Mary Kleinheksel may be the poster child for how to survive and thrive after a stroke.
With help from family, first responders, emergency medical providers and other caregivers, the Zeeland, Michigan, resident has experienced a remarkable recovery.
It all started in the blink of an eye.
Just after 11 p.m. on Dec. 3, 2021—a Friday night—Mary and her husband of 36 years, Kevin Kleinheksel, readied to turn in for the evening.
Kevin sat in bed, talking to Mary as she prepared to brush her teeth in the bathroom.
Mary, 62, has a history of periodic, non-epileptic seizures. But she had never experienced a stroke.
“It came out of the blue,” she said. “I started feeling dizzy. The first thing I thought of was, ‘Oh, here comes a seizure. I better help myself to the floor.’”
Kevin quickly noticed the trouble.
“We were talking back and forth and then I noticed she had stopped talking,” he said. “I then heard what sounded like a couple of moans.”
Mary remembers those first few minutes vividly. After that, it became a fog.
“When I got to the floor, I couldn’t move, I couldn’t speak, my right eye was glued shut,” Mary said. “My left eye, I really wanted to close it but I couldn’t.
“Kevin came in and said to me, ‘Mary, c’mon, what’s going on? Talk to me,’ but I couldn’t,” she said. “And then he said, ‘Mary, do I need to call 911?’”
At first, Kevin thought it might be a seizure.
“Usually, when she has one of her seizures, either her lips or her fingers are trembling,” he said.
But this seemed different.
Mary communicated as best she could.
“I blinked my left eye really quickly,” she said. “And he said, ‘OK, I see you blinking your left eye. Do you want me to call 911?’ And I blinked my left eye again.”
Kevin, suspecting a stroke, sprung into action.
“I knew we needed some help,” he said. “This was something different.”
Mary, too, suspected a stroke.
“Thankfully, Kevin picked up on my eye movement,” she said. “He called 911. The paramedics arrived within 10 minutes and quickly assessed my situation and got me in an ambulance and took me to Spectrum Health Zeeland Community Hospital.”
‘Time equals brain’
The Kleinheksels live only 3 miles from the hospital. They were happy Mary was headed to a Spectrum Health hospital, as their youngest daughter, Katelyn Kleinheksel, RN, works at Spectrum Health Butterworth Hospital—in the neurology stroke unit.
At the Zeeland Community Hospital emergency department that night, physician Adam Kelly, MD, led the care team.
“She arrived with severely disabling neurologic deficits and elevated blood pressure,” Dr. Kelly said. “My initial concern was for severe intracranial bleed.”
Fortunately, a CT scan showed no bleeding in her brain.
“The next most likely concern was that this was an ischemic stroke affecting the basal ganglia,” Dr. Kelly said. “This is a type of stroke that is life-altering and often causes severe, permanent neurologic deficits.”
Dr. Kelly consulted the stroke neurology team and determined Mary would be a candidate for tissue plasminogen activator, a medication that works by dissolving clots that block blood flow to the brain.
“Mary was incapacitated at the time and not able to speak, so I discussed risks and benefits with her husband,” Dr. Kelly said.
Most people will notice no change after the treatment, Dr. Kelly said. Some people will improve. A small number can experience complications.
“In the end, all were in agreement that, given the severity of symptoms, the benefits outweighed the risks and we proceeded to give the drug,” Dr. Kelly said.
The speed of Mary’s treatment impressed Kevin. She went in for a CT scan at about the time he arrived at the hospital. Doctors administered the medication shortly thereafter.
“That quick intervention made all the difference in the world,” Mary said. “Time equals brain.”
Mary stayed in the emergency department while the medication took effect.
“We watched her miraculously improve,” Dr. Kelly said. “This is one of the most dramatic improvements that I have ever personally seen after giving someone tPA. On reassessment, she was alert, talking and moving all her extremities. She even half-jokingly—I think—suggested going home.”
Doctors had already scheduled her transfer to Butterworth Hospital.
Kevin contacted his daughter, Katelyn, who worked that evening as inpatient supervisor in the neurology intensive care unit in Grand Rapids. The unit would normally receive a patient such as Mary.
Katelyn alerted another nurse to take the transfer call from Zeeland Community Hospital. Following protocol, she wasn’t permitted to care for a family member.
“Luckily, my dad got ahold of me about 10 minutes before the call came from the transfer center, saying they’re sending a patient from Zeeland,” Katelyn said. “If he wouldn’t have got a hold of me when he did, I would have received a call regarding my own mother. I probably would have had a little heart attack myself.”
Mary went to another unit, where a neurology ICU nurse cared for her.
“I knew she was in my hospital and that was enough for me,” Katelyn said. “I felt like I knew where she was and who was taking care of her. I was happy she was near me at least.”
Kevin, a pastor at Central Park Reformed Church in Holland, Michigan, updated their two other children.
And he comforted Mary.
“I put on my pastor hat a couple of times,” he said. “I read scripture with her and prayed. She was quite anxious, as she was very limited in what she could do and say. That’s one of the things I know how to do in settings like that. So I read some scripture and prayed with her. “
“I think I was on four prayer chains,” Mary said, laughing.
A quick recovery
On a stroke severity scale of 1 to 42, based on brain function, Mary’s initial score landed at 37—very near the most severe score of 42.
Despite that, she continued to improve rapidly.
“Over the next few hours, things began to come back, piece by piece,” Kevin said. “Movement on her right side first, then her left side much slower, coming back later.”
Her ability to speak slowly returned, too.
“First it was kind of moaning, then a few words,” Kevin said. “And then within a few hours she was able to speak again.”
“It was amazing,” Mary said.
“One of the nurses mentioned she was coming back much more quickly than what they usually see,” Kevin said. “She kept saying to us, ‘I’ve never seen this quick of a recovery.’”
Every time a nurse came in, it seemed Mary’s speech and movement had improved.
“(The nurse) kept coming in and saying, ‘Wow, this is unbelievable, I’ve never seen this happen so fast,’” Mary said. “So in our minds, it was a miracle.”
Doctors discharged Mary from the hospital that Sunday, just two days after the incident.
Once home, she immediately began physical therapy to strengthen her left leg and improve her balance. She walked on a treadmill, performed leg exercises and walked up and down stairs and on uneven surfaces.
Other than losing minor peripheral vision in her left eye, she’s expected to a make a full recovery.
She and Kevin remain grateful.
“The first week after coming home from the hospital, we were both feeling very blessed—to survive realizing how bad it was and how well it turned out,” Kevin said. “After about a week of that, the reality hit—we’ve been through a stroke.”
Mary is now focused on physical therapy and follow-up appointments.
“Since then it’s been, ‘How do we get going on life again,'” Kevin said.
For Mary, this includes walking, exercising regularly, spending time with their three children, four grandchildren and singing as part of the worship team at church.
‘I really wanted to sing’
On a Christmas Day walk, Mary explained to her grandchildren how grandma’s brain suffered an injury.
“They took my hand—my 9-year-old grandson and my 6-year-old granddaughter on the other side—and they held my hands all the way around the block,” Mary said. “They have been part of my recovery, these little grandkids that love me unconditionally and know that grandma has been hurt. They’re just phenomenal.”
At the start of the new year, she’s feeling pretty good.
“My brain is just tired,” she said. “The fatigue is probably the No. 1 thing I’ve been battling.”
Shortly after the stroke, she set out to sing again at church. That happened Dec. 19, when she joined with the worship team.
“I was nervous about singing, but I wanted to do it,” Mary said.
The following week—Christmas Eve service—she sang again.
“Our kids were all here, and I really wanted to sing because it’s one of my passions,” she said. “Music has been a part of my life my whole life.
“I did sing Christmas Eve but it was very humbling because I had to go up two steps and, when I came down, Kevin needed to hold my hand,” she said. “I could not get down by myself.
“It was very humbling to put myself out there,” she said. “But this is my life—I did it.”