Tryston Zohfeld’s life changed very quickly.
On July 24, the 17-year-old got out of the shower, but he could not warm up. He put on a hoodie, sweatpants and two comforters, but he was still cold. His legs and stomach were cramping, and his whole body hurt.
Within 48 hours, he could not get a full breath and was throwing up. He could feel his heart pounding in his chest and went to his mom, who took him to the hospital. An X-ray showed a blockage in his lungs, and Zohfeld was rushed to Cook Children’s Hospital in Fort Worth.
He spent the next 18 days there, 10 of which he was in a medically induced coma with a tube down his throat so a machine could do his breathing for him. A lung biopsy turned up blank, tests for autoimmune diseases or an infection were negative — doctors knew his lungs were failing, but they did not know why.
After two days of inconclusive tests, his doctors started researching a new diagnosis, one that researchers across the country are attributing more and more cases to — respiratory failure caused by vaping.
Vaping is when someone smokes an aerosolized chemical, usually from an e-cigarette. Many of the pods used in these e-cigarettes, also called vape pens, contain more nicotine than cigarettes. The amount of nicotine in a pod for a Juul — the most popular brand of vape pens — is about the same as a pack of cigarettes.
A JUUL Labs spokesman sent a general statement in response to Zohfeld’s diagnosis: “JUUL Labs takes consumer safety seriously and we have a robust safety and medical monitoring system in place. We will continue to vigilantly monitor for any evidence of safety issues as we work to combat youth usage and eliminate cigarettes, the number one cause of preventable death in the world.”
Zohfeld vaped for three years up until his medical emergency. At his school in Weatherford, kids smoked the small devices in the bathroom. Almost all his friends had their own device — often the size of a USB flash drive — and they’d seen kids as young as sixth grade pick up the habit.
“No lie, it really is the majority of teens nowadays,” Zohfeld said. “If you’re going to do it, you need to know what you’re getting into. We have no idea what we’re getting into.”
Zohfeld said he knows many friends who smoke two to three pods a week — the equivalent of six to eight cigarettes a day.
At Cook Children’s, Dr. Corwin Warmink sees about one patient a week for vaping-related problems. Some of the patients are children as young as 5, who accidentally ingest vaping liquid, according to a Cook Children’s article written by Zohfeld’s primary doctor, Dr. Diane Arnaout.
Part of the problem is the relative newness of vaping, said Dr. Karen Schultz, Medical Director of Pediatric Pulmonology at Cook Children’s. Schultz was one of the doctors who helped diagnose Zohfeld.
In Zohfeld’s case, and many others, the diagnosis is one of exclusion — when everything else is ruled out, doctors have to look at the possibility that vaping is to blame.
Vaping has been attributed to lung problems across the country. In Wisconsin, 12 people have been hospitalized with lung damage caused by vaping, and 13 other cases are being investigated, the Wisconsin Department of Health Services said. Ninety-four possible cases of severe lung illness associated with vaping have been reported from the end of June to Aug. 15, the CDC reported.
Doctors still don’t know the long-term effects of vaping or how likely a user is to develop health problems.
“Nobody knows what’s in these things for sure, and I want to get the word out that they’re extremely dangerous,” Zohfeld said.
E-cigarette pods also come in dozens of different flavors such as coffee, lemon tart and peppermint, which can be misleading,
“All these flavored pods taste a lot better than tobacco smoke. The kids will use it more frequently, and it tastes better, and they don’t feel bad,” Schultz said.
Teenagers also think if they do not inhale the vapor fully into their lungs, they are not exposing themselves to nicotine, Schultz said. But nicotine is absorbed through the mouth regardless of whether it is making its way into the lungs or not.
“It’s just not worth it,” she said.
Zohfeld does not remember much of his hospital stay, as he was in and out of consciousness. Two days after he woke up, Zohfeld’s doctors told him their determination — that it was his vaping habit that caused his lungs to fail.
The Weatherford High School graduate said he made three immediate decisions; to take medical classes at a local college, study to become a firefighter and never vape again.
Eight days later, Zohfeld is still recovering from his hospital stay. On Tuesday, he was able to go shopping without getting winded, but he still has sharp pain in his right side and back from his surgery and biopsy.
He also has made it his mission to warn other people about the insidiousness of vaping.
“I don’t mind being that one person it happened to as long as I know I can get other people to stop,” he said. “Honestly, a lot of people don’t know that their kids are doing it. You may think your kids are not, but they more than likely are.”
More than 40 percent of teenagers in the U.S. have tried vaping, according to the CDC’s 2017 Youth Risk Behavior Survey. From 2017 to 2018, 1.5 million young people started using e-cigarettes, according to a February report from the CDC.