On September 21, 2008, 27-year old ML started feeling short of breath. It quickly got worse; she began to feel dizzy and started sweating profusely. Her family called an ambulance and she was rushed to NewYork Presbyterian’s Allen Hospital, where her condition deteriorated. Mysteriously, her lungs were filling with blood, and she couldn’t get enough oxygen to survive – even on a ventilator. The doctors at the Allen Hospital called their counterparts at the NewYork-Presbyterian/Columbia University Medical Center to see if she could be transferred. However, she was too sick to make the two and a half mile trip by ambulance. She would need to be transferred on a device called ECMO to keep her alive – something the ECMO team had been preparing for. But ECMO traditionally requires blood thinners and could worsen her bleeding. The risk would be high. Finally, when lack of oxygen caused ML to have a cardiac arrest, the ECMO team felt that she needed to be transferred. Her family decided to take the risk.
ML flatlined again during the ambulance ride, but she did not die. She made it safely to NYP/Columbia because of the advanced procedure known as ECMO, or extracorporeal membrane oxygenation – a process that takes over the function of the lungs. A patient’s blood is run out of his or her body and through the ECMO machine, which oxygenates the blood, and is then sent back into the body. The machine serves essentially as a set of mechanical lungs, supplementing the patient’s failing lungs. It also allows the lungs to rest and recover because it is less damaging than the mechanical ventilator, which forces the patient’s lungs to breathe and often harms them in the process.
When ML was put on ECMO in 2008, using full dose blood thinners was the standard of care and that could make her worse. But the ECMO team and her attending physician in the Medical ICU, Dr. Jennifer Cunningham recognized that ML was just barely clinging to life; keeping her on ECMO was her only chance for survival. So, ML was kept on ECMO with a minimum of blood thinning for a full 13 days — and, against all odds, she recovered. Dr. Cunningham called it “miraculous.”
It was from their experience with ML that Dr. Matthew Bacchetta, Director of the Adult ECMO Program, and Dr. Daniel Brodie, Director of the Medical ECMO Program, helped lead the field in decreasing the amount of blood thinning used in ECMO, thereby drastically reducing the risk of bleeding while on ECMO.
During ML’s illness, it was learned that her lung failure was caused by an illicit cosmetic injection to her buttocks gone awry. The silicone from the injection migrated into her bloodstream and found its way to her lungs, where it caused severe bleeding and nearly killed her. Having survived this near-fatal episode, ML now urges women around the world to avoid cosmetic injections performed by unqualified, unlicensed practitioners, because as her story attests, they can have serious, if not deadly consequences.
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