Ashley Zimmerman had a stroke in 2014 after an infection damaged one of her heart valves. Wanting to be a mother but told she would be high risk, she got a second opinion at Mayo Clinic and after a closely-monitored pregnancy, delivered a son. She will be a coach at the Heart Walk in Jacksonville.

Two months before her June 2014 wedding, Ashley Zimmerman had a stroke.

She was only 24.

"I was in shock and kind of disbelief," she said. "I was in the emergency room for a very high fever, my face started to droop and I was not able to move the left side of my body."

The cause was endocarditis, an infection of the endocardium, which is the inner lining of the heart chambers and heart valves. The result was open heart surgery, replacement of an infected valve and the devastating news that one of her dreams, having a child, should not become a reality. Pregnancy and delivery would be too dangerous, her doctors told her.

But Zimmerman, who will be a coach at the 2019 First Coast Heart Walk fundraiser on Sept. 21 in Jacksonville, refused to give up.

About four years later, because of her persistence, modern medicine and a supportive Mayo Clinic cardiologist, son William safely arrived.

"It was the most overwhelming joyous experience being able to bring a precious life into this world when I was told I wasn’t going to be able to," she said. "I still get moments of disbelief looking at him knowing that I was told that it wasn’t a good idea and watching him grow and become the happiest little boy … has been amazing."

Because of that gift, Zimmerman, a certified medical assistant at Mayo, now volunteers for the American Heart Association annual Heart Walks.

"I am trying to get as many people to walk to help raise awareness and money," she said. "It means so much to me to be able to participate in this walk. Without the research and the medical advances that the American Heart Association has helped achieve, I may not be here, let alone have a beautiful baby boy."

Her six months of stroke recovery included physical and occupational therapy, getting married on schedule in June 2014 and beginning a search for second opinions about her ability to have a baby. She and husband Ben lived in New Hampshire at the time but relocated to Jacksonville in 2016.

Here she found a cardiologist, Sabrina Phillips, who was "comfortable … helping me to have a child," she said. Also crucial was that Zimmerman was "confident enough" in the doctor and in the monitoring plan during pregnancy, she said.

The high risk to pregnancy stemmed from the blood-thinning medication Zimmerman has to take, Phillips said. The medication is necessary because, during her open-heart surgery, her infected valve was replaced with a "mechanical" valve made of metal.

"These mechanical valves are prone to clotting, so the patient must take a blood thinner to prevent valve clotting for the rest of their life," she said. "The blood thinner used long term in these patients is warfarin, which … affects a growing fetus."

In the first trimester, it can result in birth defects and in the last two trimesters can lead to fetal bleeding, she said.

"There are some other drugs that can be used during pregnancy, but these drugs are difficult to manage, and even if managed meticulously, can result in the mother having a clotted valve which could lead to her death," Phillips said. "It is recognized as a very risky process to have a pregnancy … with a mechanical valve, for both the mother and baby."

Phillips said she informed Zimmerman and her family on the possible risks and the methods to reduce risk, which included "various strategies for blood thinners." Zimmerman chose to use an injectable blood thinner during the first trimester that does not pass through the placenta to the fetus but requires close lab monitoring, warfarin during the second and part of the third trimester, then injectables again and a planned delivery, Phillips said.

Zimmerman also agreed to frequent blood draws, regular cardiology and obstetrics visits.

"I had to monitor my blood work very carefully and I received ultrasounds once a month to check on the baby’s development … and then once a week toward the end of my pregnancy and blood work once a week," she said.

William was delivered by Cesarean section at 38 weeks on Sept. 26, 2018.

"The pregnancy and delivery in this case went very smoothly, partly because Ashley was so committed to her care program. She had no major complications, nor did her baby boy," Phillips said. "Both are doing very well with no long-term consequences from the pregnancy."

Zimmerman being told she would have a high-risk pregnancy — and Phillips' assessment that she could overcome the risk — stemmed from information gleaned in research and advances in treatment. The need to fund such work led about 25,000 people to participate in the 2018 Heart Walk, which raised $1.6 million.

This year's fundraising goal is $1.75 million.

"The Heart Walk is focused on funding groundbreaking research through the passion of walking together to change lives," said Tom Van Berkel, CEO of The Main Street America Group, chairman of the local event. "The walk brings together both companies and individuals to raise funds to support vital research projects that will help find a cure for cardiovascular diseases."

Beth Reese Cravey: (904) 359-4109

Heart Walk Vitals

The 2019 First Coast Heart Walk will be Saturday, Sept. 21, at Metropolitan Park, 1410 Gator Bowl Blvd. in Jacksonville. Opening ceremonies and related activities begin at 8 a.m. with the walk at 9:30 a.m.

The walk is 3 miles, but there is also a 1-mile option. To register, donate or get more information, go to firstcoastheartwalk.org. Questions? Call (904) 903-5220 or email firstcoastheartwalk@heart.org. For information about the American Heart Association, go to heart.org.

STROKE SYMPTOMS

• One side of the face is drooping or numb

• One arm is weak or numb

• Speech is slurred or hard to understand

Other symptoms can include sudden confusion, difficulty seeing or walking, dizziness, loss of balance and severe headache.

If a person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital. Immediate medical attention may minimize the long-term effects of a stroke and prevent death.

For more information about stroke, go to heart.org.