Within days, Alexander Mitchell had gone from being a 20-year-old hiker to being kept alive by two machines that forced air in and out of his lungs and oxygenated his blood outside his body.
"In just two days, he went from illness to the door of death," recalled his father, Daniel Mitchell, as he struggled to grasp the unthinkable. "The doctor said he was going to die. To be honest, I prepared to schedule a funeral for my child. I cried and cried for this boy.
The physicians of Alexander Mitchell at a hospital in Payson, Utah were stunned when the tests turned out to be negative for bacterial pneumonia and a variety of common diseases. However, one study found that something unusual ̵
A doctor's clue would help save Mitchell's life. The young man's lung had failed – he had an acute respiratory distress syndrome, a life-threatening and often fatal lung injury. The doctor told the family that he suspected that the disease was related to Vaping after hearing of similar cases elsewhere. The Provo, Utah, husband, and his parents had mentioned using e-cigarettes. But until then nobody had connected the points. The doctors sent him to the University of Utah Hospital in Salt Lake City, 65 miles away, for the most up-to-date life support to maintain oxygen flow and heal his lungs.
Mitchell's Case Is One of the Most Common Degrees Among the vaping-related lung diseases currently under investigation by state and federal health authorities, doctors have seen at least 193 cases in 22 states, many of them adolescents and young adults. On Friday, Illinois health authorities announced the first known death from a steam-related lung disease in an adult. They refused to provide more details. Meanwhile, the state health authorities are reporting an increasing number of cases.
There are more questions than answers to the lung diseases and their connection to devices that are becoming increasingly popular despite little researched long-term effects. E-cigarettes have been introduced to help smokers quit by quenching their craving for nicotine without lighting up. In teenagers and young adults, however, their consumption is now at an epidemic level.
The patients have various substances, including nicotine, evaporated marijuana-based products and "self-brewed" over various periods and in different places. Although the cases look similar, officials at the Centers for Disease Control and Prevention do not know whether the diseases are related to the e-cigarette devices themselves or to certain ingredients or contaminants inhaled by them. It is not even clear if they have a common cause or if they are different diseases with similar symptoms.
The severity of some illnesses in previously healthy young people has unsettled family members and even some doctors.
It is extremely alarming to see patients so ill, "said Sean Callahan, a pulmonary physician at the University of Utah.
Alexander Mitchell believed he had the flu when he woke up this summer with severe nausea, chest pain, and trouble breathing. But he deteriorated so fast that his parents and even the doctors were astonished.
The scariest moment may have come for his parents when doctors said their son's lung failure required an additional aggressive life support machine called ECMO. The device pumps blood from the patient's body into an artificial lung, which adds oxygen and removes carbon dioxide, thereby replacing the function of one's own lung. The device then sends the blood back to the patient.
"Two tubes came out of it, one dark red and the other bright red," Daniel Mitchell recalled. "The doctors said that one third of his blood is out of his system at some point."
When Alexander pulled out his hoses, they warned his parents, "He would be dead in 30 seconds and we could not do anything."
Doctors told his parents that if he showed no improvement, he might need a lung transplant After about nine days, the life-support machines healed his lungs and he was able to go home on July 7.
The Utah University doctors, who saw Mitchell in addition to four similar cases this summer, have their own theory about it what could cause the steam-related illnesses.
They say a culprit may be the liquid commonly known as vapu juice, which is part of all e-cigarettes.The products are very different, but all contain a heating element that consists of a liquid the user inhales through a mouthpiece, generates an aerosol.
In some cases, the over-voltage may open Something that has recently been added to the oils to dilute or supplement them, "said Scott Aberegg, a pulmonologist and specialist in critical care at the University of Utah, who looked after Mitchell and four other patients at his hospital and two more in another facility.
Some of the patients had been muffled for months and years So if there had been an earlier accumulation of cases, "we would have recognized them earlier."
In some cases, it was difficult to traced the vapor to the place of purchase. Some patients claimed to have purchased cartridges containing ingredients in other states. One patient told the doctors he had his cartridges in Las Vegas and it turned out they had been opened, presumably to introduce THC, the main ingredient that causes the mind-altering effects of marijuana, Aberegg said. THC is not legal in Utah.
Vapors may contain nicotine, flavorings, propylene glycol, vegetable glycerin, and other ingredients, according to the Food and Drug Administration, which regulates tobacco products, including e-cigarettes.
When the fluid is heated, the resulting aerosol may contain fine and ultrafine toxic particles, including heavy metals, chemicals used for flavoring, such as diacetyl, associated with a severe lung disease, the so-called popcorn lung, and volatile organic compounds that can cause long-lasting substances.
"We do not know if it's propylene glycol or glycerine or other additives in the vaping fluids provided by the manufacturers or those that occur in the US Combine with other adulterers after manufacturing when people add or mix them "Aberegg said.
Some of the Utah patients had milder illnesses than Mitchell. But four of the five also had abnormal immune cells in their lung samples, Aberegg said. Such cells are indicators of a variety of diseases, including a rare disease known as lipoid pneumonia, which includes chest pain and breathing difficulties similar to the symptoms of bacterial pneumonia.
Immune cells in persons with vapor-related illnesses.
But "in many cases we have a high degree of confidence that they are not just associations, but vapors and everything contained in the products. Said Aberegg. The abnormal cells could be a "very important marker for vapor-induced pneumonia" and "an important indication of what is going on".
Six weeks after hospital discharge, Mitchell resumed walking. But with a 25 percent reduction in lung capacity, it does not go as long or as often as it used to. He also fights with his short-term memory. Doctors say they are not sure if he will recover completely.
Doctors say that his youth was a deciding factor in his survival. "He was young, otherwise healthy and in good physical condition before the disease started," said Aberegg, one of about 20 doctors treating the young man.
Mitchell said he has little recollection of what happened while he was in the hospital because most of the time he was in a medically induced coma. But he's amazed that doctors attribute his near-death experience to vaping – a practice he started about two years ago because he did not want to use traditional cigarettes.
"It's getting healthier," he said.
Most of the time, he said he vapourized flavored nicotine products, but THC consumed a few times with friends, he said. None of them got sick.
In mid-June, Mitchell said he had bought another brand of Vaps juice – peach-menthol flavor – at his regular e-cigarette store and used it with the same e-cigarette device. It was the first time he used a well-known brand. The family did not want to identify it until the FDA makes further investigations. "It was a brand new box," Mitchell recalls. Inside was "the bottle provided with a seal".
He said he had steamed less than usual then. The next day, he felt sick and started his life-changing medical odyssey.
Adults can make decisions for themselves, Mitchell said. But he said his experience should be a warning of dangers that are not clearly formulated for steaming.
"I did not think it would make me literally lie on my deathbed," he said.