Staying or getting fit during a global pandemic is challenging even for the healthiest of individuals, but for one tenacious 28-year-old native of Milford, it was likely a matter of life or death.
In March 2020, with news of COVID-19 yet a whisper in the wings of the world stage, Julia Frense Maria started feeling unusually tired. “Exhausted, really,” she recalls. Living on her own in the Midwest where she worked for Lands’ End as an international fashion sourcing specialist, she contacted her then-primary care physician (PCP) who ran a series of lab tests revealing high calcium levels—a recurring result that Maria remembers “writing off” in the past.
This time, however, her PCP was not convinced it was a one-off or something to disregard. After retesting confirmed elevated calcium, the PCP ordered additional labs to evaluate Maria’s parathyroid hormone levels, which also came back high. The combined results indicated a possible tumor on her parathyroid gland—a diagnosis confirmed by ultrasounds of her neck, which revealed the presence of a mass on one of her glands.
The relatively rare disorder is clinically known as hyperparathyroidism and casually referred to as “stones, bones, moans and groans” for the havoc it wreaks on the body resulting from an overabundance of calcium.
Her doctor scheduled surgery right away due to the potential health impacts on someone so young. Of the body’s four parathyroid glands, the surgeon removed one full gland and a portion of a second gland.
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Lying on the couch a few days post-surgery, Maria suddenly felt strange. Sweating profusely, she felt oddly uncomfortable in her own skin with a painful pressure in her chest that ran down her arm. Thinking it might be a panic attack or some other benign reaction, she freshened up with a shower, took a Tylenol and settled down to sleep.
“I’m in bed, propped up on this wedge, and the pain shooting down my arm starts getting progressively worse—thumping and radiating,” she relays. Alarmed that she might be having a heart attack and gifted with self-awareness of her propensity toward the dramatic, she texted her twin brother for a second opinion. “No, Julia, I’m sure you’re fine,” he replied.
A couple of hours later, around 11 p.m., Maria woke up her then-fiancé Jordan Maria and asked him to take her to the emergency room. “I knew something wasn’t right,” she recalls. At the ER, the intake nurse took one look at Maria—a seemingly healthy 26-year-old woman who maybe could stand to lose a few pounds—and routinely dismissed her heart attack self-diagnosis. “You’ll be fine,” she insisted.
However, out of an abundance of caution, ER doctors ordered a blood panel to check for elevated levels of the enzyme troponin, a biomarker that indicates heart damage from a recent heart attack, which revealed Maria’s troponin was, in fact, high.
“That’s when the entire demeanor of the examination room shifted,” she remembers. “I was no longer some typical 20-something woman who’s having a panic attack or some weird chest discomfort. That’s when I really started to panic.”
Although her memory of exactly what transpired after remains shrouded in a fear-induced haze, Maria pieces together what she can from that fateful ER visit. “They put IVs in both arms and tested for any blood clots or a possible pulmonary embolism, both of which came back negative.”
Nevertheless, her troponin level remained at an alarming .91, which suggested impaired cardiac function. At that moment, faced with her own mortality and the fragility of life, Maria found herself seeking answers to questions she never imagined asking as a young woman still four years shy of her 30th birthday.
She asked the attending physician what was happening to her. His response brought little comfort. “I’m not sure,” he admitted.
“Did I have a heart attack?” Maria pressed, anxious for a sliver of clarity she could cling to as apprehension swept over her like a tidal wave. “You’re having all of the symptoms of a heart attack, and your heart is showing that its under stress,” the doctor informed her. He conceded that it was possible that she had or was having a heart attack, but he wasn’t convinced due to her age.
It was determined that Maria’s condition required a more intensive approach. As dawn crept over the horizon, she was transported by ambulance to another hospital better equipped to monitor the situation. Jordan followed behind in his car. Strapped to a gurney with IVs in both arms, Julia found much-needed comfort in Jordan’s face visible through the back window as he trailed the ambulance.
Another series of tests ensued, including an echocardiogram to determine heart-tissue damage and an angiogram that employs contrast dye via a catheter to reveal blockages or narrowing of blood vessels that feed the heart. Doctors administered nitroglycerin and monitored her troponin levels, which, thankfully, were trending in the right direction. The pain in her chest and arms began to subside, and she started feeling a little better.
After 24 hours of tests and procedures, Julia was diagnosed with a normal, healthy heart and discharged. As for what caused symptoms severe enough to land her in the ER? The attending medical team, clearly baffled, presented a short list of possible options that included myocarditis or subclinical hemodynamic imbalance resulting from the surgery, which may have caused her to have an acute, stress-related cardiac event.
Over the next several months, she continued to experience a burning sensation in her chest.
“You get one life and one body in this world. I feel the best now that I’ve ever felt about myself because I’m taking action. And I want every woman to feel that way about themselves.”
Voicing her concerns proved fruitless and only added to the confusion. Faced with a grab bag of mixed messages such as “the burning will subside over time” and “take Advil for relief” to a stern reprimand from her PCP for even considering Advil or any type of nonsteroidal anti-inflammatory drugs after suffering a possible cardiac event, Julia felt lost. Left to untangle this knotted jumble of tests and diagnoses herself, she returned home to Jordan in Philadelphia.
It was now June of 2020. The pandemic was in full force, mounting its death march across the U.S., and Julia was still plagued by a burning in her chest that showed no sign of abating.
Due to COVID-19’s onslaught, brief speculation that her health struggles were the result of unknowingly contracting the virus was soon put to bed when antibody tests came back negative.
Determined to take control of her own health, Julia reached out to a well-known cardiologist in Philly who ordered a comprehensive battery of tests, leaving no stone unturned. The results further confirmed the absence of blockages or arterial damage. In short, her heart was receiving what it needed to function properly, with no indication of extensive tissue damage.
“You either have myocarditis [inflammation of the middle layer of the heart wall commonly caused by a viral infection] or vasovagal syncope [a physiological reaction to certain triggers or stress that results in a sudden drop in heart rate and blood pressure],” he explained, adding that her cholesterol was concerningly high and required treatment with statins.
A few more tests revealed that her high cholesterol wasn’t purely the result of unhealthy food choices and a sedentary lifestyle; she carried the gene APOE4 that marked her as a “high cholesterol absorber.”
Julia, too young to be plagued with the health issues of someone twice her age, resolved to do something—anything—to reverse this downward spiral. Admittedly at her heaviest weight, having allowed herself to go like so many others as the pandemic raged, she had hit the wall.
“At that point, I was fed up,” she recalls. “Hyperparathyroidism, likely myocarditis and a genetic predisposition to high cholesterol and being overweight—I was done.”
The first steps in reclaiming her health involved an exercise regime of walking 30 minutes a day and eliminating from her diet poultry, pork, and red or processed meat, which is typically high in saturated fatty acids and can contribute to an increase in LDL, or “bad” cholesterol.
She purchased a large dry-erase calendar, hung it in the kitchen and diligently kept track of her daily progress to keep herself accountable. After researching the best nutrients for her particular needs and conditions, she adopted a Mediterranean diet and reintroduced fish into her regular food intake.
She began consistently losing weight and decided to try running a 5K, which she discovered she enjoyed. “I challenged myself to run a 5K every single weekend,” she explains. “That was my thing.”
With Jordan’s full support, they would bundle up and head to the Navy Yard, where Julia would run her 3.1 miles. “It started becoming more of a habit than an impossible accomplishment—a way for me to feel good about myself and to feel empowered.”
She also began biking. Between the cycling, running and change in eating habits, Julia lost 40 pounds and gained a newfound joy in pushing herself physically. By the end of 2021, she had completed her first half-marathon and has since competed in several triathlons.
As she reinvented herself, Julia sought out women on a similar path. “My triathlete community consists of all women; I hired two women coaches, and I currently volunteer for Girls on the Run, an after-school program that teaches girls to navigate their feelings through embracing healthy activities,” she reveals.
“Exercise and healthy eating have given me back a part of myself that I either forgot or never knew I had,” she says. “But I do know that I am on a mission to empower women all over the world. I don’t know yet what that looks like long-term, but that’s where I’m headed.”
Currently, Julia continues to maintain her health while inspiring others and working for a nonprofit committed to empowering women and girls.
“You get one life and one body in this world,” she asserts. “I feel the best now that I’ve ever felt about myself because I’m taking action. And I want every woman to feel that way about themselves.”
Since openly sharing her renewed health and sense of self achieved through diet and exercise, Julia has received countless messages from friends and peers who say she has inspired them to take ownership of their bodies and forge their own path towards wellness.
Although she’s not interested in becoming an influencer, she regularly posts her day-to-day fitness/food goals and successes on Instagram. Her feed also includes inspirational messages designed to help other women navigate their own discovery of self-empowerment.
“My main goal is to inspire and somehow wrap this into a living because, let’s face it, I’m 28 now and I can’t continue to not work,” she says with a laugh.
Armed with a new attitude, a healthy body and a firm belief that the universe is directing her to where she needs to be, Julia is ready for her next adventure. “I know it will have something to do with empowering women and girls,” she emphasizes. “I can’t wait to see where it takes me!”