Know the Signs: Margot Ridgeway

On June 23, 2020, a healthy, young, athletic Margot Ridgeway suffered a stroke. Despite showing multiple signs, Margot’s stroke when undiagnosed by multiple doctors over many days. After taking time to recover, Margot returned to the field to play for NC State, but now she has a greater purpose than just winning games. Margot is raising awareness for stroke and heart disease, by partnering with Tedy’s Team, a group started by former New England Patriot after he suffered a stroke at the age of 31. We encourage you to donate to Margot’s personal fundraising efforts at the link here.

I am a 21-year-old student-athlete and a stroke survivor. Those two adjectives are not often used to describe someone as a senior in college. I suffered from an ischemic stroke on June 23, 2020. I was diagnosed four days later, after three trips to two different hospitals. When my stroke was happening, I didn’t know it; my friends, family, and multiple nurses and doctors did not know either despite presenting clear and evident warning signs. The signs of stroke I showed were continually overlooked because of my age and health. 

The morning of my stroke was spent like many others during summer in 2020; I had gone for a run with my good friend Lily. I had been home since March when classes moved online, and our spring season was canceled due to COVID-19. Lily and I were training for our upcoming seasons, her field hockey season at Stanford and my junior soccer season at NC State. My head coach, Tim Santoro, advised us over Zoom calls throughout those first months of the pandemic to stay in shape and be ready for the fall. No one knew what to expect; our goals and any likelihood of a season seemed to be moving farther and farther away, out of our control. For me, over the course of the next week, everything I knew about soccer and my life would feel completely out of my control.

 Earlier that year, I started suffering from migraines with aura. Migraines with aura are like regular migraines but start differently, with blurry vision or spots. This did not occur every time, but I would get intense headaches with nausea and vomiting, leaving me bedridden for most of the day. They would flare up around my period, lack of sleep, too much caffeine, or dehydration. I thought this was normal, especially as a young woman dealing with fluctuating hormones and hormonal contraception. I was unaware that suffering from migraines with aura while on the birth control pill would drastically increase my chance of stroke. 

When I went for a run that morning with Lily, I could feel a migraine start to come on. My vision started going blurry as I drove home to lay in bed and suffer through it. A few hours later, I woke up like normal and headed to my friend’s house to go swimming. We swam, ate dinner, and everyone went home. I decided to drive back later that night and around 10 pm, my speech started to slur. It sounded like I was speaking complete and utter gibberish. I tried my hardest to say things, but they would not come out correctly. So I tried writing it down and texting my friends; nothing was working - not even auto-correct could decipher my thoughts into words. At that moment, I started laughing. I didn’t know what was going on; I was nervous and scared; I think it helped me from freaking out. By then, I was even having a hard time balancing. I struggled to stand straight and would tip over. My friends thought I was drunk, on drugs, or messing with them but really I was showing the first signs of a stroke, the last thing to cross any of our minds. 

 My friends forced me to me sleep over that night, but I woke up early the next morning to drive home. I rushed back into bed; my head was killing again. Thinking it was another migraine, I laid in bed drifting in and out of sleep, throwing up intermittently throughout the rest of the morning. I kept trying to talk out loud to myself to see if my words were coming out any better, but they weren’t. It wasn’t until around 11 am when my mom came upstairs, and I tried to tell her what was happening that we knew something was seriously wrong. My parents drove me to the hospital five minutes down the road. However, because of COVID-19 protocols, they couldn’t accompany me into the ER as I was no longer a minor. 

I tried to recap the day before to the nurses. The only unusual thing I could think of was my migraine in the morning and being pushed forward under the water by a friend in the pool that day. The providers decided to solely focus on that event and take steps toward diagnosing me with a concussion, even though I still presented clear signs of a stroke. They tried asking me simple questions about my insurance card and the hospital’s name. I knew the answers, but they wouldn’t come out right; I was still stuttering and speaking gibberish. At this point, I started to get upset. I was all alone and none of the doctors seemed to be worried. I couldn’t even say the name of the hospital I had driven by millions of times for the past twenty years. I could only communicate with my mom on my apple watch, drawing out each individual letter of the messages I was sending. The doctors diagnosed me with a bad concussion and told me to come back again if my head felt worse or if part of my body went numb. 

Early the next morning, that’s exactly what happened. I woke up to extreme head pain and the entire right side went of my body went numb. I would pinch my arm and punch my leg but would feel nothing. We urgently made our way back to the same ER once again. I don’t remember very much of what happened next. I was alone again. My head was in so much pain, I couldn’t bear to look at the bright hospital lights above me. Once again, despite presenting with further signs of a stroke with intense head pain and numbness, the doctors determined it was just a severe concussion and sent me home with a prescription for pain medication. 

As a soccer player, I have experienced multiple concussions before. They were never this bad or presented symptoms like this. My signs of stroke were continually overlooked because of my age and health. By the end of the week, I had been to the emergency room two times and seen an outside concussion specialist who ordered an MRI for the following day on Friday. At this point, my speech was very slowly coming back. I was still stuttering and mixing up words, my texts were still horribly misspelled, but my family and I were hoping we could get to the bottom of this soon. 

The MRI was delayed until about 5 pm on Friday afternoon. I remember the technician speaking into the microphone to stay very still, that I only had five more minutes left. I closed my eyes and listened to the machine roar around my body. A moment later, the technician came in hurriedly to say that my brain may be bleeding and I needed to go to the hospital right away. They pulled my mom from the waiting room, called 911, and told me to get dressed. My mom was visibly upset for a good reason, calling my father and talking to the doctors. All I could do was just sit there and wait and think about all the things that could go wrong, like if I was potentially going to die, a solemn thought. I texted my two best friends in a group chat to update them, “Hey I’m on the way to the hospital the MRI was stopped because my brain is bleeding please don’t worry,” in the most nonchalant way as possible, before I was put in an ambulance and rushed to the hospital.  

That night I was admitted to the pediatric emergency room at St. Barnabas Medical Center. I spent the night in the neuro-ICU. At that point, I was stable and not in present danger. Still, they needed to monitor me regularly throughout the night to be sure. Throughout the next week, multiple teams of doctors and nurses worked to find the cause of my stroke. I had numerous tubes of blood sent off to screen for various clotting disorders, MRIs on my head and pelvis, doppler scans of my legs, and procedures on my brain and heart. 

An MRI of my pelvis revealed the blood clots’ source and a bubble echocardiogram of my heart showed that I had a PFO. A PFO or patent foramen ovale is a hole between the heart’s upper chambers. This hole exists in everyone before birth and usually closes shortly after being born, except in 30% of the population, including myself. Most people will never know they even have a PFO, there are no symptoms, and there are no severe side effects unless you have a stroke as I did.

 One of the worst days of my stay in the hospital was when the hematologist team delivered the news that the blood clots originated from my pelvis. They told me that I may never be able to play soccer again. I could potentially be on blood thinners for the rest of my life. The doctors couldn’t seem to understand my reaction. I was completely shattered. In their defense, they weren’t aware I had been playing soccer for the past 15 years, attended college on an athletic scholarship, or that soccer was a foundational aspect of my life, who I am, and who I wanted to be; it defined me. I cried that entire day alone in my hospital bed. The hospital wasn’t allowing any visitors due to COVID protocols. I felt so alone as I googled ‘athletes on blood thinners, ‘low-impact sports,’ ‘how to play soccer on blood thinners.’ The google searches and results were not the answers I wanted to hear. I was devastated.

I left the hospital on July 1st. A week after, my blood tests confirmed I did not have any genetic blood disorders. I would not have to be on blood thinners for the rest of my life, and I could play soccer again. I was beyond relieved. The plan going forward was for me to be on blood thinners for the next six months, during which I couldn’t play full-contact soccer. I injected myself twice a day with Lovenox shots, a high-dose blood thinner. Based on the blood thinner timeline, I was scheduled to undergo surgery for my PFO closure in late December. However, I was lucky enough that they pushed my surgery up to the end of October. At that point, I knew I would be able to return to soccer; it was only a matter of time after finishing my blood thinners and surgery.

In terms of recovery, because I was only 20 years old and my stroke was not massive, I am very fortunate that the recovery process was not as difficult as it usually is for many stroke survivors. I attended physical therapy and speech therapy twice a week for about two months. On the outside, I seemed completely fine, like nothing even happened. Speech therapy was different; my actual speech had returned relatively quickly, almost two to three weeks after my stroke. However, I struggled a lot with my spelling, writing, texting, and reading. It was important to continually work on this aspect because my fall semester was starting in early August. I also have always considered myself good at spelling and a fast-paced reader. These skills are integral for my major, philosophy of law. I started to notice the most drastic differences in those two areas early on; it made me question if I would ever get those skills back, or if I would ever be smart enough, pass my classes or reach my academic and career goals of attending law school.

As I progressed through rehab, my family decided it would be best to stay home and finish recovery in New Jersey. It was hard to deal with that initially, but I understood and took it in stride. It made sense. I knew I could support my team from afar and keep in contact with everyone. It did get more lonely as my friends at home went back to their schools. As student-athletes, our days are scheduled down to the minute, going from one place to the next, so I tried to do the same at home to keep myself as busy as possible. I enrolled in 15 credits to stay on top of my academic progress and not fall behind. In addition, I received extra accommodations from the Disability Resource Office. After clearance from my doctors, I started playing non-contact soccer, running, and weight lifting. I attended early morning strength and conditioning sessions multiple times a week. I was away from my team and training for so long; I had to work hard to regain my strength and muscle memory. I also got my F license in coaching. I started assistant coaching at my previous club, Cedar Stars Academy, for the u15-u18 girls’ teams. I worked with multiple local youth groups in my area, putting on training sessions for 10-year-old boys groups and two kindergarten-aged sessions. Looking back, it made me appreciate the start to my soccer career and those early days of rec soccer, what it took to learn and get good at something. They enjoyed just being there and having fun with their friends. As we get older, our sports become so hyper-focused on the details we sometimes forget the bigger picture of why we even started playing in the first place.

It has been much harder than anticipated to deal with my stroke mentally and something I continue to struggle with. In those first few weeks and months, I just pushed through. I focused on what I had to get done. I couldn’t control what had happened to me. I knew this would eventually teach me an important life lesson and lead to something great. I was honestly surprised at how optimistic I felt right after. However, I think it was because I had just experienced a traumatic medical emergency in which I could have died. I have struggled in the past with my mental health, dealing with depression and life-ending thoughts at times, so my stroke helped me put that into perspective. I didn’t want to die, and I don’t know why I ever wanted to. I have so much to live for.  

However, I don’t think I could process everything until months later; things set in a lot more so after my PFO closure surgery in October when I was home and not as busy. The week after my surgery, I experienced complications with severe migraines with aura every day for a week. I was bedridden for the entire week and couldn’t look at any screens, a big problem for online classes. As the fall semester was ending, one of my best friends' mothers passed away, and a week later, my grandmother suddenly died as well. On top of that and finals, December was probably one of the most challenging months. I declined quickly. I wouldn’t leave my bed, and I barely ate. My hair started falling out, and I lost motivation for school and life in general. 

It’s hard not to ask why these things happen to us, why this, why me, why now. It was even more challenging for me to contextualize my stroke and the losses I was personally experiencing, as the entire world and people around me were dealing with such loss and trauma every day throughout the pandemic. It is still hard for me to compare my struggle and invalidate my experience because so many people deal with much worse things. As in, I didn’t have that bad of a stroke, I didn’t suffer that much, and I should be grateful; it could be so much worse. One of my favorite quotes is from the book Just Mercy by Bryan Stevenson, “We all share the condition of brokenness even if our brokenness isn’t equivalent.” So I have to remind myself of what I went through and that I am a stroke survivor, and I’m very fortunate to be alive. Not many people my age can say that.

I returned to NC State in mid-January. I was so happy to be back with my team and on-campus again; it had been almost a year. Initially, I thought I would be able to play with the team right away. Still, after my physical, the team doctor, and our team medical trainer, Devyn, decided it would be best to wait until I finished my last round of anticoagulants. I was frustrated at the news. I was anxious to return and had precisely scheduled with my doctors at home to be ready when I got to school. I worked with Devyn and our strength coach Sam to prepare for practice with the team.

I kept asking, “am I doing enough?” “can I do more?”. My first full-contact practice back was February 1st, and our first spring game was that upcoming Sunday. I started and played the full 90 minutes of our first two games of the season. It was nerve-wracking and amazing in every way. As a team, we had not played a full game in almost a year, so it honestly helped that my teammates were in the same boat, and we had to get through it together. I am grateful for every opportunity to get on the field, let alone start and play the full 90 minutes. I know my coaches worried how long I would last with my adrenaline pumping and everything. I am grateful they allowed me the opportunity to come back and prove to myself that I could do it after everything I went through. I also can’t thank my team enough for being so supportive throughout this entire process. My stroke changed my mindset about practice and soccer in general. I don’t wake up anymore complaining about having to do things. I wake up being grateful that I get to do these things. I have dreamed about these opportunities since I was a little girl, and I admit that I took for granted opportunities in the past and didn’t seize them as best I could. 

However,  as I progressed through the spring semester and season, I soon became highly overwhelmed returning full time. I was enrolled in 17 credits of classes and practicing full time, which is a lot to handle for any in-season student-athlete, let alone one recovering from a stroke. I had too much on my plate, and I could feel many of the effects I experienced after my stroke returning. My memory and concentration were still suffering. I couldn’t make it through class readings, and I struggled to write and spell. I was losing motivation again and felt like I was regressing to how I felt in December. Fortunately, I have access to numerous resources here at school. I was able to receive more accommodations for class and neurocognitive testing to pinpoint the exact areas of my brain that continue to be affected by my stroke and how it impacts my learning. I wanted so badly for my recovery to be a continuous uphill climb to reach my goals one after the other. But I’ve realized that just isn’t how it works. It will probably take me years to fully recover physically and mentally from my stroke. There will be bumps in the road, setbacks, and obstacles that I just have to take in stride.   

I am a 21-year-old student-athlete and a stroke survivor. Many young people, especially student-athletes, can take their health for granted and feel invincible; I know I did. But we need to question when something is wrong and speak up, especially as young women. I wasn’t fully aware of the risk of stroke while on birth control. I didn’t know the migraines I thought were normal were migraines with an aura that increased my chance of stroke. This unique combination of risk factors makes women more susceptible to stroke. In general, stroke in young people has been on the rise in recent years. Despite a decline in the general population, stroke rates and hospitalizations have increased by more than 40% among younger adults in the past several decades. Risk factors like drinking, smoking, or vaping, and being on birth control significantly increase the chances of stroke. However, 1 in 3 people younger than 45 does not know the five most common stroke symptoms. Even when my stroke was happening, I didn’t realize it. My friends, family, and multiple nurses and doctors did not know either despite presenting evident warning signs. It took me three trips to the emergency room and four days to be diagnosed. I’m fortunate that my brain has fully recovered because of my age. Still, hours and minutes can make the difference in recognizing a stroke and receiving proper treatment. The acronym is BE FAST: balance difficulties, eyesight changes, face drooping, arm weakness, speech difficulties, time to call 911. By learning and sharing the F.A.S.T. warning signs, you just might save a life from stroke.