Over dinner, Sonia Jamin’s dad cried tears of joy. When Sonia revealed she was pregnant with her second child, her father was so moved that he wept, laughed and bought wine for the entire restaurant.
The following morning found her dad crying again. This time, though, he was terrified.
“The next call he gets from me was from the ambulance telling him I’m having a stroke,” Sonia said. “He said, ‘I’m so scared.’ I told him, ‘I am too, but I’m going to the right place.’”
Moments before being put in an ambulance headed to Hoag, Sonia, 39, healthy and seven-weeks pregnant with her second child, had been visiting her grandmother at a nursing home. Sonia experienced a numbness and faintness that she associated with the early stages of pregnancy, so she brushed it off, as she walked into the hallway to retrieve a nurse for her grandmother.
Standing in the hall, she lost control of the left side of her body, twirling downward to slump on the ground. Nurses knew immediately what was happening and called 911.
“Very quickly, there was a line of paramedics outside the nursing home. They scooped me up and took me straight to Hoag,” she said. “I still replay that day in my mind. I’m so beyond grateful for how fast they were. I know that if I had been at home, I would have thought that I was just dizzy from pregnancy. I would have gone to bed, and I wouldn’t be here right now.”
When a person experiences a stroke, every second counts. Nationally recognized for its stroke care, Hoag is a designated Stroke-Neurology Receiving Center with Orange County Emergency Medical Services. Hoag’s stroke team does more than move quickly, it works with a level of expertise that comes with being one of the busiest stroke centers in the state. This was key for Sonia, who was no ordinary stroke patient.
At Hoag, Sonia’s care would enlist experts from across several institutes and specialties – neurology, interventional radiology, hematology, cardiology, obstetrics, the Obstetrics Emergency Department and maternal fetal medicine.
“It was phenomenal,” she said. “Everyone was so warm and expeditious. They were candid that there was a risk to my baby, but calmly and consistently reassured me that they were doing everything they could to ensure a positive outcome.”
Often, stroke patients receive medication to dissolve the blood clot in the brain, but neurologist Jason Muir, M.D., program director of Hoag neurophysiology services, determined that this was not an option for Sonia while pregnant. Instead, interventional radiologists Christopher Baker, M.D., director of Interventional Neuroradiology at the Pickup Family Neurosciences Institute at Hoag, and Alexander Misono, M.D., chief of Interventional Radiology at Hoag Hospital Irvine, performed a minimally invasive procedure to remove Sonia’s stroke-causing blood clot within 45 minutes of her arrival at the hospital, through a tiny incision made in her groin. Anesthesiologist Stephen Skahen, M.D., and critical care intensivist Neema Aghamohammadi, D.O., played instrumental roles managing her critical illness during and after her procedure.
Sonia awoke feeling normal, and her baby was safe and sound. No slurred speech. No numbness or paralysis. Her blood clot was gone. But her medical journey was not over. Subbarao Myla, M.D., medical director of Cardiac and Endovascular Labs and Cardiovascular Research at the Jeffrey M. Carlton Heart and Vascular Institute at Hoag visited her in the recovery room.
“Dr. Myla came in and said, ‘I’m your cardiologist,’” she said. “I said, ‘Why do I need a cardiologist?’ And he said, ‘Because you have a hole in your heart.’”
An athletic person her whole life, Sonia had never experienced so much as a heart murmur. But while treating Sonia, doctors learned she had a patent foramen ovale (PFO), a hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but usually closes in infancy. Sonia’s never closed, leading to a history of migraines and, eventually, her stroke.
Dr. Myla explained the 10-minute, minimally invasive procedure that would permanently close the hole using an Amplatzer™ occluder.
OB/GYN Zhanna Pinkus, M.D., entered the room as Dr. Myla spoke to Sonia about next steps. Sonia said she was struck by how gracious the doctors were as they negotiated the timing of Sonia’s next surgery to close the PFO.
“Dr. Pinkus advocated for the baby, saying that we needed to wait for 14-16 weeks [of gestation] to do the surgery because vital organs were still in the process of formation,” Sonia said. “They discussed the timing with so much respect and decided to wait until after the first trimester.”
Following that surgery weeks later, Sonia said she again felt the full breadth of Hoag’s expertise and compassion.
“It felt as though all of the nurses and doctors spent so much time with us,” Sonia said. “I guess this doesn’t happen often. You don’t usually have a pregnant patient experience a stroke and a PFO and need to have everyone collaborating and weighing in.”
One week after her heart surgery, Sonia was cleared for prenatal yoga and her normal life. Sonia’s care team also included perinatologist, David Lagrew, M.D., chief of service, maternal fetal medicine at Hoag; hematologist Pooja Motwani, M.D., neurologist David Brown, M.D., and primary care physician Jill Panitch, M.D. She had follow-up appointments and additional monitoring, but nothing about her health suggested she had just undergone neurologic and cardiac surgery while pregnant.
Sonia received her prenatal care from Jody Lai, M.D., and on Aug. 15, 2023, she was back at Hoag in Newport Beach to deliver her baby.
“It was the fastest, most painful 44 minutes of my life. My baby’s heart rate plummeted because he was stuck in my pelvis,” Sonia said.
Once again, a team of about 15 doctors, including OB/GYN Rhonda Flora, M.D., rushed to her side and safely welcomed Rhodes Louis Jamin into the world.
Reflecting on her 8-month journey from a pregnant stroke patient to new parenthood, Sonia said: “Having a baby at Hoag, and a stroke and a heart surgery at Hoag, I can say that Hoag is the only place I want to be for my care.”
