It wasn't goodbye: COVID-19 nearly killed 25-year-old three times

Chest X-rays showed doctors what they were up against.

Healthy lungs full of air look black on the image. In Jason Barbosa's lungs, inflamed and filled with fluid, it looked like a whiteout.

Barbosa was 24, a dad, a husband and a gym buff who liked to lift weights. He was strong, but he wasn't invincible against COVID-19 and a litany of complications.

Doctors had tried everything possible to keep him alive. His ventilator had been turned to the highest setting. It still wasn't enough.

Three times, Barbosa's condition seemed so dire that doctors told his family to say goodbye.

“It takes a lot for me to call a family and say, 'I think this is the end,'” said Dr. Jonathan Tomasko, a cardiac surgeon at Northwestern Medicine Central DuPage Hospital in Winfield.

But no one could let him go. There was still one option left.

The last resort

Barbosa's first virus symptoms were a cough and loss of taste and smell. Then one morning in May, he was struggling to breathe when he told his brother to call an ambulance to their Carol Stream home in DuPage County, where hospitalization rates among Hispanic or Latino people are now 2.2 times higher than those of non-Hispanic residents.

Barbosa remembers calling his grandparents and parents and their last words of comfort: “We're not going to leave you.”

Caring for Barbosa became a hospital-wide effort at Central DuPage. Tomasko ticks off the expertise involved: Doctors, nurses, respiratory therapists, interventional radiologists, operating room staff, the hospital chaplain and an interpreter to help update his family in Mexico.

“No matter what we did, he wasn't responding to any of the treatments,” Tomasko said.

And the longer he stayed on the ventilator, doctors were concerned the machine itself would do damage to the lungs. When Tomasko first saw Barbosa, multiple organs were beginning to fail.

“Any advice at all, any other move we could make, I was willing to entertain it to get him through this, because at some point it was just so complicated and so many things going on that we were backed into a corner,” he said. “We had nowhere else to go.”

His medical team turned to a last-resort therapy. For weeks, tubes in his veins funneled blood from his body to an artificial lung that removed carbon dioxide and infused oxygen before the machine pumped it back.

The process known as extracorporeal membrane oxygenation, or ECMO, carries significant risks. But doctors use ECMO on the sickest COVID-19 patients to buy time and give their lungs a chance to heal.

At Central DuPage Hospital, nine patients with COVID-19 have received ECMO support over the course of the pandemic. Two died, five have recovered, one patient is being evaluated for a lung transplant and another is still on ECMO, though doctors remain hopeful in that case.

Barbosa needed to be chemically paralyzed for a good portion of the time ECMO diverted blood outside his body.

“His body was so sick that any movement and he had basically lost his oxygen levels,” Tomasko said.

Doctors also had to contend with severe bleeding issues and many more complications from the disease.

At one point, Barbosa started spontaneously bleeding into his chest because his lungs were so inflamed, Tomasko said. To control the bleeding, he had several surgical procedures, including a thoracotomy.

“We would battle to get something fixed or at least stabilized, and then something else would start up,” Tomasko said.

Turning a corner

What kept his doctors from despair? Barbosa was young. His family held onto hope. And Tomasko refused to give up.

“We always had a small path forward I guess is the thing that kept me going,” Tomasko said. “There was always one more thing we could try and do.”

Barbosa's condition took an unexpected and abrupt turn as doctors weaned him off the paralytic drugs, and he could cough and begin to breathe on his own.

“I didn't realize that his lungs had been healing in the background and the inflammation had been clearing in the background,” Tomasko said, “because we had no indication of that based on the rest of his labs or vital signs or anything like that.”

As he awoke, Barbosa, now 25, thought he was having a dream. Everything was blurry.

“I lost around 40 pounds just being in that coma for six weeks,” he said. “And when I saw my feet and legs, and I wanted to move them and pick them up, I couldn't do anything of that. I was scared.”

Unable to speak, he scribbled on a board or tried to communicate by blinking his eyes on video calls with his family.

“I was crying,” he said. “I was so happy that I could actually see them once again, knowing that I was that sick and knowing that they were there for me the whole time, waiting with their faith.”

A long recovery

The worst of his illness behind him, Barbosa stayed at a ventilator hospital in Sycamore for a month before going to Marianjoy Rehabilitation Hospital for physical and speech therapy.

Barbosa finally returned home on Aug. 19. More than six months later, he's been unable to go back to his warehousing and restaurant jobs because of the numbing of sensation in his feet. He suspects he picked up the virus at work.

He hopes to serve as a reminder to people his age to get the COVID-19 vaccine when it's their turn.

“I think there's a purpose God left me here,” Barbosa said.

He's now taking medications for elevated blood pressure, nerve pain and other residual problems. There are still questions about the mysteries of COVID-19 and whether he'll make a full recovery.

“It's difficult to say, but if anybody could do it, Jason has proved he is quite resilient and incredibly strong,” Tomasko said, “so I have nothing but optimism for him.”

Barbosa has nothing but gratitude for the doctors and nurses who saved his life and kept a family whole. “They did everything for me,” he said.

He's working to regain his strength and waiting for his COVID-19 shot so he can see his wife, Melanyee, and play soccer with their sons, Ronny, 2, and Romeo, 7, who are in Mexico.

“I'm getting everything back, little by little.”