August 1st began like any other summer morning.
Ginger Zalucki-Nash, 26, was feeling good.
“My husband and I worked on building our house,” she said. “I had some garlic bread. We talked to my mother. “
Then a blinding headache.
“It came out of nowhere and made the top right corner of my view disappear,” she said.
Ginger would have been alarmed anyway, but by the 37th week of her first pregnancy, her urge to act quickly was in full swing.
Edward, her husband, drove her from her home in Onaway, Michigan to the nearest hospital: McLaren Northern Michigan in Cheboygan, about 30 miles away.
She later learned that she kept repeating her words on the way there.
“He was scared,” Ginger said of her husband.
But the chain of events that followed likely made all the difference in their outcome. The emergency room immediately suspected one ischemic stroke from a blocked artery.
Before she knew it, Ginger was in an ambulance speeding 160 kilometers southwest of Munson Hospital in Traverse City.
Much of the day is still foggy.
“I remember knowing the emergency room in the ambulance – I went to high school with her,” Ginger said. “And I remember parts of the helicopter flight.”
The most memorable part?
“When they were driving me into the elevator, a doctor told me I had had a stroke,” she said. “My family wasn’t there yet and all I could think about – all I could ask – was whether my baby would be okay.”
Surgery – and a twist
Ginger’s short trip to downtown Grand Rapids gave the Spectrum Health medical team enough time to develop a treatment plan.
“First the obstetrics team greeted her as soon as she arrived,” said Jenny Peih-Chir Tsai, MD, Spectrum Health’s interventional neurologist who operated on ginger.
“The obstetrics team was able to quickly assess her status as well as that of the baby, ”said Dr. Tsai. “We knew the baby was fine before it got into the treatment room.”
The best approach required surgery, mechanical thrombectomy, a procedure guided by fluoroscopy.
Dr. Tsai inserted a small catheter into Ginger’s wrist, then used the X-rays from the fluoroscope to help her maneuver the device toward the brain to find the clot.
Then she removed it with aspiration – “like a tiny vacuum cleaner”.
Working with pregnant patients is often more difficult, said Dr. Tsai.
“You are dealing with two lives and so much is at stake,” she said. “But that is our job. And one of the most rewarding aspects of our work, figuratively, is that through this experience we can hold the hand of our patients. “
While Ginger remembers very little about the operation, Dr. Tsai that they talked most of it – the baby’s name, what the baby room would look like.
“There is an extraordinary bond between a stroke doctor and the patient, especially when the patient is so young,” said Dr. Tsai. “It means a lot to me to be able to do this for you.”
The operation lasted about two hours.
“When we finished, the obstetrics team came back,” said Dr. Tsai. “The moment we finished Ginger’s treatment, they were ready for another check-up on the baby.”
Ginger only has a vague memory of the few days after the operation.
“I kept asking my mother and husband, ‘Did I have a stroke?’ I couldn’t believe it, ”she said.
With Ginger’s condition greatly improved, her mother, Charlene, felt reassured enough to drive home to Onaway, 225 miles north.
“Everything looked great and they were ready to send her home,” said Charlene.
Then came a terrifying turn.
Hours before Ginger was released from hospital, an ultrasound showed dangerously low levels of amniotic fluid. Doctors recommended a caesarean section.
“It was so scary,” said Ginger. “I immediately called my mother who was home less than 24 hours.”
Charlene whirled around and drove back to Grand Rapids to help Ginger and Edward welcome the baby Persephone, weighing 4 pounds, 14 ounces.
Since then, life has settled into a sweet calm for Ginger and her family.
Persephone grabs the pounds. Ginger recovers and gradually regains some of the lost eyesight.
But it was a whirlwind. Persistent worries about the stroke. The happy confusion of new parenting.
Ginger faces a series of follow-up appointments and tests to determine what may have caused the stroke.
One possibility: a small hole in your heart that may need surgery. It was discovered by members of the Spectrum Health team during imaging tests.
“The stroke came out of nowhere,” said Ginger. “So I’m worried that it might happen again – maybe even, God forbid, while I held her.”
Ginger’s recovery from a life-threatening stroke was remarkable, said Dr. Tsai.
It’s largely the result of care teams acting quickly at every step – even by providing MRIs in small rural hospitals.
“There was a collective understanding of what might have happened,” said Dr. Tsai. “The family did the right thing. Then EMS did the right thing, as did both hospitals. We expected Ginger to arrive at Butterworth Hospital before she arrived. And on arrival the neurology, obstetrics and Neurointerventional Teams banded together to provide her with the best possible care. All the ducks stood in a row. “
While most people associate stroke with older people, pregnant women are at a slightly higher risk.
Dr. Tsai hopes more people will learn the six-letter acronym, BE FASTto recognize the warning signs:
- Balance: Sudden loss of balance, loss of coordination
- Eyes: Sudden trouble seeing from one eye or side
- Face: Facial weakness or numbness, an uneven smile, or weakness on one side
- Arms: Arm or leg weakness or numbness, including an inability to raise both arms equally
- Speech: slurred or difficult to express or understand conversation
- Time: Time is the brain and every minute counts. Call 911!
The best advice for pregnancy: watch out for new and unusual symptoms and report them to your doctor, said Dr. Tsai.
While the doctor is pleased with the positive result from Ginger and Persephone, Ginger wants to raise awareness of the risk of stroke.
“If my experience can help any other woman get through this, it’s worth it,” she said.
Thank You For Reading!