Mended Hearts Open Forum

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  • 1.  Concern about Night Shifts

    Posted 11-06-2023 21:28
    Hello! I'm wondering if anyone has any advice! I'm a 34yo and was very active and healthy apart from random fainting episodes that I had since childhood--which until this year was attributed to an increased stress response and low blood sugar, etc. I'm a certified nurse midwife and was diagnosed with LVNC after passing out in the OR while assisting a c-section at 3am last year. Apparently the episode was prolonged and severe and a respiratory therapist and ICU nurse convinced me to get a cardiac workup. 8 months later I was diagnosed with Left Ventricular Non-Compaction (which is rare but similar to left ventricular hypertrophy) with extensive trabeculations and 50percent EF. I had a tilt test with an 18 second prolonged asystole and so my EP recommended an ICD since he thought I'd need a pacemaker in anycase. I stressed about this decision quite a bit considering I didn't officially meet criteria for an ICD, but decided to get one in July. During this time I stopped taking 24hr hospital shifts and just worked in the clinic. Typically my job involves very high volume busy 24hr shifts 1-2x a week with additional clinic days. I had my EF measured 4 months after I stopped taking call and it increased by 12 percent. My cardiologist said she can't say definitively but it's likely improved since I'm not working long and stressful hrs with night shifts. She also has recommended a less stressful schedule (such as just working clinic, which I'm now doing) but feels my LVNC isn't a medical reason for her to officially recommend that I stop hospital, or night shifts--as far as disability paperwork is involved. Since I stopped working nights I feel so much healthier and more energetic (big surprise!), and I very much don't want to work night shifts again. My work has been extremely accommodating during my cardiac work up, I don't want to be the "princess" of our midwife team, but I also really want to prioritize my physical and mental health. I'm really undecided about just taking 12hr day shifts at the hospital, since they are very physically strenuous, although I very much love delivering babies. I worry that my work accommodations will eventually cause resentment in my team--since my doctor has only unofficially recommended that I stop 24hr call. I suppose I'm wondering if anyone here has or continues to work night shifts, or had work accommodations related to their LVNC. I'm aware at this point I'm thankfully overall very healthy, my EF improved, and I did have an episode of Vtach seen on my ICD, which if I continue to have it sounds like they'll start me on medication. I realize it's hard to correlate stress with arhythmia frequency but I'd like to prevent more episodes, as well as prevent Afib which happens more frequently with night shifts! My apologies for such a long post, any thoughts would be appreciated 

    Madeleine Katz
    Washington Permanente
    Seattle WA

  • 2.  RE: Concern about Night Shifts

    Posted 11-07-2023 05:13

    You are an extraordinary person with a strong work ethic.  You are facing the same situation many heart patients are confronted with at some point in their lives. How to adjust work / life balance for your long-term health? I suggest you discuss your condition with the head of the obstetrics group to determine if there is another role or position you can preform and contribute to the team. 

    Best regards,


    Victor Fabry, Founder
    Greylock Advisors, LLC

  • 3.  RE: Concern about Night Shifts

    Posted 11-08-2023 11:43
    Hello Victor,

    Thank you so much for your supportive response and validation that I'm not alone with these questions regarding balancing work with a chronic condition. I appreciate your advice to discuss with the lead of our department. It gave me motivation to contact our lead yesterday--I'm grateful our OB department has been supportive and willing to work with me. I think some of the guilt about my work restrictions is self inflicted and something I'm processing, I'm sure in many fields but especially in healthcare as providers we try to put patient's and hospital needs at the top of our concerns, sometimes to the detriment of our health! Thank you again.


  • 4.  RE: Concern about Night Shifts

    Posted 11-07-2023 19:17

    Hi Madeleine,

    I don't have LVNC nor have I ever been expected to work 24 hour or night shifts, but I am a 73 year old man who has lived through a lot and learned some lessons along the way, and I hope you will forgive me offering you some fatherly advice about your "princess" midwife concerns.  A very wise person once said that whatever anybody else thinks about you is none of your business.  That is absolutely correct.  

    You need to do whatever is right for you and not make the mistake of concerning yourself about what others think.  If others don't understand what and why you do something, that is their problem, not yours.  You live your life, the best way you know how, without concerning yourself too much about what others who don't walk in your shoes may think.

    All the best to you, including a long, healthy and fulfilling life.  And welcome to Mended Hearts.


    Ira Reid
    Hoboken NJ

  • 5.  RE: Concern about Night Shifts

    Posted 11-08-2023 11:46
    Hi Ira,

    Thank you! I don't mind some "fatherly advice", I think you shared a very important reminder to focus less on what other people (my colleagues) will think about my work accommodations. I appreciate that advice, and it's a good reminder that I need to make decisions that prioritize my health and well being, which is always a challenge for me! Thank you for your response!