Alexander Mitchell's doctors at a hospital in Payson, Utah, were stopped when tests for negative pneumonia and a host of common disorders returned. One test, however, took something unusual – evidence of abnormal immune cells in his lungs – generally associated with a rare, potentially fatal pneumonia seen in older people by accident breathe drops from oil-based laxatives such as mineral oil. The hunch helps save Mitchell's life. The young man's lung failed – he had chronic respiratory disease, a life-threatening and often fatal lung disease. The family doctor said the condition was linked to vaping after hearing about similar cases elsewhere. The Provo, Utah, man and his parents mentioned that he used e-cigarettes. But until then, no dots were connected. Doctors transported her to the University of Utah hospital in Salt Lake City, 65 miles away, so they could place her with the best life support to keep oxygen flowing and allow her lungs to heal.
Mitchell's case is among the most serious doctors who have seen lung-related vaping disorders today under the supervision of state and federal health officials ̵
1; at least 193 cases in 22 states, many involving adolescents and adolescents. On Friday, Illinois health officials announced the first known death from a lung-related vaping disorder in an adult. They declined to provide further details. Meanwhile, state health departments are reporting a growing number of cases.
There are more questions than answers about lung diseases and their link to devices that have risen in popularity despite little research into their long-term effects. Cigarettes have been introduced as a way to help smokers stop their nicotine cravings without light, but their use is at an epidemic level in teenagers and adolescents.
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Patients get sick of others & # 39; other substances , including nicotine, marijuana-based products and "home brews" in different durations and in other places. Although the cases appear to be similar, officials from the Centers for Disease Control and Prevention warned that they did not know whether the diseases were associated with e-cigarette devices themselves or that they had specific substances or contaminants. obliterated them. It is not clear that they have a common cause or that they may have different diseases with similar symptoms.
The severity of certain diseases in previously healthy adolescents has not been met by family members and even some doctors.
"" To see these patients ill, it is very troubling, "said Sean Callahan, a pulmonologist at the University of Utah.
Alexander Mitchell thought he had the flu when he woke up earlier this summer with severe nausea, chest pain and shortness of breath, but he quickly deteriorated that his parents, and then the doctors, were amazed.
For his parents, the scary moment may have come when doctors said their son's failure required an additional aggressive life support known as ECMO.The machine pumped blood from the patient's body into an artificial lung adds oxygen and removes carbon dioxide, replacing the function of the lungs. Then the machine returns the blood to the patient.
"He has two tubes that come out. from him, one was dark red, and the other was bright red, "Daniel Mitchell recalled. "Doctors said a third of his blood was not in his system at all."
When Alexander pulled out his tubes, they warned his parents, "He's dead in 30 seconds and we can't do anything."
Doctors tell parents he might need a transplant lung if he did not show improvement, but after nearly nine days, life support machines allowed his lungs to heal. He was able to return home on July 7.
University of Utah doctors who saw Mitchell, in addition to four similar cases this summer, has his own theory about what can cause vaping-related illnesses.
They say A culprit can be fluid, which is usually known as vape juice, that is a component of all e-cigarettes. The products vary greatly, but all contain a heating element that makes an aerosol from a fluid that the users breathe through a mouth.
Advancing cases may be the result of something recently added to oils "to dilute or add to them," said Scott Aberegg, a University of Utah hospital pulmonologist and critical care specialist, who took care of Mitchell and four other patients at his hospital and consulted with two others at another facility.
Some patients vomited for months and years He said, so if there were previous clusters of cases, "we would have known this sooner."
Tracing liquid vaping back to where it was purchased, however, is difficult in some cases. Some patients say they buy cartridges containing the substance in other states. A patient told doctors he had taken his cartridges to Las Vegas and appeared to have opened them, presumably to introduce THC, the main ingredient that produces the mind-altering effects of marijuana, Aberegg said. Legal is not legal in Utah.
Vaping liquid may contain nicotine, flavors, propylene glycol, vegetable glycerin and other substances, according to the Food and Drug Administration, which regulates tobacco products, including e-cigarettes.
When the liquid is heated, the resulting aerosol may contain fine and ultrafine toxic particles, together with heavy metals, chemicals used for taste, such as diacetyl, which are linked to a serious Lung disease known as "popcorn lung," and volatile organic compound that can cause long term health effects, including cancer, according to a United States surgeon's report.
"We do not know whether it is propylene glycol or the glycerin or other vaping liquid additives that are placed there by the manufacturers, or that matter combines with other ghosts, labor posting, when the people add or mix them, "Aberegg said.
Some patients in Utah have milder diseases than Mitchell. But four out of five also have abnormal immune cells in their lung specimens, Aberegg said. Such cells are indicators of a variety of diseases, including a rare condition known as lipoid pneumonia, whose symptoms include chest pain and difficulty breathing – similar to bacterial symptoms that pneumonia.
Aberegg warned that many remain unaware of what causes abnormal immune cells in vaping-related illnesses.
But "in many cases, we have a high degree of confidence that our dealings are not just associations, but caused by vaping and what is inside the products," Aberegg said. Abnormal cells can be a "very important marker of pneumonia-related vaping" and "an important indication of what is happening."
Six weeks after leaving the hospital, Mitchell continued walking. But with his lung capacity reduced by 25 percent, he didn't last as often or as often as he did. He also struggles with his short-term memory. Doctors say they are not sure if he will recover well.
Doctors say his childhood was an important factor in his survival. "He was young, otherwise healthy, and in good physical condition before the onset of the disease," said Aberegg, one of about 20 young people's clinics.
Mitchell says he has little memory of what happened when he was in the hospital because he was in a medically induced coma for hours. But he fears that doctors are assuming his near-death experience – a practice he started about two years ago because he wanted to quit conventional cigarettes.
"It is promoted as healthy," he said.
Mostly, he said he found flavored nicotine products but used THC several times with friends, he said. None of them got sick.
In mid-June, Mitchell said he bought another brand of vape juice – peach menthol flavor – from his regular vape shop and used it on his same e-cigarette device. This is the first time he has used a well-known brand. The family did not want to know about it until the FDA investigated it. "It was a brand new box," Mitchell recalled. Inside, "the bottle has a seal."
He said he had been vaped less than usual that time. The next morning, she felt sick and began her life-changing medical odyssey.
Adults can make decisions for themselves, Mitchell said. But he said his experience should be a warning about the dangers that are not clearly articulated about vaping.
"I never thought it would lead to my death literally," he said.
Alice Critics contributed to this report.
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