Bad Veins


My veins suck. They have all kinds of structural issues and when combined with my chronic dehydration and other chronic health issues, they don’t like to play well with needles. I don’t expect blood draws to go smoothly. I’ve learned over the years that most phlebotomists (and some other medical professionals) aren’t going to believe me about just how bad they are. I’ve also learned that if they stay calm, it takes a shorter time, so instead of chewing them out about what’s going on, I smile and reassure them. But if I could tell them a few things, I would tell them: Stop hitting me. You may classify it as tapping or slapping, but it’s painful and it won’t help you. Slapping does not make it easier to find the veins. It doesn’t make them pop up. For me, it seems to make them “hide” because the stimuli is so painful; also, I have a connective tissue condition called Ehlers-Danlos Syndrome, so I’m prone to bruising, which make it even harder to spot the veins. The tapping/slapping/hitting also can damage the blood that you’re attempting to draw and mess with the results. I know I’m in my thirties, but my veins still roll. Every time I specifically tell one that my veins roll, they say that I’m too young for that to happen. Veins rolling is mainly associated with the elderly, but it is also associated with people who have connective tissue disorders. This is why you don’t continue a saline drip into an already blown vein. (Twitter) If I tell you my vein is blowing, then you need to listen to me. I know my veins better than anyone else, and I should since I’ve had them my whole life. I know what a blowing vein feels like, and I know what it feels like once one has already blown. For me, if I get a really cold burning sensation right where the needle is, I know that that needle better get out of my arm. I once told a nurse that the vein was blowing and she ignored me. She continued to work with the vein and even tried flushing it to start an IV. If you’ve never experienced the joy of saline flushing through an infiltrated (blown) vein, then consider yourself to be extremely lucky. I already drank the water. I am aware that being dehydrated impacts whether or not your veins are visible. Before scheduled lab tests, I make sure to drink even more water than I normally do. It doesn’t help. Stop being cocky and trust your patient. I know that some of these people are really good at their jobs, but the cockier they are the more likely they are to have problems finding my veins. And I’ve talked to other people with bad veins who have noticed this to be a common trait. Like I mentioned with blown veins, I know my veins better than anyone else. If I tell you that my veins suck, then I’m probably telling the truth. Even if the patient doesn’t actually have bad veins, the phlebotomist needs to behave like the patient does. What is the worst that will happen? Be confident. Yes, I want people who aren’t cocky, but if you’re nervous, you will miss the vein. Just be calm and respectful. Forget the gadgets. The only thing that was ever learned about my veins with a vein-finder was that they had more branches than most…and that they have are super-deep and really small. Using heating packs might help a little, but a warm towel or blanket works just as well. Oddly, a blood pressure cuff works better than a tourniquet. Tourniquets should die a painful death. Okay, back to the connective tissue disorder and its complications. If you’ve watched many episodes Law and Order or CSI:, then you may have heard of petechiae. It happens when the capillaries (really little blood vessels) explode and spew their bloody guts into the tissue that makes up the skin. Petechiae isn’t painful, but tourniquets are. (Blood pressure cuffs also cause petechiae and pain, but veins pop up quicker with them than with tourniquets.) Ask me about my allergies before you stick me. I know that it’s the patient’s responsibility to tell the phlebotomist and I try to get across that medical adhesive and latex are a no-go, but if they aren’t listening or they forget, it helps if they ask again just to make sure. Again, this is one of those what’s the worst that will happen things. Prepare your needle and equipment before you go hunting for a vein. A lot of people like to hunt for my vein before they have the needle ready to go in, which means they find one, walk away, grab their stuff, wipe me down, and then go to stick me. Veins that roll are not veins that you can just walk away from and expect to still be there when you get back. My veins have other plans. Stop digging. It hurts and it typically leads to a nerve being hit. That is pretty unpleasant. And by “pretty unpleasant” I mean that I would rather walk barefoot for 5 minutes down in Antarctica than have a needle hit a nerve. Sharp pointy things do not play well with nerves. Oh, so now you think they’re too hard to find? No shit, Sherlock. The exclamation of “these are hard to find” is always one of those things that makes me want to roll my eyes. I know that some people might lie about the difficulty, but I don’t. I don’t need your affirmation that they are hard to find. I know that they are. I’m the one who has been stuck in the palm of the hand and the top of the foot when safer/better areas were not found. I’m the one who has had to wait for the charge nurse to come do the stick or for the anesthesiologist […]

Stop Hitting Me


 Well, I survived my surgery.  Yay! I got to the hospital on time & got checked in/taken to pre-op almost immediately. Of course I had to do the required pregnancy test.1   Eventually, a nurse2 came in to set-up an IV—she only stuck me once, thus allowing her to join my unofficial Hall of Fame—while my nurse3 reviewed my medical history, medications, allergies, and the results of the unnecessary pregnancy test.4 I praised Candi for her achievement and tried to interact with Danielle. I was more calm and relaxed once the IV56 was set up. Danielle said the change in my demeanor after the IV was very noticeable.7 She wasn’t really thrilled, at first, with my mom saying that she was there to mock me while my IV got set up, but my mom explained why she does that.8 But she didn’t need to.  One big fear down, a couple more to go.  The antibiotic they used was clindamycin. It’s amazing how my old acne medicine is one of the few antibiotics my atopy-prone body has not declared war on. I guess it’s because it’s not really used that often. Danielle said that typically they’ll give Keflex9 and, if the person is allergic, they’ll use penicillin.10 Or the other way around?  Having a Keflex allergy while having a penicillin allergy isn’t exactly normal, despite their being related. It probably happened in me because of genetics11 and because my first antibiotic allergy was Ceclor, which is related to both Keflex & penicillin somehow. Anyway, Danielle made sure I was not allergic to clindamycin before they officially hooked it up.  When the anesthesiologist came in, he insinuated that I wasn’t allergic to the medicines I listed. That changed as I explained the reactions.  Each person who reviewed my list, including him, did not understand why I listed my orange juice allergy12 under the section for food allergies. Hmm. I wonder why a person would list a food allergy as a food allergy.  Maybe because: Oranges and other fruits contain proteins that are chemically similar to pollen; eating these can cause itching and irritation of the mouth in certain people, many of whom also happen to be allergic to pollen… (via Newsweek) That article points out that orange juice allergies can be worse for asthmatics because of our already inflamed airways. There are also some who believe that orange juice allergies can be a result of salicylate (aspirin-relatives) allergies/sensitivities.13 Basically, this orange juice allergy stuff is serious as fuck.  But I digress…again.  Before taking me to the OR, I was given a dose or so of Versed, aka midazolam.14 In some people,15 there is an unexpected reaction16 and medical professionals can go into denial mode over it because it is pretty much the opposite of what the drug is meant for. Eventually, I was rolled off to the OR. Special latex precautions were taken, which was expected, and was the reason my surgery took place at the hospital instead of an outpatient surgery facility. I think I was the last surgery on the schedule and there may have been a good reason. The anesthesiology team consisted of the anesthesiologists ans 2 nurse anesthetists—the 3 were monitoring me for allergic/adverse reactions. Seriously. The patient board in the OR also mentioned I had multiple allergy issues.17 Eventually, the sleepy-time doc gave me the propofol and I zonked out. My parents said the surgery took five minutes and that my orthopedist, who I saw one time today…before the surgery, said my meniscus and fat pad were fine, but that the debris in my patella was made of bone flakes and that I definitely have arthritis. He also said I need to start exercising and trying to lose weight. I got pissed when he said that because this particular doctor always dismisses that I do exercise. I told him with a previous injury that I was injured while exercising. I told him this issue became noticeable while exercising. As for trying to lose weight?    I’ve lost around 27% of the weight I wanted to lose. I’ve lost 32% of what I need to lose to reach a healthy weight. I would have lost more if my knee hadn’t been fucked up since Spring. Being fat doesn’t mean I should be dismissed like this.  Pretending like all of this is due to weight and weight alone is also bullshit.18 I’m having a hard time believing that the meniscus and fat pad1920 are totally okay, given the symptoms. I just think he’s used this to tell me that he thinks poorly of me for my weight. And that’s pathetic and superficial crap. If he’d ever bothered to listen to me, he could have come to that conclusion on his own.  After surgery, I started talking like crazy21 to the nurses in the recovery section, including Danielle, who was literally keeping watch over me afterward. She got so busy talking to me that she almost forgot to give me a dose of Fentanyl.22 And she almost forgot once again with my Demerol dose. At first, I wondered if she wanted to give me the pain relief injections because she thought it would shut me up. It just made me worse. It wasn’t long before I was getting discharged; we did have to wait for a drug-induced23 vertigo spell to pass.  I also had the lovely experience of a different nurse doing a bad job of removing my IV. She was trying to take the tape off without tearing my skin. I would be grateful for that effort except that, while doing that, she ended up removing the catheter24 rather violently. It started bleeding. A lot. As I mentioned earlier on Instagram, removing an IV so violently is not only painful and dangerous to people with conditions like Ehlers-Danlos or any other chronic health issues, it is painful and dangerous for able-bodied, healthy folks, too. And if you factor in the time it takes to stop the bleeding, taking it out […]

Operation: Get My Life Back (& My Knee Fixed)