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Problem With Having Blood Drawn


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#1 Gidget

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Posted 07 December 2006 - 03:18 AM

Does anyone have any solutions or tricks to make blood drawing easier? Because of the sclero, it is very difficult for the filbotomist to find a vein and often I end up being "pricked" 4 times and still they cannot draw any blood. They have tried the normal places, the hand and even the wrist (ouch). Not only does this process get painful but it starts to stress me out. I am especially nervous as I will be starting the Cytoxan IV and I have no idea how they will get an IV in me if it is this hard drawing blood. Also, once I start the cytoxan, I will need bloodwork drawn every 10 days. I try drinking alot of water the day before the drawing but that does not seem to make a difference. Any suggestions? Thanks for the help. Gidget

#2 LisaBulman

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Posted 07 December 2006 - 03:44 AM

Hi Gidget,
How painful! I don't have any magic remedies but when you do start the cytoxan they will put a line in you the first time and they will reuse that each time you go as long as it doesn't give out. I know someone on here had this but I am not sure who. Hopefully they will read this and chime in.

Hugs,
Lisa
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#3 Patty

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Posted 07 December 2006 - 04:03 AM

Hi Gidget,
I also have a hard time with this and now when I go they use a pocket warmer type thing on my arm to heat up my veins and make them easier to draw from. If they do not have pocket warmer things ask for a hot towel to put on your arm. This is what they do in the O.R. here when I had my surgerys. Also they sometimes go for my inside arm between my wrist and elbow. It works for me!

Good luck!!

Hugs,
Patty
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#4 janey

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Posted 07 December 2006 - 04:10 AM

Gidget,
Oh yes - I can definitely relate to this one! One thing that I now always request (and have never been denied) is a butterfly needle. It's smaller so it's easier to find those tiny veins and to poke into them. It doesn't hurt near as bad either. In addition to continuing to drink lots of water and to Patty's great suggestion of the warmer, try pumping the veins up with some light weight lifting before you go in. I'm not sure what really helps, but I do all these and when I get my IV for my infusions, I know only get poked one to 3 times as opposed to more than 15! OUCH!
Good luck and good veins!
Big Hugs,
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#5 peanut

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Posted 07 December 2006 - 06:37 AM

Gidget,
I am already receiving cytoxan via IV. I have two good veins so I don't have any problems but I share the infusion room with other patients that do. I've seen the infusion nurse place a heating pad on the arm/area before they look for a vein. The heat brings the veins out. And drinking lots of water really helps.

Why does the sclero make the veins disappear? Is it because of the skin thickening?

You can deprive the body but the soul needs chocolate
my HMO makes me wear a helmet...

#6 Sweet

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Posted 07 December 2006 - 07:42 AM

Gidget,

Drinking a lot of water is a good idea, but also do it the morning of your blood draw. A lot of patients don’t know they can drink water the morning of a draw. You can! (I’m a nurse). The other thing you can do is wrap your arm in a hot moist towel several times and even travel to your appointment like that. Keep it on until they draw your blood. Also, ask them to use a “Butterfly” needle. We use them on pediatric patients all the time. As far as your IV Cytoxin treatments, they can put a “Heparin Lock” in once they find a good vein and it can be left in, and changed only when needed. That way they don’t have to find a place each time.

My veins are just like yours. Actually I have ONE vein for them to try, if they blow that then we’re in trouble.

Hope this helped.

*hugs*

Warm and gentle hugs,

Pamela
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#7 Gidget

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Posted 07 December 2006 - 11:08 AM

Thanks for all the good advice. I will try all your suggestions.

I just got back from the oncologist office and they say they cannot find a vein -- so the suggestion is that I get something put in under the skin -- I think it is called a Port-a-Cath. I guess a surgeon cuts it in. Does anyone have this and does it effect your arm mobility? Also, I understand that they can administer the Cytoxan through it -- but can they also draw blood through it or is it just "one way".

Thanks. Gidget.

#8 Sweet

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Posted 07 December 2006 - 12:09 PM

Hey Gidget,

I don't have one, but they are used commonly. It will work wonders for you! You should still have normal mobility with your arm.

Good Luck!

Warm and gentle hugs,

Pamela
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#9 Gidget

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Posted 07 December 2006 - 12:58 PM

Thanks Pam for the insight. I was nervous that it would effect my arm mobility as I am doing whatever I can to still keep my arms moving! So many stretches just to be able to lift my arm up! All the best Gidget

#10 Sweet

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Posted 07 December 2006 - 01:47 PM

Gidget,

Good Luck and please keep us posted OK?

Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#11 Claudia-DR

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Posted 08 December 2006 - 02:34 AM

Gidget, you got some really good advice here.

I know there's a product you can buy over the counter in the US that has "benzocaine" which basically numbs the skin. It might help to make the process more bearable.

Good luck!

Claudia

#12 adensmore

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Posted 08 December 2006 - 02:59 AM

I definitely identify with this topic. I used to have GREAT viens....until my scleroderma advanced, and then they all went on hiatus. I'm on Cytoxan too. I got tired of feeling like a human pin cushion, so I requested that I have a Port-A-Cath surgically implanted. I've had it for 2 weeks today, and my last Cytoxan appointment was a breeze. I love my Port and would recommend it if you're having that much trouble getting blood drawn. It is a surgical proceedure and it's implated in your chest.

The most important thing to know about a Port is that a Phelbotomist cannot draw blood from it, only a Registered Nurse. The port has to be flushed with saline before drawing blood and with Heparin after to prevents clots, and they have to use a special needle called a Huber needle to access the port. Since Cytoxan patients need regular blood work you have to coordinate having your blood drawn with your doctor. I have to have my drawn at the hospital.

Hugs,
April

#13 DBHYGRELL

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Posted 09 December 2006 - 02:45 AM

Hello all,

I am a Clinical Laboratory Scientist and part of my job is drawing blood along with analyzing it. Everyone had excellent suggestions. Keeping your arm warm is important as well as being hydrated. Always have them use butterfly needles as they are smaller. Please try not to let them draw on the underside of your wrist - there are a lot of nerves there that can easily be damaged.

A port is a wonderful idea - and where I work we are trained to draw from these lines once they have been accessed.

It might be useful to tell the phlebotomist that you are a hard draw because your skin has scarred. We learn to look for veins and feel for them in specific spots. Having scarred skin makes this, obviously, much harder. Work with your phleb to find a good vein and tell him that in the past you have had a very hard time. Letting them know all of this in advance could help them and make you a "team". And lastly, sometimes after heating your arm let it hang down to let the blood "pool" into your veins so we can see or feel them easily.

Also, I sometimes draw a vein of the thumb. It can hurt, but it is only one poke. For our pediatric patients we can have the doctors write a prescription for emula cream which I believe has lidocaine in it to help numb the skin.

Hope some of this helps -
Denelle

#14 Gidget

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Posted 09 December 2006 - 04:38 AM

thank you for all the good information. Believe it or not, they have tried to draw blood at the underside of the wrist and boy did that hurt! I never knew that there could be a risk of nerve damage. Thank you for info on the Port as well and the tip that only a RN can do the draw and that it needs to be done a certain way. I will keep this info with me. All the best. Gidget