By Ashley Biehl, as told to Stephanie Watson
I've been an athlete for as long as I can remember. I started swimming at age 5, and I played at least five sports, including cross country and track, all through high school. In law school, I started doing triathlons.
I was training for a 10K race when the unthinkable happened – my heart failed. I was just 26.
I had no history of heart problems. Neither does anyone in my immediate family. I have had type 1 diabetes since I was 16, but I’ve always watched my blood sugar and kept it under good control to avoid it causing other health problems.
As young and active as I was, and as healthy as I felt, I never thought my heart would fail me so suddenly – until it did.
In mid-April 2017, I was working in a law firm in Elko, Nevada, and playing on a women’s league softball team. We had our first practice of the season. The fields were about 2 1/2 miles from my house, and it was a really nice day, so I figured I'd ride my bike to and from practice.
We did some fielding and hitting for a couple of hours, and then I got on my bike and started to ride home. A pain in between my shoulder blades made me stop and get off my bike to check the tire pressure. It felt like I'd overdone it during practice.
That evening as I lay on the couch watching TV, I became nauseous and threw up. I was just getting over a stomach virus, so I didn't think anything of it. But then I started to feel warm -- so warm that I had to lie on the tile floor in my bathroom to cool off. I called my mom and said, "Something's off. I don't feel right." She told me to go straight to the hospital.
In the car on the way over, the pain really started. It began to radiate my shoulder down my arm, and into my chest. By the time I got to the hospital, I was in so much pain that I couldn't walk.
The hospital staff gave me two EKGs. One of the nurses said, "It looks like a heart attack, but you're too young." They came to the ‘working diagnosis’ that I had pericarditis -- inflammation of the layers of tissue surrounding my heart -- even though a CT scan didn't show any signs of the condition. My doctor decided to fly me to the University of Utah, about 230 miles away, for more tests.
I Will Survive
When a cardiologist at the University of Utah saw my EKG results, he said, "This girl needs to be in the cath lab immediately. Her heart is way worse than we thought -- in such bad condition." He put a stent into one of the blood vessels in my heart to keep it open.
I was lying on the table in the cath lab and I felt so hot. I remember telling the nurse, "I can't breathe." I heard the doctor say, "We need to intubate her." I was crying and saying, "No! I don't want that!" That's the last thing I remember for several days.
I was put on ECMO life support. For 10 days, a machine pumped blood for my damaged heart.
My parents came out from California, and my sisters came from northern Utah and Nevada to be with me. When my mother got to the hospital and the doctors told her what had happened, she collapsed onto the floor, screaming and sobbing. My parents never left the hospital, other than to sleep for a few hours each night.
During this time, I developed sepsis. One of my nurses told me later that when I went septic, she sat in her car and cried after her shift. She thought I wouldn't be there when she came back for her shift the next day.
But I wasn't ready to quit. I was determined to survive.
Into a Tailspin
By May 3, I'd stabilized enough to leave the hospital. My doctors told me that I had to stay within a half-hour's drive of the hospital so they could keep monitoring my heart.
Throughout the next month, my heart went into a tailspin. I developed heart failure. It got to the point where I slept on the couch because I could only breathe while sitting up. I'd stop breathing for 10 seconds at a time. My mother slept in a beanbag chair at my side so she could shake me awake each time I stopped breathing. Any food that went into my body, I'd immediately throw up.
Over Memorial Day weekend, I went back into the hospital. That's when my doctors started talking about a heart transplant. At that point, I couldn't have survived outside the hospital. I was put on the transplant waiting list.
On June 28, I got the call that a heart was available. A day later, I had a new heart.
A New Normal
I spent 11 days in the hospital after my operation. For the first eight weeks, I couldn't use my arms or put them over my head. I was reliant on my mom to do just about everything for me -- even wash my hair.
During my time in the hospital, my muscles had atrophied. I needed to strengthen them again. Three times a week, I did cardiac rehabilitation. I'd walk and do little step-ups on the stairs. As I progressed, I started to be able to jog and then do squats and lungs. Slowly I got my strength back.
Caring for a new heart is a lot of work. I had to see my doctor often for heart biopsies, echocardiograms, and to make sure that my body wasn't rejecting the heart. I had to watch what I ate, and set alarms on my phone every 12 hours to remind me to take my medications.
I don't think you can ever fully get back to normal after a heart transplant. I'm living what I call "a new normal." I have to take immunosuppressant pills, which zap my energy. Between 2018 and 2019, I was hospitalized approximately 10 times for everything from a sinus infection to organ rejection.
That said, I am able to work full-time for the Legal Aid Center of Southern Nevada, which I absolutely love. I can still swim and do some of the other things I used to do.
Hanging over me is the knowledge that I will eventually need another heart transplant. My doctors told me that transplanted hearts last, on average, 12 years. I'll also need a kidney transplant at some point, because the medication that I take to protect my heart damages my kidneys.
When I was still in the ICU recovering from my transplant, I wrote a letter to my donor's family to let them know how grateful I was. Her name was Jessica. We had a lot in common. She was also 26 years old. I had a freak heart attack that I barely survived. She had a freak stroke that she didn’t survive.
I'm still in contact with her mom, little sister, and grandparents. Jessica's dream was to travel to Japan. I've made it a personal goal to take a trip there in her honor.
Another goal after my surgery was to take part in the 2018 Transplant Games of America, which I did. I competed in 12 events, including swimming and a virtual triathlon (three events spread out over two days), and I took home 10 medals. As long as it's safe to travel, I plan to compete again next summer.
At the games, I was fortunate enough to meet other transplant recipients -- people who've been through the same experience as me. Post-transplant life is full of difficulties and struggles. We've all fought hard to live. Everyone who has survived a transplant is a warrior in their own right.
Ashley is an attorney in Las Vegas, Nevada, representing abused and neglected children. In her spare time, she enjoys traveling, hiking, swimming, reading, and advocating for organ donation. Ashley is endlessly grateful for the ongoing support of her friends and family through her health journey. She encourages everyone to register with the Donate Life Registry at RegisterMe.org