- FFF Advocate:
- Michael Northrop, M.D. (brother)
- Place of Residency:
- Pittsburgh, PA
- Date of Death:
- December 5, 2009
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In December, 2009 Liza died of influenza. She was previously healthy and only 49 years old. She sought medical care early. She was cared for at a good hospital in a major city. She had no other infections. And she was unvaccinated.
To say her family was surprised is an understatement. And yet, Liza’s brother Micheal is a pediatric intensive care physician.
Her symptoms started with fever, but progressed to vomiting. She went to the urgent care clinic twice over the course of a few days before ending up in the emergency department of the local hospital. She had begun to experience difficulty breathing, and the emergency physician noted that the oxygen saturation in her blood was very low. They put her on oxygen, and an x-ray revealed that both her lungs were filled with fluid. She was initially diagnosed with pneumonia – a term physicians use to describe the situation when fluid, infection, and inflammation fill the little air spaces in the lungs.
Pneumonia can develop from viruses or bacteria. If your pneumonia is caused by a bacterium, you can take antibiotics to kill the bacteria. However, if your pneumonia is caused by a virus, like influenza, there is not much that can be done but wait for your own immune system to clear it. In some cases, antiviral medication may be used as treatment to help slow down the virus.
The doctors started Liza on an IV antiviral. She was moved to the intensive care unit downtown, and for the next few hours she struggled to breathe and her oxygen saturations continued to fall. She had to be placed on a ventilator, and the hope was that her lungs would recover after a few days. After all, it was ‘just the flu’.
Sadly, Liza never spoke again. Mechanical ventilation works by using pressure to drive air into your lungs. The pressure forces fluid out of the air spaces and allows oxygen to diffuse into the blood. The ventilator does not make you better; it only keeps you alive while your body attempts to heal.
As the flu virus raged on and as her body strove to fight the infection, her lungs became stiff and brittle, making it much harder to force air into them. The ventilator settings changed and even the ventilator itself was changed, but it quickly became clear that despite available technology and knowledge, Liza’s lung disease was progressing beyond the ability of modern medicine to support.
Eventually the delicate, injured parts of her lungs blew apart, something called a pneumothorax. The ICU team promptly diagnosed the problem and treated it by placing a tube in her chest to drain the air. But at this point, the damage was so extensive that there wasn’t enough functioning lung left to support gas exchange. With her body now starving for oxygen, there was nothing left to do.
Liza died December 5, 2009 in Pittsburgh, Pennsylvania, surrounded by family.
As a clinician, it was easy for Michael to trace the clinical course of Liza’s illness. However, it was the human side that was difficult to come to terms with. The part where he watched his sister die over the course of three long weeks. The part where he listened to a physician tell his family that they were out of options. The part where you realize that influenza is sometimes too much to handle, even with all our modern medicine. Those parts have been much harder for Michael to process.
Since Michael began his pediatric residency in 2005, he has seen too many cases like Liza’s. While flu deaths are more prominent among the very young, the very old and those with chronic medical conditions, every year he sees a handful of previously healthy young people end up in the ICU on ventilators. Most of which are unvaccinated.
While it is also true that many people who die from influenza have secondary complications such as bacterial superinfections, myocarditis (a viral infection of the heart itself that causes heart failure), sepsis (infection in the blood) or pulmonary embolism (throwing a blood clot into your lungs), Michael points out that none of these secondary problems would have occurred in the absence of influenza infection.
And finally, Michael explains that there is very little we can do in the way of treatment for influenza. Medical technology allows us to support and sometimes even temporarily replace failing organs, but ultimately we cannot reverse these processes of infection, inflammation and necrosis once they are set into motion. In fact, most vaccine preventable diseases have no effective treatment, which is why prevention through vaccination is so important. An ounce of prevention is worth ten thousand pounds of treatment, and a tiny fraction of an ounce of flu vaccine might have saved Liza’s life.
Michael shares his sister’s story in hopes that it will encourage others to get their annual flu vaccine, and his personal experience with flu has fueled his passion for advocacy and his involvement as a Medical Advisor for Families Fighting Flu.
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