surgery


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 scheduled the appointment with a family doctor. Not mine. Mine isn’t on the schedule for the rest of February and they don’t have her schedule available for March either.1 I don’t know the doctor that I will be seeing. I’m not anticipating anything good coming from the appointment, but I knew I had to make it anyway. New doctors and me don’t really mesh well. Actually, doctors in general don’t mesh well with me.2 My doctor has had some cringe-worthy moments, but she does listen to me. She understands that I am trying to take care of myself and I’m not trying to do something that my body cannot handle.3 And she’s encouraged me to exercise in the past.4 I’m hoping that she can talk to the doctor who will be seeing me or leave a note in my chart explaining that I’m not a complete masochist who wants to die from falling off a stair-stepping machine. I sent her an email explaining that I needed her help. I need a medical clearance for the Wellness Center to continue my physical therapy exercises on my own. A form was sent one to you, but I was called this morning & told someone else denied clearance because of the Ehlers-Danlos. Specifically, they mentioned skin involvement, which is mild for me. I know what exercises I can and can’t do without hurting my joints. The only things I was thinking of adding in were Pilates and pool exercise, which are both considered safe for people with Ehlers-Danlos because they’re low resistence, high repetition. I’ve never met the doctor that I’m supposed to see, which is hard for me because I tend to be intimidated by new doctors & feel like new doctors don’t always listen to me. I’m scared if Dr. ******** refuses that the strength I’ve built up since last summer and especially since the surgery will disappear. I’m worried that without continuing to do the exercises I will end up having more surgeries. Can you help? Hopefully, she’ll be able to do something. I also sent her one letting her know that I did try to get an appointment for the mini-pill prescription. I tried to schedule an appointment for the Norethindrone prescription, since it is a high-risk medicine for me, but the prescription was called in without an appointment. I thought you might want to know that I haven’t had any signs of clots while I’ve been on it. I also haven’t had any excessive bleeding while on it. Dr. ******, my hematologist, said that being on birth control is going to give me another year without infusions, but that I will probably need one this coming December or next year sometime based on my ferritin levels. I want her to know that I am trying to do things that I’m supposed to do to prevent future health problems. I’ve been by past doctors accused of not trying to take care of myself. I refuse to be blamed for these things. I refuse to let doctors, nurses, and random office workers5 who don’t know me and who don’t care about my overall well-being sabotage the progress that I’ve made and risk my life in the process. UAB Huntsville is prone to this sort of “well they aren’t on the schedule” and “oh, we don’t have a schedule for next week or next month available yet” thing. They do it to every patient, no matter what is wrong with them. No matter how dire the situation. And I’m not saying my situation is dire, but they’ve done it with my mom when she’s tried to schedule appointments for diabetes and blood pressure. ↩When you have a soft voice and you cry easily, doctors walk all over you. When you have a soft voice, cry easily, and chronic illnesses, they walk all over you while wearing heels that have Lego blocks on the bottom of them, bumpy side down. ↩Or she has acted like she understand this. ↩If she doesn’t support my use of the Wellness Center, then she’s being hypocritical. ↩The person who decided that I didn’t need the appointment for the norethindrone prescription was a receptionist with no medical training. ↩

Blood, Sweat, and Tears