WILL THIS EVER GET EASIER?
A double lung transplant saved Jesus Ceja Ceja’s life. A year later, he wonders when he can start living
Victoria Ceja Munguia peppers her parents with questions they don’t know how to answer honestly.
Why is Dad in and out of the hospital so much? Why are you so worried about us getting sick? Why can’t we visit our family in Mexico for more than a week?
The 8-year-old grows smarter every day as her mother, Perla Munguia, and father, Jesus Ceja Ceja, attempt to satisfy her with half-truths: Your Dad had an operation and can’t get sick, they remind her.
Reality is far more complicated.
It has been 15 months since Jesus’ COVID infection forced him to undergo a double lung transplant at Houston Methodist Hospital, an operation that simultaneously saved his life and diluted it. Post-surgery restrictions, including medications that compromise his immune system, mean he cannot eat the food he loves, work the job he wants, or live in the place he calls home: his family’s ranch in Cotija de la Paz in the Mexican state of Michoacán.
Jesus, a legal permanent resident in the United States, caught the virus in July 2021 while living in Baytown and working at a refinery. He joined hundreds of young, unvaccinated people across the country who needed intensive care after they were sickened by a dominant delta variant. A life-support machine kept him alive for months until he qualified for the transplant, typically reserved for older patients with late-stage lung disease.
For a younger man, this second chance carries more severe consequences. Only about 60 percent of lung transplant recipients live five years; 33 percent live 10. Survival rates can vary widely. Some double lung transplant recipients have lived more than two decades.
Jesus knows the numbers, but he does not want to be haunted by the clock. He reminds himself to live in the moment, to use what time he has left to build something for his family. Thinking about the fu
ture stings him and Perla, so they tuck those thoughts behind the day-to-day worries of paying the bills, staying healthy and caring for Victoria and their 4-yearold son, Erick.
After enduring the first year of recovery, the most critical period for a lung transplant recipient, unrelenting infections make it harder for Jesus to live with the uncertainty.
He wonders: Will this ever get easier?
Trying to work
Last June, seven months after the surgery, Jesus landed jobs for himself and Perla as industrial insulators at a not-yet-operational Lyondell Basell plant in Channelview, not far from their Baytown home.
The kids were in Mexico for the summer, so this was their chance to double their income.
Jesus only intended to train Perla for the work, which included cutting and fabricating metal, until he could return home to continue his recovery. Their financial outlook had changed after the Kiewit Corp., which owns the company Jesus worked for at the time of his illness, denied his disability benefits, saying he did not work long enough to qualify.
Jesus had wanted to save up to buy a house in Baytown. Rent, utilities and car payments remained a constant worry.
He had to be careful, though. Transplant patients run the highest risk of lung rejection, when the body’s immune system attacks the new organ like a virus, during the first year.
His doctors may not have been worried about someone with an office job returning to work after seven months, but they were uneasy about Jesus’ work, which was physically demanding, with longer hours.
“We need the money,” he told them. And, he thought, what else was he supposed to do?
He did this type of labor, supporting his family in Mexico as a journeyman insulator in the United States, his entire adult life. Besides, he reasoned, the Channelview plant did not have potentially harmful chemicals flowing through its pipes, so it was safe enough to return, despite the weakness and fatigue still plaguing his body.
He stayed on the job with Perla for two months, slowly gaining strength and feeling more like himself. Then his body revolted.
Wearing thin
A hiatal hernia, in which the upper part of the stomach bulges through the diaphragm, made it harder for him to digest food, a common problem for lung transplant recipients. Doctors detected the hernia shortly after his November 2021 operation, believing it was unrelated, but opted to wait until he was strong enough to repair it. Jesus underwent the operation in August and endured a miserable two-week regimen of protein shakes for all of his meals.
He became too tired to work. Then, three different respiratory virus infections, which can be deadly for a lung transplant recipient, further sapped his energy and forced doctors to adjust his medication.
Perla took over as the family’s sole provider. Jesus watched the kids at home with his sister, Lucero, and drove himself twice a month to appointments at Houston Methodist Hospital in the Texas Medical Center.
By December, his 5-foot 7-inch frame, which weighed 200 pounds before his infection, had dropped to 132 pounds. An intravenous line dangled from his inner elbow. He often wore an elastic band across his waist, to help him breathe. A dry cough and fatigue pestered him. His medications, which filled a rainbow pill organizer nearly the size of an algebra textbook, caused him to lose some of his short black hair.
As his health teetered, his reliance on doctors and nurses tested his patience. Adding to the stress was the Social Security Administration’s denial of his latest attempt to access disability benefits. He and Perla discussed going to Cotija for the holidays, but the trip hinged on whether they could secure an eight-day supply of his medication.
On Dec. 20, Jesus, Perla, Lucero and the kids sat on the couch and reminisced with photos and videos of their old life in Cotija. Jesus played a video of him and Perla dancing in the city plaza. “It’s Mom!” the kids said. “That’s your dad there, too,” Lucero said.
“What?” Victoria said, surprised. “You don’t look like that anymore.”
Struck by the comment, Jesus hunched and looked at the ground, then quickly moved on to the next video.
‘He made it back’
Perla and Jesus found out his medication was available the following day. The family packed and left later that evening.
Jesus smiled when they crossed the border after six hours of driving. It was the first time Perla could remember seeing her husband of nine years cry tears of joy. He missed his family desperately.
When they arrived, Jesus embraced his mother, Evangelina Ceja Aguilar, one of the few people who visited Jesus at his worst in the Houston hospital’s ICU.
Inside Evangelina’s home on the ranch, mother and son held each other in front of a makeshift memorial for Jesus’ late father, Jose Ceja, who died of COVID five months before Jesus became infected. He was Jesus’ best friend, the man with whom he shared everything.
“Why did you have to go?” Jesus asked the portrait of his father hanging on the wall. “I need you here.”
Evangelina, who at one point thought her youngest child would face the same fate, in that moment reassured her husband: “He made it back.”
Reunions continued at various ranches in Jesus’ circle of family and friends. He and his sister, Beatriz, settled into their familiar pattern of teasing. She greeted him as “bones” and told him he needed to eat more. Later in the night, she made him hand over 500 pesos (about $27), after he bet she couldn’t eat a habanero pepper. Jesus squinted from laughter as he watched her chug water and cautiously bite the yellow fruit.
At a New Year’s Eve party, friends and family threw screaming fireworks at the ground, into the air and at each other. Jesus watched from inside, shielding himself from the smoke that could damage his lungs.
He soaked in as much of home as he could before he had to return to Baytown for an appointment with his medical team, who would review his lung function. He enjoyed the lemonade made fresh from the trees on his ranch. He ate his favorite hamburger in town. He watched Erick play outside for hours, while Victoria rode her favorite horse.
There were moments when Jesus’ health receded to the back of his mind, but his body never let him forget.
The ranch’s mile-high elevation diminished his oxygen levels to 86 percent, well below the healthy 95 percent threshold. When people commented on his weight, or offered him traditional fatty foods, he remained coy. He could not eat much because he was taking antibiotics, he explained.
The food offers persisted, however. Red mole, tripe, tacos al pastor — everything he grew up eating, now a risk.
At one point, Jesus became so frustrated that he left a family gathering to feed the chickens alone.
Reasons to hope
Three weeks after Jesus returned home, he was back at Houston Methodist Hospital, this time with pneumonia from a bacterial infection and a lingering adenovirus infection. Doctors said he could be there at least a week, depending on his response to treatment.
Infections are a normal part of the lung transplant recovery process, but Jesus’ recent barrage of illnesses worried doctors familiar with his case. His lung function already was about half what they expected from a transplant recipient at his stage. Fortunately, he had been able to stave off lung rejection.
The more time Jesus spent with doctors and nurses, the more his trust in them waned.
He never liked hospitals. His life-or-death experience in 2021 left additional trauma. Now, seeing an unfamiliar doctor perform a bronchoscopy — a relatively routine examination of his lungs — rattled his nerves. He also felt like doctors had been giving him conflicting stories: A medical worker recently told him he had fluid around his lungs. Later, a doctor told him that, no, he did not have fluid in his lungs. He did not know what to believe anymore. His limited English made it harder to find answers. Perla, who speaks better English, handled that part before the transplant.
Now, she works all the time, and Jesus largely has to fend for himself.
Jesus scrolls through social media on his phone, in the same sweatpants he wore when he walked out of this same wing of the hospital 14 months ago, and lets his mind wander back to Mexico.
He allows himself to think about a future there. Despite his struggles, the recent trip was rejuvenating; it renewed his desire to build a house there, like his father and his grandparents. He wonders, if they can do it with little money and resources, why can’t I?
His goals still feel out of reach. He can’t afford the price of his medications in Mexico — and he wouldn’t receive the same level of medical care — but he will do whatever he can to leave something for the family.
He has prayed to be around for Victoria’s quinceañera, to host a big celebration with the family and give her the horse she always has wanted. He wants to speak to her like an adult and share his life plans with her, like he did with his father.
Maybe then, he could explain all he has been through, and how she and her brother helped keep him alive in his darkest moments.
“If God allows me,” he says.