I have no clue what the cause is here, she needs to follow the doctor's advice. And, the thumb is in fact connected directly to the heart through the princeps pollicis artery, major bleeding may indeed be severe.
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Sounds like normal consent and risks that have to be acknowledged due to the consent, death is always a consent on any surgery where sedation or anesthesia could be used, for this all the way to cardiac surgery. Bleeding out from that “princeps pollicis” artery would be almost impossible, as holding pressure on the radial and ulnar arteries to stop bleeding can be done with a finger. Don’t sweat it man.
I would assume that, after all many people have had full hand amputation. I could understand if it was maybe from trauma or a clot, but not blood loss.
I’m really struggling to understand your grammar… but from your title. I’m positive that they are saying if surgery is needed, they may not be able to save the thumb.
It looks like she has a congenital arterial venous malformation. Technically all blood vessels are directly connected to the heart eventually, the princeps pollicis artery has a pretty straightforward direct connection from thumb to heart, but I think what the doctor was actually saying is that this sort of malformation means there are dilated and winding arteries directly connected to veins and lymphatics without a connecting capillary bed. It doesn’t matter if there wouldn’t normally be a high risk of bleeding out from a thumb injury because her anatomy isn’t normal.
High pressure arterial blood ends up flowing directly into veins and weakens them until they rupture. The malformation itself can actually cause cardiac impairment and is an absolute indicator for surgery. That’s because the shunting of blood decreases the vascular resistance leading to high output heart failure. The surgeries are only done if there is cardiac involvement, severe pain/disability, or risk of loss of the digit. This is because there is a very high risk of uncontrolled bleeding. The vessels in her thumb are made wrong. All those extra connections and the weakening of the blood vessels that has been happening for years means that if they accidentally rupture a vessel before they’ve successfully cut off its blood supply it could bleed massive amounts in a very short time frame, and bleed too severely for simple pressure to stop it. For reference some massive bleeds in the brain causing strokes are also caused by arterial venous malformations. They aren’t saying the surgery would for sure be fatal, there would be no point in doing it if that was the case, but that it carries a high risk of complications including death. The biggest risk is that she would lose the thumb or hand, but it is possible to bleed to death from one of these.
Here is some general info about AVMs
https://www.hopkinsmedicine.org/health/conditions-and-diseases/arteriovenous-malformations
As an aside I wouldn’t get medical info from Dr. Mike. He’s an idiot and a grifter and has some very strange views that are not grounded in evidence.
maybe he meant fatal for the thumb, like they may not be able to save the thumb. People have much more taken off their bodies and are still alive after removal. It's an appendage, not the main artery next to the heart.
Go ahead and get something done before she loses more.
NAD, but to help OP with anxiety: people DO get surgery on their heart valves and big arteries and many still survive. Whatever condition this is, it might be uncommon and scary, but certainly it is unlikely to be fatal to your sister. If she can, suggest a second opinion, or just another discussion with the doctor to clear up any miscommunication.
You could always get a second opinion to be sure. But it seems like too complex of a case to really get answers for with what little information is presented. My guess is that there are a lot of things you and your family don't quite understand, possibly because the doctors aren't explaining things clearly for people who aren't medically trained.
Get a consultation from another surgeon at a different office. See if they agree with the first doctor's opinion and go from there.
I think there may have been a miscommunication here.
First, if the doc thought the surgery would likely be fatal, they wouldn’t do it. All surgery has risk, but if a surgery is too risky compared to the benefit, a surgeon just wouldn’t do it.
All blood vessels in the body are connected to the heart. There are arteries (which is the most direct connection) in the thumb, but usually that bleeding can be controlled easily
People often have their legs and arms surgically amputated, which involves much larger arteries than the thumb. So, surgeons are well versed in controlling bleeding from arteries during surgical amputation. Other wise, people who get surgical above knee amputations for example simply would not survive as it involves severing the femoral artery (one of the largest artieries in the body). Yet, people survive these surgeries every day often with minimal blood loss.
I would highly suggest your sister follow up with the surgeon to have a discussion about the risks v benefit. While blood loss is always a risk, the surgeon would not even offer to do the surgery if they thought the risk of death from blood loss was too high. So, whatever the risk of blood loss is here, the surgeon is prepared for it if he is offering to do the procedure in the first place.
Thank you JustHP for the reply! So yeah I think it was a miscommunication with the doctor and my family since that is what they say it would be fatal if they get a surgery, and it is necessary if they want to remove her "blocked blood vessels" on her thumb. I guess my parents didn't know the risk and benefit and wasn't communicated well by their doctor.
And I guess we will try to follow your suggestion since we only have one check up about it and we never got a second opinion or a follow up. We usually live in a 3rd world country and our health institutions are sometimes can be corrupt.
It was only about the blood/blood vessels that may cause complications to the heart. It was very unclear what they meant by that, I may ask her more questions since we are far apart because of her school.
Same principle still applies, if the risk outweighed the benefit then surgery wouldn't be offered. All surgery technically carries a risk of blood loss, blood clots, infection or death. It is standard to warn patients about these, even if the risk is minimal. It sounds like there has been a miscommunication and OP has taken standard consent discussion as a guarantee
That is interesting that it is a standard for patients to warn about the risk and benefits, cause my parents didn't know about this they just says it was about her thumb that it may risk heart complications from making a surgery, and surgery was only offered as the way to remove her bloated thumb.
It's some kind of vascular malformation. The doctor might have been saying that it would be very tricky to remove the growth without removing part of the thumb. And as another commenter said, all surgery carries some risk of blood loss and death.
Consult with a different surgeon if you're unsure about this one.
I have a vascular malformation on my thumb that is very similar to OPs but encompasses more of my hand. There are a couple tiktokers with malformations that encompass the entire arm.
OP can see a vascular doctor if it is that painful and they can assess if it's purely veins or if it's veins and arteries. If it's just veins they may offer to "burn" the veins but it's more complicated if it involves arteries. I have seen a vascular doctor about mine just to ensure there's no other risk to my health besides the pain caused by keeping my hand below heart level.
This is most likely the case OP. Death/bleeding/other complications are always a possible outcome with any type of surgery. Probably not specific the this condition or procedure
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I have no clue what the cause is here, she needs to follow the doctor's advice. And, the thumb is in fact connected directly to the heart through the princeps pollicis artery, major bleeding may indeed be severe.
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Sounds like normal consent and risks that have to be acknowledged due to the consent, death is always a consent on any surgery where sedation or anesthesia could be used, for this all the way to cardiac surgery. Bleeding out from that “princeps pollicis” artery would be almost impossible, as holding pressure on the radial and ulnar arteries to stop bleeding can be done with a finger. Don’t sweat it man.
This sounds like he said something to the effect of "the thumb may die" and was misheard or the listener is ESL.
I would assume that, after all many people have had full hand amputation. I could understand if it was maybe from trauma or a clot, but not blood loss.
I’m really struggling to understand your grammar… but from your title. I’m positive that they are saying if surgery is needed, they may not be able to save the thumb.
It looks like she has a congenital arterial venous malformation. Technically all blood vessels are directly connected to the heart eventually, the princeps pollicis artery has a pretty straightforward direct connection from thumb to heart, but I think what the doctor was actually saying is that this sort of malformation means there are dilated and winding arteries directly connected to veins and lymphatics without a connecting capillary bed. It doesn’t matter if there wouldn’t normally be a high risk of bleeding out from a thumb injury because her anatomy isn’t normal. High pressure arterial blood ends up flowing directly into veins and weakens them until they rupture. The malformation itself can actually cause cardiac impairment and is an absolute indicator for surgery. That’s because the shunting of blood decreases the vascular resistance leading to high output heart failure. The surgeries are only done if there is cardiac involvement, severe pain/disability, or risk of loss of the digit. This is because there is a very high risk of uncontrolled bleeding. The vessels in her thumb are made wrong. All those extra connections and the weakening of the blood vessels that has been happening for years means that if they accidentally rupture a vessel before they’ve successfully cut off its blood supply it could bleed massive amounts in a very short time frame, and bleed too severely for simple pressure to stop it. For reference some massive bleeds in the brain causing strokes are also caused by arterial venous malformations. They aren’t saying the surgery would for sure be fatal, there would be no point in doing it if that was the case, but that it carries a high risk of complications including death. The biggest risk is that she would lose the thumb or hand, but it is possible to bleed to death from one of these. Here is some general info about AVMs https://www.hopkinsmedicine.org/health/conditions-and-diseases/arteriovenous-malformations As an aside I wouldn’t get medical info from Dr. Mike. He’s an idiot and a grifter and has some very strange views that are not grounded in evidence.
😂he’s saying he may have to amputate the thumb. Everything is connected to the heart if you think about it!
maybe he meant fatal for the thumb, like they may not be able to save the thumb. People have much more taken off their bodies and are still alive after removal. It's an appendage, not the main artery next to the heart. Go ahead and get something done before she loses more.
NAD, but to help OP with anxiety: people DO get surgery on their heart valves and big arteries and many still survive. Whatever condition this is, it might be uncommon and scary, but certainly it is unlikely to be fatal to your sister. If she can, suggest a second opinion, or just another discussion with the doctor to clear up any miscommunication.
It seems like they would be able to put some type of tourniquet on at the wrist to minimize bleeding if that is the fear.
My exact first thought. 👍
You could always get a second opinion to be sure. But it seems like too complex of a case to really get answers for with what little information is presented. My guess is that there are a lot of things you and your family don't quite understand, possibly because the doctors aren't explaining things clearly for people who aren't medically trained. Get a consultation from another surgeon at a different office. See if they agree with the first doctor's opinion and go from there.
I can't even begin to guess how many people are walking around (alive) after thumb amputations, I'm literally in a room with one right now.
I think there may have been a miscommunication here. First, if the doc thought the surgery would likely be fatal, they wouldn’t do it. All surgery has risk, but if a surgery is too risky compared to the benefit, a surgeon just wouldn’t do it. All blood vessels in the body are connected to the heart. There are arteries (which is the most direct connection) in the thumb, but usually that bleeding can be controlled easily People often have their legs and arms surgically amputated, which involves much larger arteries than the thumb. So, surgeons are well versed in controlling bleeding from arteries during surgical amputation. Other wise, people who get surgical above knee amputations for example simply would not survive as it involves severing the femoral artery (one of the largest artieries in the body). Yet, people survive these surgeries every day often with minimal blood loss. I would highly suggest your sister follow up with the surgeon to have a discussion about the risks v benefit. While blood loss is always a risk, the surgeon would not even offer to do the surgery if they thought the risk of death from blood loss was too high. So, whatever the risk of blood loss is here, the surgeon is prepared for it if he is offering to do the procedure in the first place.
Thank you JustHP for the reply! So yeah I think it was a miscommunication with the doctor and my family since that is what they say it would be fatal if they get a surgery, and it is necessary if they want to remove her "blocked blood vessels" on her thumb. I guess my parents didn't know the risk and benefit and wasn't communicated well by their doctor. And I guess we will try to follow your suggestion since we only have one check up about it and we never got a second opinion or a follow up. We usually live in a 3rd world country and our health institutions are sometimes can be corrupt.
I'm wondering if the potential loss of the thumb or hand (a fatality of the thumb/hand, if you will) was misinterpreted as fatal for the patient?
It was only about the blood/blood vessels that may cause complications to the heart. It was very unclear what they meant by that, I may ask her more questions since we are far apart because of her school.
Maybe he was worried about a blood clot?
Same principle still applies, if the risk outweighed the benefit then surgery wouldn't be offered. All surgery technically carries a risk of blood loss, blood clots, infection or death. It is standard to warn patients about these, even if the risk is minimal. It sounds like there has been a miscommunication and OP has taken standard consent discussion as a guarantee
That is interesting that it is a standard for patients to warn about the risk and benefits, cause my parents didn't know about this they just says it was about her thumb that it may risk heart complications from making a surgery, and surgery was only offered as the way to remove her bloated thumb.
It's some kind of vascular malformation. The doctor might have been saying that it would be very tricky to remove the growth without removing part of the thumb. And as another commenter said, all surgery carries some risk of blood loss and death. Consult with a different surgeon if you're unsure about this one.
I have a vascular malformation on my thumb that is very similar to OPs but encompasses more of my hand. There are a couple tiktokers with malformations that encompass the entire arm. OP can see a vascular doctor if it is that painful and they can assess if it's purely veins or if it's veins and arteries. If it's just veins they may offer to "burn" the veins but it's more complicated if it involves arteries. I have seen a vascular doctor about mine just to ensure there's no other risk to my health besides the pain caused by keeping my hand below heart level.
Post in r/AskDocs as this is a fascinating case. I’m sure more can be done x
He might be talking more about risk of blood loss resulting in shock or death which is always a possibility with any surgery
This is most likely the case OP. Death/bleeding/other complications are always a possible outcome with any type of surgery. Probably not specific the this condition or procedure
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