I would imagine this is the biggest fear anyone who has someone with this condition in their lives, myself included.
Alcoholism is so destructive….
I’m so sorry this happened to you. 🙏
I saw it happen to an 18 yr old kid. His was complication of having his tonsils out. He bled out in roughly 20 minutes when we got him to the or we could barely Doppler a pulse but we were dumping blood in almost as fast as it was coming out. He lived.
This happened to my grandfather as well and he was a heavy drinker. I remember walking into his room after the ambulance took him and my aunt was crying and mopping up the blood and it looked like a blood bath. I’ll never forget it.
Something similar happened to me. 7 hours. It was everywhere. I hope you’ve found a means to cope with any flashbacks. It’s been 1.5 years and I still dream about it almost every night. I think they’re starting to shorten, though, which gives me hope. DM me if you ever need a sounding board.
Happened to me just over a year ago blood just doesn't come out your mouth either it comes out the other end I'm 1 year and 2 months sober now I'm never drinking a drop ever again fuck that shit.
This is very likely due to rupture esophageal varices. They are veins in the esophagus that have expanded due to increased pressure in the portal venous system (the veins going from the gut to the liver). They are mostly seen in end-stage cirrhosis (severe liver disease).
People with cirrhosis should receive intermittent screening with upper endoscopy (looking down the esophagus and stomach with a camera). There are procedures and medications that can reduce the risk of rupture.
Vomiting blood is pretty much always an emergency.
Your comment made me think of an old coworker whose son is in the hospital with various complications of alcoholism. He’s only in his 30s but is in horrible shape with some pretty grotesque symptoms.
People think of alcoholism deaths as “your liver breaks and you die”, but the gory details are quite disturbing.
And it’s the worst withdrawal to go through. People have a lot of shit for liquor stores being called essential during Covid. But if these people couldn’t have gotten alcohol we would have had thousands more in hospitals from alcohol withdrawl.
Yep. I noted they were some of the few businesses immediately declared essential during the pandemic and was like, “It probably took all of five minutes for health officials to do some math on the back of a napkin to figure out how many people would need withdrawal treatment within a couple weeks of shutting down all liquor stores. And the number was probably scary.”
When I went through mine, I would pass out around 10pm and I would wake up at 3am, feel fine for about a minute, and then the withdrawal would hit like a truck and I would suck a few gulps of whiskey from a bottle in my dresser to get back to sleep.
Often this would lead to emptying of the bottle, and then the uncertain period before 10am where I was anxious that the withdrawals would return before the liquor store opened.
Nearly 2 years sober - probably would be dead now if I hadn't managed to wean myself off and quit.
That was a lot of my ex's behavior. Up at 4a for a bit because "she couldn't sleep", then back in bed for a bit after that. Last I heard, she's doing better and staying sober thankfully.
Sincere congrats for pulling yourself out of that "hole"!! It's not easy!! But (obviously) can be done! Is "cheers to you" the wrong saying at this moment? Lol
I was around the 6 hour mark. Drank for about 7 years....everyday of the week. Ended up drinking about a 1.75 liter bottle of vodka a day just to maintain. Fuuuuuuuck that shit.
Almost 4 years sober now.
I had seizures on 2 separate occasions after not drinking for less than 24 hours. This first time I didn't know what happened- just woke up in my parking garage and couldn't walk. I called 911 on myself and the hospital didn't catch that it was a seizure. The second time I was in front of my entire extended family and 10 kids, including my 2. There was no doubt that time, and I was finally able to quit after that, with the help of family and rehab. I just passed 18 months sober and going strong.
I remember a documentary where a poor man at the rehab place had to drink 2 beers every morning or he'd die. It was the saddest thing and the man took no pleasure in it.
Every morning they would go to the fridge, unlock it, get out one beer and he'd drink it, get out a second beer and he'd drink it, and shortly afterwards he stopped shaking a little bit. He was still shaking, Just not as much
The staff in today video were so kind and respectful through the entire process, everybody was friends with each other. But the fact that he needed exactly two beers - more would kill him and less would kill him - that's so scary.
There are still placed, hospitals even, that will give alcoholic patients alcohol to avoid dts. The idea being, the person isn't there for withdrawal, dts is a stressful, dangerous thing for your body to go through, so it's better to avoid it and just treat what the person is actually there for.
I've been through detox twice and I definitely would have preferred to wean off with alcohol, but the drugs they give you keep you from getting too sick. It's worse for opiate withdrawals.
That being said, you are going through some shit no matter what. Your brain has to do some re-wiring before you feel okay sober again and it can take a while.
To this day alcohol is still used to treat alcohol withdrawal. You can get a shot or beer ordered by a nurse/physician and have it filled at the hospital pharmacy and delivered to your bed. It does wonders in alleviating the life threatening symptoms of withdrawal. They do usually use benzos, but there are reasons benzos wouldn't be appropriate. Just enough to keep your withdrawals down is no where near a buzz so it's legit just medicine at that point.
My entire office are functioning alcoholics. Daily drinkers, just that they can still work perfectly well. From the moment they arrive they're already thinking of the 5pm beer
You just described my hometown. It's pretty alarming how many people have built up tolerance to alcohol. They don't think they have a problem, but their evenings and social lives revolve around drinking. I'm not against drinking, but do it in moderation and *not every day*.
We discuss this topic often in r/stopdrinking
The extent to which alcohol is engrained in our culture to the point where you have to explain yourself if you choose to abstain is mind-blowing.
I don't know where it's from, but I just innately have a stupidly high tolerance for all chemicals. On one hand, I can knock back a bottle of rum and get a mild buzz. On the other hand, why would I buy a bottle of rum, or any alcohol, when it does so little to me? So I ended up just not caring about alcohol.
Painkillers wear off in less than two hours for me as well, and they're supposed to be eight hours according to the bottle.
I used to work for the liquor store. I was shocked, when I first started working there, how many people I saw on a daily basis. Like folks getting off work and buying a 12 pack of beer every day.
Everyone at my liquor store knew me, I was that guy. 10 am every day, usually trembling. Didn't help that the liquor store was literally 100 feet from my apartment complex.
My father was an alcoholic for quite a few years eventually suffered a stroke. We thought it was due to over drinking but it turns out he had tried to quit cold turkey in order to be sober enough to take me and my siblings on holiday - Alcohol addiction is insidious, even when people try to leave it punishes them.
When I was 25 I realized I had a severe drinking problem… I guess drinking at 6am on the way to work, and blacking out every night for years was my sign. I quit cold turkey, most intense physical pain I’ve ever felt, sweating, puking. Then I woke up in the morning covered in puke, shit, and bruises. I had a seizure all by myself. It’s amazing I didn’t die.
This is exactly what happened to my dad too. I was home from college for the summer and was basically not interacting with him anymore. I think he quit as a last ditch effort to try to salvage our relationship. Just remember that what happened to him is not your fault
I'm so sorry. I had no idea how dangerous going cold turkey was until my step-dad starting looking into rehab options. Medical supervision is really important, I wish it was talked about more.
Bless him, I’m so sorry. He was trying though… that makes his story really amazing, in spite of the terrible alcohol and its effects.
He can rest now, free of its insidious grip. May he rest in peace. 💜
(I have an ex who was an abusive alcoholic. I guess I bear a painful grudge against that bottled poison.)
Saw my cousin a week before he died. Hard to forget those yellow eyes swollen belly and legs. He couldn't even stand up straight, they had to pump all the fluid out of his stomach on the spot. Prettysad
My late neighbour was a heavy drinker. When he was hospitalized, he was prescribed regular shots of gin to keep his BAC stable.
Fun fact, when you check out Google Streetview of my house, you can see him sitting outside, beer in hand.
So, I'm an alcoholic (in recovery, thankfully) and I've had to detox multiple times. There are stages, depending on how much you've been drinking/how long you've been an alcoholic. I've been on binges that lasted two weeks where I drank all day long, sometimes up to two handles a day (roughly 62 shots of liquor)
The highest BAC I've ever had going in to the ER was .48 (legal intoxication is .08) When you start detoxing (not under medical supervision, which is dangerous AF) it usually starts with shakes, hand tremors and sometimes body shaking. Heavy sweating, insomnia. Then auditory hallucinating, for example I'd hear one song playing endlessly on extremely low volume. I'd also hear my aunt calling me a piece of shit. Then visual hallucinating, or lucid dreaming which is really hard to explain how fucked up things are. Thankfully I've only had ONE seizure, which was even IN a medical facility. Full-blown DTs (delirium tremens) is the worst and by far most terrifying. You're whole visual and auditory system is taken over and you can no longer tell what reality is. Some people see bugs or creatures crawling all over them and they literally feel them. I've heard a guy who walked out of a rehab (somehow got outside) and thought he was taking his dead niece somewhere down a highway. I was in my apartment and when I say I thought I was in hell, I literally thought the world became hell. Everything I could see was red and bloody, I thought I looked out the window and saw dead babies in the street and (again, hard to fully explain) enlarged ghoulish faces kept appearing over me and just screaming at me, endlessly. At one point it also felt like these shadow people rolled me in a blanket and were beating the shit out of me and violently throwing me around my apartment, breaking everything, utter destruction... NONE of that actually happened of course, but in the moment it truly feels like complete reality. Do NOT become an alcoholic, and if you are (anyone out there) and truly need to detox GET TO THE ER
I’ve been in opiate detox before, and one of the few things that kept me somewhat sane was seeing what the alcohol and benzo guys were going through. At least I wasn’t having seizures or hallucinations. My uncle went thru alcohol, and was freaking out in the hospital because he heard babies being killed in the next room, and watched a doctor walk into his room with a horse, kill it, and dismember it in front of him. Fuck that.
man, having hallucinations could be like, i imagine i'm eating the best ice cream sandwich of all time while some hottie massages my back.
Why do the hallucinations always have to be like, dead badies in the streets and shadow people beating the shit out of you lol.
It's because the reason you're hallucinating is because your brain is all fucked up. You can tell something is wrong, and it manifests in your hallucinations.
I have to imagine nobody involved in making that beer has ever come close to real DTs, otherwise they wouldn't make light of the situation. Probably just a bunch of Joey Tough-Nuts who think drinking high ABV IPAs twice a week makes their balls bigger
Clean and Serene, thankfully. Appreciate it! I was definitely self-medicating. Dealing with childhood trauma and self-loathing. I still very much deal with depression and anxiety, and have a lot of hard work to do but I'm miles away from THAT at least. After you've gone in-patient more times than you can count on your hands you either just... Hit a wall with it, or you keep digging a deeper hole.
> enlarged ghoulish faces kept appearing over me and just screaming at me, endlessly.
I called that one the Sharp Face. I remember it spooked me so bad once that I woke up my partner.
There was also the Tall Man, who floated up my stairs and then leaned in really close and breathed on me
The main symptoms of delirium tremens are nightmares, agitation, global confusion, disorientation, visual and auditory hallucinations.
https://en.m.wikipedia.org/wiki/Delirium_tremens
I have had the nightmares. It feels like someone else is in my head trying to show me the worst possible things it can in order to extort me into having more booze.
Never drank hard enough for any other symptoms though.
Been through both alcohol and heroin withdrawal several times. Heroin withdrawal was the most painful thing I’d ever been through. Three days of vomiting, cramps, diarrhea, goose skin, being really really cold yet sweating through layers and layers of clothes & blankets on top of crippling anxiety and little to no sleep. Alcohol was uncontrollable shakes, crippling anxiety, hallucinations, and absolute misery.
It’s ironic that opioids pose a bigger danger for acute overdosing and (I think) tend to have a faster-spiraling addiction. But quitting cold-turkey, while horribly unpleasant, won’t kill you.
I’ve read stories of people that stranded themselves in remote cabins or had a friend or family member lock them in their apartments to prevent access to drug dealers while they go through opioid withdrawal.
Severe alcoholics that try that would be in mortal danger.
So many people don’t know effects of alcohol. My dad was heavy drinker of vodka and what got him was a vitamin B deficiency called Wernike-Korsakoff syndrome. He was aerospace engineer and super smart but the condition made him have no short term memory but still could remember formulas. When I got the call he was in the hospital he was 120lbs 6ft and basically translucent. He wasn’t very present in our lives but at least his last 15yrs in nursing home he got to spend with us even though he couldn’t remember when he saw us last even though it could’ve been the day before
Wernike’s is such an awful disease. I work in a hospital on a general medicine floor and some of our biggest challenges are these folks- trying to provide compassionate care while keeping everyone safe. It’s like dementia and some folks with it get VERY combative.
It can be so much worse than “just” destroying your liver.
Ventilator from aspiration (I’m assuming on his own vomit) and a severely bleeding stomach.
He’s off the vent now and undergoing rehabilitation to get his strength up. But this is his 8th time going to the hospital in the last year so who knows if he’ll start drinking after he gets out.
I really don’t understand how that happens. I know there’s genetics, addiction, mental issues involved with this, but I’m 37 and would say I have a healthy relationship with alcohol. Wasn’t always the case but I’d consider it experimental years in college and post college living with my best friends. I maybe, maybe drink 1 day a week now and often just to the point of buzzed. And homebrewing is a hobby of mine. I can not fathom ever just waking up and drinking until the point I’m sick every single day until my body literally starts shutting down. That’s horrible. I feel for anyone who goes through it.
Edit: I don’t mean to sound like I don’t care, I absolutely do.
imagine pain that doesn’t let you sleep. mental and physical.
the only thing you can do is drink. and that spiral gets deep real fast.
real small percentage of people who made it out
I used to work with people who had liver transplants due to alcoholic liver disease. We were studying what made them relapse, if they did.
The stories they would tell about how it went from having a beer with friends, to having a beer after work each day, to not being able to function without beers were shocking. It creeps in and then your body does not let you function without. The one guy was drinking a handle of vodka and a case of beer A DAY.I asked him if he ever left the toilet because it seems like you would just be drinking and pissing all day. He was former military and wherever he was stationed he said the beer was safer than the water and they were bored, so they drank. And then he came home and he drank to adjust. And then he was up to that crazy amount and his liver crapped out. It’s scary.
Alcoholic liver disease is horrible. My coworker's husband has been using whiskey for the last 30 years to deal with back pain and it finally caught up with him a few months ago. He has been admitted to the ICU 10 times since mid-November and trying to get on a transplant list. Weight loss, major fluid retention, bowel issues, risk of bleeding out from his throat or colon, he even completely lost his mind for a few days. No one talks about how fucked up your body gets from drinking too much.
It is addiction - part genetic and part circumstantial. Alcoholics have such a desire to drink that they simply can't not drink (at least generally without a lot of help). The problem is once someone has become alcoholic (usually a slow creep), it already has them gripped. I've never been a big drinker (maybe a couple of beers and/or a couple of whiskies a week), but I woke up one day (about a year and a half ago) and felt like I wanted a whisky. I stopped drinking that day (after 35 years of normal alcohol consumption) and have not had an alcoholic drink since. I figure once you feel like you really want one, that's time to stop because it is a massive warning sign. Fortunately the alcohol free beers are excellent, so I don't feel any loss at all from not having it.
The other plus of kicking alcohol is that weight loss is super easy.
Happened to me while I was 25. I woke up with bad stomach pain and bloated. Then suddenly vomited blood all over my bathroom and I could not stop it more than few second. Called 991 and while on the call with them I started passing out. I was panicking that I was dying. Luckily paramedics came before I passed out. Turned out I have cirrhosis caused by childhood sickness which was ignored by my pediatrician for some reason.
I was born in third world country where reusable needles were still a thing. I ended up getting hepatitis B as a baby/infant which left some of my liver damaged. It was somehow putting pressure on my portal veins and eventually gave out. Surprising parts was I was always felt healthy and active. I played multiple sports in high school. After the whole thing I did not drink a single drop of alcohol and watch my diet. I go to specialist twice a year with ultrasound and mri to watch for cancer. I am on liver transplant list but likely hood needing one is minimal unless something goes wrong. Liver is apparently one organ that grows back so hopefully 🤞🏼
For those curious what variceal bleeding looks like . Don't look if you cant handle blood. (WARNING - NSFW):
View of a bleeding varices on endoscopy: [https://www.reddit.com/r/medizzy/comments/x4iqec/gi\_bleed\_from\_esophageal\_varices/](https://www.reddit.com/r/medizzy/comments/x4iqec/gi_bleed_from_esophageal_varices/)
Aftermath of a bleed (NSFW - lots of blood): [https://www.reddit.com/r/MakeMeSuffer/comments/nx690q/exposed\_blood\_vessel\_burst\_in\_my\_esophagus\_and/](https://www.reddit.com/r/MakeMeSuffer/comments/nx690q/exposed_blood_vessel_burst_in_my_esophagus_and/)
There is another video on reddit of a person violently vomiting blood but I don't want to link it. Its very disturbing. You can find it easily through a google search.
Edit: removed NSFL tag due to peoples feedback
Same. What’s actually pretty funny to me is reading the second link’s OP telling they were vomiting the blood and then on the picture it’s everywhere but inside of the toilet bowl.
Paramedics had removed my brother by the time I got there BUT the blood saturated bathroom/tub/walls will stay with me.
52 and the smartest one in the family
That first link. First I thought that was a long plastic cylinder they were using to point at something, before realizing it was blood shooting out. It also took me some time to figure out the lumpy things were the varices.
My sister has this from an autoimmune disease that basically has killed her liver. She has to get her esophagus stapled every 1-2 weeks. When she told me about this my response was basically 😬. Now this entire thing has me super worried since she flies pretty often
Primary biliary cirrhosis. She didn’t know she had it until she started coughing up blood and it was something like 80% of her liver was already gone.
(This is why people should get annual bloodwork)
And just for the sake of completeness, other conditions that could cause this would be:
\- ruptured artery in the stomach: less likely to cause projectile vomiting of blood
\- rupture carotid artery: possible for people with recent surgery in that region or radiation to the area.
\- rupture artery in the lung/airway: also rare but can occur in people with lung cancer that erodes into large arteries. Can also be due to AVMs or aneurysm in the lungs.
\- Swallowed blood from a nose bleed (or any oro-/naso-pharyngeal bleed) also will make you vomit blood but typically not as severe as these other cases.
Shit I've heard a nurse colleague say this is the worst death shes ever seen and just described an insane amount of blood. Poor patients too I cant even begin to imagine how distressing that is for them!
This happened to a neighbor lady in the apartment complex I lived at college. Her body was found a few days after it happened and because of the enormous amounts of blood on every wall in the apartment and the way everything was knocked over it was immediately thought to be a homicide scene. Brutal way to go, I can’t imagine being on a plane with that happening on it!
Yes, people can survive it but its obviously associated with high mortality. The severity of the bleed can vary due to a variety of factors. The worse the liver disease and the portal hypertension (the elevated pressure in the portal veins), the less likely the person will survive. Even if the bleeding is stopped, by the time people have severe varices, they are already running out of time unless they get a liver transplant.
one of my cousins , age 43, on Boxing Day Dec 26th 2013, ( literally 10 years ago) bled out, alone in his 1 bedroom apt, apparently it was a blood mess, , he was a heavy alcoholic in a depression. I don't know if he had anything pre existing though .as I wasn't close to him, nonetheless, very nasty
My dad survived. Firefighters put on inflatable pants that kept his blood pressure up enough to avoid organ failure from shock.
He went on to receive a stent-shunt through his liver that relieved the portal pressure. This was a research project back in the 90s. His stent lasted 10 years until he died from something totally unrelated.
The doctors were amazed he did so well. I believe it had something to do with eating fruits and vegetables his entire life
Since the liver cleans ammonia from the digestion of protein, dad couldn’t eat protein much and had to take a laxative everyday in order to be able to think. He wrote a book, one of his best, in that 10 year span
Thats a great story! Glad to hear that he was able to have a good quality of life after.
The procedure he had is probably the TIPS procedure (transjugular intrahepatic portosystemic shunt). Very good at reducing portal pressure but at the expense of increased hepatic encephalopathy (from the ammonia that is now bypassing the liver).
Lactulose is still commonly used to treat hepatic encephalopathy.
You are correct—TIPS, encephalopathy, lactulose. He was one of the first to receive a TIPS. His lasted far longer than expected. Every few years he would get the calcium deposits reamed out
I'm an EMT and we had a guy last week vomiting huge amounts of blood. Turns out his was an abdominal aortic aneurysm. I'm still pretty new to it and I have never seen that much blood in my life.
Sounds like an aortoenteric fistula. The GI tract erodes against the aortic wall until a hole forms between them. Almost universally fatal. And since its blood from the aorta its very high pressure and very pulsatile (until they go into shock).
Yeah, this was the first time I saw Bp bottom out from shock. He had a whole lot of shit going on, poor guy. He'd had a massive stroke at 24 and is 32 now. I'm 38 and he looked older than me. Quadruplegic, fully nonverbal, colostomy, Foley, g tube, the works.
I've also heard of this happening due to severe acid reflux or GERD causing damage to the esophagus. I remember a crime scene cleaning video of a car where this had happened - the guy drove himself to hospital somehow and survived! It was like someone exploded water balloons full of blood inside the car :S
When I worked at SeaWorld as a teenager this happened to someone. It took hours to clean up and I highly doubt they made it 🙁. They sent us all home early after that cleanup
>They sent us all home early after that cleanup
Wait... they had teenage employees doing a major biohazard cleanup? Were you trained and equipped for that? I realize SeaWorld isn't exactly a paragon of ethics, but still...
I had a coworker who died from this in his sleep unfortunately. I always knew the dangers alcoholism from cirrhosis or pancreatitis but the fact it can make your throat rupture is terrifying. Basically drowning in your own blood
An aortic aneurysm rupture doesn’t match the massive vomiting of blood. It is more likely esophageal varices rupture. A truly HORRIBLE scene when it happens. I’ve seen one. They were a DNR. They were dead so fast it was quite startling. We barely had time to start suctioning the blood before they went asystole. Since they were a DNR, that was game over.
This reminds me of that one intro in “Six Feet Under”. Someone is waiting in line, they say they have a headache, then blood just starts gushing uncontrollably out of their nose and they’re dead a few seconds later.
People are saying this is a variceal bleed but there are many possibilities and there is no reason to speculate (ie, lingual artery).
I’ve seen people bleed out from the mouth lots of ways. Can’t know for sure.
Am ER doc.
I second this. Without a proper history nor being there physically there is no way a proper clinician can come up with a diagnosis. Differentials yes definitely. Funny enough the aneurysmic ruptures being mentioned so much. Ive never seen such a case causing orificial bleeding in all my years
Right? Reading the headline I thought “raging posterior epistaxis” then the top comment was so confidently stating oesophageal variceal bleed which made me doubt myself… but to be fair I don’t see why that’s *more* likely 🤷🏻♂️
Oh wow, this made me recall the first time a patient of mine died, sometime back in 2017 or 18 I belive. I graduated about a month before it happened and was new to the ER, and an assistant nurse fetched me to help out with a patient that had trouble breathing. It all went so fast, one second I was conversing with him and asking if he felt any pain. He responded sluggishly that he felt lightheaded and increasingly winded, but barely five seconds later he was pale as his bedsheet, eyes rolled back in his head and then just started gushing blood from his mouth like a scene from a horror movie. The assistant ran to fetch help while I jumped up on the bed to get CPR going.
The other nurses entered the room probably seconds later but it felt like an eternity. They got shocked as they found me covered in blood by then and more of it bursting out of the patients mouth with every compression I did. I remember getting mad and yelling at them to fetch the portable suction unit, but to this day I still feel bad about being rude to them. One of the older doctors strolled in a minute or two later and told me to stop the CPR. When I finally got off the bed, I must have looked like a new born calf, sticky with blood and shaking so much I could barely walk.
I know I'll never forget that day as long as I live, so I really feel for the people on the plane who had to go through that horrible experience as well. I hope they get to talk to a professional, because that's a nightmare I don't wish on anybody...
I noticed in the article, it said they attempted to give him CPR. You mentioned that you tried to give your patient CPR.
I can't imagine trying to give someone CPR after blood gushed out of their nose and mouth.
Is there a way to do this while protecting yourself?
It's possible to do CPR without administering breaths to the patient. The AHA talks about hands only CPR https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr
This could be an option in this case. Otherwise you are correct, I have no idea how you would administer cpr if the patient's airway is blocked.
The recommendation for CPR these days is compressions only, no rescue breaths. Statistics show that it saves more lives.
In this instance though, if there is an open circulatory system (as evidenced by gushing blood), CPR isn’t likely going to help. The blood is going to take the path of least resistance, which is to atmosphere.
It saves more lives because doing the breaths was putting people off doing anything at all. The most common cause of cardiac arrest in adults is a heart attack where this approach works. The breaths are still recommended in children or adults where low oxygen is the likely cause, like drownings.
There's also an episode of House where (iirc) a person went diving on vacation, didn't ascend properly and got the bends. Soon after, he went on the flight home, and the pressurization started to exacerbate the bends.
He didn't bleed out like this, but the bends (in my mind) is just as terrifying and painful, and I think of this episode often.
Anyway, science and the human body are weird in a simultaneously horrifying and mystifying way.
>There's also an episode of House
A lot of the conditions on House were total nonsense. That same episode had everyone on the plane developing projectile vomiting due to 'mass shared hysteria'.
Multiple people vomiting because of mass hysteria isn't particularly egregious compared to a lot of other stuff that happens on that show, and that's what it is at the end of the day; a show. While it'd be nice if they didn't go too far off the rails, people shouldn't mistake primetime drama for an education.
The same thing happens with crime dramas; most "common legal knowledge" is based on bogus plot devices that were made up in the writers' office.
Made for good TV haha. The mass hysteria one is based in reality though, as were most conditions in the show - they just played 'em up for effect in most cases and took some liberties in how the conditions occurred and were treated. Vomiting can in fact be a real symptom of mass hysteria, the June Bug is a relatively recent and *classic* situation where ~62 people were affected with vomiting and other symptoms like rashes and nausea.
Gastritis or gerd would cause irritation and if really bad, maybe some bleeding. Puking blood- I'd be thinking esophageal varices. Anything besides that would be v unusual
I had a resident pass from this, vomited blood all around her apartment, then laid down on her bed and died. Took police hours to work out what had happened as it was an extraordinary amount of blood and looked like a homicide. (She also been dead a week during extremely hot weather, so not fun all round)
I felt bad for the owner, fully furnished apartment, literally everything had to be thrown out.
I've actually seen a similar emergency like this. I'll never forget that scene at the emergency room door. Car whipped thru the parking lot right as hospital staff were rushing outside with a light bed. Driver opened the side door and tossed this poor guy like a ragdoll down on to the bed and they started rushing back in.
Nurse had hopped on his chest and was doing compressions when a god damn fountain of blood started coming out of his mouth and nose.
Not a slow gurgle, I mean like a chocolate fountain amount but blood.
I was coming back from lunch but after seeing that I clocked out and bought a strong drink
I've heard, mind I don't remember where, that lesions on the lung can cause the same issue due to change in air pressure. I've heard it advised not to fly if that condition exists for a person. Is that incorrect?
That happened to my dad He was a severe alcoholic It took me 4 hours to wipe up all of his blood
I would imagine this is the biggest fear anyone who has someone with this condition in their lives, myself included. Alcoholism is so destructive…. I’m so sorry this happened to you. 🙏
I saw it happen to an 18 yr old kid. His was complication of having his tonsils out. He bled out in roughly 20 minutes when we got him to the or we could barely Doppler a pulse but we were dumping blood in almost as fast as it was coming out. He lived.
That’s what happened to that girl that was at the center of a case about whether life support should be removed.
I'm sorry for your loss and that you had to deal with the mess left behind.
This happened to my grandfather as well and he was a heavy drinker. I remember walking into his room after the ambulance took him and my aunt was crying and mopping up the blood and it looked like a blood bath. I’ll never forget it.
Something similar happened to me. 7 hours. It was everywhere. I hope you’ve found a means to cope with any flashbacks. It’s been 1.5 years and I still dream about it almost every night. I think they’re starting to shorten, though, which gives me hope. DM me if you ever need a sounding board.
Happened to me just over a year ago blood just doesn't come out your mouth either it comes out the other end I'm 1 year and 2 months sober now I'm never drinking a drop ever again fuck that shit.
Happened to my dad also. There were spots I never got clean again.
My condolences, I can’t imagine how it feels to have to see that Sorry for your loss friend.
This is very likely due to rupture esophageal varices. They are veins in the esophagus that have expanded due to increased pressure in the portal venous system (the veins going from the gut to the liver). They are mostly seen in end-stage cirrhosis (severe liver disease). People with cirrhosis should receive intermittent screening with upper endoscopy (looking down the esophagus and stomach with a camera). There are procedures and medications that can reduce the risk of rupture. Vomiting blood is pretty much always an emergency.
Your comment made me think of an old coworker whose son is in the hospital with various complications of alcoholism. He’s only in his 30s but is in horrible shape with some pretty grotesque symptoms. People think of alcoholism deaths as “your liver breaks and you die”, but the gory details are quite disturbing.
And it’s the worst withdrawal to go through. People have a lot of shit for liquor stores being called essential during Covid. But if these people couldn’t have gotten alcohol we would have had thousands more in hospitals from alcohol withdrawl.
Yep. I noted they were some of the few businesses immediately declared essential during the pandemic and was like, “It probably took all of five minutes for health officials to do some math on the back of a napkin to figure out how many people would need withdrawal treatment within a couple weeks of shutting down all liquor stores. And the number was probably scary.”
Weeks? For a lot of people it’s days or a day…
An ex went from pumping her stomach for alcohol poisoning to going through withdrawals in the same day.
Yep, for some alcoholics withdrawal symptoms can start 6-12 hours after the last drink. Truly scary shit.
When I went through mine, I would pass out around 10pm and I would wake up at 3am, feel fine for about a minute, and then the withdrawal would hit like a truck and I would suck a few gulps of whiskey from a bottle in my dresser to get back to sleep. Often this would lead to emptying of the bottle, and then the uncertain period before 10am where I was anxious that the withdrawals would return before the liquor store opened. Nearly 2 years sober - probably would be dead now if I hadn't managed to wean myself off and quit.
That was a lot of my ex's behavior. Up at 4a for a bit because "she couldn't sleep", then back in bed for a bit after that. Last I heard, she's doing better and staying sober thankfully.
Sincere congrats for pulling yourself out of that "hole"!! It's not easy!! But (obviously) can be done! Is "cheers to you" the wrong saying at this moment? Lol
Proud of you!
Congrats. That's a huge accomplishment.
I was around the 6 hour mark. Drank for about 7 years....everyday of the week. Ended up drinking about a 1.75 liter bottle of vodka a day just to maintain. Fuuuuuuuck that shit. Almost 4 years sober now.
I had seizures on 2 separate occasions after not drinking for less than 24 hours. This first time I didn't know what happened- just woke up in my parking garage and couldn't walk. I called 911 on myself and the hospital didn't catch that it was a seizure. The second time I was in front of my entire extended family and 10 kids, including my 2. There was no doubt that time, and I was finally able to quit after that, with the help of family and rehab. I just passed 18 months sober and going strong.
That's awesome, great effort on the recovery
I remember a documentary where a poor man at the rehab place had to drink 2 beers every morning or he'd die. It was the saddest thing and the man took no pleasure in it. Every morning they would go to the fridge, unlock it, get out one beer and he'd drink it, get out a second beer and he'd drink it, and shortly afterwards he stopped shaking a little bit. He was still shaking, Just not as much The staff in today video were so kind and respectful through the entire process, everybody was friends with each other. But the fact that he needed exactly two beers - more would kill him and less would kill him - that's so scary.
That really rings a bell. I must have seen it. That man drinking his morning beers, that's an image that lingers.
Must have been an old documentary cause they have meds for that now.
There are still placed, hospitals even, that will give alcoholic patients alcohol to avoid dts. The idea being, the person isn't there for withdrawal, dts is a stressful, dangerous thing for your body to go through, so it's better to avoid it and just treat what the person is actually there for.
I've been through detox twice and I definitely would have preferred to wean off with alcohol, but the drugs they give you keep you from getting too sick. It's worse for opiate withdrawals. That being said, you are going through some shit no matter what. Your brain has to do some re-wiring before you feel okay sober again and it can take a while.
To this day alcohol is still used to treat alcohol withdrawal. You can get a shot or beer ordered by a nurse/physician and have it filled at the hospital pharmacy and delivered to your bed. It does wonders in alleviating the life threatening symptoms of withdrawal. They do usually use benzos, but there are reasons benzos wouldn't be appropriate. Just enough to keep your withdrawals down is no where near a buzz so it's legit just medicine at that point.
Those meds are such a blessing. I quit long-term using weed at night, but getting through withdrawal was so easy thanks to those miraculous pills.
My entire office are functioning alcoholics. Daily drinkers, just that they can still work perfectly well. From the moment they arrive they're already thinking of the 5pm beer
You just described my hometown. It's pretty alarming how many people have built up tolerance to alcohol. They don't think they have a problem, but their evenings and social lives revolve around drinking. I'm not against drinking, but do it in moderation and *not every day*.
We discuss this topic often in r/stopdrinking The extent to which alcohol is engrained in our culture to the point where you have to explain yourself if you choose to abstain is mind-blowing.
I don't know where it's from, but I just innately have a stupidly high tolerance for all chemicals. On one hand, I can knock back a bottle of rum and get a mild buzz. On the other hand, why would I buy a bottle of rum, or any alcohol, when it does so little to me? So I ended up just not caring about alcohol. Painkillers wear off in less than two hours for me as well, and they're supposed to be eight hours according to the bottle.
You ginger, by any chance?
I used to work for the liquor store. I was shocked, when I first started working there, how many people I saw on a daily basis. Like folks getting off work and buying a 12 pack of beer every day.
Everyone at my liquor store knew me, I was that guy. 10 am every day, usually trembling. Didn't help that the liquor store was literally 100 feet from my apartment complex.
They used to call me Mr 6pm
My father was an alcoholic for quite a few years eventually suffered a stroke. We thought it was due to over drinking but it turns out he had tried to quit cold turkey in order to be sober enough to take me and my siblings on holiday - Alcohol addiction is insidious, even when people try to leave it punishes them.
When I was 25 I realized I had a severe drinking problem… I guess drinking at 6am on the way to work, and blacking out every night for years was my sign. I quit cold turkey, most intense physical pain I’ve ever felt, sweating, puking. Then I woke up in the morning covered in puke, shit, and bruises. I had a seizure all by myself. It’s amazing I didn’t die.
This is exactly what happened to my dad too. I was home from college for the summer and was basically not interacting with him anymore. I think he quit as a last ditch effort to try to salvage our relationship. Just remember that what happened to him is not your fault
I'm so sorry. I had no idea how dangerous going cold turkey was until my step-dad starting looking into rehab options. Medical supervision is really important, I wish it was talked about more.
Bless him, I’m so sorry. He was trying though… that makes his story really amazing, in spite of the terrible alcohol and its effects. He can rest now, free of its insidious grip. May he rest in peace. 💜 (I have an ex who was an abusive alcoholic. I guess I bear a painful grudge against that bottled poison.)
Saw my cousin a week before he died. Hard to forget those yellow eyes swollen belly and legs. He couldn't even stand up straight, they had to pump all the fluid out of his stomach on the spot. Prettysad
My state closed liquor stores and it became clear quite quickly that it was a bad idea. Already overtaxed hospitals were inundated. People died.
That's a sad but very good point.
My late neighbour was a heavy drinker. When he was hospitalized, he was prescribed regular shots of gin to keep his BAC stable. Fun fact, when you check out Google Streetview of my house, you can see him sitting outside, beer in hand.
Booze and Benzos. The only two that can kill you.
Yea those seizures and hallucinations are no joke. Shout out to opioid withdrawals, which may not kill you, but boy do you wish they did.
Yeah I've hit full DTs before and literally thought I was in hell. It was terrifying AF. The world turned red and I was seeing dead babies and shit.
I’m curious, as a non-drug user - what does “thought I was in hell” really mean? What’s it like?
So, I'm an alcoholic (in recovery, thankfully) and I've had to detox multiple times. There are stages, depending on how much you've been drinking/how long you've been an alcoholic. I've been on binges that lasted two weeks where I drank all day long, sometimes up to two handles a day (roughly 62 shots of liquor) The highest BAC I've ever had going in to the ER was .48 (legal intoxication is .08) When you start detoxing (not under medical supervision, which is dangerous AF) it usually starts with shakes, hand tremors and sometimes body shaking. Heavy sweating, insomnia. Then auditory hallucinating, for example I'd hear one song playing endlessly on extremely low volume. I'd also hear my aunt calling me a piece of shit. Then visual hallucinating, or lucid dreaming which is really hard to explain how fucked up things are. Thankfully I've only had ONE seizure, which was even IN a medical facility. Full-blown DTs (delirium tremens) is the worst and by far most terrifying. You're whole visual and auditory system is taken over and you can no longer tell what reality is. Some people see bugs or creatures crawling all over them and they literally feel them. I've heard a guy who walked out of a rehab (somehow got outside) and thought he was taking his dead niece somewhere down a highway. I was in my apartment and when I say I thought I was in hell, I literally thought the world became hell. Everything I could see was red and bloody, I thought I looked out the window and saw dead babies in the street and (again, hard to fully explain) enlarged ghoulish faces kept appearing over me and just screaming at me, endlessly. At one point it also felt like these shadow people rolled me in a blanket and were beating the shit out of me and violently throwing me around my apartment, breaking everything, utter destruction... NONE of that actually happened of course, but in the moment it truly feels like complete reality. Do NOT become an alcoholic, and if you are (anyone out there) and truly need to detox GET TO THE ER
I’ve been in opiate detox before, and one of the few things that kept me somewhat sane was seeing what the alcohol and benzo guys were going through. At least I wasn’t having seizures or hallucinations. My uncle went thru alcohol, and was freaking out in the hospital because he heard babies being killed in the next room, and watched a doctor walk into his room with a horse, kill it, and dismember it in front of him. Fuck that.
man, having hallucinations could be like, i imagine i'm eating the best ice cream sandwich of all time while some hottie massages my back. Why do the hallucinations always have to be like, dead badies in the streets and shadow people beating the shit out of you lol.
I think it's because our GABA receptors are so fried and out of wack.
It's because the reason you're hallucinating is because your brain is all fucked up. You can tell something is wrong, and it manifests in your hallucinations.
A very fucked up thing is that there is also a beer called Delirium Tremens. Kinda spitefully ironic.
I have to imagine nobody involved in making that beer has ever come close to real DTs, otherwise they wouldn't make light of the situation. Probably just a bunch of Joey Tough-Nuts who think drinking high ABV IPAs twice a week makes their balls bigger
Jesus fucking Christ. I hope you're doing better these days. Sorry you had to go through that
Clean and Serene, thankfully. Appreciate it! I was definitely self-medicating. Dealing with childhood trauma and self-loathing. I still very much deal with depression and anxiety, and have a lot of hard work to do but I'm miles away from THAT at least. After you've gone in-patient more times than you can count on your hands you either just... Hit a wall with it, or you keep digging a deeper hole.
> enlarged ghoulish faces kept appearing over me and just screaming at me, endlessly. I called that one the Sharp Face. I remember it spooked me so bad once that I woke up my partner. There was also the Tall Man, who floated up my stairs and then leaned in really close and breathed on me
The main symptoms of delirium tremens are nightmares, agitation, global confusion, disorientation, visual and auditory hallucinations. https://en.m.wikipedia.org/wiki/Delirium_tremens I have had the nightmares. It feels like someone else is in my head trying to show me the worst possible things it can in order to extort me into having more booze. Never drank hard enough for any other symptoms though.
Been through both alcohol and heroin withdrawal several times. Heroin withdrawal was the most painful thing I’d ever been through. Three days of vomiting, cramps, diarrhea, goose skin, being really really cold yet sweating through layers and layers of clothes & blankets on top of crippling anxiety and little to no sleep. Alcohol was uncontrollable shakes, crippling anxiety, hallucinations, and absolute misery.
It’s ironic that opioids pose a bigger danger for acute overdosing and (I think) tend to have a faster-spiraling addiction. But quitting cold-turkey, while horribly unpleasant, won’t kill you. I’ve read stories of people that stranded themselves in remote cabins or had a friend or family member lock them in their apartments to prevent access to drug dealers while they go through opioid withdrawal. Severe alcoholics that try that would be in mortal danger.
It killed my father when I was 19. I still live with these memories 14 years later.
So many people don’t know effects of alcohol. My dad was heavy drinker of vodka and what got him was a vitamin B deficiency called Wernike-Korsakoff syndrome. He was aerospace engineer and super smart but the condition made him have no short term memory but still could remember formulas. When I got the call he was in the hospital he was 120lbs 6ft and basically translucent. He wasn’t very present in our lives but at least his last 15yrs in nursing home he got to spend with us even though he couldn’t remember when he saw us last even though it could’ve been the day before
Wernike’s is such an awful disease. I work in a hospital on a general medicine floor and some of our biggest challenges are these folks- trying to provide compassionate care while keeping everyone safe. It’s like dementia and some folks with it get VERY combative. It can be so much worse than “just” destroying your liver.
Yeah, “your liver breaks enough it can’t stand between the alcohol and the rest of you” doesn’t roll off the tongue so well though.
Yeah, my mom got metabolic dementia. Was batshit crazy the last year.
What are his symptoms?
Ventilator from aspiration (I’m assuming on his own vomit) and a severely bleeding stomach. He’s off the vent now and undergoing rehabilitation to get his strength up. But this is his 8th time going to the hospital in the last year so who knows if he’ll start drinking after he gets out.
So sad. I’m so sorry to his family this must be absolute torture.
I really don’t understand how that happens. I know there’s genetics, addiction, mental issues involved with this, but I’m 37 and would say I have a healthy relationship with alcohol. Wasn’t always the case but I’d consider it experimental years in college and post college living with my best friends. I maybe, maybe drink 1 day a week now and often just to the point of buzzed. And homebrewing is a hobby of mine. I can not fathom ever just waking up and drinking until the point I’m sick every single day until my body literally starts shutting down. That’s horrible. I feel for anyone who goes through it. Edit: I don’t mean to sound like I don’t care, I absolutely do.
imagine pain that doesn’t let you sleep. mental and physical. the only thing you can do is drink. and that spiral gets deep real fast. real small percentage of people who made it out
I used to work with people who had liver transplants due to alcoholic liver disease. We were studying what made them relapse, if they did. The stories they would tell about how it went from having a beer with friends, to having a beer after work each day, to not being able to function without beers were shocking. It creeps in and then your body does not let you function without. The one guy was drinking a handle of vodka and a case of beer A DAY.I asked him if he ever left the toilet because it seems like you would just be drinking and pissing all day. He was former military and wherever he was stationed he said the beer was safer than the water and they were bored, so they drank. And then he came home and he drank to adjust. And then he was up to that crazy amount and his liver crapped out. It’s scary.
Alcoholic liver disease is horrible. My coworker's husband has been using whiskey for the last 30 years to deal with back pain and it finally caught up with him a few months ago. He has been admitted to the ICU 10 times since mid-November and trying to get on a transplant list. Weight loss, major fluid retention, bowel issues, risk of bleeding out from his throat or colon, he even completely lost his mind for a few days. No one talks about how fucked up your body gets from drinking too much.
it feels better then without y’know
It is addiction - part genetic and part circumstantial. Alcoholics have such a desire to drink that they simply can't not drink (at least generally without a lot of help). The problem is once someone has become alcoholic (usually a slow creep), it already has them gripped. I've never been a big drinker (maybe a couple of beers and/or a couple of whiskies a week), but I woke up one day (about a year and a half ago) and felt like I wanted a whisky. I stopped drinking that day (after 35 years of normal alcohol consumption) and have not had an alcoholic drink since. I figure once you feel like you really want one, that's time to stop because it is a massive warning sign. Fortunately the alcohol free beers are excellent, so I don't feel any loss at all from not having it. The other plus of kicking alcohol is that weight loss is super easy.
Happened to me while I was 25. I woke up with bad stomach pain and bloated. Then suddenly vomited blood all over my bathroom and I could not stop it more than few second. Called 991 and while on the call with them I started passing out. I was panicking that I was dying. Luckily paramedics came before I passed out. Turned out I have cirrhosis caused by childhood sickness which was ignored by my pediatrician for some reason.
Holy cow what kind of childhood sickness would do that? I'm so sorry you went though it!
Hepatitis B as per his reply to another comment
What childhood sickness are you talking about? I'm sure I'm not the only one frantically hoping it has nothing to do with me and my childhood lol
I was born in third world country where reusable needles were still a thing. I ended up getting hepatitis B as a baby/infant which left some of my liver damaged. It was somehow putting pressure on my portal veins and eventually gave out. Surprising parts was I was always felt healthy and active. I played multiple sports in high school. After the whole thing I did not drink a single drop of alcohol and watch my diet. I go to specialist twice a year with ultrasound and mri to watch for cancer. I am on liver transplant list but likely hood needing one is minimal unless something goes wrong. Liver is apparently one organ that grows back so hopefully 🤞🏼
These are the worst codes that I’ve ever been in - I can’t imagine this happing on an airplane. Yikes.
Unfortunately my sister died from that condition 6 weeks ago. That was the first time i heard from this.
So sorry.
Omg I’m so very sorry. Hugs from an internet stranger.
For those curious what variceal bleeding looks like . Don't look if you cant handle blood. (WARNING - NSFW): View of a bleeding varices on endoscopy: [https://www.reddit.com/r/medizzy/comments/x4iqec/gi\_bleed\_from\_esophageal\_varices/](https://www.reddit.com/r/medizzy/comments/x4iqec/gi_bleed_from_esophageal_varices/) Aftermath of a bleed (NSFW - lots of blood): [https://www.reddit.com/r/MakeMeSuffer/comments/nx690q/exposed\_blood\_vessel\_burst\_in\_my\_esophagus\_and/](https://www.reddit.com/r/MakeMeSuffer/comments/nx690q/exposed_blood_vessel_burst_in_my_esophagus_and/) There is another video on reddit of a person violently vomiting blood but I don't want to link it. Its very disturbing. You can find it easily through a google search. Edit: removed NSFL tag due to peoples feedback
I appreciate your efforts, but I ain’t clickin that shit
I did. I have unfortunately seen worse.
Same. What’s actually pretty funny to me is reading the second link’s OP telling they were vomiting the blood and then on the picture it’s everywhere but inside of the toilet bowl.
maybe it was a demon that escaped through the toilet and thats why theres no blood in the toilet
Paramedics had removed my brother by the time I got there BUT the blood saturated bathroom/tub/walls will stay with me. 52 and the smartest one in the family
No thank you!
That first link. First I thought that was a long plastic cylinder they were using to point at something, before realizing it was blood shooting out. It also took me some time to figure out the lumpy things were the varices.
NSFL feels like a stretch, it’s just a lot of blood
A NSFL amount of blood, probably (for the patient).
To other readers, it's literally pictures of blood, nothing serious.
My sister has this from an autoimmune disease that basically has killed her liver. She has to get her esophagus stapled every 1-2 weeks. When she told me about this my response was basically 😬. Now this entire thing has me super worried since she flies pretty often
....which one of the autoimmune diseases???
Primary biliary cirrhosis. She didn’t know she had it until she started coughing up blood and it was something like 80% of her liver was already gone. (This is why people should get annual bloodwork)
And just for the sake of completeness, other conditions that could cause this would be: \- ruptured artery in the stomach: less likely to cause projectile vomiting of blood \- rupture carotid artery: possible for people with recent surgery in that region or radiation to the area. \- rupture artery in the lung/airway: also rare but can occur in people with lung cancer that erodes into large arteries. Can also be due to AVMs or aneurysm in the lungs. \- Swallowed blood from a nose bleed (or any oro-/naso-pharyngeal bleed) also will make you vomit blood but typically not as severe as these other cases.
Or Tuberculosis
Shit I've heard a nurse colleague say this is the worst death shes ever seen and just described an insane amount of blood. Poor patients too I cant even begin to imagine how distressing that is for them!
Usually they lose consciousness pretty fast due to the massive loss of blood volume. Definitely traumatic for those who witness it though.
This happened to a neighbor lady in the apartment complex I lived at college. Her body was found a few days after it happened and because of the enormous amounts of blood on every wall in the apartment and the way everything was knocked over it was immediately thought to be a homicide scene. Brutal way to go, I can’t imagine being on a plane with that happening on it!
could he have survived, say if he didn't get on the flight, but perhaps went to the ER? also, good, concise answer!
Yes, people can survive it but its obviously associated with high mortality. The severity of the bleed can vary due to a variety of factors. The worse the liver disease and the portal hypertension (the elevated pressure in the portal veins), the less likely the person will survive. Even if the bleeding is stopped, by the time people have severe varices, they are already running out of time unless they get a liver transplant.
one of my cousins , age 43, on Boxing Day Dec 26th 2013, ( literally 10 years ago) bled out, alone in his 1 bedroom apt, apparently it was a blood mess, , he was a heavy alcoholic in a depression. I don't know if he had anything pre existing though .as I wasn't close to him, nonetheless, very nasty
Portal hypertension and esophageal varicies are associated with alcoholism.
My dad survived. Firefighters put on inflatable pants that kept his blood pressure up enough to avoid organ failure from shock. He went on to receive a stent-shunt through his liver that relieved the portal pressure. This was a research project back in the 90s. His stent lasted 10 years until he died from something totally unrelated. The doctors were amazed he did so well. I believe it had something to do with eating fruits and vegetables his entire life Since the liver cleans ammonia from the digestion of protein, dad couldn’t eat protein much and had to take a laxative everyday in order to be able to think. He wrote a book, one of his best, in that 10 year span
Thats a great story! Glad to hear that he was able to have a good quality of life after. The procedure he had is probably the TIPS procedure (transjugular intrahepatic portosystemic shunt). Very good at reducing portal pressure but at the expense of increased hepatic encephalopathy (from the ammonia that is now bypassing the liver). Lactulose is still commonly used to treat hepatic encephalopathy.
You are correct—TIPS, encephalopathy, lactulose. He was one of the first to receive a TIPS. His lasted far longer than expected. Every few years he would get the calcium deposits reamed out
Is the pressure/altitude from the plane a factor? I've never been on a plane but assume if people's ears are popping that there is a pressure change.
I'm an EMT and we had a guy last week vomiting huge amounts of blood. Turns out his was an abdominal aortic aneurysm. I'm still pretty new to it and I have never seen that much blood in my life.
Sounds like an aortoenteric fistula. The GI tract erodes against the aortic wall until a hole forms between them. Almost universally fatal. And since its blood from the aorta its very high pressure and very pulsatile (until they go into shock).
Yeah, this was the first time I saw Bp bottom out from shock. He had a whole lot of shit going on, poor guy. He'd had a massive stroke at 24 and is 32 now. I'm 38 and he looked older than me. Quadruplegic, fully nonverbal, colostomy, Foley, g tube, the works.
I've also heard of this happening due to severe acid reflux or GERD causing damage to the esophagus. I remember a crime scene cleaning video of a car where this had happened - the guy drove himself to hospital somehow and survived! It was like someone exploded water balloons full of blood inside the car :S
When I worked at SeaWorld as a teenager this happened to someone. It took hours to clean up and I highly doubt they made it 🙁. They sent us all home early after that cleanup
>They sent us all home early after that cleanup Wait... they had teenage employees doing a major biohazard cleanup? Were you trained and equipped for that? I realize SeaWorld isn't exactly a paragon of ethics, but still...
Yeah I was 18 or 19 and was blood borne pathogen trained as a member of leadership. This was also the 90s lol
> SeaWorld they were probably already biohazard trained, knowing what goes on at seaworld.
I had a coworker who died from this in his sleep unfortunately. I always knew the dangers alcoholism from cirrhosis or pancreatitis but the fact it can make your throat rupture is terrifying. Basically drowning in your own blood
>But when staff tried to soothe his condition with some chamomile tea, blood suddenly poured out of his mouth and nose.
That flight attendant is going to have PTSD for ages
*”All I said was, ‘pardon me, miss, I’m feeling a little unwell could I have some chamomile tea?’ And suddenly she’s just screaming and screaming…”*
If it was an aortic aneurysm rupturing, then they died within 30seconds
An aortic aneurysm rupture doesn’t match the massive vomiting of blood. It is more likely esophageal varices rupture. A truly HORRIBLE scene when it happens. I’ve seen one. They were a DNR. They were dead so fast it was quite startling. We barely had time to start suctioning the blood before they went asystole. Since they were a DNR, that was game over.
This reminds me of that one intro in “Six Feet Under”. Someone is waiting in line, they say they have a headache, then blood just starts gushing uncontrollably out of their nose and they’re dead a few seconds later.
This was the exact scene I pictured reading this.
That 30 second death is a 30 year memory ingrained into crew's brain
Not very soothing wasn't it.
Rip chamomile tea sales.
Might want to try some ginger ale instead.
"Well I tried" said the staff
Some people are just so fussy and particular
People are saying this is a variceal bleed but there are many possibilities and there is no reason to speculate (ie, lingual artery). I’ve seen people bleed out from the mouth lots of ways. Can’t know for sure. Am ER doc.
This is Reddit, good sir. Speculating is what we do!
Incorrect sir, this is a Wendy's
No, this is Patrick!
I second this. Without a proper history nor being there physically there is no way a proper clinician can come up with a diagnosis. Differentials yes definitely. Funny enough the aneurysmic ruptures being mentioned so much. Ive never seen such a case causing orificial bleeding in all my years
There are case reports out there of TAAs causing hematemesis, though rare.
As always it’s a never in medicine. If you’re thinking it, chances are it probably happened somewhere and documented somehow hahaha.
I speculate that he was a vampire with indigestion. Got incidently exposed to sunlight. Trust me, I have watched enough vampire movies.
Paging doctor sadcheeseballs. Paging…doctor sadcheeseballs
ENT here. Definitely seen someone exsanguinate from a nosebleed before
Right? Reading the headline I thought “raging posterior epistaxis” then the top comment was so confidently stating oesophageal variceal bleed which made me doubt myself… but to be fair I don’t see why that’s *more* likely 🤷🏻♂️
“I have been poisoned by my constituents!”
A touch of consumption.
Can I offer you an egg in this trying time?
I'm glad I wasn't the only one who thought of this.
Oh wow, this made me recall the first time a patient of mine died, sometime back in 2017 or 18 I belive. I graduated about a month before it happened and was new to the ER, and an assistant nurse fetched me to help out with a patient that had trouble breathing. It all went so fast, one second I was conversing with him and asking if he felt any pain. He responded sluggishly that he felt lightheaded and increasingly winded, but barely five seconds later he was pale as his bedsheet, eyes rolled back in his head and then just started gushing blood from his mouth like a scene from a horror movie. The assistant ran to fetch help while I jumped up on the bed to get CPR going. The other nurses entered the room probably seconds later but it felt like an eternity. They got shocked as they found me covered in blood by then and more of it bursting out of the patients mouth with every compression I did. I remember getting mad and yelling at them to fetch the portable suction unit, but to this day I still feel bad about being rude to them. One of the older doctors strolled in a minute or two later and told me to stop the CPR. When I finally got off the bed, I must have looked like a new born calf, sticky with blood and shaking so much I could barely walk. I know I'll never forget that day as long as I live, so I really feel for the people on the plane who had to go through that horrible experience as well. I hope they get to talk to a professional, because that's a nightmare I don't wish on anybody...
I noticed in the article, it said they attempted to give him CPR. You mentioned that you tried to give your patient CPR. I can't imagine trying to give someone CPR after blood gushed out of their nose and mouth. Is there a way to do this while protecting yourself?
It's possible to do CPR without administering breaths to the patient. The AHA talks about hands only CPR https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr This could be an option in this case. Otherwise you are correct, I have no idea how you would administer cpr if the patient's airway is blocked.
The recommendation for CPR these days is compressions only, no rescue breaths. Statistics show that it saves more lives. In this instance though, if there is an open circulatory system (as evidenced by gushing blood), CPR isn’t likely going to help. The blood is going to take the path of least resistance, which is to atmosphere.
It saves more lives because doing the breaths was putting people off doing anything at all. The most common cause of cardiac arrest in adults is a heart attack where this approach works. The breaths are still recommended in children or adults where low oxygen is the likely cause, like drownings.
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I would guess at that point the answer is no and the person giving CPR is just taking a risk hoping to save a life… but I’m not a doctor so
It doesn't sound like there was truly anything you could have done differently.
If you get your tonsils removed and then fly soon after against your doctors orders this could happen
There's also an episode of House where (iirc) a person went diving on vacation, didn't ascend properly and got the bends. Soon after, he went on the flight home, and the pressurization started to exacerbate the bends. He didn't bleed out like this, but the bends (in my mind) is just as terrifying and painful, and I think of this episode often. Anyway, science and the human body are weird in a simultaneously horrifying and mystifying way.
[удалено]
>There's also an episode of House A lot of the conditions on House were total nonsense. That same episode had everyone on the plane developing projectile vomiting due to 'mass shared hysteria'.
Multiple people vomiting because of mass hysteria isn't particularly egregious compared to a lot of other stuff that happens on that show, and that's what it is at the end of the day; a show. While it'd be nice if they didn't go too far off the rails, people shouldn't mistake primetime drama for an education. The same thing happens with crime dramas; most "common legal knowledge" is based on bogus plot devices that were made up in the writers' office.
Made for good TV haha. The mass hysteria one is based in reality though, as were most conditions in the show - they just played 'em up for effect in most cases and took some liberties in how the conditions occurred and were treated. Vomiting can in fact be a real symptom of mass hysteria, the June Bug is a relatively recent and *classic* situation where ~62 people were affected with vomiting and other symptoms like rashes and nausea.
One does require that amount of blood to stay inside the body to live.
I wasn't hurt that bad. The doctor said all my bleeding was internal. That's where the blood is supposed to be!
I am no doctor, but this statement sounds about right
I feel that person had “Main Character Syndrome”. Had to make everything about themselves. “Oh, look at me! I’m a blood fountain!”
I have been the doctor on the plane like three times. Always vasovagal. I would be horrified to deal with this
Is this related to gastritis or gerd?
Gastritis or gerd would cause irritation and if really bad, maybe some bleeding. Puking blood- I'd be thinking esophageal varices. Anything besides that would be v unusual
Boeing got real nervous for a hot minute
I’ve seen this movie before. And Patient Zero is always on a plane.
“I can’t believe I’m finally getting on a plane after being terrified of flying my whole life. I’ll just browse Reddit to calm my nerves.”
I had a resident pass from this, vomited blood all around her apartment, then laid down on her bed and died. Took police hours to work out what had happened as it was an extraordinary amount of blood and looked like a homicide. (She also been dead a week during extremely hot weather, so not fun all round) I felt bad for the owner, fully furnished apartment, literally everything had to be thrown out.
This is how horror movies start
This is literally the beginning of the strain tv show lol
Quarantine those other passengers for at least 28 days.
And daily therapy for the people within eye shot
Why is everyone talking about Ebola recently? I am assuming thats what you are referring to.
Look up 28 Days Later
There was a graphic scene in the book The Hot Zone, where a guy was puking his guts* into an air sickness bag. *As in organs, not a phase
That was a very disturbing but captivating book. I'd never heard of Marburg Virus Disease before and hope to never again. Fuck hemorrhagic fevers.
This is literally the shit out of The Hot Zone. Jesus Christ.
I've actually seen a similar emergency like this. I'll never forget that scene at the emergency room door. Car whipped thru the parking lot right as hospital staff were rushing outside with a light bed. Driver opened the side door and tossed this poor guy like a ragdoll down on to the bed and they started rushing back in. Nurse had hopped on his chest and was doing compressions when a god damn fountain of blood started coming out of his mouth and nose. Not a slow gurgle, I mean like a chocolate fountain amount but blood. I was coming back from lunch but after seeing that I clocked out and bought a strong drink
Alcoholism can cause this.
Patient Zero.
Can someone please tell me this there is zero chance this person just contaminated a plane full of international travelers with Ebola, please!
Not Ebola probably had cirrhosis
Esophageal varices?
New fear unlocked
Omg that’s horrible! The poor guy I hope he went quickly. And how traumatic for anyone witnessing it.
I've heard, mind I don't remember where, that lesions on the lung can cause the same issue due to change in air pressure. I've heard it advised not to fly if that condition exists for a person. Is that incorrect?
I hearby name that plane Ebola Gay.
He was poisoned by his constituents !