Arterial Ischemic Stroke: Avery’s Story

It was the summer of 2014 and Avery Marz was living her dream. An all-state high school basketball point guard from Sinking Spring, PA, she’d earned a full scholarship to play Division 1 basketball at St. Joseph’s University. 

Avery Stroke Patient, Basketball PlayerAvery had just completed six weeks of intense training with her new team and was excited about the upcoming season, her freshman year, and living away from home.

On Aug. 23, 2014, Avery’s mom, Mary Beth Schoellkopf, arrived to help her daughter set up her dorm room. As they unloaded the car, Schoellkopf chided her daughter about how much stuff she’d packed. Avery just laughed and carried more clothes into her room.

That’s when her left knee gave out. She didn’t think much of it, but sat down on the bed. Seconds later, she was unconscious, lying on the floor of her dorm room.

She’d had a stroke. She was 17 years old.

Initial treatment

Avery’s mom jumped into action and called 9-1-1. She got on the floor with her daughter, talked to her and supported her until help arrived.

“My whole left side — from head to toe — wasn’t moving at all,” says Avery.

Minutes later, an ambulance arrived and rushed Avery to the closest hospital. Within 90 minutes, Avery received tissue plasminogen activator (tPA), a medication used to dissolve the blood clot that caused the stroke and improve blood flow to her brain. Avery spent the night in the hospital’s intensive care unit.

Care by stroke experts at CHOP

The next day, after Avery had been stabilized, doctors recommended a transfer to Children’s Hospital of Philadelphia (CHOP), where pediatric stroke experts could examine her and determine next steps.

“I was very confused — especially at the beginning,” Avery says. “I didn’t even know what a stroke was or why it happened to me. I mean, I was a competitive athlete. I was worried about ACL tears and overuse injuries. I never even considered stroke.”

Though stroke is rare in children — occurring in two to three out of 100,000 children younger than 18 — stroke is among the top 10 causes of death for children in the U.S.

Pediatric neurologist Rebecca N. Ichord, MD, a nationally-known leader in pediatric stroke, helped Avery and her mom understand what had happened: Avery had had an arterial ischemic stroke, caused by a blood clot that blocked an artery in the right side of her brain. The stroke had damaged a key relay center of her brain that controls strength and movement, affecting the entire left side of her body.

Over the next five days at CHOP, Avery underwent a full battery of complex neurological tests, cardiac monitoring and laboratory analysis to determine what caused the blood clot to form in her brain.

Her doctors identified two possible types of risk factors: abnormalities in tests of her blood clotting system leading to an increased tendency to form a blood clot; and the use of hormonal birth control pills, which have the rare side effect of increasing the tendency to form blood clots, thereby leading to an increased risk of stroke. 

Through it all, Avery’s mom was at her side. At night, she slept on a cot in Avery’s Hospital room. During the day, she sat with her daughter as Avery processed a range of emotions — confusion, anger, denial, sadness — until she finally accepted what had happened to her and began to focus on the future. The nurses and doctors who cared for Avery also helped build her strength and mend her mental state.

“Being at CHOP was literally one of the best experiences of my life during one of the worst times in my life,” Avery says. “Everyone was very positive and open to the idea of me playing basketball again.”

Rehabilitation

After six days at CHOP, Avery was transferred to a rehabilitation facility closer to her home. There, she received intense therapy for five hours each day to relearn how to perform everyday activities such as showering and dressing.

In mid-September, Avery returned home. For the next two months she continued outpatient stroke rehabilitation at the same facility.

“I was progressing fast and I didn’t necessarily need more stroke therapy,” Avery says. Dr. Ichord recommended the next step in Avery’s recovery: sports-focused rehabilitation therapy at CHOP’s Specialty Care Center in King of Prussia.

There, Avery worked to get back into shape with the help of Ashley Moll, MS, OTR/L, and Julie Dyke, DPT, PT, CSCS, two members of CHOP’s Sports Medicine and Performance Center team.

Occupational therapy with Moll — such as picking up blocks, moving them, dropping them in a specific order, and then picking them up again — helped improve Avery's fine motor skills. Physical therapy with Dyke focused on improving Avery’s gross motor skills such as running and jumping.

“Dr. Ichord was always very positive about my recovery. She knew I wanted to be back on the court and she said she has no doubt I’ll play again,” Avery says. “She just doesn’t know the level I’ll be at … that’s how she phrased it.”

Dr. Ichord says Avery is a model of courage and a source of inspiration.

“Avery found that amazing inner strength — that power of her mind and her will — and applied it to the hard work of healing her body from day one,” Dr. Ichord adds.

Making a comeback

avery playing basketballAfter taking medical leave in the fall, Avery returned to classes at St. Joe's in the spring. With a double major in communications and sports marketing, she is busy pursuing her long-term goal of becoming a sports broadcaster.

In the meantime, she continued twice-weekly occupational and physical therapy, working hard to improve her dexterity, strength and coordination, with the hopes of getting back on the basketball court.

In the summer of 2016, Avery played in her first scrimmage since her stroke. Leading up to the game, she knew her body was ready, but wondered how she’d adjust to not being the same player she used to be, and worried about finding a way to contribute and be a good teammate.

“My coach said ‘You just have to get out there and throw yourself into it,’ but it was one of the hardest things for me to do,” says Avery. “I realized my body is ready, now it’s my mind that needs to take that jump. It was very emotional.”

After the game, the magnitude of what she had just accomplished settled in. That first scrimmage was a breakthrough, not only for Avery’s physical recovery, but her emotional recovery as well.

“I remember lying in bed that night thinking, ‘Wow, you did it,’” recalls Avery. “That was huge.”

Moving forward with courage

Since then, Avery has smashed her goal of playing again. In the 2017-2018 season, she played in 27 games for the Hawks, starting in two of them.

In Dec. 2017, Avery was selected as the U.S. Basketball Writers Association's 2018 Pat Summitt Most Courageous Award recipient. She also received the 2017 Most Courageous Award from the Philadelphia Sports Writers Association.

She plans on taking her additional year of eligibility to continue her basketball career in the fall, while she works towards her master's degree.

Originally published April 2015

Updated May 2018


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