Phoenix VA Health Care System
Phoenix VA's first COVID-19 positive Veteran
A Tough Year
Phoenix VA’s first COVID-19 positive Veteran details the fight of his life – and how he made it through it with the help of his wife – his rock – Ruthie
Army Veteran Armando Contreras knows a thing or two about fighting. Nearly a year ago, Armando entered the Phoenix VA Health Care System Intensive Care Unit for the fight of his life. But, Armando’s story of fighting didn’t start when he became the first Phoenix VA Veteran diagnosed with COVID-19. No, Armando and his wife of five years, Ruthie, have been battling for a while.
It was a Sunday morning and Ruthie was at church on Oct. 27, 2019, when she got the call. After more than five years of dialysis and two years on the kidney transplant list, it was time. Six hours after her phone rang, they were on a medical flight bound for Oregon where Armando would finally get his new kidney.
They arrived at the Portland VA and settled in for the battle, which went far better than his doctors expected. He was recovering from his transplant well and it was time to head home to Arizona. They’d heard mention of a new virus, that it’d been in China and Italy, but didn’t pay close attention. All they knew was that their prayers had been answered – he received his kidney!
Then, as they prepared to return to Portland in January 2020 for a post-transplant checkup, more information was coming out about COVID-19 in Seattle. As a transplant patient, Armando had to be careful. Ruthie made sure of it. Still, they needed to get to Portland, so off they went.
It was after their return from that checkup in late January that Ruthie got sick. It wasn’t like any sickness she’d ever experienced, and the doctors told her she’d come down with the flu. She took precautions around Armando and soon started feeling much better.
After a couple of weeks, Armando started exhibiting symptoms. Ever the cautious one, Ruthie insisted on a visit to the VA hospital because she knew, post-transplant, that her husband was much more vulnerable to illness. The Emergency Department doctors confirmed he, too, had the flu. He was sent home with a typical influenza treatment plan.
As the week progressed, Armando was not improving. By Saturday, March 14, 2020, his skin gray, breathing labored, Ruthie told him they were going back to the VA. She took him to the screening station outside the Emergency Department and soon she saw him wheeled inside.
Within an hour, he was diagnosed with pneumonia and intubated. Within two hours, he was in the Intensive Care Unit. Ruthie waited in the parking lot for four hours, hoping for news. She returned home, lost, with very little information on her husband’s condition or when she would see him again.
She returned to the Phoenix VA several times that first week, trying to “sneak up to see him,” but with the newly implemented visitor restrictions, she was unable to see him. Finally, on March 19, 2020, she was able to spend 30 minutes with him because the medical team was concerned he wouldn’t make it home.
He hung in there, though, and by Saturday, March 21, 2020, the former Army Soldier’s COVID-19 test came back – positive. Prior to this, the medical team suspected COVID and had been trying different treatments. They even reviewed international research to find information. As the Phoenix VA’s first COVID patient, not a lot at the time, but doctors here knew they would fight especially hard for Armando.
“When the doctor told me he was not going to pull through, I decided to write everything down (in a journal),” Ruthie said, holding back tears. “There were his daughters (to think about) and I felt … a responsibility. It was important to be his advocate even though I didn’t know what was happening. I could only go by what they told me.”
The journal was important, she said, because the process of writing down what was happening reinforced her belief in God and her belief in the strength of her husband.
"I prayed and said, ‘God didn’t give him a kidney to take him from me five months later,’” she said. “He was heavily sedated, so I did it for his family because I knew I had to give them some kind of answers as to what happened.”
The journal would prove valuable to more than just Ruthie. While Armando was in the hospital for 33 days, 24 of which he was intubated in the ICU, he recalls being there for just 3 days. Without Ruthie’s details, he might never know what happened or just how close he had come to dying.
She remembers the doctor telling her, “Brace yourself (for his passing). I’m trying to keep it real for you.” Ruthie said she understood, but defiantly said, “I have a powerful God and a whole nation praying for him. I’m going THAT route.”
Later that week, one of the doctors said if he didn’t start improving on the ventilator, they were going to put in a tracheotomy. Ruthie urged them not to do it. They obliged. But, then began another hard conversation. The medication could damage his brand-new kidney. The doctor said he needed Ruthie to know that if it came down to it he would prioritize saving Armando's life.
Constant communication didn’t just come from the health care team in Phoenix. Ruthie had many discussions with the transplant team in Portland. They assured her that if he lost his kidney, he would go back on the list and they’d work to find him another one.
Another time, when his dependency on the ventilator went from 100% to 90%, and then to 50%, the medical team waited for him to start responding. He didn’t. So, the team called Ruthie, asking her to go in and try to motivate him to dig deep.
“He didn’t recognize me,” she said. “He kept referring to me as his ‘significant other’ and I said, ‘No, I’m your wife,’” Shortly after, the improvement started. Still, Armando had what was described as cement in his lungs and it didn’t appear to be going anywhere.
At that point, the team put Armando on a rotoprone bed, which rotates the body, in order to clear the lungs. After three days, the treatment had worked enough that he was taken out of ICU and placed in a regular COVID unit.
Armando said when he read back through his wife’s journal, he was struck by her strength.
“I can’t believe she went through all of that,” he said. “It hit me how much hard work and dedication she and one of my daughters put into the fight. I couldn’t do anything – I just laid there.”
But, Armando did fight. He’s been a fighter as long as Dr. Penelope Baker, Phoenix VA Chief of Renal, has known him. That fight continues.
“It’s about the strength of the Veteran,” Dr. Baker said. And in Armando, she saw strength.
The relationship between Armando and Dr. Baker goes back several years.
“She’s taken care of me from the very beginning, so she knew how strong I was.” Armando said. “I would tell her, ‘I’m doing my part. I need you to do your part and get me a kidney.’ It took five years, but she did.”
Later, he heard Dr. Baker helped Ruthie throughout his COVID journey, providing her information and reassurance that Armando was being given the best care possible. He wasn’t surprised. He calls her his “most trusted doctor” because she never left his side and guided him through all his issues, including his renal failure and diabetes.
Armando was released from the hospital about 11 months ago. Recovery has been long and arduous. The Contrerases say you don’t realize the aftereffects of this disease until you have to go through it. He had to go to physical therapy and speech therapy. And, nearly a year after his diagnosis, he’s still not 100 percent. He has scars on his lungs that keep him from speaking long sentences. He asked and doctors told him the scarring will never go away. He has a foggy memory and Ruthie is helping him fill in some of the gaps.
“The doctors went from not knowing a lot about COVID to (researching every option) to fight for my husband,” Ruthie said. “When the time came for his discharge, I was so excited. Thirty-three days without my husband was so hard.”
Her final journal entry read: “It’s (April) the 17th and he’s coming home today. He’s still positive, but not contagious. It’s a two-week quarantine for him. He has new meds, a wheelchair and a walker. Happy, happy Friday. Thank you, God.”
Armando, who has now received both doses of the Pfizer COVID-19 vaccine, said he owes a debt of gratitude to the VA.
“I have to praise the VA,” he said. “They’ve never let me down. Ever. My doctors never gave up. I trust them. They give the best care anywhere. For my fellow Veterans, I say you can count on the VA to always be there when you fall. They’ll help you up – slowly and carefully. Don’t ever give up.”
The couple also said they have a new look on life.
“We are going through all of this for a reason,” Ruthie said. “It’s made us better people.” Armando agreed.
“The kidney gave me a brand-new life,” he said. “This COVID has given me understanding and appreciation of my brand-new life. I’m going to keep it as long as I can.”
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