The story behind HEART RESERVE
A clinician. A patient. A mother.
I’m Lisa Zahakos, RPA-C, a physician assistant, medical writer and mother of four. I created HEART RESERVE to make heart health easier to understand and help women bring their own stories into their care. I know what it is like to be the person explaining—and the person waiting for answers.
Read my story
I’m Lisa Zahakos, a physician assistant and founder of Heart Reserve.
For years, I thought of my twin pregnancy as my sons’ story.
In twenty eighteen, I was pregnant with identical twin boys, Peter and Maurice. They shared one placenta and developed a serious condition called twin-to-twin transfusion syndrome. Blood was flowing unevenly between them.
We traveled to Miami for fetal laser surgery. I had complications of my own. Ten days later, I delivered the boys by emergency C-section at twenty-eight weeks and five days.
Peter came home after fifty-three days in newborn intensive care. Maurice stayed for about three months.
I understood the medical language, but I still needed help. I needed our medical team, my family, prayer, and other mothers’ stories. I started writing about our experience, and that connected me with other families.
Today, Peter and Maurice run across soccer fields.
At forty-five, I went for a checkup because I didn’t feel quite like myself. I began asking which parts of that pregnancy might still matter to me, their mother.
I can’t say my pregnancy caused the changes I noticed years later. I wanted to understand whether anything in my history should change how we looked at my health now.
Some pregnancy complications, including high blood pressure and diabetes during pregnancy, are linked with a higher chance of heart disease later. What they mean for you depends on your whole history and your health now.
Pregnancy history is heart history.
I created Heart Reserve to help you bring your health history, your test results, and your questions into a more useful conversation with your clinician. I want you to understand what you’re hearing and know what to ask next.
Maybe you’re trying to understand a blood test, noticing changes in midlife, or wondering what a heart problem in your family means for you. You belong here whether you’ve been pregnant or not.
When I talk about reserve, I’m thinking about the life I want to keep living. I want to stay active, keep my independence, and be there for my children as they grow. I want women to have the information and support to care for that future.
Before your next routine visit, write down one part of your health history you’re unsure about. Then ask: “Does this change what we should check for my heart now?”
The free Heart Story at heart reserve dot blog can help you organize what you want to bring.
This podcast offers education. Your own care team can help you decide what the information means for you.
Love your heart. Live your life.
Narrated with an AI version of Lisa Zahakos’s voice, created and used with her permission.
Download the audio
“The patient knows what happened to her. The clinician has the training to decide what that information means medically. Good care requires both.”
My story
My twins, Peter and Maurice, shared one placenta. A dangerous pregnancy complication meant one baby received too little blood and the other too much. One was also growing far less than his brother.
Fetal surgery, an emergency delivery and months of newborn intensive care followed. Medicine saved my sons. Today, they run across soccer fields.
Our story · She Said Next
I share what happened during my twin pregnancy, our NICU months, and why that history belongs in the conversation about my own heart health.
Read our story at She Said Next (opens in a new tab)When the Clinician Becomes the Patient at Health Story Collaborative (opens in a new tab)The diagnosis was Stage 3 twin-to-twin transfusion syndrome, or TTTS. Blood was flowing unevenly through connections in the shared placenta.
We traveled to Miami for fetal laser surgery. Ten days later, I delivered both boys by emergency C-section at twenty-eight weeks and five days. Peter came home after fifty-three days in newborn intensive care. Maurice stayed for about three months.
I began Peter & Maurice in 2018, writing in real time through fetal surgery, the NICU and the life that followed. The blog has received approximately 58,000 views and continues to connect me with families facing similar experiences.
Read the Peter & Maurice blog (opens in a new tab)
Did your baby need NICU care? Keep your own health history in the conversation with the free NICU worksheet.
At forty-five, I went for a checkup because I did not feel quite like myself. I began asking which parts of that pregnancy might still matter to me, their mother.
My pregnancy does not mean I will develop heart disease. I cannot say it caused the changes I noticed years later. I wanted to ask: does anything in my history change how we look at my health now?
Read more about an early or small baby and your own heart history, or who follows your heart health after postpartum visits.
I built HEART RESERVE to help you prepare for that conversation. You do not need to know every medical term. Start with what happened, what has changed and what you want to keep doing. Your clinician can help you understand your options and decide what comes next.
Build my Heart Story
What my dad taught me
Exercise has been part of my life for as long as I can remember.
Wake up. Brush your teeth. Exercise. That was my dad.
He started lifting weights at thirteen. Growing up, my sister and I went to the gym with him. Eventually, he taught me to train. Movement became part of my life because he made it part of ours.
To me, he is Superman.
He is 75 now, and training is still part of who he is. When he was diagnosed with cancer, some of his first questions were about whether he could keep exercising, keep lifting, and stay strong through what was coming.
That did not surprise me. He has spent more than sixty years making strength a way of life.
Years earlier, when my sons were in the NICU, he drove me back and forth to the hospital. After my C-section, when I couldn’t drive, he took me. He sat beside me through those uncertain days.
When I think about his strength, I think about having him there.
Now, as he goes through cancer treatment, I understand those decades of training differently. I think about the strength, muscle, and endurance he built through thousands of ordinary days, long before he knew what life would ask of him.
That is what reserve means to me: the physical capacity we build, and work to preserve, for the life ahead.
Training cannot guarantee how treatment will go. I am grateful for every year he spent caring for his body, and I understand more clearly why I care for mine.
I want to keep moving, remain independent, and be there for my children as they grow, just as he has always been there for me.
I am training for the future I want to be strong enough to live.
My dad helped me begin. At 75, he is still showing me why we keep going.
My commitment to advocacy
Other mothers helped me find care when I was struggling to understand the options for my sons. Mary at the TTTS Foundation directed me toward Dr. Ruben Quintero. On Palm Sunday, someone who had seen my post sent me his phone number.
I called. He answered.
Dr. Quintero spent hours speaking with me. He explained twin-to-twin transfusion syndrome, listened to my questions and invited us to Miami for further evaluation. He was honest about the uncertainty. His willingness to investigate and help gave us a next step when we desperately needed one.
When the TTTS worsened, he performed fetal laser surgery while my sons were still inside me.
During the NICU months, I prayed for the things many parents get to take for granted: breathing without help, feeding, coming home. My gratitude to Dr. Quintero, the teams who cared for them and the people who helped us reach that care is part of every ordinary day we get to have together.
Writing helped me process what we were living through. Sharing it connected me with other families—and with mothers searching for care, just as I once had.
That is where my commitment to advocacy began. Today, I support families affected by TTTS and help women find the words for health experiences they may have carried for years.
Find Dr. Quintero’s information at The Fetal Institute, the TTTS Foundation’s parent communities, and resources for preemie and NICU families.
My background
I have been a physician assistant since 2003. I now work in psychiatry and addiction medicine, following earlier years in cardiology and preventive and integrative care. Since 2018, I have also supported families facing TTTS and the NICU. That work helped shape HEART RESERVE.
In Dr. Farid’s interventional cardiology practice, I evaluated patients, performed cardiac stress testing, interpreted rhythm recordings and provided medication management and follow-up. My work connected symptoms and test findings with ongoing care and prevention.
I helped patients address blood pressure, cholesterol, diabetes, nutrition, physical activity and medication adherence as part of reducing cardiovascular risk.
At Dr. Eric R. Braverman’s PATH Medical in New York City, I brought my interventional-cardiology background to cardiovascular assessment and executive physicals. PATH stands for Place for Achieving Total Health; the integrative practice addressed hormones, metabolic health, nutrition, weight management and healthy aging.
I reviewed symptoms, medical history, blood pressure, cholesterol, blood sugar, ECGs and prior cardiac testing in preventive, hormone and metabolic care. My patient care also contributed to clinical research activities associated with PATH Foundation NY. Published research from this setting during my tenure examined menopause, hormones, body composition and cognition. I also volunteered with the practice’s Wounded Warrior Program.
See my clinical experience and the practice’s published research.
I provided outpatient psychiatric assessment, medication management and ongoing care for adults with mood, anxiety, attention, sleep and substance use disorders.
I monitored treatment response, side effects, interactions and adherence, coordinated additional medical evaluation, and helped patients work through practical barriers to their treatment plans. This experience strengthened my attention to the relationship between mental health, physical health and daily life.
I continue clinical work in psychiatry and addiction medicine alongside family advocacy and women’s heart-health education.
Community leadership
I support families worldwide facing twin-to-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (SIUGR), fetal surgery and the NICU. I help parents organize questions, find credible information and connect with specialist evaluation and second-opinion pathways.
My sons and I also contribute videos to the TTTS Foundation’s annual December awareness campaign, coordinating with founder Mary Slaman.
I founded and led a volunteer network that delivered more than 500,000 masks to frontline workers. I mobilized professional seamstresses, 20 Broadway costume designers and community volunteers during the pandemic. I led two Citi collaborations supporting frontline workers and back-to-school donations, organized a Lush-supported campaign for 3,000 gift bags, and designed mask adapters that I had 3D printed to help relieve strap pressure for healthcare workers and children.
I’m developing patient-education contributions with the American College of Cardiology’s CardioSmart team, bringing clinical and lived experience to pregnancy history, cardiovascular health and practical questions for healthcare visits.
I’m developing Pregnancy Is Heart History, a case-based CME/CE initiative. Work includes accreditation and grant planning with Global Education Group, hosting and distribution planning with myCME / Haymarket Medical Education, and separate program-development discussions with ReachMD.
These activities are in development; approvals, funding and launch are pending.
I’m developing research questions on reproductive history and cardiovascular risk in consultation with Women’s Health Initiative investigators.
Following our conversations, Graham’s Foundation, NICU Strong, FLRRiSH, Sisters@Heart and Dear NICU Mama agreed to share HEART RESERVE with their communities.
Finalist for Inspiring Change Leader of the Year. The nomination centered on helping women and clinicians make decisions together, free Heart Story resources and community leadership.
Dr. Wenger provided a signed letter supporting my AMA Honors — Excellence in Communication Award nomination, based on the pregnancy and cardiovascular-health writing she reviewed.
With gratitude
Meet the researchers and contributors, read their work, and see what each person contributed to HEART RESERVE.
Meet the researchers & contributorsArticles link to their medical sources and explain what is still uncertain. An expert is named only for the work described in their credit. Education helps you prepare; your clinician helps you decide on your own care.
Read the editorial policyPublished in Healthcare IT Today
By Lisa Zahakos, RPA-C ·
A woman’s latest test result is only one part of her health history. In this guest article, Lisa Zahakos, RPA-C, explores how health records could bring past events, symptoms and results into a timeline that patients and clinicians can review together.
The article considers how to preserve a patient’s own words, check the sources behind a summary, correct errors and make the next step clear.
Read the published article (opens in a new tab)Featured in Women of Wearables
Lisa Zahakos, RPA-C, shares why she founded HEART RESERVE and how her clinical work and experience as a mother shaped its approach to women’s heart health.
Read the interviewSpeaking, media, publishing, and collaboration
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