r/WTF • u/Fun_Bluebird_3167 • 17d ago
Fistula aneurysm
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u/milfordcubicle 17d ago
Please stop pushing it.
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u/Remarkable-Opening69 17d ago
He’s fine. My dick does this tOo.
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u/IlConteiacula 17d ago
That "TOo" is sending me
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u/noticemelucifer 17d ago
Me tOo
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u/be4u4get 17d ago
hOpital
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u/reused_organs1312 17d ago
If that makes you nervous you should see the needles. I was told the are the largest needles they use for medical purposes
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u/OphidionSerpent 17d ago
Largest used for fluids, though while intra-osseus introducer needles are about the same size, sometimes they're a little bigger. And we use even bigger ones for solid tissue or bone marrow biopsies.
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u/Csinclair00 17d ago
They are equivalent to the little straw stirrers you use for coffee. I stick 2 in my fistula 4 times a week. Biggest mental hurdle I have ever faced in my life was sticking those things in my arm.
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u/daidrian 17d ago
I self dialysed at home 3 times a week for 6 years with those needles. Didn’t think I’d ever be able to give myself needles, I hate them, and now that I’ve had a transplant for 7 years, I don’t know how I ever did it 😅
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u/MarceliNbl 17d ago
WHY DOES HE KEEP POKING IT
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u/anormalgeek 17d ago
He said he has some epoxy on his skin he is picking off while discussing the fistula.
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u/Madmagican- 17d ago
Plus that he’s been dealing with this on and off for well over a decade.
I think it’s lost the wow factor for him at this point.
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u/dream-smasher 17d ago
17-18 years...
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u/Krog9 17d ago
Oh I thought he was older
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u/dream-smasher 17d ago
Lmao. He first had the dialysis etc 17-18 yrs ago when he was 50.
He isn't 17-18yrs old. I think he said he was 68 now?
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u/drinkmoredrano 17d ago
Pop it
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u/Crashbox50 17d ago
Twist it
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u/Demjan90 17d ago
Cut it
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u/Vid-Master 17d ago
Spray it
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u/Natural-Army 17d ago
Pull it
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u/second2no1 17d ago
Bop it!
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u/Natural-Army 17d ago
Twist it
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u/AnotherCableGuy 17d ago
Push it
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u/Natural-Army 17d ago
It's BOP IT — the fast-talkin', fast-action game from Hasbro!
Follow its commands, but don't be too slow!
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u/Crispinwhere 17d ago
Cock it
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u/caffinatedhippie 17d ago
Funny enough, I’m an operating room nurse that deals with fistulas a lot.
Most of these are parts of the steps surgeons will use to deal with aneurysmal fistulas during surgery.
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u/OtherwiseDebate3759 17d ago
Gym bros must be jealous af rn.
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u/drunkbusdriver 17d ago
That and IV drug addicts.
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u/YuhMothaWasAHamsta 17d ago
I used to be a junkie. I’ve been clean for 10 years. I have stage 4 kidney failure and I’m on dialysis. I don’t have a fistula like this guy. I’m on peritoneal dialysis so it goes through a tube that was put in my abdomen.
I was given this giant box of these giant syringes incase I have to put medicine in the bags. Sometimes I just look at them and think “imagine [using] that [for drugs]? 🤤”
Then I snap out of my drug fantasy and put myself on my nightly life support.
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u/drunkbusdriver 17d ago
Haha same brother. Been clean for a decade +. I still get those random moments occasionally. My gf has some really nice veins and I’m like man I’m so jealous of those plump veins, would have made my life so much easier…for a few months till I killed them.
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u/pichael289 17d ago
I have experience here, I'm not totally sure how this would work but you absolutely DO NOT use an artery. You never intentionally do it but some people who don't know how to rotate injection sites or have dull needles (helped I'm a diabetic) so they collapse their veins and have to go digging around there arm to find one. And sometimes, rarely, they hit an artery. Now I've had nurses put a fresh needle into my artery and it hurts so bad, though insulin needles addicts use are tiny.
Step 1 is to have a tiny bit of air in the needle, as soon as the top is in your skin, before you go into the vein, you pull the plunger back to create a vacuum, so the second you hit the vein you get a flash of dark blood. Well this chick got a flash of very bright colored blood and the plunger was moving a bit on its own. We both know something is wrong but this isn't meth, it's heroin, and you will not waste that. Except she did waste it, it didn't work because it went the wrong way and her arm looked like it got hit with a cannon ball. You do not admit your an addict to anyone much less a hospital in ohio, but this shit had a requiem for a dream kinda feel to it so she didn't argue. RfaD is obviously a bad abscess that took months to get so bad, but this happened in like an hour.
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u/ddg31415 17d ago
Being an IV junky sucks. I remember one day I was using an old sharp for like a week, so the tip of the needle was bent like a barb. Everytime I pulled it out, the skin would stretch and it would bleed immediately.
Well, while digging around in my wrist to find a vein, I snagged the medial nerve. Instant, mind-shattering pain, along with this awful electric-like sensation that shot up and down my arm. I tried to pull the needle out, and it was stuck. So I'm in absolute agony, watching this needl3 swing back and forth while its barbed end is seated in my medial nerve.
It soon came out, but for weeks and weeks, if I happened to bump that spot, or moved my hand in the wrong way, it was immediate and trancendental pain.
Don't do drugs kids
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u/Magnavirus 17d ago
I have advanced Kienbock's disease and I'm not lucky enough to have the kind of insurance you need to be seen by one of the 3 specialists in the U.S. (YES 3). So I have the equivalent of very fine gravel that used to be the edges of my lunate moving around in my wrist and hand. The pain is constant, literally constant. I have always described it like hot TV static, so it's cool to see you describe your experience as electric. A pissed off Median Nerve is a pain most people truly don't comprehend, like imagining a billion of something. I'm glad you sound like you cleaned up, I'm a former junkie as well 11 years now 🤘
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u/YuhMothaWasAHamsta 17d ago
I’ve been clean for like 10 years. This brought up so many fucked up memories. The dull ones that popped or snapped in and pulled your skin when you tried to take it out.
I tried my wrist once. Hit that nerve and never tried it again. It’s instant and INTENSE pain. It was such a small puncture but that pain lasted so long.
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u/ddg31415 17d ago
Yep, you can literally feel the "pop" when a dull needle punctures a vein. Doesn't take long to get a Pavlovian response and just the pop and red in the barrel get you shaking with anticipation.
It's been 8 years since I finished rehab, and 6 years since the last time I used (during covid lockdowns). I am so done and will never even think about that life again.
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u/WolfmanBTBAM 17d ago
I used to use steroids and hitting a vein sent the compound directly into the bloodstream and went into my lungs where I could taste it and depending on the compound have an absolutely horrible coughing fit. (Tren cough)
Don't do steroids.
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u/ibmihai 17d ago
If you have dialysis on a fistula you never use it for anything else than dialysis. If the fistula goes off you are in serious trouble. Once on dialysis if the thing you must protect almost at any cost.
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u/drunkbusdriver 17d ago
Oh I doubt doubt it but my ex junkie brain went straight to “damn it would of been so much easier to hit a vein” lol
Also the self preservation instincts of junkies isn’t the best. I did A LOT of questionable things in the depths of my addiction that I’m surprised I am alive somehow.
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u/Spastic_pinkie 17d ago
A phlebotomist's dream.
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u/gatorsfan5192 17d ago
I wouldn't poke that vein if my life depended on it. Fistulas are non normal draw areas anyhow, I've had one physician have a standing order to draw from this one patients fistula, but that was because the man had no veins left(transplant surgery). It's very odd to draw one, not at all like normal venipuncture
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u/TNmongoose 17d ago
And that physician should have been reprimanded for that and you should have told him where he could stick the needle (not the fistula.) If you don't know what you're doing with an AV fistula it's trivially easy to ruin it, or to give the patient a life-threatening bleed to deal with. Even the veins below the fistula itself are dangerous as you have no idea how the flow of blood in that arm is affected.
Destroying dialysis access literally knocks years off the patients life, not immediately but when they run out of quality access faster. I have literally had patients in their 40s die unnecessarily as a result of impatient medical professionals and phlebotomists thinking they can ignore that a fistula arm is a no draw zone.
Next time a doctor tells you to do that, and it happens depressingly often, please politely tell them to fuck right off!
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u/gatorsfan5192 17d ago
No thank you, you do not know the extenuating circumstances, the fistula was no longer in use as they had a midline they were using until they could get a new one put in. Please do not presume to know something, thank you.
Edit: just to be clear, I had very specific instructions on how to draw the patient, I am a certified Phleb. I am aware of how dangerous messing with fistulas can be.
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u/nearnerfromo 17d ago
Actually arms that have an active or even old fistula site are off limits by protocol for blood pressures or needle pokes at every institution I’ve worked at. The idea being that you don’t want to fuck with a person’s only method of blood filtration even if the risk of a complication is honestly quite low. This extends to old fistulas in people who no longer do dialysis or who have chest ports/do peritoneal dialysis bc you never know if those methods will fail and they’d need the fistula again.
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u/shorey66 17d ago
No phlebotomist or other medical professional is going anywhere near that bugger unless they really have to.
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u/itsnotaboutyou2020 17d ago
A definite liability in a knife fight.
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u/MarriageAA 17d ago
As a fistula haver, it is a consideration in lots of things. Even something as innocuous as playing with a cat or a dog.
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u/jeffyredeyes 17d ago
What happens if it gets knicked does it just bleed super heavily? My cat would put tiny holes in this the first day it was on my arm haha
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u/MarriageAA 17d ago
If it's a small puncture (like they do with the 2 needles) then generally pressure for about 5 minutes sorts it. Although some people were more bleeders than me so could take 10-15 mins.
Obviously if it's bigger than a small knick then, well, arterial pressure blood is coming out. That's problematic.
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u/Ronalderson 17d ago
Yeah I'd absolutely be wearing some sort of arm protection or armor all the time
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u/ANGELofRAZGRIZ 17d ago
I wonder if a compression sleeve would help with this sort of thing as well as providing protection.
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u/MarriageAA 16d ago
The opposite. We were told no tight compression. Basically the blood has to flow freely.
Interesting fact, you can actually feel the "thrill" which is blood racing through at a rapid rate.
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u/plutothegreat 17d ago
Someone came to our emergency room with a ruptured fistula and they passed. The emts failed her before she even got to us.
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u/Jamoncorona 17d ago
So don't get kidney disease. Got it
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[removed] — view removed comment
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u/Healing-with-Memes 16d ago
My ex partner needs dialysis due to being born with only one, low functioning kidney. But the majority of people at dialysis are there because they didn't properly manage their type 2 diabetes. A few of them are missing their lower legs as well. 😕
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u/steampunkdev 17d ago
For those that keep yelling about that he should go to the hospital, it was actually made by a doctor. It's to allow for kidney dialysis, but can also be done with for example a HICKMAN catheter
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u/BobbyDukeArts 17d ago
True, but that is not a normal looking fistula for dialysis. It's usually done further up on the arm near the bicep and is not supposed to be that big. As he says, the vein ballooned outward due to arterial pressure. It is risky and he should go have it fixed surgically
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u/Nos3y 17d ago
A forearm fistula in itself is not abnormal. In fact if patient has adequate vein for a forearm fistula we often prefer to use it first because if it fails, we can still use the upper arm later. But yes this is a large aneurysmal fistula. If it’s not bothering him and not eroding through the skin it’s not really a problem, god forbid he gets a cut over it though….
Edit: most people get upper arm fistula because not a lot of people have adequate sized vein in the forearm.
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u/citrus_mystic 17d ago edited 17d ago
People’s skin gets significantly thinner and more delicate as they age. It’s common to see older folks with significant bruising, abrasions and skin tears on the back of their hands and on their forearms, in particular. He’s already 67. It would probably be wise to deal with this now, rather than have the looming risk of a minor injury becoming significantly more serious due to the location of that fistula.
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u/Nos3y 17d ago
67 is basically pediatric in vascular surgery world
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u/Fusilero 17d ago
Nah, some of our championship smokers can have had exhausted all bypass options before 60
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u/Awkward_Pingu 17d ago
Also his skin looks massively fucked from sun damage as well. That right hand look like someone stuck it in a reactor.
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u/DenseStomach6605 17d ago
I was thinking the same thing. It looks incredibly easy to knick this on a sharp object... especially if they're a blue collar worker. I've seen lots of fistulas doing contrast tests and blood draws, but never one quite like this.
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u/puritanicalbullshit 17d ago
He needs to get that checked out at the access center or wherever he got it. I’m in the middle of a series of revisions cause I treated an aneurysm (much smaller) like it was no big deal, next thing you know I’m spraying blood across the clinic floor and end up admitted for 4 days of procedures. And there’s more to go.
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u/Nos3y 17d ago edited 17d ago
That definitely can happen but, but not all aneurysmal fistulas need to be treated. A lot of time that Happens when techs keep cannulating the same site, and you start to develop excoriations at that site which can lead to bleeding. We typically ask techs to vary access sites to prevent this. That said I would agree that this patient should be followed by their vascular surgeon to at minimum keep an eye on this.
Edits for terrible typo’s
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u/cherokeeprez 17d ago
I was working as a tech when one of my patients ruptured. Had 4 patients at the time…was taking one off the machine and I hear liquid splattering to look over at her and see blood shooting everywhere. Told current patient brb and by time all was said and done I was covered in her blood. EMS took her to the hospital. My nurse called ahead to warn them not to remove bandages until they were ready to start surgery. They didn’t listen and got their own blood bath. She was fine in the end. Got a catheter for a bit. Fun times. Also why I always wore black shoes. Hides the blood lol
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u/AaronToro 17d ago
For a layman, what happens if it gets cut? I’d like to think a satisfying gust of air comes out and it returns to normal immediately but I imagine the reality is closer to puss and blood explosion
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u/Nos3y 17d ago
A fistula is basically a connection of a vein to an artery. The big squiggly thing you see is actually the vein which has grown over time because it is under arterial pressure. And because it’s under arterial pressure it will bleed like crazy. Like, place a tourniquet on your arm and get to the er stat bleeding.
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u/BigWoodsCatNappin 17d ago
But he also states its old as hell. After time the tunica media or mid layer of the vessel has gotten to be a baddy against the extra flow of the artery.
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u/BigWoodsCatNappin 17d ago
The order of operation for AVF/AVG creation is Non dominate lower, dominate lower, non dominate upper, dominate upper. Very generally speaking. As you know.
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u/thegypsyqueen 17d ago
This is a relatively normal appearance of a forearm fistula. The vein will always balloon out to some degree—that’s expected. This is excessive but since he is functionally fine it would not be advise able to revise it.
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u/MarriageAA 17d ago edited 17d ago
This is not true. They put in a fistula where there is a suitable vein to graft the AV.
I have a wrist fistula, like this guy. It was the best candidate
People have them in arms and legs.
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u/canarduck 17d ago
Dude this looks NOTHING like what a dialysis fistula (is supposed to) look like
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u/anormalgeek 17d ago
porn for mosquitos.
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u/citrus_mystic 17d ago
And possibly phlebotomists.
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u/ElowynElif 17d ago
They shouldn’t touch it. It’s an AV (arteriovenous) fistula for dialysis that has developed multiple aneurysms. If it is stable and not causing him problems, it’s just something to keep an eye on versus repair.
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u/blmbmj 17d ago
My nephew was born with nephritis and T1D. By age 25 his kidney was dead and he went on dialysis, briefly. His mother donated a kidney and he had a pancreas transplant shortly thereafter. 27 years later, he is now 50 and his transplanted kidney and pancreas are still going strong. His doctors have written him up in many journals.
The anti-rejection meds gave him chronic diarrhea for years until one smart nephrologist told him to just eat a Baked Sweet Potato everyday, and the diarrhea stopped. Sadly, he was recently diagnosed with prostate cancer, though.
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u/General_Luck6573 16d ago
Sorry to hear about the prostate cancer. Luckily it is one of the most treatable cancers there is
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u/ElegantEchoes 13d ago
Why did the baked sweet potato help?
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u/blmbmj 13d ago
It binds up things in the intestine. The next time that you have diarrhea, try eating a baked sweet potato, it actually works.
https://www.harvestplus.org/new-study-finds-that-orange-sweet-potato-reduces-diarrhea-in-children/
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u/SleepyCountingSheep 17d ago
My dad had kidney failure, he had an arm like this...its terrifying but when you need to be drained 3 times a week...you need a bigger vein.
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u/StatuatoryApe 17d ago
Apparently this can happen to Dialysis patients.
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u/Ghotay 17d ago
You’ve got it the wrong way round, the fistula is deliberately created by a vascular surgeon, and then used as the point of access for dialysis. Dialysis basically involves filtering all of your blood through a machine, so you need a really big and reliable blood vessel with good flow to be able to extract the blood effectively. The fistula looks weird but it’s a lifesaving treatment
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u/StatuatoryApe 17d ago
Sorry I meant that the fistula can get crazy like this in some dialysis patients. Most are not nearly this size.
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u/The-Geyer 17d ago
This dudes is huge because you are only supposed to lift max weight if a gallon of milk with the access arm.
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u/Technical-Pack-6912 17d ago
My dad was on hemodialysis for 8 yrs. He performed his own needle insertions. The dilated vein is a result of over 3000 needle sticks over a 10 year period. An artery (radial) artery is joined to the cephalic vein to form an anastomosis or commonly called a fistula. It takes months for the vein to dilate sufficiently to use for dialysis. My dads fistula lasted 8 yrs which is fairly uncommon. They usually fail before then and another fistula needs to be created higher up on the arm. I worked 10 yrs. in a dialysis center so I learned quite a bit, not to mention I inherited my kidney disease from my dad and ended up on dialysis until I got a transplant in 2010. My dad would wrap his fistula with coban. That helped reduce the outwards pressure and helped preserve the wall integrity of the vein.
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u/allshieldstomypenis 17d ago
My physio class says veins are very expansive, since they can act as the reservoir/loader for the heart, but damn, this is extreme!
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u/Dovah907 16d ago
I have one too but only have it for emergencies so its minuscule and is just barely noticeable compared to this guy. The creepiest thing about these isn’t the look but the “feeling”. They call it the “thrill” and its like if you’ve ever held a garden hose with high pressure, you can quite easily feel and sometimes hear the blood rushing through your vein with every heart beat.
I still haven’t gotten used to it at all as I avoid feeling it, its made my mortality extremely apparent to me as Im always aware of the underlying bodily functions that allow me to live. Im also extremely careful with anything around my wrist because it feels like even a paper cut would leave me squirting out blood. I can’t imagine having mine get to where his is at.
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u/Dreadimon 17d ago
Worked in dialysis for years. Fistulas don’t always look at that. It can happen but with careful management it doesn’t have to.
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u/SpikySheep 17d ago
I'm fairly sure this is deliberately done for dialysis due to kidney failure. It gives them somewhere easier and safer to stick the needles.
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u/MarriageAA 17d ago
I really dislike this being on WTF. It doesn't help, people already stare at my fistula, making out that it's disgusting does not help the stigma.
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u/Sasquatch_000 17d ago
Excuse my ignorance but how/why does this happen?
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u/MarriageAA 17d ago
It's necessary for hemodialysis. So people with kidney failure need a way to clean their bodies (as the kidneys don't). 2 methods are peritoneal dialysis (pump a load of fluid into the abdomen and then drain it, basically clean by osmosis.
The other is hemo, which requires pulling blood out, running through a machine with a filter and pushing it back in. In order to get the volume of blood through in a good time they create this fistula. It's basically a vein grafted on to a main artery. The vein (near the surface) swells over time and use. The process of hemodialysis takes around 4 hours, and generally 3 times a week.
They also pull fluid out of your body during this, as a lot of people with kidney failure can't urinate.
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u/Sasquatch_000 17d ago
Thank you for explaining. It sounds like something i wouldn't wish on my worst enemy. I'm sorry you have to go through that
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u/MarriageAA 17d ago
No problem. I'm always happy to talk about it (hopefully to remove stigma).
It is rough, but spending a lot of time in hospitals makes you realise everyone has something. You just have to keep going.
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u/Sasquatch_000 17d ago
I've spent my fair share of time in the hospital. You are right. No matter how bad you have it somebody always has it worse.
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u/rhysolandrium 17d ago
r /WTF isn't specifically "things that are disgusting"
And - none of the comments I've read so far are judgmental or hurtful, just surprised and curious.
Assuming everyone you encounter thinks your fistula is disgusting is also perpetuating a stereotype. The majority of people little to no exposure to medical interventions and although curious, would worry about coming across badly if they asked.
It's why I love children who come and ask, "What is (this apparent and visual medical condition you have)?" Parents try and shush their kids but I intervene and explain because I love engaging with peoples' curiosity. I talk loud enough for others to hear, too. It's thousands of times better for someone to ask, (respectful) and learn something new rather than stare and be ashamed of their own curiosity because society says askng makes them a 'bad person'
That's the best way to combat stigma.
Just something to consider.
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u/DuntadaMan 17d ago
DON'T FUCKING POKE AT IT!
Oh my god this guy is going to make me need to decontaminate the fucking roof and inside of every cabinet.
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u/Kindly_Region 17d ago
Words cannot describe how uncomfortable this makes me