Seven years ago, Sandra Holloway thought she had turned a corner. She’d beaten breast cancer in her 20s. She had gastric bypass surgery in her 30s only to need it reversed after suffering complications.
And after her weight expanded to a new high of 365 pounds, she’d finally been able to start losing again. By walking every day and using a meal-delivery service designed for weight loss, she was already down 60 pounds.
Then, in the spring of 2013, she went for her usual stroll around her farm in Townsend, MA, and collapsed. “The next thing I knew, I was waking up in the cardiac-care unit, diagnosed with diastolic heart failure,” says Holloway, who’s 52. “It was very frightening.” She required a wheelchair, supplemental oxygen, and nursing care for more than six months.
Diastolic heart failure occurs when the heart’s left ventricle loses its ability to relax normally, so the heart can’t fill with blood during the rests between heartbeats. Doctors aren’t exactly sure what caused Sandra’s heart failure, but they suspect the chemotherapy she’d gotten for her cancer (chemo can sometimes cause heart damage) as well as her obesity may have played a role; being overweight or obese has been recognized as a risk factor for developing heart failure for some time, according to a 2016 research roundup published in the journal Circulation.
Her son Zachary, 29, had graduated from high school with plans to join the Army but changed his mind when his mother got ill. But, Holloway says, “I told him, ‘This is what you're meant to do and you're going to go. I’ll work on me.’” She also has a daughter, Kaleigh, age 23.
Holloway kept her promise. While Zachary was at boot camp, she went through a supervised cardiac-rehabilitation program, then started working with a nutritionist and a trainer. She ate more fruits and vegetables and severely limited her salt intake. “I knew heart-wise I could only do a little bit, so I’d only walk a tiny bit or bike for maybe five minutes, and then I started doing free weights with a professional body-building team.”
Within a year, she lost over 200 pounds and had gotten a lot stronger.
When Zachary’s unit was scheduled to be deployed a year and a half after her initial diagnosis, Holloway surprised him by showing up at Fort Hood (where he was stationed) and falling in line during physical-readiness training. At first Zachary didn’t recognize her. When he did, he was thrilled. “He was so excited about my transformation,” she says. Holloway eventually became a certified personal trainer and took courses in holistic nutrition.
In 2016 Holloway entered an annual competition sponsored by World Beauty Fitness & Fashion Inc., in the Transformation Division. “Never in a million years would I have stepped onto a stage in a bikini weighing over 300 pounds,” she says. “I had lost over 100 inches on my body, head to toe. But it wasn’t about placing or winning. Just being on the stage with so many other amazing people and hearing them say my name, I knew I had won.”
Holloway started being asked to speak at groups about her experience losing weight, and especially about measures she'd taken to improve the health of her heart. For her, it was all about giving herself permission to take care of herself. Then you can set goals and accomplish them, she says.
In 2018 she was crowned Mrs. Massachusetts International in the annual competition showcasing remarkable married women in the state. She used the platform to advocate for women’s heart health. That led to her speaking to lawmakers during a “Go Red For Women” campaign, sponsored by the American Heart Association in Boston.
“The idea that I was able to share my story at the Massachusetts State House is unreal,” Holloway says. “I would have been thrilled seven years back to think that I would be an example to others.”
Heart Failure Setbacks
Holloway faced a new challenge when her father died of cancer last year, however. Being his caregiver during treatment and hospice took a toll. She gained 40 pounds, and then her heart health spiraled downward.
One day in February, she experienced the sudden filling of her lungs with fluid, shortness of breath, extremely high blood pressure, and a severe headache. She ended up in the hospital and back in a wheelchair after she was discharged. She’s also had two transient ischemic attacks (TIAs), which is when blood flow to the brain is briefly interrupted and causes temporary stroke-like symptoms.
“This past six months have been a challenge,” Holloway says. “There's a lot of anxiety and stress around my heart failure and trying to put things back in place to get back to where I was before.”
Heeding Her Own Heart Advice
But another health comeback seems likely. Holloway put herself back on a cardiac-rehabilitation regimen in June  and is back to eating well, favoring a Flexitarian diet—mostly plant foods with the occasional meat and fish. She keeps her sodium intake to a minimum, using herbs to season foods.
This time around, she knew what to do. “It's about knowing how to plan and how to eat, because the nutrition along with the hydration, your medications, and being honest with yourself are the biggest keys for managing heart failure,” Holloway says. “With other diseases, you can make excuses for slipping up every now and then. But you can’t play with your heart. Have a sword fight with your heart and you lose.”
Holloway says it’s important to work closely with a doctor who really talks to you and that you understand. “Don't ever walk out of your cardiologist's office saying, ‘I'm just not sure,’” she says.
Determined to improve her health, Holloway is listening to the advice she gives others: “Listen to your body. Take your meds. Respect your health condition and do the best you can,” she says. “Right now I'm clawing my way back from a crisis. But this is just another bump in the road.”