Kristy Mackey began singing again recently.
Her audience of one and biggest fan is her talkative, blue-eyed baby girl, Madelyn, now almost 11 months old and walking about her parents' southwest Santa Rosa home with steadier steps every day.
Stuffed animals cover the furniture and brightly colored musical toys are strewn on the floor around every corner. One plays a looped tune about Old MacDonald and his farm.
The snapshot of early parenthood is very normal.
But the path to this point for mother, daughter and all who have rallied around them has been extraordinary.
It started 33 years ago with a heart defect discovered in the moments after Kristy's own birth. An open-heart operation followed when she was 3 months old and a cardiac arrest almost killed her in her early 20s. Ten surgeries would follow.
But some of the most complicated challenges came a decade later, in near life-or-death decisions about what should have been a happy development in her young marriage — the news, unexpected and unplanned, that she was pregnant.
Since her heart failure, she had long been told by physicians that carrying and delivering a child would put too much strain on her heart. She and her husband, Lauren Mackey, had tried surrogacy instead and when that failed they considered adoption.
Yet once she was pregnant, doctors in San Francisco saw new vitality in Kristy's once-fragile heart. Motherhood was making it stronger.
Buoyed by their medical and family support, the couple decided to go forward, prepared all the while for a struggle that could include months of bed rest or worse — the possibility of Kristy's heart failing again and having to end the risky pregnancy.
Eight months of weekly or daily trips to the doctor's office followed, and when Madelyn arrived on that dark January morning in a large 15th floor hospital room overlooking San Francisco Bay, it wasn't the family's first wonder.
"When she cried when they were holding her, I thought 'She's alive, she made it,'" said Kristy Mackey, who graduated from Santa Rosa's Montgomery High School in 1998.
Then it dawned on her: "And I'm alive. It's over. We did it," she said.
A family accustomed to grave worries over matters of the heart was able to celebrate, just as they will Thursday in Santa Rosa, marking Madelyn's first Thanksgiving in the local clan.
"It's something to be thankful for, for sure," said Lauren Mackey. "We're looking at the second generation of miracles."
Kristy Mackey's heart was the size of a golf ball in 1980 when a team headed up by Denton Cooley, arguably the most acclaimed U.S. cardiac surgeon, opened up her tiny chest.
The goal was to fix what was essentially a plumbing problem caused by transposed arteries that left her body starved for oxygen-rich blood within hours of her birth.
She was a "blue baby," and was whisked away from her mother's hospital bedside in Decatur, Ill., and rushed by ambulance to an operating room in St. Louis for an emergency procedure.
"I put my hand in this little incubator thing and I patted you and then they took you away," Sher Miersemann, Kristy's mother, recounted to her daughter this week. "It was awful."
Three months later, Cooley, who performed the first successful human heart transplant in the United States in 1968, used a piece of the membrane surrounding her heart, called the pericardium, to create a shunt or tunnel that tied the two closed loops of her artery network together and allowed oxygenated blood to flow throughout her body.