OMAHA — There were flowers and balloons, a few tears, thunderous applause from hospital staff who lined up to see their patient off and — hopefully — a caramel cake waiting at home.
Ruby Jones walked out of CHI Health’s Immanuel Rehabilitation Institute on Thursday morning after surviving a battle with the coronavirus that left her weakened but more determined than ever to gain back her strength, gab with her two “old lady” best friends again and hug her family close.
Her monthlong hospital stay hints at what the 73-year-old Omahan has endured and overcome.
Jones became sick with COVID-19 in early April but doesn’t know how she was exposed to the coronavirus.
“I stayed at home in my apartment. Everybody said, ‘Stay home, stay home,’ ” she said.
She had a dry, itchy cough that she initially chalked up to sinus problems. She also has diabetes and high blood pressure, two conditions that seem to exacerbate COVID-19 complications.
A friend told her she sounded confused over the phone. The next thing she remembers is waking up at the Immanuel Medical Center, disoriented. Where was she? How much time had passed?
Jones ended up spending 25 days in the intensive care unit, 15 of those hooked up to a ventilator to help her breathe. After her condition stabilized, she spent another 14 days in rehab, relearning how to sit up, walk, dress and feed herself after weeks of lying still in a hospital bed.
“She has been through it,” granddaughter Jennifer Allen said.
Much remains hazy about the period when she first felt ill and the time she spent on the ventilator, sedated and surrounded by beeping machines, tubes and doctors and nurses who all looked alike in long gowns and masks. But some things come back clearly.
“Truthfully, I can still remember the love I got,” she said.
Jones retired after a long career as a certified nursing assistant at nursing facilities like Immanuel Fontenelle. She’s not used to being on the other side, as the patient in need of care.
“I loved helping people, not people helping me,” she said.
When Jones was first admitted to the hospital, Dr. Erik Jacobson said she wasn’t doing too badly — she was scared of the contagious virus sweeping across the world but hoped she’d be able to head back home and recover there.
That was not in the cards. Within a day or so, her condition quickly worsened and she had trouble breathing.
“What we are seeing with this is that people can have this period where they’re really feeling OK, their body is trying to manage this and then suddenly they can have this change where they will decompensate,” he said.
This was still early on in the coronavirus pandemic, and doctors were trying to figure out — as they still are now — what medications and therapies would help patients ward off the frightening new virus.
Jones was given hydroxychloroquine, which was briefly touted as a promising treatment by some, but it didn’t do much. Doctors tried to keep her blood pressure from spiking and made sure she got adequate nutrition through a feeding tube.
Jacobson tried some blood thinners and anti-inflammatory drugs toward the end of Jones’ stint on the ventilator. Whether it was just timing or the medications, she began to improve.
“If you’re having a heart attack, we have a very common pattern of treatment. We know how to do that,” Jacobson said. But it’s hard for patients and their families to accept that there is no approved treatment for COVID-19, though doctors are trying different combinations of drugs, including trials for remdesivir, and plasma therapy.
“Without a known way to fix this, it’s very scary,” he said.
Jones improved enough to be removed from breathing support, but her recovery was just beginning.
COVID-19 patients seem to spend more time on ventilators than patients with other respiratory ailments, said Jacobson and Dr. Aishwarya Patil, the associate medical director of the Immanuel Rehabilitation Institute. Having a tube down your throat for a prolonged period of time can make it hard to talk and swallow once it’s removed.
Long ICU stays can lead to other problems: muscle weakness, fatigue, depression, anxiety, a form of disorientation called “ICU delirium” and cognitive problems with memory and problem-solving.
Immanuel decided to start rehabilitation even though Jones was still testing positive for the coronavirus.
“The sooner you start the rehab, the better your outcome is,” Patil said.
Most, if not all, rehabs are not accepting patients who still have the coronavirus, she said, so therapists visited Jones in the coronavirus unit, taking care to wear protective gear. Once she tested negative, she was moved to the Rehabilitation Institute nearby. She spent three demanding hours each day doing physical, occupational and speech therapy, with plenty of breaks to rest.
“Ruby survived — that is a miracle in itself — and we just had to step it up and help her,” Patil said. “Ruby lived up to it and she did everything we asked her to, so that was very motivating for us.”
Jones will continue her recovery at her granddaughter’s house. Her great-grandchildren made bedazzled posters thanking the staff at Immanuel for saving their grandma, and the medical teams that cared for her in the ICU and in rehab came down to cheer her as she was discharged, slowly but determinedly pushing a walker.
She’s feeling stronger every day, and credits her “sweet and loving and kind and patient” caretakers and her family for pushing her to get well.
“I see myself coming back to me a little bit at a time,” she said.
Even her appetite is returning — just in time for a slice of that caramel cake her great-granddaughter promised she’d make.
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