Friday, June 19, 2009

Another Blood Draw, Another Bruise

You know it's a bad sign when the lab technician says, "Jeez, you just don't want to clot, do you?!" as she raises your arm in the air and presses with gauze on the site of the blood draw.

My hematologist read his email while on vacation, and I got the call this morning that he'd like to repeat the platelet function test to make sure it wasn't a fluke or a lab error (although with the elevated result from November 2007, it seems unlikely that it was a fluke) as well as to run some autoimmune coagulation tests. Unfortunately, I didn't get the names of those tests today, so I'll have to wait until I get the results to find out exactly what he was looking for.

My hematologist teaches and treats patients at OHSU, Oregon's medical school, so you deal with a lot of students there. A phlebotomy student who finished her coursework and is doing her internship asked if it was all right for her to draw my blood.

I told her no problem, but also alerted her that my veins can be challenging to get a needle into. Then she looked at both my arms, with 4-inch-long, 2-inch-wide bruises at both wrists and a large bruise in my right elbow, and bit her lip.

She felt around tentatively for a vein that wasn't in the center of one of the bruises, before she asked the other tech to trade patients with her. Poor kid. I was fine with letting her try a poke or two on me since I figure students need practice on the people with tricky veins as well as the ones with easy veins. But she didn't want to hurt me by poking me in one of the bruises, and those were the only veins she felt semi-confident of being able to tap.

Her more experienced colleague got lucky on the first poke, and then was determined that she wouldn't add a new bruise, hence the holding my arm up when I didn't clot with normal pressure.

I got only a little bruise where the needle poked me, but I got a series of bruises higher on my arm where she tied the tourniquet.

But what are you going to do when you bruise easily and have for your entire life?


SharonMV said...

Hi Aviva,
If you know you're going to have a blood draw, being extremely well-hydrated can help. Drink as much water as you can the day before & the day of the test. I'm a hard stick & have to have an IV every 3 weeks & drinking the water helps. Don't know if it helps the bruising directly, but fewer blown veins means fewer bruises.
The platelet & clotting problems do occur in Lupus - definitely could be autoimmune. Good luck with your hematology appointment.


Aviva said...

SharonMV: I do try to hydrate. I'm convinced that part of the reason I got the monster bruises from the blood patch is because they told me to not eat or drink past midnight, so it was about 9 hours with no liquids. But thanks -- I appreciate the reminder!!