Danny Warren’s family is celebrating life over death this Easter Sunday, but their triumphant story goes beyond what’s typically told from the pulpit.
Warren’s wife, Alma Zepeda, gave birth before Christmas, got COVID-19, went downhill quickly and spent 2½ months on a ventilator. Those involved with her case, from doctors and nurses to a chaplain, told Warren it was time to let her go, that her lungs were so badly damaged, she’d never breathe on her own again.
Warren wouldn’t—he couldn’t—accept it. He saw his 40-year-old wife and Army veteran as a strong and independent woman, a police officer in Alexandria who investigates crimes against children. The couple have two little ones, a toddler named Jacob who loves everything about “Wreck-It Ralph,” and a newborn, Olivia, who barely had the chance to be snuggled by her mother.
He was convinced his wife had a full life ahead of her.
“I kept saying, no, her story’s not done yet,” he said. “Her story’s not done.”
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As Warren prayed—his mother, Tammy, said he got on his knees a lot—he asked others to join him, from neighbors in North Stafford to co-workers, friends and even those with Joel Osteen’s television network.
He believes those prayers and conversations—and being at his wife’s bedside almost every day, asking questions and pleading for more time—led him to the manufacturers of an experimental drug, which officials at Mary Washington Hospital agreed to administer.
With the treatment, the mother went from being on death’s door to waking up from her medically induced coma. She started to talk again, despite months of inactivity and sedation.
She was transferred to Encompass Health Rehabilitation Hospital in Fredericksburg in mid-March to relearn how to use her hands and feet, which were severely impacted by being bedbound for so long.
In less than a month, she was able to come home—thrilled to meet her goal of being back in time for Jacob’s third birthday on April 10. When she got up from her wheelchair at Encompass and rang a bell signifying that portion of her treatment was over, health officials around her applauded—and wiped away a few tears.
“Emotional, remarkable, miraculous, uplifting—there’s no shortage of positive adjectives to describe the whole story,” said Dr. Ali Hafiz, who works with Pulmonary Associates of Fredericksburg and treated Zepeda in MWH’s intensive care unit.
He developed a particular connection with Warren as both men welcomed home babies in late December. When Hafiz saw Zepeda spiraling downward—and heard Warren’s pleas for help—the doctor thought about his own wife and child.
“It immediately appealed to my emotions,” Hafiz said.
That wasn’t the only time Warren made a personal connection with those around him.
“I’m telling you, all I did was pray and just follow where God led me,” the father said. “The medicine is probably what cured her, OK? But God put every person in my path so that this could get done.”
‘LET HER GO’
While Warren describes the “long battle,” his wife sits on the couch, listening as if he’s describing a stranger. She has little memory of what happened. Olivia was delivered by emergency C-section on Dec. 17, then Zepeda went back to Stafford Hospital four days later.
She had been in the shower, raising her hands to wash her hair when she sensed something was wrong.
“I felt a tightness in my chest like someone was squeezing my lungs and I was out of breath, just from shampooing, and I was like, this is not normal,” she said.
At the hospital, Zepeda tested positive for COVID-19. She had not been vaccinated, but planned to get the shot after the baby was born.
Everyone else in the family later tested positive as well, and Warren wasn’t allowed in the hospital for a while. He kept track of things by phone, and by New Year’s Eve, Zepeda was put on a ventilator and sent to Mary Washington Hospital.
The COVID-caused pneumonia had progressed to the more severe acute respiratory distress syndrome, which is often fatal.
“They told me that after seeing her CT scans that her lungs are completely gone and that she will never come off the ventilator,” Warren said. “It was explained to me that you’re like holding her back from going up, and you gotta let her go.”
Warren said he understands their perspective. The omicron variant of COVID-19 was raging and Fredericksburg-area hospitals were treating more than 150 patients—on their way to setting all-time COVID records. Plus, the ongoing labor shortage was heightened, making January and February the worst two months of the pandemic, Mary Washington Healthcare officials said recently.
‘POWER OF STEM CELLS’
As friends and co-workers of Warren and Zepeda extended the request for prayer, the chain reached someone who works for Direct Biologics, a Texas company that manufactures regenerative biologic products. Soon, Warren was talking with Anastasiya Shulman, director of medical affairs.
Warren explained his situation and she explained ExoFlo, an investigational drug in clinical trials for treating COVID patients with acute respiratory distress. It hasn’t been approved by the Federal Drug Administration.
Derived from bone marrow, the drug “harnesses the power of stem cells without using the cells” themselves, said Dr. Vikram Sengupta, chief medical officer at Direct Biologics. The treatment uses the proteins and other information found in genes to create a mechanism that turns down the inflammation present in COVID patients and turns up the body’s ability to regenerate tissue, Sengupta said.
“It’s not just one molecule hitting one target, it is a whole population of active molecules hitting the inflammation network at different points and a whole suite of other molecules helping cells regrow,” he explained.
After numerous phone calls and discussions, Warren wanted to try ExoFlo and Direct Biologics agreed to provide it, for free, through its compassionate care clause. The hospital had to agree to administer it and apply to the FDA for permission to use it.
A lot of conversations followed and Warren credits all the doctors, nurses and respiratory therapists who listened, and talked with him, about the situation.
“It was kind of a last-ditch effort,” said Shulman at Direct Biologics, and she sensed doctors agreed, both because of Warren’s persistence and the notion that it couldn’t do any harm.
Dr. Mohammed Choudhry filled out the piles of paperwork and Zepeda was comatose when she got the first treatment, an hourlong infusion. Warren had been warned it might take up to two weeks to see results, and near the end of the 14th day, she showed slight improvement.
Dr. Erik Osborn asked Warren about a second treatment, and the father, and Choudhry, went through the process again of seeking federal approval. They’d do it a third time as well.
By that time, Zepeda had awakened and a respiratory therapist suggested putting a device over the tube going down her throat, to see if she could talk.
When word spread that she could, Hafiz had to see it for himself. He asked a few questions, and in the clearest voice, without the slightest rasp—which he said is unheard of for someone in her condition—she told him her stomach hurt.
“I was almost trembling when I came out of that room, my expectations were shattered,” Hafiz said. “I would never in a million years have predicted that moment would have happened. I was completely mind blown by then.”
‘WHAT YOU CAN DO’
Images showed Zepeda’s lungs had repaired themselves. Because she suffered other damage from being ventilated that long, she headed to Encompass for intense rehab.
“She was determined from the beginning,” said Michele Burke, her case manager at Encompass. “We’re all just very happy and pleased with all the progress she made, and especially as one mom to another, to see her go home to her children.”
However, her recovery is far from over. Her right hand hangs heavily at her side, “like it weighs a thousand pounds,” she said, and her left wrist is curled from being in the same position for so long. Her feet are pointed downward as well, but exercises and braces are designed to correct the issues.
Warren’s parents, Tammy and W.O. Warren, have cared for Olivia, day and night, and Zepeda’s goal is to phase in the baby’s eventual return home. Jacob has been in child care by day and with his father in the evening.
Zepeda says she feels like a third child, as she can’t do anything without assistance. Getting up off the couch, standing in front of her walker and taking a dozen steps wears her out, but she does it hourly. The movement leaves her gasping for breath.
“I’ll be honest, depression sets in,” she said. “I have to tell him when I have to go to the bathroom, when I’m ready for bed, when I’m hungry, when I’m thirsty. Everything. There is no independence.”
In her mind, “it was like a three-day span” from the time she entered the hospital again, after Olivia’s birth, to when she came home on April 7, but “apparently not.” While she struggles to deal with what she’s lost—and tries not to get too anxious about how much she may recover—her husband is on the opposite end of the emotional spectrum.
He’s jubilant. He keeps telling her about all the progress she’s made because he saw for himself her swollen body and deteriorating condition, as machines did everything for her. Even after she woke up, she couldn’t sit or stand without assistance—and he still wants to be close by when she does either, in case she needs help.
But the couple, along with his parents and family, feel grateful and blessed in so many ways, Tammy Warren said. His co-workers at Fresenius Kidney Care, where he’s a biomedical technician, have donated paid time off. Zepeda’s income has continued through a COVID relief program, but the couple is certain they’ll have piles of medical bills.
A friend set up a GoFundMe account for the two, named Life After Covid.
Neighbors have bought groceries or offered help with Jacob. One came over to brush and braid Zepeda’s hair before an interview. Her police captain at work has checked in regularly with Warren and co-workers have said how much they’re looking forward to her return.
She tries to digest all that, reconnect with Jacob and get to know her baby daughter, who’s already sitting up and teething. Her husband is just glad to have her home, after watching Zepeda teeter on the edge of death and come back from it.
“You realize how much you miss and love people when they’re not here,” he said.
Cathy Dyson: 540/374-5425