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Sara Didn’t Know the Risks of Vaping

by UPMC Susquehanna

It was almost too late for Sara Mitcheltree of South Williamsport, PA, when she learned about the risk of vaping. What started like symptoms of a sinus infection — coughing and shortness of breath — quickly worsened on Dec. 14, 2019. Sara was taken by ambulance to UPMC Williamsport where her care team wasn’t immediately sure of the cause of her respiratory symptoms. It seemed like she had pneumonia, but her test results were inconclusive. 

After ruling out other illnesses, doctors talked to Sara’s family and found out she was a long-time smoker and she occasionally used vaping products available at her neighborhood smoke shop. Sara only used flavored nicotine vaping products, which have become popular in recent years among young adults and youth.

When Sara woke up in the Intensive Care Unit (ICU) after nine days in a medically induced coma, she learned her lungs were permanently damaged by EVALI — an acronym created by the Centers for Disease Control and Prevention (CDC) for Electronic Cigarette, or Vaping, product use-Associated Lung Injury.

“I didn’t know anything bad could come from vaping,” said Sara. “EVALI was a foreign word to me.” 

A Rise in Vaping Illnesses 

Illnesses and deaths related to EVALI and vaping began growing in summer 2019. By mid-February 2020, the CDC reported more than 2,800 cases of EVALI requiring hospitalization across all 50 states, and 68 deaths.

Typical symptoms of EVALI include:

  • Coughing
  • Chest pain
  • Shortness of breath
  • Abdominal pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Fever
  • Chills
  • Weight loss


Life and Death

Sara was on a ventilator while in the ICU, but her lungs were so inflamed that even that extra support couldn’t keep her alive. Dr. Michael Lazar, UPMC cardiothoracic surgeon, placed Sara on an Extracorporeal Membrane Oxygenation life-support machine, or ECMO. ECMO pumps blood through your body like a heart-lung machine used in heart surgery. It adds oxygen to your blood and removes carbon dioxide, things her lungs would usually do. It can be used longer than a typical heart-lung machine, some patients have been supported for a month or more. ECMO does not cure heart or lung disease, it only provides time for the heart or lungs to heal.

UPMC doctors and nurses were amazed by Sara’s progress when she woke up from the coma. She remembers nurses dropping in to check on her and wish her well because they had never seen a patient on ECMO be able to communicate so well with staff. She was taken off the ECMO machine just three days before she went home.
“After I woke, I spent time with the nurses, and chaplain. It was very emotional. I owe them everything,” said Sara.

Home for Christmas

“The ICU team saved my life. I would not be here without them. There are not words to express what they mean to me and what they have done for me,” said Sara.” When I woke up and had this machine connected to me, I understood how close I was to dying.”

Sara was discharged on Dec. 26, 2019. She was determined to get home to open presents with her two daughters.

“Christmas is my favorite holiday,” said Sara. “The nurses in ICU had decorated my room because they knew how special the holiday was to me. I woke up on Dec. 21 and all I could think about was getting home.”

Lung Damage Caused by Vaping

Since having EVALI, Sara has been hospitalized with pneumonia a few times and has chronic asthma. Now, with the COVID-19 pandemic, Sara has to take even more precautions. She will be in home isolation longer than most because she can’t take the risk of getting sick.

“After fighting for my life once, I understand that I am not only staying home for my health, but for my life,” said Sara. “My life is interconnected with so many other people’s lives that need me and depend on me. I owe it to them to stay home — my daughters, Ashley and Madalyn; my wife, Tracy; my mother, and so many others.”

Sara and Dr. Osevala
Sara and Dr. Mark Osevala

A Warning to Others 

Sara no longer smokes or uses vaping products, although she tries not to judge others. She said, “I smoked for 26 years and I knew there was a risk of lung cancer. The difference with vaping is I didn’t know the risks. I actually thought it was safer than smoking and it was more socially acceptable than smoking.”

Sara felt like she didn’t make an informed choice about vaping. The FDA and the media have been shining a light on the dangers of vaping and laws now say you must be 21 to buy vaping products, but that came after Sara almost lost her life.

“You may not like my opinion, but I am living proof” said Sara. “I shop where you shop, my kids went to school with your kids. If it can happen to me, it can happen to anyone.”