Breathing Easy After Vaping Lung Injury

Caitlin Hayes

August 12, 2020

Typically, we photograph every patient appearing in HealthU. Because this story was planned during the surge of COVID-19, that contact would have been too risky. Instead, our team took a creative approach and replaced photo shoots with illustrated portraits of patients.

When Caitlin Hayes, 23, wasn’t feeling well in early January 2020, she thought it was a simple stomach bug. She didn’t expect that she’d soon be in the intensive care unit fighting to take a full breath.

“I was sick for about five days, throwing up with a high fever. I went to the walk-in clinic, and they said there was a stomach bug going around, so they gave me medicine for nausea and vomiting and sent me home,” Caitlin says. But after a few more days without improvement, Caitlin started to have slight trouble breathing. Her mom, Donna, decided to take her to the Emergency Care Center at Bayshore Medical Center.

There, a chest X-ray suggested pneumonia in the lower left lobe of her lung. Caitlin was given IV antibiotics before going home. But the following day, her breathing worsened. “It felt like I was dry drowning,” Caitlin says.

Donna, who is a home-care nurse for Hackensack Meridian At Home, used her equipment to check her daughter’s vitals. “She looked septic to me,” Donna says. “I took her temperature. It was 105, and her oxygen level was very low.”

They returned to the Bayshore Emergency Department where doctors immediately did another chest X-ray. It showed the pneumonia in her left lobe had worsened and pneumonia in her right lobe was forming, as well.

Her medical team suspected a vaping-related lung injury, which took Caitlin by surprise. “I had an e-cigarette for a little over a year, but it’s not like I was using it like crazy—not as much as other people I know,” she says. “I didn’t even realize the effect that this could have on my lungs from vaping for such a short period of time.”

Though shortness of breath and a dry cough are the two most well-known symptoms of EVALI (e-cigarette or vaping product use-associated lung injury), gastrointestinal symptoms such as nausea, vomiting, diarrhea and abdominal pain can also be present.

Prompt Treatment

Omar Awan, M.D., a hospitalist at Bayshore, met Caitlin the morning she was admitted. “Caitlin was very short of breath and couldn’t speak in full sentences. I could hear a lot of crackles in her chest, which is something you don’t expect with somebody who’s an otherwise healthy, young female,” he says. He ordered a CT scan of her chest and transferred her to the ICU for a higher level of care and closer monitoring. “I was worried that she might wind up on a ventilator, so I had that discussion that same morning with her parents.”

Caitlin’s aggressive treatment—high-flow oxygen, empiric antibiotics and steroids—was successful. A follow-up CT scan a week after her first showed remarkable improvement in her lungs, says Mona Awad, M.D., a pulmonary medicine and critical care medicine specialist at Bayshore.

“Caitlin responded very well to treatment, and her lungs improved tremendously. She was extremely symptomatic when she was first admitted and had a very severe lung injury. But day by day, she improved, and her symptoms and oxygen requirements lessened as she continued to recover,” Dr. Awad says. “With everyone’s care and support, and early intervention, thankfully she had a great outcome.”

All in the Family

Although Donna had a deeper understanding of what was happening to her daughter because of her professional background, she found she had to separate her two identities and stop thinking like a nurse. “I was scared. I had to go into ‘mom mode’ and not think about how bad it could be because I couldn’t take it,” says Donna, who didn’t think her daughter was going to survive. “I didn’t want to be scared in front of Caitlin, so I had to act like everything was going to be OK.”

Even though Caitlin doesn’t remember much from those first few days in the ICU, she knows her mother was by her side. In those rare moments when Donna stepped out for a break, Caitlin felt she was in good hands.

“The nurses and doctors were so great. It really felt like a family,” says Caitlin, joking that the high level of care and attention she received felt like being in an episode of “Grey’s Anatomy.”

Donna agrees. “The entire staff at Bayshore, from the people who cleaned the rooms to the nurses and doctors, everybody was incredible. If you had to be sick, it was the most wonderful experience you could possibly have,” she says.

A Life-changing Experience

After 10 days in the hospital, Caitlin was able to return home. “By the time I went home, I felt a million times better than when I went into the hospital,” she says.

Full recovery took a few weeks while she slowly regained her strength and energy, but she now feels back to her normal self. She has returned to her studies, where she is training to be a medical assistant and patient care technician.

The excellent nursing care she received at Bayshore has inspired her to continue her education to become a nurse, and Caitlin hopes to work in emergency medicine or critical care.

The whole experience also drove home the hazards of vaping to Caitlin, who has since stopped using e-cigarettes and vaping products. “Don’t vape,” she says. “It’s not worth it.”

Next Steps & Resources

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

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