Sunday, July 31, 2011

Curiosity Satisfied

I had a patient last night- a youngish man, very thin, with the most beautiful eyes I had ever seen. They were blue, cat-like, full of things unsaid, and fringed with jet black lashes that were long and straight. He came in for his swollen foot and was polite when I asked him if I could take his blood pressure and then take a blood sample.

When I looked at his veins, I found a long, wide streak of brown over one. It was the width of a quarter and a few quarters long on his skeletal arm near the crease of his elbow.

"What's that?" I asked with wide eyes.
"I used to use heroin."
"Oh..." I looked at it again. I couldn't help myself. "Can I touch it??"
"Sure." He was bemused by my request. I am not sure if anybody had asked him that before.

It felt like a large bubble, later I learned about how shooting-up can cause pseudoaneurysms beneath the skin, covered by a thin sheath of brown, leathery callous.

Some people who lose their peripheral veins from shooting up too much will go and use major vessels. The doctor on duty told me a story about seeing someone who had destroyed the skin and flesh in the upper thigh, creating a perfect funnel exposing the femoral vein.
My patient with the beautiful eyes had stopped using 3 months ago, but he already contracted hepatitis. I hope he stays off.


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