Everything had been arranged down to the last detail: the cake, the menu, the venue. It was going to be a beautiful event, and Denver couple Sonny Hutchison and his wife, Mary Anna, were excited to be hosting family and friends for the wedding of their son and his soon-to-be bride, who both lived in Tennessee.

Plenty of sunshine was forecast for Labor Day weekend 2023, and the excitement mounted as the week progressed and loved ones began arriving, celebrating in the Hutchisons’ Crestmoor Park neighborhood backyard.

But unknowingly and uninvited, an unwelcome guest crashed the festivities. Its arrival would severely alter the lives of the entire Hutchison family, specifically its patriarch. In the days leading up to the nuptials as they all celebrated in his backyard, Sonny was bitten and infected by a mosquito carrying the West Nile virus.

The illness would cause him and his wife to miss the rehearsal dinner and the wedding as he was disoriented and confused for a week in the hospital and recovering in a second hospital for two more. When he finally came to, he had to learn how to sit up, walk and gain control of many of his daily functions, and months later, some vestiges of the illness remain.

“When I woke up in the hospital, I remember thinking, ‘How in the hell did I get here?’’’ Sonny said.

During his recovery, a team of skilled health care professionals at UCHealth assisted Sonny with the aftermath of his illness. That included physical and occupational therapies and treatment for vision and neurology problems that arose from the viral infection.

“I feel good although I’m not quite 100 percent. My doctors tell me under the circumstances, I’m doing really well. I know how lucky I am,” said Sonny, 75.

Creating a legacy in Denver’s media industry

Sonny is a well-known fixture in the Denver media market as well as in the national arena. He is an award-winning producer and photographer, and co-founder of High Noon Entertainment, which produced hit shows including Cake Boss and Fixer Upper.

He and a partner also produced the critically acclaimed documentary series, How the West Was Lost for the Discovery Channel and they’ve produced numerous films for the National Park Service.

Sonny and his wife both grew up in Louisville, Kentucky and have known each other since before they even began kindergarten. They married after they graduated from college, went on to raise four children, and have been happily settled in Denver for decades.

The wedding of his son Dustin was an opportunity to celebrate Sonny’s health. For the past 10 or so years, Sonny has waged a health battle along two fronts: dealing with rheumatoid arthritis (RA) as well as pulmonary fibrosis or interstitial lung disease (ILD), a serious side effect of RA.

RA is a chronic autoimmune and inflammatory disorder that attacks healthy cells and causes painful swelling in the joints, while ILD causes scarring of lung tissue. Doctors believe genetics play a role in their origin, along with smoking — a habit Sonny picked up at a young age growing up in tobacco country. He quit more than 35 years ago and developed a healthy and active lifestyle.

With the help of a multidisciplinary care team at UCHealth who have been treating Sonny to get both conditions under control, he can even play his favorite sport, tennis, albeit with a portable oxygen unit strapped to his waist.

But with a compromised immune system, he would be severely tested when confronted with a new disease for which there is no treatment.

A bug bite in the backyard leads to a three-week hospital stay

On Friday, the day before the wedding, the mood in the Hutchison household was less than upbeat as Sonny was feeling increasingly worse and experiencing chills and spiking a fever. To complicate things even more, his wife Mary Anna, a nurse, was dealing with a broken collarbone that she sustained earlier that week.

That day, he landed an appointment with his UCHealth internal medicine physician, Dr. Ronald Colson.

“I don’t even remember arriving at his office,” Sonny recalled. “I was feeling really bad. The rehearsal dinner was that night, and I have no idea what’s wrong with me.”

Colson has been Sonny’s primary care physician since 2020 and the “quarterback” helping choreograph his medical needs with myriad UCHealth caregivers. He had just seen Sonny two weeks prior for a routine visit and the change was quite noticeable.

His oxygen level was at 83%, well below the target range of 95 to 100, and he was working hard to breathe. A chest X-ray showed nothing out of the ordinary. Colson could see that Sonny was struggling. But what was the cause?

“He was modestly confused that day, and he is usually very sharp. The fever, the low oxygen, the confusion — my general concern at that moment is that he needed to go to the hospital,” said Colson who is also an assistant professor with the University of Colorado School of Medicine on the Anschutz Medical Campus.

Sonny and his wife were referred immediately to a local hospital’s ER department. Fortunately, the attending physician on the medical floor was familiar with West Nile virus symptoms, which can also mimic the flu. They include stomach pain, fever, headache, sore throat, vomiting, muscle aches and a rash.

Most people infected with West Nile virus do not feel sick. About one in five will develop a fever and other symptoms, and about one of every 150 infected people will become seriously ill. While there is a blood test that checks for antibodies that develop when someone has the virus, there are no medications to treat it and there is no vaccine to prevent it.

For people like Sonny who have compromised immune systems, it can be a very serious illness.

Because the medical staff suspected West Nile, members performed a lumbar puncture, results of which were inconclusive.

For the next week, Sonny remained disoriented as his body fought off the West Nile infection. When he finally was conscious of his surroundings, he was transferred to another hospital where he spent two weeks in a neuro rehabilitation center learning how to regain mobility as well as his cognitive functions.

“First, they had to train me to get out of bed. Then I was leaning on a walker and could barely move. A few days later, I am walking, but with the assistance of canes. Then, they had me going up and down the halls and finally, steps. It was not easy.”

He was able to return home on Sept. 20 and began the long process of recovery, which included vision problems and regaining not just his strength, but working through some vestibular issues he was experiencing.

West Nile virus can cause eye problems that last for months

On his first day home, Sonny was lucky enough to be seen by Dr. Naresh Mandava, UCHealth ophthalmologist and chair of retinal diseases at the UCHealth Sue Anschutz-Rodgers Eye Center on the Anschutz Medical Campus.

During his hospital convalescence, Sonny had been bothered by enormous “floaters” in his left eye. Unfortunately, physicians have learned that West Nile virus can cause a variety of ocular problems, most of which resolve on their own, although it can take several months.

“In my field of vision, it was like the branch of a tree with lots of limbs and branches,” Sonny said. “It never changed shape, but it was always there. Even with my eyes closed I could see it.”

During an eye exam, Mandava could see the viral lesions in Sonny’s left retina.

According to Mandava, who is also the chair of the Ophthalmology Department at the University of Colorado School of Medicine, the West Nile virus is a neurotrophic virus which means it primarily affects the nervous system. For patients like Sonny with immunosuppressed systems, it can lead to temporary or — in rare instances — permanent vision problems.

“The virus likes to go where nerves are, and the eye contains many,” Mandava said. “The retina and choroid underneath the retina have nerves where the virus can attack. Then, the body’s immune system reacts.”

The floaters that Sonny was seeing were, in essence, his eye’s own immune system responding to the West Nile virus in his left retina.

Mandava explained that the center of the eye is filled with an optically clear jelly-like substance called vitreous that is attached to the retina. Usually, we see through the vitreous. But when an infection such as the West Nile virus enters the retina, the vitreous becomes “stained” with the inflammatory cells our body is producing to fight it.

“The floaters Sonny saw are related to inflammation because his eye was trying to fight the virus. They are predominantly inflammation cells stuck to the vitreous,” he said. “The eye is a camera. The retina is the film of the camera. And what he was viewing was like a clear gel stained with inflammatory cells.”

While it was frightening for Sonny to be experiencing the phenomena, Mandava assured him his eye would improve over time, which went a long way to decrease Sonny’s anxiety.

“Right away, Dr. Mandava was on it,” Sonny said. “He was great, and he soothed my concerns. He told me it would go away, but it would take two or three months, which it did.”

Knowing that his vision problem would resolve itself with time, Sonny moved on to his next health hurdle: intense physical therapy to help with his dizziness, as well as rebuilding his stamina and strength.

Physical therapists work to decrease Sonny’s dizziness

Sonny had to deal with a variety of challenging post-West Nile virus symptoms.

“Every time I stand up, I’m lightheaded. Every time I turn my head, it’s delayed, and I have to give my brain a few seconds to catch up. I had no stamina. I fatigued easily. I had lost 15 pounds during my hospital stay. If I was up and moving around, I wasn’t exactly dizzy, but when you added motion to it, I was not perfectly steady. Looking up and down while I was walking really messed me up and was tricky for me,” he said.

The West Nile virus had clearly affected Sonny’s vestibular system. The vestibular system is what gives us our sense of place in the world in terms of balance, posture, and movement. Located mainly in the inner ear, it’s a sensory system that provides information to our brain and helps us retain a sense of equilibrium.

About a month after returning home, Sonny began working with UCHealth physical therapy experts who also specialize in vestibular therapy for patients such as Sonny who need to regain their sense of balance and equilibrium.

Enter ​therapists Lina Kleinschmidt and Cassandra Constine. Their goal was to give Sonny, a vigorous and active man, his life back.

“He had gone through a lifechanging event with West Nile,” said Kleinschmidt, a doctor of physical therapy who works at the UCHealth at University of Colorado Anschutz campus. 

Constine, who works at the UCHealth Boulder Health Center, added, “We knew we could help him a lot more than just recovering from the weakness he was experiencing. We knew he wanted to eventually get back to the court and play tennis. We just listened to him describe his symptoms and adjusted our therapy to his needs.”

They started with “gaze stabilization” exercises where they had Sonny coordinate his head and eye movement to retrain his vestibular system.

“We usually start sitting and progress to standing and then walking. In standing and walking, we will add uneven surfaces, feet together, and more dynamic movement. We will also do exercises with eyes closed to uptrain the vestibular and somatosensory system since many people have visual reliance with all walking and stability movements,” Kleinschmidt said.

Our somatosensory system helps inform us about the external world around us through senses such as touch.

Progress for Sonny

Through his therapy, Sonny was beginning to see and feel results.

“One thing they were really good at was making me push myself. They set specific goals for my heart rate: they wanted me to get to a certain heart rate and then relax. That was really starting to help me a lot,” he said.

The first time Sonny tried to walk, he made it about 100 feet before his oxygen level dropped and fatigue set in. But recently, he was back to playing tennis after a six-month hiatus and he works out twice a week on flexibility and strength.

“I’m slowly getting stronger,” he said. “My stamina is improving. I’m going to push myself more.”

His primary care provider, Dr. Colson, has been impressed with Sonny’s positive outlook.

“He’s always grateful. He’s always willing to do the work. And it’s interesting because not everyone who has chronic lung disease and chronic rheumatoid arthritis would have such a good attitude,” Colson said.

Looking ahead to another summer and fears of West Nile

Sonny is healing. While he occasionally feels down about his situation, he has the support of Mary Anna, whom he calls his “guardian angel,” along with family and friends.

He tries not to rush the healing process, though he is eager to get back in the game in more ways than one. He’d like to begin traveling again with Mary Anna. The couple had to cancel a planned trip to France because he just wasn’t up for it, and he feels fortunate to be hitting the tennis ball again.

While acknowledging that his pulmonary and RA issues, while stable now, might slow him down in coming years, he doesn’t dwell on it.

“I feel so fortunate,” he said, adding that he’s thankful for his UCHealth care team who have been by his side for years, notwithstanding his latest battle against West Nile virus.

“I love Anschutz. It’s a caring community. It’s a highly skilled community. Everyone I dealt with has been wonderful. They were all so good and had their own unique approach for what they wanted me to do.”

Despite missing his son’s wedding, he made do with videos, photos and knowing that his children gathered around him that first difficult week and during his long convalescence.

“It was challenging for everyone,” he said.

With summer approaching and the possibility of West Nile virus infecting Colorado residents, he wants people to educate themselves about the disease and take proper precautions when outside, including  covering up with proper clothing and using mosquito repellent.

When asked if he was planning on changing his behavior to decrease the possibility of contracting West Nile again, he paused.

“I don’t have an answer for that. I need to start thinking about this,” he said. “When it comes to West Nile and its prevalence in Colorado, you need to be thoughtful about it.”