prickly reminders of the past

[pellicle]

as a self tester stuff like this every few weeks is just a memory

but now and then I get a jab done to check that my technique with my coaguchek is OK

So while I'm waiting for the results I get to have the reminder of why I don't do it at the clinic anymore

 

[epstns]

Honestly, I think phlebotomist means the same as "butcher" where some of these people come from. While I'm no longer taking warfarin, I do have to do periodic blood tests, and I've found that heavy pressure on the puncture site helps me to reduce the incidence of bruising and other "blow-outs."

Of course, this will only work well as long as they stay away from veins in my neck. . .

 

[pellicle]

for the interest of others the INR came back from the lab as 2.5 while my Coaguchek was 2.3

as it happens I have never used this lab (a large company) and had previously always used a Govt one.

Euther way I made no dose alteration and would have made no dose alteration had I dosed on the basis of the other result either)

I may go to them again in future and see what happens again.

 

[Aggie85]

You look like you have nice veins. Surprised you got hit this bad. I assume the big bruise is result of Warfarin therapy. I'm a difficult stick... Small veins that are hard to find, roll, are tough and then collapse when they get in them. I'm used to getting stuck 2-3 times for each time I need blood drawn. I've learned to stand up for myself. Blatantly ask, who is your most experienced person and then insist on them doing the draw. When we discovers that POCs aren't working for me (see other thread), I went and talked to the lab director and asked for names of who I should request. She was very accommodating. I've also found, since starting Warfarin, that draws in my hand (often done out of desperation after failing elsewhere) seem to bruise less. Try asking them to use a hand vein next time.

Does it hurt as bad as it looks? I've noticed that the several I have now (in various color stages) don't hurt. They just look awful and seem to take forever to fade away.

Maybe we could start a new thread to go along with Tawdry Shirt one. Vampire Bruises!
Linda

 

[pellicle]

Hi

You look like you have nice veins. Surprised you got hit this bad.

yeah ... over the years its been like this from time to time ... even before I was on warfarin. Depends if they scratch the vein much on the way in (and out).

Does it hurt as bad as it looks?

this one didn't actually hurt much ... so it was just an example of why I don't like getting needles. No one can get anything on my right arm due to 2 catheters at different times (in the long ago past when things weren't as slick as they are now) and a collapsed brachial vein from (probably) a main-line insertion.

Maybe we could start a new thread to go along with Tawdry Shirt one. Vampire Bruises!

nice idea ... followup pictures welcome "phlebotomy wall of shame"

 

[epstns]

I've tried another approach. First, I tell the tech that I'm a difficult stick. I ask them to use a "butterfly" (pediatric) needle. I also tell them that if they stick me more than twice, I'll go out into the hall and start to cry very loudly. Nobody wants to see an "old grey-haired dude" out there crying, do they?

The usual team of tech's remember me, and it all becomes a joke - as long as they do a good job (and they usually do).

 

[Aggie85]

That's the approach I usually did and would go in asking for most experienced. This year, seemed to be running A LOT more into the "we now how to do our jobs! don't worry..." And then needing multiple sticks because they didn't listen. I also often get the, but it hurts more there (mid arm, hand, etc) and my answer is yes, but less so than multiple sticks. I went to director when I realized this was going to be a semi(?) permanent weekly visit and I had trouble with the tech arguing with me NOT to use my AC "vein" she THOUGHT (my word, she insisted she DID) she felt. I've had 8 cath cut downs there since they can't do Femoral Vein caths on me, and have lots of scarring. She insisted and of course got nothing when she tried.

They warm my arm and hand to have it ready, with a hot pad and do the whole hand pump thing, etc.... I had hoped that now that I'm off the Lasix it would at least be a little better, but no such luck.

I'll let this hand bruise develop a day or so, to get its full colors going and then see if I can figure out how to post pics here. The bruise from two weeks ago is still there but too faded for camera. Oh, of course, the day after advising folks to try hand draws as they seem to bruise less for me and not be painful... Today's hand draw WILL be a doozy and is VERY tender as the vein blew while he was collecting but was still filling vial even while filling my dermal skin layer too and neither of us was willing to go for a third attempt when blood was still going into the vial!

Because of the dang POC machine issue, I'll be a weekly pin cushion possibly for rest of my life, certainly for next few months. So should have new veins of shame posts often. :thumbd: No, I don't intend to come griping every week! Maybe every other!?!?! :angel:

Linda

 

[T in YVR]

The clinic I go to in Vancouver uses a different needle to draw blood for patients on warfarin. It's smaller/thinner and creates way less inconvenience (pain)/chance of bruising/bleeding etc. A couple times a less experienced lab tech used the bigger/standard needle they use on everyone else, and you can definitely feel the difference. I also had a bit more bruising with it. Might be worth asking them if they have the smaller needle. Its way better!
Tony

 

[Aggie85]

They're using the smallest needle they can; 22(?)guage pediatric butterfly needle. Is the one they're using on you a butterfly needle? It's a small needle with plastic wings attached just at base and a thin tube that is then hooked up to the test tubes the blood goes in. I'm pretty sure the pediatric needles they use on me are smallest available.

Biggest problem is my veins aren't near the surface, are small, roll, and tough to puncture. I've known this for years and always dreaded blood draws. When I had gotten a job at Children's Hospital as a RN, I had to have a blood test as part of new employee work up. Even the phlebotomist at a CHILDRENS HOSPITAL had problems, gave up, and ended up doing a finger stick sample on me for a simple CBC. SHEESH. Knew I was a problem then!

Now it's really come to the forefront since looks like it has to be done every week from now on unless we figure out why the POC machine isn't working on me.

Thanks for advice though!
Linda