Challenging Blood draws

I am a parent of a 6 year old boy with ITP that was diagnosed 5 weeks ago. For the most part, we are having weekly blood test, some have been sooner. He is adamant that he does not want a finger prick so we are going into the vein. On 3 occasions, we have had to try 3 different veins. The nurse can get the needle into the vein but no blood flow. They mentioned that the veins are closing up. We are really hydrating him before blood tests to rule that out as a cause, but this is a real challenge. Does anyone have some feedback, information or advice on this situation? Having ITP is one thing, but all these blood tests are really starting to wear on our emotions.

Thanks ever so much,
Heidi

Hi Heidi, Sorry you have to be here. Is it the same nurse each time? And they use Numbing cream? Joan

Hi! Yes, we do use numbing cream... Thank goodness for numbing cream! Because we had a bad experience with the local lab, we drive to the pediatric hematology oncology center. They are wonderful! We generally have the same nurses. Last time they got the needle in the vein but no blood flow. They said the vein is closing up. We put numbing cream on the other arm, waited and the same thing happened. Finally we had to just get the sample so used a vein that had no cream. The whole thing took an hour and a half! It's just so emotional! Is it typical to have problems with veins that are used every 5 - 7 days?

Regards,
Heidi

Have you tried the butterfly needle yet? Very tiny, but adequate for a CBC. My kid actually prefers the finger stick, or as one of our folks calls it, "finger slice." When she has to have a venous draw, she likes the butterfly.
Norma

The butterfly would definitely be in order. But the other thing I wanted to mention is that numbing cream will not only cause veins to roll (nearly 100% of the time for us) but it also affected the ability to get blood flowing. I highly recommend you do not use the numbing cream. You could use arnica cream on the skin after the blood draw to help heal the veins quicker as well. And quite frankly, we only allowed blood tests when WE felt the need for them, not when the doctor wanted them.

Hi, Heidi -

Sorry your son has to go through all of this. My son (now 14) was diagnosed when he was 5 and he has had hundreds of blood draws. But he always gets a finger stick. If you have the right person doing it, Brady swears a finger stick does not hurt. Brady has terrible veins (we know this from the many treatments he has had to have). We used to always use the numbing cream until we found out (as Patti said) that the cream can cause the veins to close or shrink. That's what was happening to Brady, so we stopped using it!

This is what we do when Brady has to have an i.v. started now: get hydrated beforehand, ask them for a heat pack to put on the arm beforehand, use a butterfly needle. Brady needs bloodwork right now, but he refuses to get a vein draw, so we just keep waiting, thinking he may eventually need a treatment and they can draw blood then. But I think we're going to have to just bite the bullet and have the bloodwork done. It's so difficult because once they've been stuck multiple times while the nurse is trying to find the vein the fear is there before the person even starts. And the nurses always tell Brady that him being afraid makes his veins shrink. But he can't help being afraid. At our previous hematology practice they had to poke him five or six times before they'd find a vein. Now, we go to a practice associated with a hospital and ask for the same person every time. She's in the neonatal icu and she's amazing at starting i.v.s. We always remind them every time that Brady has terrible veins and needs the one nurse. Of course by now they remember, but it never hurts to remind them.

Good luck - maybe try a finger stick some time?

Thank you so much for the feedback! They are using a butterfly... I'll be sure to ask about the numbing cream having an adverse affect and about the cream mentioned for help to heal the veins. Unfortunately we are only 5 weeks in. Grady was diagnosed when his platelets were at 20k and we had a winrho treatment. His count went sky high but has fallen back to 68k so we are having blood tests every 5-7 days. We so wish he would do a finger stick and my husband and I have put on the full sale on the facts but he is VERY adamant against it. If these veins don't cooperate we may not be able to give him a choice but don't want to make him more nervous. Thanks again and I'll let you know how it goes on Monday!

Regards,
Heidi

Hi Heidi,

Poor little guy! I hate that they have to get stuck like that. My daughter was 12, but she still didn't like it. At Children's they always had the same little old man draw the blood each time, and he was really good--he used to massage her arm a bit, and sometimes would use the warm compress. I think those helped. But, when getting infusions, you never knew who you'd get, sometimes would be a newbie, and that could get really ugly! I would be very proactive about making sure that they know of his fear, and insisting on having a very experienced nurse, because it can make a world of difference.

In regards to what Patti said about applying homeopathic Arnica cream afterwards, this is one place where this would NOT be a good idea. Homeopathic Arnica should never be applied externally to broken skin, as it can irritate it, causing a rash, or can make it bleed more. But, it could certainly be helpful and safe to take it internally (orally), a 30X or 30C potency is good. I've never met a kid who didn't like it, as the remedies are applied to tiny sugar pills that simply melt in the mouth-no bitter taste or need to swallow pills or capsules.

But, for bruising of the veins, I find that a remedy called Bellis perennis, which is in the same botanical family as Arnica, is usually the better choice. Homeopathic Ledum can also be an excellent choice, especially if a nerve was nicked and it's painful, or if there is much swelling at the injection site. You can read more about each of these in the Natural Treatments section under:
www.pdsa.org/forum/8-natural-treatment-methods/13113-homeopathic-remedies-for-various-kinds-of-bruises.html

Witch Hazel, which can be purchased at any drugstore, can also be applied topically to help with any bruising or pain from blood draws. Homeopathically, it is called Hamamelis.

There are also remedies that can be given for fear of needles, or anxiety about going to the doctor. These are usually chosen on an individual basis for each person.

Also, I know that some have been told to give a dose of Arnica or Traumeel (which is a combination remedy containing Arnica), prior to getting a blood draw or to a vaccination. I would not recommend this before hand--save it for afterwards. My experience is that the Arnica shuts the valves of the veins, which is good for stopping any bleeding, but not so good if you want the blood to flow out, as in a blood draw.

Do you have "Where's Wally?" or something similar in the States? When Dougie has blood tests (finger pricks) the nurses always sit him down with that book and get him searching for Wally first, and he then hardly notices the prick. Dougie also used to refuse to get thumb pricks, prefering a vein - although I have no idea why. One of the nurses told him that he would be better saving his veins because they get used up. I don't know whether this is true, but it certainly persuaded him.

Anyway, here's hoping for a quick recovery so that blood tests of any description are soon unnecessary!

Ali

Hallelujah! He got the courage to do a finger stick! It was so nice to have the blood draw done in 30 minutes instead of an hour and a half of tears! Downside is that the platelet count went down to 66,000 and he has an ugly bruise on his arm and a small cut today that took awhile to stop bleeding. Life with ITP is certainly life of wait-and-see!

Thanks to all for the feedback!
Heidi