KANSAS CITY, Mo. — Gwen Starkey is headed to rehabilitation without the machine that helped her breathe for more than 300 days — 322 by her daughter’s count.

She went on the ventilator last February and spent December being weaned from it. On Dec. 31 she received a colorful document signed by a respiratory therapist that reads: “Certificate of Ventilator Liberation.”

“It’s so fantastic for her because she hadn’t eaten real food for almost a year,” Starkey’s daughter April Shaver, of Kansas City, told The Star. “And her thing right now is tacos.”

Starkey was little more than a “body in a bed,” as Shaver described it. While she was on the ventilator, Starkey’s father died and she turned 60, which she celebrated last month with Wendy’s french fries in the hospital cafeteria.

“We’re just removing 2021 from the calendar,” Shaver said. “It never happened. We get a redo.”

Her mom got infected before COVID vaccines were widely available.

“Now that the vaccine’s available and it’s free and people are getting sick and they’re dying because they’re unvaccinated, it doesn’t make sense to me,” said Shaver. “And it’s sad because it’s preventable.”

Shaver said her prayer list is longer than it has ever been, full of friends and acquaintances sick with COVID. A 29-year-old friend who “just never got around” to getting vaccinated recently returned home after spending a few days on a ventilator with COVID.

Her neighbor’s son just lost his teacher to COVID.

She was 31.

Noisy and uncomfortable

Starkey had only been retired from the Ford Motor Co. Kansas City Assembly Plant in Claycomo a few months when she and several relatives got infected with the coronavirus during a family gathering a few days before the Super Bowl. Starkey got it the worst.

It shocked family members to see the otherwise healthy, active grandmother flattened by the virus and hooked up to a ventilator. Shaver had never seen her mother so helpless, her hands so “frail, cold and lifeless.”

Last summer Shaver posted a Facebook photo of herself holding her mom’s hand in the hospital and scolded people who called the virus a hoax, writing: “This. Is. Covid. Please stop trying to say it’s not real.”

Now, nearly two years into the pandemic, COVID patients aren’t placed on ventilators as quickly as they were at the outset, but the sickest patients still wind up there. With cases surging, some hospitals are running short on machines.

Last week the Lyon County Board of County Commissioners in Emporia declared a local emergency after the town’s hospital, Newman Regional Health, asked for two additional ventilators from the state’s Emergency Operations Center.

Having oxygen forced into your body is noisy, uncomfortable and debilitating for two days or 100 days, let alone 322.

Starkey couldn’t speak for months with a tracheotomy tube in her throat. In September a valve was placed over the trach, allowing her to talk in that way Shaver has heard lung cancer victims speak, “raspy, deep, kind of like a mechanical sound,” she said.

“When she coughed through that it was really loud and kind of intimidating. But she’s been getting better and better at the talking.

“And now they don’t have to put the voice valve in. They can actually put a plastic cap over the top of that trach and she can just talk normal.”

How many times she worried that her mom wouldn’t be able to fight her way out of all the setbacks — collapsed lungs, kidney failure, internal bleeding, hallucinations and “COVID brain” confusion.

But Starkey was determined, and filled with faith. About a month after she was hospitalized, she told her family on FaceTime that she didn’t work all those years at the Ford plant just to die in a bed with COVID.

She was first admitted to Liberty Hospital with pneumonia caused by the virus. Then she was taken by ambulance to Saint Luke’s in Kansas City, where she spent three weeks hooked up to an ECMO — extracorporeal membrane oxygenation — external bypass machine.

She’s been on a ventilator at Kindred Hospital Northland, a transitional care hospital, since June.

A constant companion

She came off the ventilator for a handful of days in August. Staff even rolled the machine out of her room, after which Shaver sent an optimistic update to The Star.

“Yesterday she did 14 straight hours breathing on her own,” she said at the time. “She is holding her own and slowly started weening off that vent. We’ve had long days of delirium and depression but that’s starting to ease up too.

“My sister and I have been taking turns gowning up and visiting her inside. I picked flowers from my garden and delivered them to her in a beautiful bouquet which she enjoyed.

“And a couple days ago I got a call from her at about 9 a.m. that she needed me right away, so I went to her and all she wanted was for me to hug her.

“So I crawled up on her bed as much as I could and just held her for about an hour. It was awesome. She said ‘this is what I needed.’”

But the hope faded quickly when her mom struggled to breathe without the ventilator and went right back on it.

Except for the first three weeks she spent in isolation, Starkey’s husband of 25 years, Troy, has been at her bedside. The couple live in Polo, northeast of Kansas City.

“My dad has been there since day 21 (when he was allowed in), he has not missed a single day,” said Shaver. “If it weren’t for him she wouldn’t be where she is.

“He lives an hour away. He would drive up there and drive back, every single day.

“He got to the point where he knows as much about the ventilator, about the tubing and the trach, as much as that staff does. I think having someone to be an advocate and keep an eye on the way things go and to be there and support you was the biggest thing that got her where she is. And of course, her fight to survive.”

Let her eat cake

Speech therapists did innumerable swallow tests to make sure Starkey wouldn’t aspirate food into her lungs before they allowed her to eat real food again. She took baby steps, starting with the “minced and mashed” menu of apple sauce, mashed potatoes and other soft foods.

Now that she can safely eat again she’s been wanting tacos and grilled cheese sandwiches.

But “her favorite food, believe it or not, is the macaroni and cheese from QuikTrip,” said Shaver. “I brought her some in one day and she’s been craving it since then. So every day I go to visit her, I stop at the QuikTrip and I get some macaroni from the deli there.

“I’ve been bringing in cake. All of those things that she wants, we bring it in.”

Starkey’s father died of COPD last April while she was on the ventilator, but her family decided not to tell her, afraid the shock would be too much. A beloved cousin died of cancer soon after.

“It would have been a lot,” said Shaver. “She would have been really sad, and she wasn’t in the mind set to take that kind of sadness.”

But right before Thanksgiving, Starkey found out her father was gone.

“And that’s when she started getting her mind right,” said Shaver.

As Starkey’s mind grew sharper, “that’s when her progress started skyrocketing,” Shaver said.

She thinks the news of her grandfather’s death lit a fire under her mother that life is passing her by outside the walls of the hospital.

And suddenly, her mom was telling the family, “Let’s do this. I’m ready to get out of here.”

She heads to rehab in Johnson County this week for who knows how long, with a shaved head. Sharkey got tired of her hair getting matted and had it shaved off a couple of months ago.

“We really hope that her one-year anniversary is her leaving the hospital and coming home,” said Shaver.

The family is eyeing Feb. 12 for a homecoming, the day before the Super Bowl.