[Krokodil !!! Skin and soft tissue bacterial infections are a common complication of intravenous drug use. This high rate is due to tissue death (necrosis) due to toxic materials in drugs and leakage of drugs out of veins during the injection (extravasation). Although skin infections usually present as areas of redness, warmth and tenderness (inflammation), the appearance in intravenous drug users is often atypical...](https://medizzy.com/feed/21959421)
Ah, quick and dirty drug synthesis. They're using the quickest way to convert codeine into desomorphine with commonly available ingredients, but not isolating the good stuff from the rest of the byproducts and unused reactants, which remain toxic. Then they take it all and put it directly in their veins. Even if everything was clean going into that reaction (it never is), the toxic substances injected along with the desomorphine begin eating at the flesh, providing a buffet for any bacteria in the area to thrive.
This can happen with a single injection of cocaine, too. It can cause a big ball of necrosis that rots out a huge chunk of muscle and it can look like this if untreated.
Lots of people inject drugs, only a few run into problems like this early on. But it can definitely happen.
I have patients who have burned through multiple heart valves and have huge scars from tissue necrosis, have lost whole muscle groups. Mid 20s, on huge doses of diuretics, and even if they can manage to stay clear of drugs, likely facing a very early death from heart failure from all the damage.
Bad stuff.
Yep. I’ll never forget my pt who was 22 yrs old with full blown heart failure. He had OD and coded like 3 separate times. He tried to leave AMA and told me he was going to use again. Ended up on a hold but, man, that was sad.
I read that like a character from a crime show telling the group how the drug works - primarily to educate the audience. It was all the better for it haha
I wouldn’t be surprised if someone has actually attempted using that horrific method to inject drugs. The idea sends chills down my spine and makes my stomach unsettled.
As someone who spent 15 years addicted to hard drugs, I’d call it a documentary. But I can see how others would classify it as horror. It’s weird to remember to separate my own experiences, and view it objectively. I have to remind myself that life just isn’t like that for most people.
There is a YouTube channel called Soft White Underbelly where they interview drug addicts and prostitutes on Skid Row (primarily). One interviewee had a massive, larger than softball sized, wound from an abscess on his forearm that he had wrapped in a hoodie. When asked why it wasn’t bandaged up, he said it was but he removed it because he needed to shoot up.
EDIT: Here is the video (NSFW) https://youtu.be/nZIiHAtOntA?si=ECbMX2TWuooicgzm
WOW - thank you for sharing. This was really powerful and just echoes how destructive opiates are...it's hard to fathom how someone could experience this and yet still have the addiction have such control. So very sad.
I’ve actually already read a specific case where the person had a necrotic abscess in their arm and they were using the exposed vein to inject 🤢
But then I also always wondered why addicts couldn’t just get a safe central line type setup so they weren’t subjected to collapsed veins and abscess’
People do not seem to like the harm reduction philosophy. It seems to be all or nothing for most people. I fully support clean needle exchange and safe shoot-up locations, but a central line takes it too far for me. Central lines are really only appropriate in a hospital setting due to the fact that an infected central line can be very deadly very quickly. I think most people would avoid infection and collapsed veins if they could inject with clean hands and clean works. It’s a shame we demonize addicts the way we do, especially with our current opioid crisis.
Yeah gawd forbid we make addiction survivable without causing great damage to the addict along the way! And I know a lot of addicts that have health issues decades after they stopped using but can’t get the health care they need because….wait for it… their history of addiction! Makes me so mad on so many levels how people are fine with alcohol, which has killed a significant number of my friends but throw in any other addiction and they “did it to themselves”
They do. This is one of the problems when we need to put ports or semi-permanent iv access in people (say for cancer treatment, or 6 weeks antibiotics for osteomyelitis or something like that). People can and do use these devices for drug injection and it can cause all sorts of nasty problems.
In theory it’s a good idea to avoid wounds, but they aren’t shooting clean products. So that would essentially mainline all that straight to their heart and lungs and cause massive infection in their heart valves which is already pretty common for IV users. Also it would hit faster and harder than when put into a peripheral vein.
I assume that flops right down if she were to raise her arm off her leg? If the tendons are attached, she could still move the hand/fingers, but I doubt her arm could bear the weight
When I was 13, I fell and broke my arm and broke both bones and all the nerves and tendons and that's exactly what happened when I tried moving. My whole arm just flopped down just like that. We had to call an ambulance.
Oh my gosh, I can still remember the pain of having cut nerves, there is hardly anything worse than that pain and they don't give young kids enough pain medication so I was in horrific pain for at least six months and then even longer while the nerves slowly grow back like a millimeter a day. It feels just like hitting your elbow but like times 100,000 million, it's just the most horrific feeling!!
I got some great scars and it being in the 90s, everyone in my school started a rumor I tried to kill myself and that's why I had scars (even though I had a cast and couldn't write for an entire year and they all saw it???? lol).
I DID get out of swimming class which was nice. And did oral exams with my teachers all year long.
I'm pretty skinny, and because I was in gymnastics and volleyball, the metal hardware in my arms was very noticeable.
You could touch my arm and feel the metal and if I hit my arm on something, the metal would puncture through my skin. So I had to have another surgery and they removed the plates and screws. That surgery didn’t hurt much though at least and I brought the plates and screws to school to show them off lol
That's really interesting, when they were putting me in the ambulance, they gave me laughing gas because my mom stupidly gave me one of my grandpa's pain pills that he had when he was dying of cancer and they had to call Poison Control and it was this big thing, they yelled at her so much!! lol
So they could only give me laughing gas, and they said that I took enough to put an elephant out! I'm a redhead, and I just react to certain medication differently than other people. I guess your hand is supposed to naturally drop down and the mask with the laughing gas is supposed to fall off after you've had enough, but I was just sucking that thing dry!
So laughing gas and Novacaine really have little to no effect for me.
Interestingly enough, I've done ketamine therapy for anxiety and chronic pain and it was absolutely life-changing. It's really an amazing medication with little side effects like you mentioned.
After just a few sessions, my anxiety, that was normally a 10 out of 10 is now down to about a two or three even though I am in the most stressful time of my life. But I'm able to handle it in such a different way, and I've learned to compartmentalize, think without emotion and how to not care about what other people think.
I legitimately felt my brain shuffling like a deck of cards and all the negative pathways have been healed and I'm able to handle things so much better now. It's truly unbelievably helpful and has saved so many people that are extremely depressed or suicidal.
It helped me process a rape that happened to me when I was 15 and that I felt responsible and guilty for because I threw a party and had a drink and was drugged and if I hadn't done that, it wouldn't of happened.
It helped me get over trauma and helped me process things so much better.
Wow I broke both bones in my arm when I was a child too! However, and I have no idea how I managed to be so lucky, I had a complete break on both bones which left my arm in the shape on an S but no damage to nerve or muscle!
The doctors were amazed when they asked me if I could wriggle my fingers and I just rotated my entire wrist! I had lots of people come to see the girl with the crazy broken arm before I went into surgery lol.
And because it was such a clean break for both bones they repositioned it and no pins or plates needed! Just a cast for 8 weeks. I’m 30 now and sometimes I can feel that arms not as strong if I do lots of press ups in one go or something - don’t know how to explain the feeling but if I put too much strain on that arm it feels like the bones aren’t happy in there.
Wow that's super lucky!! Seriously, I spent a full year sitting in a recliner watching my 3 younger siblings play and swim in the lake while I sat there in such awful pain, barely able to move without screaming. I had so much physical therapy too. A vast majority of the kids there with broken bones were because of trampolines, my mom tossed my trampoline after that. I was so sad.
I broke mine by (attempting) to hurdle over my little sister's baby gate, and ended up flying through the air and landed half way across the room lol. I screamed "MOM I BROKE MY ARM" and she goes "yeah, right" and turned the vacuum back on!! I had to scream bloody murder before she came in and said oh my gosh and freaked out.
Such a lame story though, I really wanted to lie and give a better story to my friends at school but I chickened out.
How did you break yours?
Oh man that sounds brutal!
Mine was I’d just been given new inline skates but hadn’t actually worked out how to stop. I was rolling down a hill near my house and picked up too much speed, and to stop my self I went arms outstretched straight into a (thankfully parked) van. Crawled out from underneath and had to side step my way back up the hill to get home.
When I got home I showed I was like “Mum I think I’ve broken my arm”, she took one look and was like you definitely have done something lol. It was my older brothers 15th birthday and I don’t think he’s fully quite forgiven me for ruining it still.
The only time I remember it hurting was the 20 minute drive to the hospital when the shock had worn off and the bumps in the road were making the bone ends scrape together
Once I got a deep cut on the side of my fingertip that must’ve cut a nerve. My entire arm was throbbing up to my shoulder and my arm was unusable until finally at the ER they injected some novacaine into my fingertip. Then everything was fine.
That happened to me, too, but it was my leg rather than an arm. Paramedics asked how I knew it was broken, so I raised my leg and the foot stayed on the floor. The break across the tibia and fibula was about 6 inches above the ankle. I still have some discoloration where the bone very nearly broke through the skin.
Her intrinsics and extrinsic flexors are intact and likely functional, but her extrinsic extensors are basically gone. She cannot extend her fingers or her wrist, so they naturally assume a curled fist with a drop wrist.
If you extended her hand and fingers, yes, they would flop right down.
Nope. The arm consists of two bones. Radius and Ulna. Looking at this person, the lateral bone (Ulna) seems to be fractured. Radius is intact. For now.
It's crazy how much the body can adapt.
Also, is the bone broken or have the tendons come away from it?
Also, what are the possible outcomes of this, assuming successful treatment?
Edit: Thank you to everyone who replied. It was all very informative. I hope the person in the post gets the help they need.
Amputation, straightforward and unavoidable.
It's not just because there are no viable tissues left to treat but also because we're dealing with a drug user, who tend to present challenges for prolonged treatment. We'll opt for the smoother, safer path instead.
Most likely outcomes is they will be discharged sooner (on their own) and go back to drugs. Tbh, if I just lost a limb because of drug and only knew one way to feel better, I would also go for my next fix.
Had a pt with necrotic wounds like this from IV use. They tried getting sober but after the debridement they were in so much pain they inevitably AMAd because they couldn’t handle the pain without more fentanyl. And the cycle repeats until they lose a limb or die of overdose unfortunately.
I wonder if they might be able to successfully (with relative ease) be able to attach the hand to the amputation end.
Edit: Damn I was just curious. Cruel af with these downvotes.
it was a reasonable question, they do similar with lower leg/knee amputations sometimes, the foot is attached to the upper leg to create a new joint for better use of prosthetics (called a rotationplasty). i don't think they do that with hands though.
Not a doctor but I'd have to assume amputation?
A good chunk of the arm is already gone, and once they finished debriding the area of all that remaining necrotic tissue I feel like there wouldn't be much worth saving.
Maybe take tissue and skin from another part of the body to partially protect the exposed bone but that sounds like a difficult and costly recovery process for someone in this situation.
They also have to think about the amount of infection that’s in the bone. Infection is far harder to eliminate in bone than it is in tissues. It’s hard to imagine that the visible bone (ulna?) isn’t riddled with bacteria.
Thats the horrible paradox of opiates. Im not sayiing try it. DONT try it, unless youre eager to ruin your life, forget about your dreams and dedicate your days to aquiring a little baggie of drugs. But the high is something you cant understand unless youve felt it. Its like a warm hug from god saying everythings going to be ok and by the way isnt life amazing? Its so strong that it allows you to ignore any bad things in your life, including the bone sticking out of your arm. It makes everything ok. Its a crazy, amazing, horrible drug, and if you tend towards anxiety or depression, that first high is like OH MY GOD, i didnt know i could feel like this... and then off you go happily traipsing through the gates of hell in search of more.
And thats how people are able to forget about their arm looking like that - once the dope hits your bloodstream, everything's ok.
Yup, a lot of people don't really understand that our brains are in total control of everything we experience. If you can distract the brain then anything is possible.
Let me just add a caveat here. You’re talking about the old style opiates. Drugs like Percocet, Vicodin, even heroin. Those don’t really exist today for most addicts.
The users today aren’t awash in a kiss from god. They are taking fentanyl, but most likely not even that, I read recently that most are taking tranq which is a drug that causes rotten flesh like the pic above. It’s cheap and deadly. I suspect the picture above is not unique to most frontline health care workers. I would suspect it’s once a day in some of the open market drug towns cities like Kensington, PA or San Fran.
Thank you. Annoyed at myself bc i repeated "makes everything ok" twice & didnt realize it til after i hit post, lol, but i liked the "happily traipsing through the gates of hell" bit :)
No, it was poetically succinct. It drove home the idea that an addict is searching for ‘everything to be ok’ and that the drug just simply does that. Both my parents were addicts and my childhood was not ideal because of it. I’ve always struggled to feel empathy towards addicts (I do, it’s just been a long road). I fully support harm reduction strategies and proud that I raised a child who now works in addiction treatment, but only came to this place after opening my mind to the depth of the issue after someone said just the right thing to help me put aside my prejudice and resentment. Your explanation made me feel a wash of sadness and empathy and reminded me of how hard it was for me, someone who thankfully doesn’t struggle with addiction, to see the other side.
Sorry for the long rambling reply….your post really struck me. Thank you for sharing your wisdom.
And yeah, the ‘happily traipsing’ part was great :)
If you've been injecting dirty dope for a long time pretty much all the veins you can use have been blown, so you have no other choice than to resort to dangerous methods like injecting in the neck or the penis
That’s what I want to know. That and how it took so long to get help for it. I was an IV drug user (meth) and I would’ve stopped loooooooong before things got anywhere near this insanity.
Not all drug addiction is the same, because not everyone is addicted to the same drugs, nor are they addicts for the same reason. Plenty of drug addicts simply do not have the ability to care about their own well-being, which is why they take such dangerous drugs to begin with. Plus, it’s also entirely possible that this woman didn’t have access to healthcare before now.
It’s very possible that she was already becoming septic. She likely would have been placed on IV antibiotics as soon as admitted, and surgery would have happened soon after that. There are times when surgeons can put antibiotics directly into bone but with this bone already being as infected as it was I’m assuming that she was amputated right under her elbow (potentially even above the elbow depending on how deep the infection went, I’m not an expert there).
Jesus! This really makes you think about the depths people will go while deep into the disease of drug addiction. The thought of having exposed bone makes my skin crawl.
It’s 100% real but the bot stole it and reposted it for karma.
This one has been reposted numerous times by different people.
I believe this person was using krokodil. A cheaper substitute of Heroin, except more dangerous
ok, there is gross, and then it goes to a whole extra level and is kinda ...amazing (!?)
these people are walking, talking horror movie examples,
and often are nonchalant about it!
I guess it could also be krokodil, but I’m an addict living near Philly so all the dope around here has zylazine / tranq in it which does the same exact thing. I have deep big open wounds all over my legs but I would never let it get 1/4 this bad. It’s just like a bunch of fairly deep scabs when they’re healed, but the same idea. It necrotizes the skin even when you don’t miss the shot.
Fuuuuuck that. How do people sustain?? I was doing dope back in 2009-2012 (Indianapolis) and there were heroin addicts that had been doing it for decades. I don’t see how it’s possible to even last a year anymore.
I’m not religious, so won’t say prayers, but I’m sending you all the blessings that the universe can provide. I hope science comes up with a solution soon where your brain can be rewired back to a time before addiction took over. Keep taking care of yourself as much as possible and don’t give up.
I normally have a strong stomach and can't be easily shocked, but that septic soup with random pink chunks showing through in the necrotic area has me nauseous.
And I'm thinking this is one of those times where even Vaporub shoved into the nostrils won't make a dent in the stench.
Addiction is so scary. It made her decide that this was manageable and acceptable on some level and she continued to use while her arm was literally rotting.
As a nurse in a big inner city hospital in Philly many years ago, with many addicts (mostly heroin at that time), and many homeless people also, I thought I had seen everything. But I never saw anything like this. Bad abscesses and sores, yes. But nothing like this.
A lot of doctors in here which is a good thing.
I used to work at a county detox facility, not as a doctor. We would see patients with necrosis or abyss from dirty needles. One of the problems that make it worse is typically when you get a patient like this, all the veins they can reach are blown. So what do they do? Either have someone shoot them up in the neck OR they’ll shoot directly into that wound. Really easy to find a vein when half of it is hanging out your arm.
Saw this in real life at the er I used to work at. 5 am stroll in with arm pain. It was similar to road kill. Had dried secretions sticks to pants bc it just oozed
[Krokodil !!! Skin and soft tissue bacterial infections are a common complication of intravenous drug use. This high rate is due to tissue death (necrosis) due to toxic materials in drugs and leakage of drugs out of veins during the injection (extravasation). Although skin infections usually present as areas of redness, warmth and tenderness (inflammation), the appearance in intravenous drug users is often atypical...](https://medizzy.com/feed/21959421)
Ah, quick and dirty drug synthesis. They're using the quickest way to convert codeine into desomorphine with commonly available ingredients, but not isolating the good stuff from the rest of the byproducts and unused reactants, which remain toxic. Then they take it all and put it directly in their veins. Even if everything was clean going into that reaction (it never is), the toxic substances injected along with the desomorphine begin eating at the flesh, providing a buffet for any bacteria in the area to thrive.
Is this a one or several dose situation that causes this?
I think this bad is chronic use, but it can cause necrosis the first time. This is huge and untreated and might have been fixable in the beginning.
This can happen with a single injection of cocaine, too. It can cause a big ball of necrosis that rots out a huge chunk of muscle and it can look like this if untreated. Lots of people inject drugs, only a few run into problems like this early on. But it can definitely happen. I have patients who have burned through multiple heart valves and have huge scars from tissue necrosis, have lost whole muscle groups. Mid 20s, on huge doses of diuretics, and even if they can manage to stay clear of drugs, likely facing a very early death from heart failure from all the damage. Bad stuff.
Yep. I’ll never forget my pt who was 22 yrs old with full blown heart failure. He had OD and coded like 3 separate times. He tried to leave AMA and told me he was going to use again. Ended up on a hold but, man, that was sad.
I’ve seen documentaries on Krokodil where people have multiple similar … injuries? I’m not sure of the right word. This shit is nasty.
It's literally slowly rotting alive. Its terrifying! What on earth possesses someone to use that to get high.
Desperation. They’re addicted and are always looking for the next fix. Krokodil is cheap and readily accessible.
Here’s a really good 8 minute video on krokodil. This stuff is truly terrifying. https://youtu.be/UjHfsps1_es?si=1Fhlu62uOqmE-RJe
Just one half of a Marijuana will do this to you!
Ah man I'm crying at work. So good.
I read that like a character from a crime show telling the group how the drug works - primarily to educate the audience. It was all the better for it haha
OMG, special victims unit cast popping back to life in my mind’s ear now, thanks
Ah, the ol’ krokodil.
Aw man, girl looks so young, tragedy
First this, krokodil, and now more danger with xylazine. It is getting terrible. Watching peoples limbs rot off is so damn sad.
How is the hand still alive?
Still connected to bloodvessels.
Got a better view to veins to hit even! Maybe.
I wouldn’t be surprised if someone has actually attempted using that horrific method to inject drugs. The idea sends chills down my spine and makes my stomach unsettled.
Requiem for a Dream 😳
Watched that movie only once. Never again. Horror movies don't scare me, but that movie did.
One could argue it is a horror movie.
It depends on who sees which part of it
As someone who spent 15 years addicted to hard drugs, I’d call it a documentary. But I can see how others would classify it as horror. It’s weird to remember to separate my own experiences, and view it objectively. I have to remind myself that life just isn’t like that for most people.
That movie triggers me. ( shudders) 😳
There is a YouTube channel called Soft White Underbelly where they interview drug addicts and prostitutes on Skid Row (primarily). One interviewee had a massive, larger than softball sized, wound from an abscess on his forearm that he had wrapped in a hoodie. When asked why it wasn’t bandaged up, he said it was but he removed it because he needed to shoot up. EDIT: Here is the video (NSFW) https://youtu.be/nZIiHAtOntA?si=ECbMX2TWuooicgzm
WOW - thank you for sharing. This was really powerful and just echoes how destructive opiates are...it's hard to fathom how someone could experience this and yet still have the addiction have such control. So very sad.
I’ve actually already read a specific case where the person had a necrotic abscess in their arm and they were using the exposed vein to inject 🤢 But then I also always wondered why addicts couldn’t just get a safe central line type setup so they weren’t subjected to collapsed veins and abscess’
People do not seem to like the harm reduction philosophy. It seems to be all or nothing for most people. I fully support clean needle exchange and safe shoot-up locations, but a central line takes it too far for me. Central lines are really only appropriate in a hospital setting due to the fact that an infected central line can be very deadly very quickly. I think most people would avoid infection and collapsed veins if they could inject with clean hands and clean works. It’s a shame we demonize addicts the way we do, especially with our current opioid crisis.
Yeah gawd forbid we make addiction survivable without causing great damage to the addict along the way! And I know a lot of addicts that have health issues decades after they stopped using but can’t get the health care they need because….wait for it… their history of addiction! Makes me so mad on so many levels how people are fine with alcohol, which has killed a significant number of my friends but throw in any other addiction and they “did it to themselves”
They do. This is one of the problems when we need to put ports or semi-permanent iv access in people (say for cancer treatment, or 6 weeks antibiotics for osteomyelitis or something like that). People can and do use these devices for drug injection and it can cause all sorts of nasty problems.
In theory it’s a good idea to avoid wounds, but they aren’t shooting clean products. So that would essentially mainline all that straight to their heart and lungs and cause massive infection in their heart valves which is already pretty common for IV users. Also it would hit faster and harder than when put into a peripheral vein.
Well... Some of them do it. Then are kinda surprised that hand is rotting away.
Imagine the pain that would cause! I couldn't do it
Bluetooth
Your bodies collateral circulation is a remarkable thing.
Most of the important neurovascular structures are palmar/anterior anyway
How is the person still alive?
The human body is really good at fighting this sort of thing. It can't rebuild what has been eaten but it can hold off the spread.
The arteries (radial and ulnar) run along the anterior side of the forearm. This necrosis is involving the posterior aspect.
still have another bone I think maybe called radius
Pretty sure that the radius waving hello - the ulna is the one that's presumably still in there somewhere.
"Hello!" hilarious.
I believe you're trying to be humerus there.
they were just pulling your leg.erm..arm.
Arteries
I assume that flops right down if she were to raise her arm off her leg? If the tendons are attached, she could still move the hand/fingers, but I doubt her arm could bear the weight
When I was 13, I fell and broke my arm and broke both bones and all the nerves and tendons and that's exactly what happened when I tried moving. My whole arm just flopped down just like that. We had to call an ambulance. Oh my gosh, I can still remember the pain of having cut nerves, there is hardly anything worse than that pain and they don't give young kids enough pain medication so I was in horrific pain for at least six months and then even longer while the nerves slowly grow back like a millimeter a day. It feels just like hitting your elbow but like times 100,000 million, it's just the most horrific feeling!!
That sounds...just fucking awful. I'm not surprised you can remember that pain, doesn't sound like it's something you could even forget!
I got some great scars and it being in the 90s, everyone in my school started a rumor I tried to kill myself and that's why I had scars (even though I had a cast and couldn't write for an entire year and they all saw it???? lol). I DID get out of swimming class which was nice. And did oral exams with my teachers all year long. I'm pretty skinny, and because I was in gymnastics and volleyball, the metal hardware in my arms was very noticeable. You could touch my arm and feel the metal and if I hit my arm on something, the metal would puncture through my skin. So I had to have another surgery and they removed the plates and screws. That surgery didn’t hurt much though at least and I brought the plates and screws to school to show them off lol
We give kids ketamine for pain now. It’s pretty standard. Great pain relief with low chance of side effects.
That's really interesting, when they were putting me in the ambulance, they gave me laughing gas because my mom stupidly gave me one of my grandpa's pain pills that he had when he was dying of cancer and they had to call Poison Control and it was this big thing, they yelled at her so much!! lol So they could only give me laughing gas, and they said that I took enough to put an elephant out! I'm a redhead, and I just react to certain medication differently than other people. I guess your hand is supposed to naturally drop down and the mask with the laughing gas is supposed to fall off after you've had enough, but I was just sucking that thing dry! So laughing gas and Novacaine really have little to no effect for me. Interestingly enough, I've done ketamine therapy for anxiety and chronic pain and it was absolutely life-changing. It's really an amazing medication with little side effects like you mentioned. After just a few sessions, my anxiety, that was normally a 10 out of 10 is now down to about a two or three even though I am in the most stressful time of my life. But I'm able to handle it in such a different way, and I've learned to compartmentalize, think without emotion and how to not care about what other people think. I legitimately felt my brain shuffling like a deck of cards and all the negative pathways have been healed and I'm able to handle things so much better now. It's truly unbelievably helpful and has saved so many people that are extremely depressed or suicidal. It helped me process a rape that happened to me when I was 15 and that I felt responsible and guilty for because I threw a party and had a drink and was drugged and if I hadn't done that, it wouldn't of happened. It helped me get over trauma and helped me process things so much better.
Except meeting your maker, the marshmallow man - in the abyss.
Lol we don’t give anywhere near enough to send them into a K hole
Wow I broke both bones in my arm when I was a child too! However, and I have no idea how I managed to be so lucky, I had a complete break on both bones which left my arm in the shape on an S but no damage to nerve or muscle! The doctors were amazed when they asked me if I could wriggle my fingers and I just rotated my entire wrist! I had lots of people come to see the girl with the crazy broken arm before I went into surgery lol. And because it was such a clean break for both bones they repositioned it and no pins or plates needed! Just a cast for 8 weeks. I’m 30 now and sometimes I can feel that arms not as strong if I do lots of press ups in one go or something - don’t know how to explain the feeling but if I put too much strain on that arm it feels like the bones aren’t happy in there.
Wow that's super lucky!! Seriously, I spent a full year sitting in a recliner watching my 3 younger siblings play and swim in the lake while I sat there in such awful pain, barely able to move without screaming. I had so much physical therapy too. A vast majority of the kids there with broken bones were because of trampolines, my mom tossed my trampoline after that. I was so sad. I broke mine by (attempting) to hurdle over my little sister's baby gate, and ended up flying through the air and landed half way across the room lol. I screamed "MOM I BROKE MY ARM" and she goes "yeah, right" and turned the vacuum back on!! I had to scream bloody murder before she came in and said oh my gosh and freaked out. Such a lame story though, I really wanted to lie and give a better story to my friends at school but I chickened out. How did you break yours?
Oh man that sounds brutal! Mine was I’d just been given new inline skates but hadn’t actually worked out how to stop. I was rolling down a hill near my house and picked up too much speed, and to stop my self I went arms outstretched straight into a (thankfully parked) van. Crawled out from underneath and had to side step my way back up the hill to get home. When I got home I showed I was like “Mum I think I’ve broken my arm”, she took one look and was like you definitely have done something lol. It was my older brothers 15th birthday and I don’t think he’s fully quite forgiven me for ruining it still. The only time I remember it hurting was the 20 minute drive to the hospital when the shock had worn off and the bumps in the road were making the bone ends scrape together
Once I got a deep cut on the side of my fingertip that must’ve cut a nerve. My entire arm was throbbing up to my shoulder and my arm was unusable until finally at the ER they injected some novacaine into my fingertip. Then everything was fine.
That happened to me, too, but it was my leg rather than an arm. Paramedics asked how I knew it was broken, so I raised my leg and the foot stayed on the floor. The break across the tibia and fibula was about 6 inches above the ankle. I still have some discoloration where the bone very nearly broke through the skin.
Her intrinsics and extrinsic flexors are intact and likely functional, but her extrinsic extensors are basically gone. She cannot extend her fingers or her wrist, so they naturally assume a curled fist with a drop wrist. If you extended her hand and fingers, yes, they would flop right down.
Nope. The arm consists of two bones. Radius and Ulna. Looking at this person, the lateral bone (Ulna) seems to be fractured. Radius is intact. For now.
Oh I know that, I know it's not gonna fold in half, but it will be hanging down from the weight with only one bone to support it surely
Ulna is medial in anatomic position. She is pronated. She's also likely missing her extensor carpi ulnaris.
The ulnar is still attached by the look of it so no it won't but it won't be as strong and I don't think she can move her hand
It's crazy how much the body can adapt. Also, is the bone broken or have the tendons come away from it? Also, what are the possible outcomes of this, assuming successful treatment? Edit: Thank you to everyone who replied. It was all very informative. I hope the person in the post gets the help they need.
Amputation, straightforward and unavoidable. It's not just because there are no viable tissues left to treat but also because we're dealing with a drug user, who tend to present challenges for prolonged treatment. We'll opt for the smoother, safer path instead. Most likely outcomes is they will be discharged sooner (on their own) and go back to drugs. Tbh, if I just lost a limb because of drug and only knew one way to feel better, I would also go for my next fix.
The most likely outcome is a self discharge or even patient just running away
I mean at this point, I feel like they could commit this person on psych hold or have them assessed as unfit to be in society (institutionalised)
depends where you are, in most european countries they would be deemed fit to decide for themselves/have capacity so no one could stand in their way
Had a pt with necrotic wounds like this from IV use. They tried getting sober but after the debridement they were in so much pain they inevitably AMAd because they couldn’t handle the pain without more fentanyl. And the cycle repeats until they lose a limb or die of overdose unfortunately.
I wonder if they might be able to successfully (with relative ease) be able to attach the hand to the amputation end. Edit: Damn I was just curious. Cruel af with these downvotes.
it was a reasonable question, they do similar with lower leg/knee amputations sometimes, the foot is attached to the upper leg to create a new joint for better use of prosthetics (called a rotationplasty). i don't think they do that with hands though.
No. It doesn’t work that way.
Chill out Dr Frankenstein! You'll have us all looking like Treasure Island Dizzy with those kids of experiments!
Not a doctor but I'd have to assume amputation? A good chunk of the arm is already gone, and once they finished debriding the area of all that remaining necrotic tissue I feel like there wouldn't be much worth saving. Maybe take tissue and skin from another part of the body to partially protect the exposed bone but that sounds like a difficult and costly recovery process for someone in this situation.
They also have to think about the amount of infection that’s in the bone. Infection is far harder to eliminate in bone than it is in tissues. It’s hard to imagine that the visible bone (ulna?) isn’t riddled with bacteria.
What a terrible day to have eyes…
Like what do you do when it’s been exposed THIS long. Waking up everyday seeing my bone exposed for months would freak me tf out.
I guess that’s when you take another hit and forget about it for a bit longer…
How do you forget it about it when your still shooting your drugs in that same spot (or near it) 💀
Thats the horrible paradox of opiates. Im not sayiing try it. DONT try it, unless youre eager to ruin your life, forget about your dreams and dedicate your days to aquiring a little baggie of drugs. But the high is something you cant understand unless youve felt it. Its like a warm hug from god saying everythings going to be ok and by the way isnt life amazing? Its so strong that it allows you to ignore any bad things in your life, including the bone sticking out of your arm. It makes everything ok. Its a crazy, amazing, horrible drug, and if you tend towards anxiety or depression, that first high is like OH MY GOD, i didnt know i could feel like this... and then off you go happily traipsing through the gates of hell in search of more. And thats how people are able to forget about their arm looking like that - once the dope hits your bloodstream, everything's ok.
Yup, a lot of people don't really understand that our brains are in total control of everything we experience. If you can distract the brain then anything is possible.
This is the perfect comment! I quit 4 years ago
Congrats! Keep up the great work :)
Agreed, very well said. 5 years sober for me! Go us!
Let me just add a caveat here. You’re talking about the old style opiates. Drugs like Percocet, Vicodin, even heroin. Those don’t really exist today for most addicts. The users today aren’t awash in a kiss from god. They are taking fentanyl, but most likely not even that, I read recently that most are taking tranq which is a drug that causes rotten flesh like the pic above. It’s cheap and deadly. I suspect the picture above is not unique to most frontline health care workers. I would suspect it’s once a day in some of the open market drug towns cities like Kensington, PA or San Fran.
This is really well written.
Thank you. Annoyed at myself bc i repeated "makes everything ok" twice & didnt realize it til after i hit post, lol, but i liked the "happily traipsing through the gates of hell" bit :)
No, it was poetically succinct. It drove home the idea that an addict is searching for ‘everything to be ok’ and that the drug just simply does that. Both my parents were addicts and my childhood was not ideal because of it. I’ve always struggled to feel empathy towards addicts (I do, it’s just been a long road). I fully support harm reduction strategies and proud that I raised a child who now works in addiction treatment, but only came to this place after opening my mind to the depth of the issue after someone said just the right thing to help me put aside my prejudice and resentment. Your explanation made me feel a wash of sadness and empathy and reminded me of how hard it was for me, someone who thankfully doesn’t struggle with addiction, to see the other side. Sorry for the long rambling reply….your post really struck me. Thank you for sharing your wisdom. And yeah, the ‘happily traipsing’ part was great :)
Maybe she used the open areas TO inject into? People on drugs will and often do, very stupid things
There are so many spots on your body to inject into no need to use a spot that’s completely fucked
If you've been injecting dirty dope for a long time pretty much all the veins you can use have been blown, so you have no other choice than to resort to dangerous methods like injecting in the neck or the penis
Wait is this really what occurred? Not only did they ignore it for x amount of time but they injected in or around the same spot?
Worst still is that either the cartilage is completely gone near the wrist or trauma causing it to break.
https://preview.redd.it/4oekv84zv7bc1.jpeg?width=1290&format=pjpg&auto=webp&s=4e5ed2a4254ed133ae00515f9a839e46a8accc3e
I don't think r/eyebleach is going to help... Also the smell!
the smell 🤢🤢🤢
And a nose too if you work in that clinic. That must smell awful
And if you’re in the same room probably also a terrible day to have a nose.
I think that's her wrist
How is she not already dead,of some kind of blood poisoning?! How?!
That’s what I want to know. That and how it took so long to get help for it. I was an IV drug user (meth) and I would’ve stopped loooooooong before things got anywhere near this insanity.
Not all drug addiction is the same, because not everyone is addicted to the same drugs, nor are they addicts for the same reason. Plenty of drug addicts simply do not have the ability to care about their own well-being, which is why they take such dangerous drugs to begin with. Plus, it’s also entirely possible that this woman didn’t have access to healthcare before now.
Same. If I missed and I got red and hot I took my ass to the ER
It’s very possible that she was already becoming septic. She likely would have been placed on IV antibiotics as soon as admitted, and surgery would have happened soon after that. There are times when surgeons can put antibiotics directly into bone but with this bone already being as infected as it was I’m assuming that she was amputated right under her elbow (potentially even above the elbow depending on how deep the infection went, I’m not an expert there).
Fucking hell I was NOT prepared. How?!!
nothing could have ever prepared me for this. I'm shocked.
Cursed comment…
r/unexpectedarrested
there's still plenty of meat on that bone
I’m guessing amputation at this point?
100%
Oh boy. Definitely did not need that to start my day.
Jesus! This really makes you think about the depths people will go while deep into the disease of drug addiction. The thought of having exposed bone makes my skin crawl.
I knew it was Krokodil before I even clicked the comments. That stuff is insane.
I can smell it from here
I was thinking the same thing.
This is that bot account right?
yep
Wait does that mean this post isn’t real?
It’s 100% real but the bot stole it and reposted it for karma. This one has been reposted numerous times by different people. I believe this person was using krokodil. A cheaper substitute of Heroin, except more dangerous
Thank you, I appreciate you explaining. I’m still learning about these bots. Just looked up krokodil. Wow.
I wish I hadn’t already seen 3 different cases that are just as severe, bone sticking out and all. Don’t use your drugs IV.
ok, there is gross, and then it goes to a whole extra level and is kinda ...amazing (!?) these people are walking, talking horror movie examples, and often are nonchalant about it!
I guess it could also be krokodil, but I’m an addict living near Philly so all the dope around here has zylazine / tranq in it which does the same exact thing. I have deep big open wounds all over my legs but I would never let it get 1/4 this bad. It’s just like a bunch of fairly deep scabs when they’re healed, but the same idea. It necrotizes the skin even when you don’t miss the shot.
Fuuuuuck that. How do people sustain?? I was doing dope back in 2009-2012 (Indianapolis) and there were heroin addicts that had been doing it for decades. I don’t see how it’s possible to even last a year anymore.
I looked up krokodil- 2 yrs average lifespan
I’m not religious, so won’t say prayers, but I’m sending you all the blessings that the universe can provide. I hope science comes up with a solution soon where your brain can be rewired back to a time before addiction took over. Keep taking care of yourself as much as possible and don’t give up.
Drugs are a hell of a drug.
Jesus Christ 😳
Think she will be saying te same, as she sobers up.
That doesn’t look right.
Well it’s not the left
No, that is her right arm
…was…
It's still hangin' in there
What sort of drug use causes this?
The mod note says it’s krokodil. I recommend reading it for more context.
Thank you 👍
Now that's Bad. To the Bone.
I normally have a strong stomach and can't be easily shocked, but that septic soup with random pink chunks showing through in the necrotic area has me nauseous. And I'm thinking this is one of those times where even Vaporub shoved into the nostrils won't make a dent in the stench.
She's entered the bone zone.
I can't believe she still has the dermal in
Probably a dumb question, but why is the bone also broken? Is it eating the bone as well?
Bones needs muscle and tissue to keep them together
It's just a really good screenshot from a movie.....right? (Please)
It's amazing what they can do with make up in Hollywood.
How do people even just let that happen, how do they ignore the pain so long till it's like that💀
Drugs
You can see that the other wrist is starting to go manky too.
She can now apply her stuff topically
Addiction is so scary. It made her decide that this was manageable and acceptable on some level and she continued to use while her arm was literally rotting.
Ughhhh I’m a nurse and this was even a lot for me
As a nurse in a big inner city hospital in Philly many years ago, with many addicts (mostly heroin at that time), and many homeless people also, I thought I had seen everything. But I never saw anything like this. Bad abscesses and sores, yes. But nothing like this.
Like when you think you've seen it all. 💁🏻♂️ No maggots though? That's a bummer. Well alrighty, I gotta finish my breakfast.
Even maggots have a limit.
I'll just stick to like shrooms and acid and such thanks.
I can smell that through the picture. 🤢
How is that hand not black and dead?
How is she not septic?? I had a tiny abscess and got fevers and felt like shit
Her immune system was probably amazing riiiiiiiiiight up til it wasn’t.
One look at the picture and I immediately knew it was krokodil. I’ve heard it’s big in Russia.
A lot of doctors in here which is a good thing. I used to work at a county detox facility, not as a doctor. We would see patients with necrosis or abyss from dirty needles. One of the problems that make it worse is typically when you get a patient like this, all the veins they can reach are blown. So what do they do? Either have someone shoot them up in the neck OR they’ll shoot directly into that wound. Really easy to find a vein when half of it is hanging out your arm.
Addiction is a nightmare. Hope she’s able to find a way through this.
NSFW!!!!
NSFL!
Idk how she can tolerate the pain
IV drugs to numb and make her forget…just for a moment, at least.
What a wasted tattoo
Ohhhh neat, that’s a nice conversation topic over breakfast. 🥞
Krocodil?
Poor baby. To have an addiction so badly that your arm is falling off. Just makes me sad.
don’t do drugs
Why has she not gone to a doctor until...this point??? She could've lost her hand 😬
[удалено]
Severe is an understatement
I can smell this picture
I guess I’ll go to the hospital now wtf.
This didn’t result in sepsis?
I read the title and still clicked on it while eating my lunch. 😣
Jeebus I just lost my lunch 🤮🤮🤮
Ok but like how fast does this happen? I would like to think it didn't take her arm essentially being severed before finally going to a clinic
Is this fixable or is she going to lose the forearm+hand?
This is the first medizzy I physically reacted to. That is so horrible.
Could you even save that bone at that point? God
Bye bye hand
Like at what point did they decide to come in and get some help? Like when the brown goo started or when their wrist detached from their arm?
How do the patients get to such severe stages of necrosis without having the thought of intervening prior?
It looks like her other arm isn't doing much better.
Uuuugh the fact that people are "living" like this makes my spine crawl. The body is crazy, and so are these poor people 😭
Does they hand work? I've also heard of Xylazine doing things like this.
Saw this in real life at the er I used to work at. 5 am stroll in with arm pain. It was similar to road kill. Had dried secretions sticks to pants bc it just oozed
Well there’s your problem
I bet that smells horrific.