D’Ambrosio vaped, started vomiting, was intubated, temporarily paralyzed, and put into a medically induced coma, while his mother, sitting bedside, considered her son’s funeral.
By Jesse Bedayn
Ricky D’Ambrosio felt the seizure before it came. He was seventeen. He slipped out of bed, just before midnight, and walked to his mother’s room.
Christy D’Ambrosio lay asleep. The door opened and Ricky collapsed on the floor. Awakening, Christy watched her son’s lips turn blue and his face go pale. He couldn’t breathe. She screamed, then called 911 to their home in Loomis, northeast of Sacramento.
That was in 2014. But Ricky has had grand mal seizures since he was seven. Christy still has nightmares about her son seizing on the floor.
Then, on Tuesday, Aug. 27, 2019, the two went out for Mexican food. Ricky had shredded beef enchiladas. When they arrived home, Ricky started vomiting. Over the next couple of days, the nausea persisted, and a fever ensued. Christy considered taking her son to the ER. Ricky has type 1 diabetes — if he can’t keep food down, he can struggle to control his blood sugar levels. Drop too low and he’d have a seizure.
She worried about her son. Ricky, who has short blond hair and blue eyes, has always been shy and quiet, possessed of, as Christy says, “a wonderful, good, loving heart.” At a young age, he was taught to thank those in uniform, and always did. Christy remembers him asking to buy a firefighter a gift card in a grocery store, then running to give it to him.
Now, though, his condition deteriorated. On Friday, she took him to a doctor, who told her that the nausea and fever were merely a bad flu. But Christy was worried the symptoms might be related to Ricky’s epilepsy or diabetes.
By Saturday morning, he looked gaunt. Ghostly. He hadn’t slept and had lost weight. Christy rushed Ricky to the ER. She left the car running in front of the hospital, the door still open. The doctors in the ER were baffled. She began to worry in earnest.
As of Nov. 5, 2019, 2,051 reported cases of vaping-related acute lung injury have been recorded by the Center for Disease Control (CDC). In some instances, the illness has been fatal, killing 39 nationally, two in California. A CDC laboratory recently found vitamin E acetate to be in lung samples of patients suffering from the vaping related illness. The CDC said they suspected that it could be the culprit, but their findings are not final.
Unknown to doctors and Christy, small particulates of chemicals — potentially vitamine E acetate — from Ricky’s marijuana vape, inhaled deep into Ricky’s lungs, were causing inflammation and injury to the interstitium — where oxygen is introduced to the bloodstream and CO2 is released.
Human lungs filter chemicals, viruses, and bacteria. But in Ricky’s case, the chemicals overwhelmed this defense mechanism.
On Sunday, doctors kept Ricky at the hospital while Christy headed home to sleep. At 3 AM Monday morning, her phone rang. He can’t breathe, a doctor told her. We have to intubate him. We are rushing him to the ICU.
Though the cause of Ricky’s lung failure was unknown to doctors at the time, Mark Courtney, a Lung Therapist at the American Lung Association, provides a retrospective analysis. The lung’s lining, interstitium, is made up of something called alveoli — 300 million small sacks of air in the lungs that allow for the exchange of oxygen and CO2. In Ricky’s lungs, however, toxic chemicals were inflaming the alveoli, making them fill with liquid or collapse. Inhaled oxygen had no place to go. Without enough oxygen, Ricky’s brain and heart wouldn’t be able to function.
Christy arrived at the hospital just before intubation. Ricky hunched over; his breathing shallow and labored. She told him she loved him. You are going to go to sleep, she said. Your body is going to heal, and then you are going to come back to me.
All Ricky could do was nod his head, ‘yes’.
Then they pushed her out of the room so they could intubate him — putting a tube down Ricky’s throat to control his breathing. But Ricky, semi-conscious on sedatives, kept trying to rip the tube out. They strapped his arms to the bed.
After initiating a medically induced coma, doctors temporarily paralyzed Ricky to stop him from pulling the tube out of his throat and decrease his body’s oxygen expenditure.
Waiting in the other room, Christy got the news from the doctors. It was time for her to call family and friends. If Ricky didn’t start recovering, his organs could fail.
She went into a trance. “I remember crying,” she says. “ I remember the air leaving my body, I just couldn’t breathe.” This is not real, she told herself. This is not happening.
Christy called Ricky’s sister, Caitlynne D’Ambrosio, who had left for college. Caitlynne wants to be a trauma surgeon. She can shut off her feelings and be very matter-of-fact, Christy said. But when she first walked into the hospital room, and saw her brother with tubes protruding from his body, she was crying.
Tuesday morning, Caitlynne mentioned to doctors that Ricky vaped. It was noted. But the doctors were still ruling out other diagnoses. They were trying three new antibiotics that day. But in the evening, he was getting worse.
Christy was spending nights next to Ricky. She was sleep-deprived. She held his limp hand, wondering if she would be on their family vacation in December, or at a funeral. Ricky wanted to be cremated. She knew where he wanted his ashes spread.
Tuesday night, Caitlynne started researching. A friend had sent an article about another mom, in another state, whose child was enduring something similar. Their diagnosis: vaping.
Vapes heat liquids, typically containing THC or nicotine, into an aerosol that users, like Ricky, then inhale. Different chemicals are used to administer THC or nicotine to the lungs. Doctors on the case Christy heard about had administered steroids. The next morning, Caitlynne and Christy inquired about doing the same with Ricky. He began a course of treatment that day.
By Wednesday night, his body responded — the alveoli in his lungs were healing. Doctors relayed the news to Christy. Her son would live.
Christy walked out of the ICU. Ricky’s friends and family waited in the hallway. The room broke down. As Christy says now: “It is a pretty amazing feeling to know that you are not going to lose your child that day.”
By Saturday the tube was gone and Ricky was awake. “Do you know where you are, Ricky?”, Christy asked. He couldn’t talk much; his throat was too sore. One of his best friends made a joke. He laughed, even though it hurt his lungs.
As vaping related lung injuries continue to crop up across the country, the CDC is partnering with the FDA and state agencies to discover the cause. They have activated an Emergency Operations Center and sent officers from the Epidemic Intelligence Service to support states. But no specific chemical has been identified as a cause.
On Tuesday, Sep. 3, the doctors let Ricky go home. He’s now back at work, back to doing chores around the house, and taking care of his dog, Lucy, “Just being a normal 21-year-old”, Christy said. She says he never wants to vape again.
The terror of the week still lingers. During the ordeal, Christy wrote a Facebook post that ended up going viral. She included a photo of Ricky with tubes protruding from his body and made a plea to other parents, and teens, about vaping, writing, “The only thing that is safe to put into your lungs is air, not smoke, not oils, its air.”
She still points people to the post, hoping others hear their message. “Is it worth this?” she wrote. “Let Ricky be an example so you or your loved ones DO NOT NEED TO GO THROUGH THIS. As a momma sitting by her son’s hospital bed, wondering if we still get to go on our family trip together or if I’ll be planning his funeral… I can tell you that IT IS NOT WORTH IT!”