria, something, whatever. But I did, I felt extremely

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dismissed, unheard. And this was

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from someone who had opened the door and said, whatever questions

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you have. Right. But you, but I'm going to meet you with trash

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can diagnosis. Hello, Trash can diagnosis.

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Astonishing to me. I thought it was very unprofessional, quite

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frankly. Yeah. For the listeners out there, like

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run my advice, I'm not a doctor here,

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but you Know, if, if, if a cardiologist says that to

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you and you're able to push back.

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I was there when this happened with Lucinda, and it was

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not, it was not in a, in a environment where she could have

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pushed back and be like, hey, what do you mean by that? But, but

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if it's like in a room, like, where you're getting assessed by a

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cardiologist in a, like, legit appointment, push back on that

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and be like, no, really, what do you mean? Because this is how that felt

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when you said that to me. And you,

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you have the right to push back and ask more.

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And if the cardiologist is put out by that, find a new

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cardiologist. Now, I say that

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knowing that might be the only cardiologist in network,

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and I have faced that myself. And that's when it's

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almost like PhD level skills of

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like, you need to keep. You don't have a choice,

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and you have to keep working with this cardiologist. But then

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you just get, you have to get better at going

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in with boundaries, asking questions, being

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fearless about, asking for what you need. And that's just

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kind of the sad state of the healthcare system

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and different parts of the United States and probably

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the world. And for me personally, just,

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this is just me reflecting with you, Lucinda. This is when I have to

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get, like, extra generous in my thinking and

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being like, this is this person's best they can do today.

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It doesn't make it okay. It does not make it

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okay. But. Wow. I have come to an empty

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well for water.

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Well to, you know, to, to help with your listeners, too. I just

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want to make sure I will follow up at. I will be

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following up on that in communication with this, with

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this particular person. But also it's a

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reminder that if that happened in a, in

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a doctor's office, I would hope that you would have had

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somebody with you. After when I was telling you the story of, when I was

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told I had the tricuspid valve and I was, like, freaking

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out, that's when I promised myself that I would not go

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to a cardiac cardiology appointment again

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without somebody else there, whether it's my husband or, you know,

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my neighbors up the street. I've talked, I've said, hey, they know what's going

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on with me, and I know that they're recently retired, so they have, you know,

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they have the time. And I've said, if, if I, I have like three

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or four people that I could go to and say, you, John,

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can't make this appointment, would you be able to go with me. And so

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I. And I make them aware. Here's my list of

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questions. Here's my goal for this visit. Please

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make sure that I stick to my goals. If something is

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said and you see that look in my eyes where

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you're like, oh, she's, she's drifting away, please

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ask follow up questions for me on my behalf.

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Yeah, Love it. I think that's great advice to end

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with. Have an advocate with you. Absolutely.

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Yeah. I did come up with a new phrase today. Before

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you say goodbye, is that I think we need heart doulas.

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Oh, I. I already offer that on my website. Do you

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really? Fantastic. Okay. Yep, yep. Heart

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doula surgery services. So,

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yeah, they kind of got. It kind of got put on ice until recently,

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but yeah, so it's. Thank goodness we don't have to go through life

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alone. And that's the purpose of Women Heart. That's the purpose of this

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podcast. Just ask for what we need and trust that the

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right people will be there with us every step of the way.

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Thank you so much, Boots. Yeah, thank you. Lucinda

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and I will have in the show notes how you can learn more about Lucinda.

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She is just a bright light in the world as you have witnessed today.

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So thank you and thank you again for

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listening to this episode. What would make my heart

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so happy today is if you would please leave a review if you haven't

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already. And if you aren't following this podcast, make sure you

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hit follow. Every follow I see every

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single time someone chooses to follow this podcast. And it just makes

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me so happy because that means I'm helping another heart. I

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really meant it when I said it at the beginning. I'd love to hear from

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you. And you'll find me over on social media as well. I

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love you. Your heart matters. Your heart as your best

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friend. Be sure to come back next week.

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