Justin's and Lizzie's Journal 12/30/25
Justin's Journal 12/30/25:
Got up and took to ER. Still thinking severe altitude sickness. ER tried oxygen tube, nebulizer, forced oxygen mask. None worked. Decided to transport her via ambulance to full hospital. I called my mom and asked her to fly up to help with the kids. She was here five hours later. Lizzie asked why I called her - I said I needed help. Lizzie said she wished she just went home. I told her that her SP02 was at 56 when we got to the ER. She would have died if we went home instead. I took the kids to McDonald's (two days in a row!) then we made in back in time to see Lizzie loaded into the ambulance. We followed to the UC Health Hospital in Longmont, CO where they immediately put her into ICU and prepped Lizzie for intubation. Lizzie was really worried they would do it without sedation - they assured her she would be sedated. The kids and I hugged her and a wiggle of her foot to say goodbye. We left. About 2:50 - 3 PM Tuesday 12/30 was her last time fully awake. I granted consent for them to place PICC line, then we left to get Gran at the airport. I picked her up, got a car, got a call at 5:30 pm that they were transferring Lizzie via life flight to UCHealth Denver, the main hospital campus. I made it before the helicopter and watched. They wouldn't let me see her while they set up her PICC. I went to AirBNB with my mom about 11 pm and tried to sleep.
Lizzie's Reflections of 12/30/25:
I remember bits of pieces of this day, and I guess that makes sense because my brain wasn't getting enough oxygen. I have no memory of the ambulance or life flight. I remember trying to wave bye to them, but not having the strength. I wiggled my toes and said "happy first family vacation" between hacking coughs. I felt so defeated.
Friends texted me several times that day to check in and I didn't respond.
So many tests were run between urgent care. ER #1, ER#2, and ICU. My white blood cell count was incredibly low,my blood pH was crazy low as well. When checked at noon, my blood O2 was 48%, and I had an abnormally high concentration of CO2 in my blood. When checked again at 3 PM, my blood O2 was 22% (95%-100% is normal). No wonder my organs all stopped working. My x ray showed "atypical infection" of my upper right lung. This is when I tested positive for group A strep in my blood and blood in my urine. I also had a severely abnormal liver panel. A chest, abdomen, and pelvis CT showed findings of multifocal pneumonia with a few areas of central lucency in right upper lobe, which could represent early cavitation or underlying cystic lesion. At 5 PM I went back for intubation, arterial line placement, and central line placement.
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| CT of Lung with Cavitation |
I wonder if it was during the ECMO cannula procedure leg suturing when I was "dreaming" that I was in the study at my old house and someone was cutting my leg open and shoving pieces of aluminum foil in the cuts.
Co-Pilot's Interpretation of 12/30/25
🫁 Lungs / Respiratory System
Your lungs were the main source of the emergency.
What happened:
- You had Influenza B, which can cause severe lung inflammation.
- Your lungs developed multifocal pneumonia — meaning infection in many areas of both lungs.
The CT scan described “extensive bilateral groundglass and nodular opacities” and “areas of central lucency…which could represent early cavitation.” - You arrived with dangerously low oxygen levels (as low as the 60s and 70s, even on oxygen).
- You were coughing up blood‑tinged sputum (hemoptysis).
- Doctors were also concerned about DAH (diffuse alveolar hemorrhage) — bleeding into the lungs — because of the combination of blood in sputum, abnormal imaging, and kidney issues.
How it progressed:
- High‑flow oxygen wasn’t enough.
- You were intubated (a breathing tube placed) because your oxygen levels kept dropping.
- Even on the ventilator, your oxygen levels stayed critically low — consistent with ARDS (Acute Respiratory Distress Syndrome).
- Because your lungs could not oxygenate your blood, you were placed on VV ECMO (a machine that oxygenates your blood outside your body).
❤️ Heart / Circulation
Your heart itself was not the main problem, but it was affected by the severity of your illness.
What happened:
- You were in shock, meaning your blood pressure was dangerously low.
- You needed three different medications to keep your blood pressure up (norepinephrine, vasopressin, phenylephrine).
- Your heart was beating very fast (130–140s), which is common in severe infection and low oxygen.
- An ultrasound of your heart did not show signs of a blood clot in the lungs (PE).
🧠 Neurologic System
- You remained alert and oriented until intubation.
- You have a history of seizures, so doctors continued your seizure medication (Vimpat).
- After intubation, you were sedated for comfort and safety.
🩸 Blood / Immune System
Your labs showed your immune system was overwhelmed.
Key findings:
- Severe neutropenia (very low white blood cells):
WBC dropped to 0.8; ANC around 0.4.
This makes it harder to fight infection. - Lactic acidosis:
Lactate levels were extremely high (6–8.5).
This means your tissues weren’t getting enough oxygen. - Platelets slightly low, but not dangerously so.
🩺 Kidneys / Renal System
Your kidneys were under stress.
What happened:
- You developed AKI (acute kidney injury).
Creatinine rose from your baseline of 0.79 to 1.4. - Your urine showed:
- Protein
- Blood
- High specific gravity (sign of dehydration)
- Doctors suspected the kidney injury was from:
- Severe infection
- Low blood pressure
- Poor oxygen delivery to organs
🧬 Autoimmune / Vasculitis Concerns
Because you had:
- Lung bleeding (possible DAH)
- Kidney injury
- Severe inflammation
Doctors ordered an ANCA panel to check for autoimmune vasculitis (a condition where the immune system attacks blood vessels).
This was a rule‑out, not a diagnosis.
🦠 Infection / Sepsis
You met criteria for sepsis and later septic shock.
Evidence included:
- Very low oxygen
- Very high lactate
- Low blood pressure
- Severe infection (Influenza B + pneumonia)
- Organ dysfunction (kidneys, lungs)
You were treated with:
- Antibiotics (ceftriaxone, doxycycline, linezolid)
- Antivirals (Tamiflu)
- Steroids (solumedrol)
- Large amounts of IV fluids
- Pressors to maintain blood pressure
🧂 Electrolytes / Metabolic System
Your labs showed multiple abnormalities due to severe illness:
- Low potassium
- Low magnesium
- Low calcium
- Low albumin
- High anion gap metabolic acidosis
All of these were treated with IV replacements.
🫀 Vascular Access / Procedures
Because of the severity of your condition, you required:
- Intubation
- Arterial line (for continuous blood pressure monitoring)
- Femoral central line (for medications and fluids)
- VV ECMO cannulation (to oxygenate your blood)
🧍♀️ Other Chronic Conditions (not the cause of the emergency)
Your history includes:
- Thyroid cancer → hypothyroidism
- POTS/dysautonomia
- Asthma
- Raynaud’s
- Fibromyalgia
- Chronic migraines
- Seizure disorder
- Endometriosis (post‑hysterectomy)
- Kidney stones
- Sleep apnea
These were noted but not the primary drivers of the crisis.
In Plainest Terms
You became critically ill because Influenza B triggered a severe lung infection, which caused respiratory failure, shock, and multi‑organ stress. Your lungs could no longer oxygenate your blood, even with a ventilator, so you required ECMO — a machine that temporarily takes over the job of your lungs.
This was a life‑threatening medical emergency, and the care team acted quickly and aggressively to stabilize you. You were transferred via ambulance from a regional ER at 1:46 PM to Longs Peak Medical Center ER where you were intubated. At 5:33 PM you were transferred via air ambulance to UCHealth Anschutz Medical Campus for ECMO.
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