The first hint something was wrong came when Carole Lewis’ legs started swelling.

Then, she was plagued by shortness of breath. Next, fatigue started to drag her down. This past summer, she could barely walk across the parking lot to her job and had to sleep sitting up. She knew she needed help.

Lewis, 60, learned she had congestive heart failure. Bacteria from her use of dirty needles to inject methamphetamine had severely damaged a valve in her heart. She had stopped shooting up six years before but the infection had raged on.

In June, doctors at University Hospital sliced open her chest for a five-hour operation to replace the valve. It worked, and Lewis had a functioning heart once again. Her surgeon told her not to expect a second miracle.