When Ashley Ruhlig was born, she was diagnosed with tricuspid atresia, a congenital heart defect in which the tricuspid valve between the heart’s two chambers isn’t properly formed.
Blood is not able to flow freely between the heart and the lungs with this condition, so the lungs are not able to supply the body with the oxygen it needs to survive.
Twenty-eight years later, Ashley is married to her love, Mark, and they are raising Lucy, born on March 10, 2014, in the pretty lakeshore town of Ludington.
She’s feeling great.
The chances of this scenario, Ashley now realizes, were slim to none.
A heart defect like Ashley’s put her at high risk for pregnancy. Although she had a life-saving Fontan procedure performed when she was an infant, Ashley’s doctors had cautioned her to consider motherhood very carefully.
Dr. Joseph Vettukattil, chief pediatric cardiologist at Helen DeVos Children’s Hospital, explains the Fontan procedure: “Ashley has hypoplastic right heart syndrome, the opposite side of the heart as most such patients. The Fontan procedure is done after a heart catheterization. It’s the third stage of a procedure to build a connection between the right ventricle to the lung and the pulmonary artery.”
Pregnancy and going into labor, Dr. Vettukattil says, were indeed very risky for someone with Ashley’s heart defect.
And still, following her heart, Ashley and her husband, Mark, decided to try for a baby.
“I prayed a lot,” says Ashley, who works as a church secretary. “I had my annual checkup a couple months before we started to try, and I asked my doctor, Dr. Helayne Sherman, if I went ahead, what I could expect. She explained all my options and my risks to me. In the end, it was my choice.”
When Ashley quickly became pregnant, she felt it was meant to be. Her pregnancy, under the close watch of Dr. Sherman, went smoothly. Two weeks before her due date, Ashley went into labor, and her husband drove her – fast – to Spectrum Health, where Ashley underwent a Cesarean section, which put less stress on her heart than a normal delivery.
“It all went well,” Ashley smiles. “I just had to take some blood pressure medicine when I went home.”
A couple weeks after going home, Ashley was looking forward to an outing with her husband and baby girl. The family went to the grocery store together. As Ashley got out of the car, however, she started to feel odd.
“It was an eerie feeling,” she recalls. “I couldn’t breathe. I thought maybe I was having a panic attack.”
Ashley rested for a moment then tried to return to the car, but the uncomfortable feeling persisted. She was fighting for air, and Mark knew she was in trouble. He rushed her to the emergency department at Spectrum Health Ludington Hospital, but Ashley’s blood pressure climbed to dangerous levels, and a CT scan showed an alarming mass in her chest. It was a pulmonary embolism.
“I was immediately transported by Aero Med helicopter to Grand Rapids,” Ashley says. “It was my first helicopter ride, and we got there fast. When we got to Spectrum Health in Grand Rapids, I felt strangely peaceful, although I know my family was worried. They said I needed surgery …”
Ashley says she doesn’t remember much after that. Dr. Vettukattil does.
“She smiled at us and said she trusted us to take care of her,” he says. “The clot was massive, blocking her lungs, near 7 inches long. It had formed in her leg during delivery and slowly moved upward.”
Dr. Vettukattil worked on a team with Dr. Marcus Haw, pediatric cardiovascular surgeon with Spectrum Health Medical Group.
She later says: “Dr. Haw was so confident, but very careful with his wording. He made us aware that he had never faced a situation quite like mine, but he knew exactly the condition I had and how to work around it. He was quite hopeful and positive, but still made the risk very evident … I kissed my husband and was taken into surgery.”
The massive clot was successfully removed, and Ashley spent the next four days in intensive care, then was transferred to the Fred and Lena Meijer Heart Center for two weeks. The most difficult part of her recovery, she says, was missing Lucy. Friends and family brought her baby to her bedside on a regular basis, but goodbyes at the end of a visit never got easier.
“I had a whole-body CT scan while I was in the hospital,” she says. “My doctors found more clots, some calcified, and with medication, we were able to get rid of all of them without surgery. I’m told it could be a year before I feel completely normal, but I’m feeling good now, and it feels good to be home with my baby again.”
Future children, Ashley says, will be adopted. But she will never forget her health care team at Spectrum Health – the staff at Spectrum Health Ludington Hospital, on Aero Med, and in Grand Rapids at the Meijer Heart Center.
“I’m deeply touched by the care I received,” she says. “These people, the doctors, the nurses, everyone—they have hundreds of patients to worry about, but when they were with me, I felt like I was their only patient. In fact, Mark and I have been talking. We are thinking about moving closer to Grand Rapids, just so we can be closer to the kind of health care we get here.”