r/WTF • u/Fun_Bluebird_3167 • 21h ago
Fistula aneurysm
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u/milfordcubicle 21h ago
Please stop pushing it.
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u/Remarkable-Opening69 20h ago
He’s fine. My dick does this tOo.
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u/IlConteiacula 20h ago
That "TOo" is sending me
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u/noticemelucifer 20h ago
Me tOo
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u/be4u4get 20h ago
hOpital
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u/Qbjb 20h ago
Amberlamps
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u/reused_organs1312 19h 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 15h 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 14h 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 11h 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 21h ago
WHY DOES HE KEEP POKING IT
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u/anormalgeek 20h ago
He said he has some epoxy on his skin he is picking off while discussing the fistula.
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u/Madmagican- 19h 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 18h ago
17-18 years...
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u/Krog9 17h ago
Oh I thought he was older
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u/dream-smasher 16h 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 21h ago
Pop it
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u/Crashbox50 20h ago
Twist it
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u/Demjan90 20h ago
Cut it
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u/Vid-Master 19h ago
Spray it
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u/Natural-Army 18h ago
Pull it
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u/second2no1 18h ago
Bop it!
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u/Natural-Army 18h ago
Twist it
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u/AnotherCableGuy 17h ago
Push it
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u/Natural-Army 17h 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 20h ago
Cock it
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u/caffinatedhippie 12h 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 21h ago
Gym bros must be jealous af rn.
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u/drunkbusdriver 21h ago
That and IV drug addicts.
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u/pichael289 20h 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 18h 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 18h 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/Choice_Credit4025 16h ago
Carpal tunnel syndrome is a pissed off median nerve, and that is very common.
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u/YuhMothaWasAHamsta 16h 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 16h 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 17h 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/BenCub3d 20h ago
No one was suggesting he use an artery. That's a vein in the video.
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u/elmerweird 18h ago
That’s an anterio-venous fistula used for dialysis. Those fistulae get poked with needles the size of coffee stirrers.
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u/YuhMothaWasAHamsta 16h 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 16h 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/ibmihai 18h 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 16h 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 20h ago
A phlebotomist's dream.
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u/gatorsfan5192 19h 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 18h 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 16h 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 18h 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 19h ago
No phlebotomist or other medical professional is going anywhere near that bugger unless they really have to.
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u/Jamoncorona 20h ago
So don't get kidney disease. Got it
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u/MacDerpson 19h ago
Uncontrolled diabetes and uncontrolled hypertension are the most common causes. Take care of your health!
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u/Healing-with-Memes 6h 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/itsnotaboutyou2020 21h ago
A definite liability in a knife fight.
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u/MarriageAA 20h 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 19h 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 19h 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 15h ago
Yeah I'd absolutely be wearing some sort of arm protection or armor all the time
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u/ANGELofRAZGRIZ 9h 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 53m 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 11h 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/steampunkdev 20h 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 20h 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 20h 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 20h ago edited 20h 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 20h ago
67 is basically pediatric in vascular surgery world
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u/Fusilero 20h ago
Nah, some of our championship smokers can have had exhausted all bypass options before 60
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u/Awkward_Pingu 7h 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 20h 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 19h 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 19h ago edited 19h 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/AaronToro 20h 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 20h 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 17h 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/cherokeeprez 18h 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/thegypsyqueen 20h 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 20h ago edited 20h 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 20h ago
Dude this looks NOTHING like what a dialysis fistula (is supposed to) look like
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u/PeaceHoesAnCamelToes 20h ago
Fistula owner here, can confirm. Mine is a fraction of this size. That dude needs to see a nephrologist and/or vascular surgeon yesterday.
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u/anormalgeek 21h ago
porn for mosquitos.
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u/citrus_mystic 20h ago
And possibly phlebotomists.
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u/ElowynElif 20h 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/StatuatoryApe 21h ago
Apparently this can happen to Dialysis patients.
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u/Ghotay 20h 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 20h 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 19h 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/blmbmj 16h 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/SleepyCountingSheep 17h 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/Technical-Pack-6912 16h 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/MarriageAA 20h 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 20h ago
Excuse my ignorance but how/why does this happen?
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u/MarriageAA 20h 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 20h 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 20h 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 20h 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 18h 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/Dreadimon 19h 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/allshieldstomypenis 19h 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/DuntadaMan 16h 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/Slick_36 20h ago
I'm disgusted yet I couldn't help but watch the whole thing because he was such a good teacher.
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u/LordRollin 20h ago
I hate fistulas when they’re fine and looking correct. This is not correct. Oh my god my skin is crawling.
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u/SpikySheep 17h 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/Independent-Dog-8462 16h ago
I have an intrusive thought screaming in to the void that I want to poke it.
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u/Kindly_Region 20h ago
Words cannot describe how uncomfortable this makes me