Aug. 1 started like any other summer morning.
Ginger Zalucki-Nash, 26, felt fine.
“My husband and I were working on building our house,” she said. “I had some garlic bread. We talked with my mom.”
Then, a blinding headache.
“It came out of nowhere and made the top right corner of my vision go away,” she said.
Ginger would have been alarmed anyway, but at 37 weeks into her first pregnancy, her compulsion to act fast kicked into overdrive.
Edward, her husband, drove her from their home in Onaway, Michigan, to the closest hospital: McLaren Northern Michigan in Cheboygan, some 30 miles away.
She later learned she kept repeating her words constantly on the drive there.
“He was terrified,” Ginger said of her husband.
But the chain of events that followed likely made all the difference in her outcome. The emergency department immediately suspected an ischemic stroke from a blocked artery.
Before she knew it, Ginger found herself in an ambulance speeding 100 miles southwest, to Munson Hospital in Traverse City.
Much of that day is still foggy.
“I remember that I knew the EMT in the ambulance—I went to high school with her,” Ginger said. “And I remember parts of the helicopter ride.”
The most unforgettable part?
“As they were wheeling 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—all I could ask—was whether my baby was going to be OK.”
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, the Spectrum Health interventional neurologist who operated on Ginger.
“The obstetrics team was able to quickly evaluate her status as well as the baby’s,” Dr. Tsai said. “We knew the baby was well before she arrived in the procedure room.”
The best approach called for surgery, mechanical thrombectomy, a procedure guided by fluoroscopy.
Dr. Tsai threaded a small catheter into Ginger’s wrist and then used the fluoroscope’s X-ray images to help her maneuver the device up toward the brain, to the location of the clot.
Then, using aspiration—“like a tiny vacuum cleaner”—she removed it.
Working with pregnant patients is often more challenging, Dr. Tsai said.
“You’re dealing with two lives and there is so much at stake,” she said. “But this is the work we do. And one of the most rewarding aspects of our job, figuratively speaking, is that we can hold our patient’s hand through this experience.”
While Ginger remembers very little of the operation, Dr. Tsai remembers they chatted through most of it—about the baby’s name, what the baby’s room would look like.
“There is an exceptional bond between a stroke physician and the patient, particularly when the patient is so young,” Dr. Tsai said. “It means a lot to me to be able to do this for her.”
Surgery lasted about two hours.
“As we were finishing up, the obstetrics team came back,” Dr. Tsai said. “The moment we finished with Ginger’s procedure, they were ready for another check on the baby.”
Ginger has only a blurry recollection of those few days following surgery.
“I kept asking my mom and husband, ‘Did I have a stroke?’ I couldn’t believe it,” she said.
With Ginger’s condition much improved, her mom, Charlene, felt enough reassurance to drive back home to Onaway, 225 miles north.
“Everything was looking great and they were ready to send her home,” Charlene said.
Then came a terrifying twist.
Hours before Ginger’s discharge from the hospital, an ultrasound revealed a dangerously low level of amniotic fluid. Doctors recommended a Cesarean section.
“It was so scary,” Ginger said. “I instantly called my mom, who had been home for less than 24 hours.”
Charlene spun around and drove back to Grand Rapids, in time to help Ginger and Edward welcome baby Persephone, weighing in at 4 pounds, 14 ounces.
Life has since settled into a sweet calm for Ginger and her family.
Persephone is packing on the pounds. Ginger is recovering, gradually regaining some lost vision.
But it’s been a whirlwind. Lingering worries about the stroke. The happy befuddlement of new parenthood.
Ginger faces a series of follow-up appointments and tests to pinpoint what may have caused the stroke.
One possibility: a small hole in her heart, which may require surgery. Spectrum Health team members detected it during imaging tests.
“The stroke came out of nowhere,” Ginger said. “So I worry it could happen again–maybe even, God forbid, while I was holding her.”
Ginger’s recovery from a life-threatening stroke has been remarkable, Dr. Tsai said.
It’s largely the result of care teams acting fast each step of the way—even by providing MRIs in small rural hospitals.
“There was a collective understanding of what was potentially happening,” Dr. Tsai said. “The family did the right thing. Then EMS did the right thing, as did both hospitals. We were expecting Ginger before her arrival to Butterworth Hospital. And on arrival, the Neurology, Obstetrics, and Neurointerventional teams converged to get her the best care. All the ducks lined up in a row.”
While most people associate stroke with older patients, pregnant women are at a somewhat elevated risk.
Dr. Tsai hopes more people will learn the six-letter acronym, BEFAST, to help spot the warning signs:
- Balance: Sudden loss of balance, loss of coordination
- Eyes: Sudden trouble seeing from one eye, or one 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 evenly
- Speech: Slurred or difficulty expressing or understanding conversations
- Time: Time is brain, and every minute counts. Call 911!
The best advice for pregnancy: Pay attention to and report any new and unusual symptoms to your provider, Dr. Tsai said.
While the doctor remains delighted at the favorable outcome for Ginger and Persephone, Ginger is eager to raise awareness about the risk of stroke.
“If my experience can help even one other woman going through this, it’s worth it,” she said.