When Zach Strayer vomited a tiny bit of blood last summer, his parents knew it had come time to see a lung specialist.


The 2020 Sparta High School graduate had recently been discharged from the hospital with lung issues, and now his condition had quickly worsened.

His parents, Brian and Barb Strayer, scheduled a same-day appointment with Spectrum Health pediatric pulmonologist Johanna Zea-Hernandez, MD of the Spectrum Health Helen DeVos Children’s Hospital Pulmonary and Sleep Medicine group.

The doctor had been away from her Grand Rapids office that day, so she could only see them via telecart—a virtual video system—if they’d be willing to give it a try.

When the Strayers arrived at the office on Friday afternoon, a medical assistant connected them with Dr. Zea-Hernandez via video.

“It’s neat. We’re seeing the doctor and the doctor is seeing us and asking questions,” Brian said. “The doctor said, ‘I want to listen to his lungs and heart,’ so the medical assistant put the stethoscope on Zach. It was just like she was in the room.”

Based on her exam, Dr. Zea-Hernandez ordered more tests.

That evening, she sent Zach to Spectrum Health Helen DeVos Children’s Hospital, where she had reserved a room so he could skip the emergency department.

By Sunday, the doctors diagnosed Zach with granulomatosis with polyangiitis, an uncommon and very aggressive autoimmune disorder that affects blood flow to the nose, sinuses, throat, lungs and kidneys. They began treating him right away.

Doctors told the Strayers this had been the quickest any patient had been diagnosed with the disease at the children’s hospital.

“If we had waited, we believe his kidneys would have failed and he would have been on dialysis,” Brian said. “We just don’t believe this would have happened that fast if we didn’t have telemedicine available.”

Groundhog Day

Zach is an athlete who enjoyed high school baseball and soccer. After graduation, he stayed fit with trips to the gym and running.

“I love working out and staying healthy,” he said.

When Zach initially had joint pain last spring, he attributed it to exercise or too much lifting at his part-time grocery store job.

But his aches worried his parents. They arranged for X-rays of his wrists, elbows and knees, which didn’t show any obvious problems.

Then things got worse.

“One day he came upstairs and was out of breath and complained his rib cage hurt,” Brian said. “We decided there’s something going on here. Let’s go to the ER.”

Doctors suspected fungal pneumonia. After a few days of hospitalization, Zach and his family hoped he had found the road to recovery.

Then the fevers started. And the lack of energy. And finally, vomiting.

After Dr. Zea-Hernandez sent Zach back to the hospital, he spent more than two weeks receiving plasma exchanges and other treatments to bring his disease under control.

While friends stayed in touch via Snapchat, Zach kept a good attitude despite missing out on the fun.

“Every day felt like Groundhog Day,” Zach said, referring to the Bill Murray comedy in which daily events repeat themselves over and over.

Determined to stay in shape, he began walking laps of the hospital floor, carrying his vitals monitor with him. One day he walked 70 laps, setting a possible hospital record.

Today, Zach is staying in shape despite a temporary compromised immune system that puts limits on his social life due to COVID-19 concerns. He can only take his Muskegon Community College classes online.

Through it all, the Strayers count their blessings.

Brian and Barb adopted Zach and his brother from an orphanage in Russia when the boys were just 18 months and 10 months old.

Although the reality hasn’t really hit Zach yet, his parents are struck by how differently things could have turned out. Especially if he stayed in Russia instead of coming to Michigan.

“Emotionally he seemed fine, but we were basket cases,” Brian and Barb  agreed. “Maybe because we were more experienced with life and death, we were worried.”

Different location, same care

Dr. Zea-Hernandez is enthusiastic about using the possibilities that telecart technology offers to patients, especially those who don’t live near cities with extensive medical facilities.

“With this equipment we are able to listen to your lung and heart, see into the ears, mouth and nose, and examine patients’ skin” she said. “It’s done with a medical assistant who has the training to help us do the physical exam with patients.”

Currently she is using telecart technology to examine patients in Grand Rapids, Lansing, Ludington and Traverse City.

While Zach can count himself among the first patients examined by way of telecart, Dr. Zea-Hernandez envisions a future in which the technology will serve people from more remote areas, such as Michigan’s Upper Peninsula.

“Families won’t have to drive for hours. I think that is one of the most important things,” the doctor said. “We want to let families know you are going to get the same care without driving all the way to Grand Rapids. We have a very high percentage of telemedicine visits.”

Zach’s parents say the telecart system is one of many “little miracles” that saved his life.

“God’s hand was in it,” Barb said.