Anyone have trouble with blood draws?

Anyone have trouble with blood draws?

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DokaGirl

Senior Member (Voting Rights)
Recently I had blood tests. Drawing my blood is almost always a problem. I wonder if this is a common phenomenon with pwME.

After several tries, a lab technician may be able to get enough of a sample for testing. If I've had to wait quite some time, all the while sitting upright, my heart may be hammering, and I feel faint. Not ideal, as my blood has most likely collected in my legs, and my heart is struggling to re-circulate it.

I try the tricks - lots of water before the test, heat on the targeted spot for the blood draw, and of course the lab tech does the usual tourniquet etc. to bring up a vein.

Before ME, blood draws were uneventful. Now, it usually involves several tries, and lots of bruises. Sometimes I need to revisit the lab to complete the sampling.

For several years now, we have resorted to using my hands for these draws. But my veins still collapse, and wiggle away. Blood when it does come is slow, and stingy, sometimes meaning the draw is ruined, and then rejected.

My theory is that the circulatory problems with ME effect the ability to draw blood. This seems to make sense. What do you think?

Nurses, lab techs and doctors all have trouble getting blood out of me. Just call me "Stone"!
 
My veins are small, and tend to hide. Always been like that, but more of a problem now. It takes them a looong time to get enough blood, as it comes out at a slow pitiful trickle. Syrupy.

If they listen to me and stay with the right arm as I tell them to, it usually goes alright. The right one is tricky, but the left one is impossible.
 
DokaGirl said:
Syrupy blood. A couple of health care professionals have told me I have thicker blood than the norm. And mine comes out at a trickle too with blood draws.

Didn't Dr. Leslie O. Simpson theorize about blood viscosity, and ME?
Click to expand...

I think, if I remember rightly, he found evidence of change in shape and deformability of red blood cells which reduces their ability to flow through tiny capillaries, and Ron Davis's team are currently researching this. I have no idea whether that same factor would affect the ability to do blood draws.
 
Thanks @Trish! That rings some bells.

Early in the 1990s there was some research and/or info on Evening Primrose Oil helping. This may have been to do with viscosity.

Hope Dr. Davis' group finds evidence.

Thanks again!
 
Same problem here. Plus I have haemochromatosis which means they regularly have to get about half a litre of blood out of me in one go. This is becoming more and more difficult. My veins are actually very good, or so I'm told, but the blood seems to clog up the needles.

Here's a list of tips I've gleaned from haemochromatosis circles, some are more applicable than others in ME, so use common sense and discuss your particular situation with your doctor. Some of the measures you're already taking @DokaGirl, but hopefully there's still something useful here.

  • Reclining position - neither lying flat nor sitting upright - is best.
  • Before the blood draw walk around the block and swing arms to get blood circulation going (tricky with ME).
  • Work a squeezy-ball with your hand just before the draw to improve blood flow.
  • Warmth. I get handed wheat bags as soon as I arrive at the clinic, and they turn on an extra heater.
  • Extra fluids starting a day or two before the blood draw.
  • Experiment with different needle gauges.
  • Experiment with different types of tourniquets and pressures.
  • Blood-thinning medication/supplements. This is controversial. Some doctors recommend it, others advise against it for fear of getting the blood too thin and causing major bleeding or bruising. My doctor was against aspirin but is happy for me to take fish oil or EPO and this does seem to help in my case. But blood thinning is obviously not something you want to get wrong so definitely discuss with your doctor if it would be suitable for your particular situation.
There are also several conditions that can cause thick blood by themselves so might be worth asking your doctor about testing for those if you have syrupy blood, just to be sure there isn't something going on in addition to ME.
 
DokaGirl said:
Drawing my blood is almost always a problem.

I try the tricks - lots of water before the test, heat on the targeted spot for the blood draw, and of course the lab tech does the usual tourniquet etc. to bring up a vein.

Before ME, blood draws were uneventful. Now, it usually involves several tries, and lots of bruises. Sometimes I need to revisit the lab to complete the sampling.

For several years now, we have resorted to using my hands for these draws. But my veins still collapse, and wiggle away. Blood when it does come is slow.
Click to expand...
Yes! All of those points exactly apply in my case too. And only since I became ill, never before.

I even had one instance of phlebotomists putting tourniquets on my legs and trying to draw blood from my feet (which didn't work either), because they couldn't get any out of my arms.

What seems to produce the most 'success' (using the term mildly, because it's still always a problem) is having the blood test in the afternoon instead of the morning, and drinking a glass of water and walking around a bit first to get the circulation moving, and sometimes they put hot water bottles on my inner arms.

But it's still always a struggle. The expertise of the person doing the blood draw is always a big factor, too - if I find a good one who is particularly deft, I try to always see that one again for subsequent tests if possible!
 
Thank you @EzzieD, @Ravn, @Trish, @andypants, for your comments and suggestions.

The syrupy blood concept did ring a bell for me, and I followed up on NZ researcher, Dr. Leslie Simpson's work. He looked at blood viscosity, red blood cell shape, blood flow and the possibility of smaller than normal capillaries in pwME.

This is an article by ME activist Craig Maupin on Dr. Simpson's work with blood flow:

http://www.cfidsreport.com/Articles/researchers/lessimpson.htm

And, below is the abstract from an article written by Dr. Simpson: http://orthomolecular.org/library/jom/1997/articles/1997-v12n02-p069.shtml

The Journal of Orthomolecular Medicine Vol. 12, 2nd Quarter 1997

Myalgic Encephalomyelitis (ME): A Haemorheological Disorder Manifested as Impaired Capillary Blood Flow

Leslie O. Simpson, Ph.D.


Abstract
The differences between the concepts of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are discussed with particular reference to the problems arising from the multiple definitions of fatigue. It is pointed out that our earliest published work with ME patients showed altered blood rheology and subsequent tests using scanning electron microscopy of immediately fixed blood samples provided a basis for understanding the poor blood filterability described earlier.

The consequences of stiffened, shape-changed red cells would be to impair capillary blood flow particularly in tissues with smaller than usual mean capillary diameters. The degree of reduction in the rates of delivery of oxygen and nutrient substrates would be related to symptom severity. As there have been a number of previously reported studies of the red cells in a number of chronic disorders, the obsevation is not new. Furthermore, the changes in red cell shape populations which occur in ME also occur in other chronic disorders so red cell shape analysis alone is not diagnostic for ME. The observed changes are probably of importance in the pathogenesis of tiredness.

Patients benefit from the results of red cell shape analysis test as it provides evidence of a change which can explain their illness, even if they are unresponsive to treatment. As changes in rheology can be shown to occur in the blood of ME patients, haemorheologic agents which have the potential to improve the flowproperties of blood are recommended as therapeutic agents.

1.Department of General Practice, P.O. Box 913 Dunedin, New Zealand



Dr. Simpson also wrote the book:

Blood Viscosity Factors: The Missing Dimension in Modern Medicine
  • Paperback: 276 pages
  • Publisher: Mumford Institute Inc (April 1, 2008)
  • Language: English
  • ISBN-10: 0615254578
  • ISBN-13: 978-0615254579

It's very good the OMF team are working on this!
 
I don't get blood tests that often but when I do I prefer they take it from my right arm. For some reason it is more painful on my left arm so always ask if they can take blood from my right arm. I haven't had any other problems other than that though.
 
For about five years I had to drink a liter of water about an hour before giving blood or the average phlebotomist could not find the vein. The last draw things were back to pre-2012 for some reason. I am hoping that persists.
 
Problems with blood draws include, but are not restricted to two situations: poor vein status for whatever reason, be it ME, or whatever, and the usual tendency of health care professionals to view the public as unreliable sources of information, even about their own health.

I've had several blood draws in the last few days, and have seen that my cautions about use a smaller needle, and heat are often dismissed, at least at first, until they try, and poke around for a while with no success. Then, they seem to reluctantly believe me, and try things I've suggested.

These little scenarios seem to reflect something of the bigger picture in medicine. The disregard for the lay person's experience, knowledge, and credibility. And, the confidence that health care training, and the super structure behind them cannot be wrong. Also, that all should be accomodated by a one size fits all system of care, and if an individual doesn't, that individual is the problem.
 
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