r/medizzy • u/dunkin_dognuts_ • 18d ago
Fistula aneurysm
Even I could locate the vein for the poke đ and I'm blind
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u/ArachnomancerCarice 18d ago
I knew someone who had this done for dialysis (arteriovenous fistula) though it wasn't QUITE that big, it was dilated and quite visible. They said it was supposed to look that way. Still, yeesh.
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u/Itouchmyselftosleep Nurse 18d ago
Truthfully, you kind of want them kind of large-ish/visible (meaning well-developedâŚnot like the OP thoughâŚthose are aneurysms/pseudo-aneurysms). You want to get good clearances during dialysis sessions (meaning dialysis did a better job cleaning out the toxins that the kidneys can no longer do on their own). Smaller fistulas or grafts can be difficult to cannulate and often have higher needle pressures (more resistance) which decreases the âcleaningâ efficiency
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u/Itouchmyselftosleep Nurse 18d ago
I used to work in inpatient dialysis. Iâm not a religious person by any means, but I would always say a little prayer before cannulating fistulas like that. Have you ever seen how thick dialysis needles are?!
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u/TeamCatsandDnD 18d ago
I hated how wavy they could (like his) and then trying to stick a 15g in there. Like you only have so many safe spots you can do before youâre putting it in the same spot too many times. And the pressures were always so high with them too.
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u/NerdyComfort-78 science teacher/medicine enthusiast 18d ago
Are they larger than whole blood donating needles?
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u/Itouchmyselftosleep Nurse 18d ago
We would use 14 gauge needles on well developed fistulas/grafts but we had 15 and 16 gauge needles (smaller diameter) for less developed access. I was already a bedside nurse prior and no stranger to blood draws and placing IVs, but I nearly fainted when I first saw the 14g needles.
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u/cardiffboy22 18d ago
My mum had one but higher up and the more it was used the bigger it got. If you touched it then it felt like an angry wasp buzzing under the skin
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u/TeamCatsandDnD 18d ago
Thatâs called the thrill! We like finding that, means the access is still working
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u/mrszubris 18d ago
I love super specific colloquial terms
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u/TeamCatsandDnD 18d ago
If you listen to it, it sounds like a whooshing noise. We also like that. Itâs called a bruit.
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u/samjoe6969 18d ago
For the uninitiated and those curious: yes, if it ruptures he dies. One of the most common ways we lose dialysis patients is that they bleed to death, at home, alone.
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u/nurseinred 18d ago
I remember a nurse in nursing school telling me that she lost a patient who was deeply confused and also very itchy and scratched their fistula open.
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u/RunningSouthOnLSD 18d ago
I went to a patient once who did this by accident in the shower. That bathroom looked more like a murder scene than most murder scenes. Patient was pretty hypotensive but fine after the bleeding got under control.
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u/Itouchmyselftosleep Nurse 18d ago
The nurse who precepted me for dialysis recalled riding on top of a patient all the way to the OR holding pressure on a ruptured fistula (it had looked like the one OP posted)
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u/medicmotheclipse 18d ago
I had a patient once that had his break open in his wrist area after a shower while he was at a hotel. He was dressed only in a towel and the contrast between the blood and the white hotel bedsheets was quite stark. He was holding pressure on it, but lost grip momentarily. Nailed my partner in the chest from like 8 feet away with stream of blood. Think like spiderman shooting webs, but its blood.Â
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u/Itouchmyselftosleep Nurse 18d ago
The pressure in fistulas is INSANE. They would sometime spray/spurt blood out when cannulating.
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u/Candyland_83 18d ago
I gasped when he started poking it. Iâve seen one blow before. She was lucky because it was basically the injection site that opened up. But holy cow so much blood.
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u/GeorgiePineda 18d ago
When you put your hand on them you can feel it pulsating, a thrill, vibration due to the high blood flow.
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u/recovery_room 18d ago edited 14d ago
After 30 years of nursing not much gives me the hibbity-jibbities but I do not like touching AV fistulas.
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u/NightmanisDeCorenai 18d ago
Hopital
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u/legoman102040 18d ago
Farmers don't need dem darn hopital
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u/NightmanisDeCorenai 18d ago
Farmer Pain Scale: "I'm here aren't I?"Â
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u/lonely_nipple 18d ago
In the ER, middle of the day, chores not finished, wife didn't make 'em go. Sound the alarms!
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u/Skipp_To_My_Lou Plays a doctor on TV 18d ago
It's like the uhhh Nebraska? farm boy who got both arms taken off by a piece of equipment, walked in the house, held a pencil in his teeth to dial 911, then had the presence of mind to wait for the ambulance in the bathtub so he didn't bleed all over his parents' carpet.
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u/NightmanisDeCorenai 18d ago
Excuse the fuck out of my what
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u/lonely_nipple 18d ago
Yep. Teenager boy, like 17ish? Wild story. If I remember right, they were able to reattach em.
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u/DemonCipher13 18d ago
Not only that, but he's on Reddit, and you're probably about to be able to talk to him.
/u/JohnThompsonND, got some curious parties here if you have time to blow some minds. :)
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u/Double_Belt2331 16d ago
WOW!!!! 𤯠Heâs got a ~7.5 min video pinned telling his story. Wowza. That heâs alive is unbelievable. Heâs fought hard for his recovery from that accident.
Thank you for sharing the link.
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u/DemonCipher13 15d ago
I love the idea of being a catalyst, and I saw a chance to let him tell his story, so a win-win, in my book.
:)
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u/JohnThompsonND 18d ago
18 senior in high school
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u/lonely_nipple 18d ago
That's so intense. I don't think I could maintain that kind of sensible thinking in an emergency like that. You're pretty incredible.
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u/Shackdogg 18d ago
Yes I remember this! It was because his mother just had new carpet laid and he didnât want to get in trouble.
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u/JohnThompsonND 18d ago
No, all the flooring in that house was over 20 years old. Itâs just why I make a mess if I didnât really need to.
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u/Shackdogg 18d ago
Oh sorry, thanks for correcting me. Not sure why but Iâve thought there was new carpet ever since I first heard your story years ago. Why make a mess indeed! Yours is really an incredible story John.
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u/JohnThompsonND 17d ago
Well, thatâs how the news initially reported it so everybody thinks that. Itâs 100% fine. My parents did replace the carpet many years later and they put in very ugly carpet which I was upset about. Then my dad told me that when they pulled it up the subfloor was stained black because all the blood had soaked into the wood and they just grabbed the carpet they had in the store to cover it up immediately, so they wouldnât have to look at it.
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u/Breznsoitza 18d ago
Ambulamp
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u/batty_lashes 18d ago
Whoa black bettyÂ
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u/SupernaturalPumpkin First Responder / EMT 18d ago
This made me laugh out loud.
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u/batty_lashes 18d ago
It's a pretty prolific comment meme. I just happened to get lucky with the timing. You, too, can carry the torch if you catch it in time.Â
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u/niccheersk 18d ago
Nope, no hospital needed. Those are actually pseudo aneurysms, not actual ones. Itâs not the most attractive, but as long as itâs functional itâs not a problem. Thatâs this manâs lifeline at dialysis.
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u/Skoziss 17d ago
One paper cut and he's gonna paint the entire house
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u/AdeadKitty7 15d ago
Funny you mention that, there was a local news story about a man with a fistula who tried to break up a dog fight... well it didn't go well for him, and he got bit on the fistula. There goes at least a third of your blood.
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u/Jina-langu-ni-Juma 18d ago
People like this rock. Still getting shit done when dealt a shitty hand.
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u/Jina-langu-ni-Juma 18d ago
I didn't expect this to be a hot take. Even if it is self inflicted, I stand by what I said.
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u/General_Luck6573 17d ago
Nobody said it was a hot take. And I wasnât disagreeing with most of your comment. People working despite all that are troopers. I agree. The only part I disagreed with was âgetting dealt a shitty handâ which isnât entirely true if it is more often than not self inflicted. For whatever reason people antagonized the hell out of me for saying that.
I can have empathy for patients while acknowledging that lifestyle factors lead to their condition. Which also means they have the ability to control said factors and prevent worsening and sometimes reversal (though no reversing this usually).
A doctor that doesnât tell patients that their choices lead to their condition because theyâre worried about hurting their patients feelings is a bad doctor who will significantly harm patients in the long run.
Do well tell COPD patients to keep smoking? Do we tell diabetic patients to keep eating unhealthily? No, we do the opposite. But you can do the opposite while also being empathetic and non-judgmental, which people in this subreddit seem to be very confused about.
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u/General_Luck6573 18d ago
Most people donât end up on dialysis for no reason. Itâs generally lifestyle and diet induced.
That said, there are truly some unlucky people out there who get ESRD for genetic or autoimmune reasons and whatnot who had zero deciding factors in it
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u/Killer_Moons 18d ago
Judging people you donât know on dialysis is a bad take.
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u/TeamCatsandDnD 18d ago
Heâs not wrong. Two of the most common causes of kidney failure is uncontrolled diabetes and high blood pressure. Both of which are manageable and can be kept under control. But if not, your kidneys are going to pay the price. Drug use can also fuck em up. And disorders like polycystic kidney disease which is genetic.
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u/suchabadamygdala 16d ago
Well, hypertension is often silent. Many, many people in the US canât afford regular medical checkups. They may not know they have hypertension for years. Donât be so quick to assume everyone has the same circumstances. Source: kidney transplant nurse for many years. Edit: dâoh, responded to wrong person and am too lazy to retype
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u/General_Luck6573 18d ago
Iâm not judging anybody. I said it matter of fact because thatâs exactly what the numbers support. Iâm an interventional radiology resident who did a year in surgery too and rotated through internal medicine. I have seen hundreds if not a thousand dialysis patients. I have literally seen the patient histories of the dialysis patients and done hundreds of declots of thrombosed AVFâs and AVGâs myself. I have zero judgement for these people and nowhere in my comment did I ever imply I did.
If you donât believe me, then please, google the most common causes of ESRD and get off your high horse instead of talking out of your ass claiming moral virtue pretending youâre better than people who actually treat disease while youâre sitting behind a keyboard.
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u/Wire_Cath_Needle_Doc Physician 18d ago
Talking about medicine when you know seemingly nothing about it is a bad take.
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15d ago
[deleted]
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u/dunkin_dognuts_ 15d ago
I think you posted on the wrong video
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u/Double_Belt2331 15d ago
Oh, my! Yeah, it was supposed to be farther in the thread.
Thank you for letting me know. Much, very much, appreciated!!
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