Tuesday, August 22, 2017

Don't order (or let your doctor order) more than you can chew

Not her expression at blood draw time
I adore lab personnel that can draw blood on my daughters' tiny arms.
Having attempted many a blood draw and IV myself, and failing innumerable times on the healthiest and plumpest of veins, I am always willing to wait for the best 'peds stick' to come back from lunch or wherever he or she has gone.  That being said, wonderful as they are, keep in mind that lab personnel generally have no idea why they are drawing the labs that they are drawing.  This morning my 2 year old, fasting and grumpy, went in for her blood to be drawn, and when they chose which tube to fill with the most blood, they chose the tube that
had to be sent to another facility for evaluation of her fatty acids and fat
soluble vitamins.  It makes sense to some extent - those labs will take
longer to get back, so if we are going to repeat a blood draw, might as well
repeat the one that we can just get the results of in our own facility!  The
thing is, I don't really care about her fatty acids and fat soluble
vitamins.  All right, if we already have the blood, I don't mind checking
it.  But the lipid panel and triglycerides are all I REALLY care about,
especially since she's fasting!  Fatty acid and fat soluble vitamin panels
don't require fasting!  If the lab personnel had asked us (but what do
parents know?) we would have emphatically explained that the lipid panel was far more important than any other lab.  I bet they've never faced the wrath of a fasting 2 year old and haven't thought about it much.  But I have.  And now I am trying to come to terms with bringing my baby girl back to that same horrifying lab next week, to repeat a fasting lab draw.  It's sure to imprint itself on her memory in a special way, such that she won't be able to even see the lab in the future without starting to cry and scream.  Sigh.

Other tips for blood draws on little ones:
-always ask for pediatric sized tubes.  It's pathetic to see the little baby drops of blood in a giant grown-up sized tube, and it's unnecessary for many labs to have that much blood.
-warn the technicians, especially if they run the lab in the facility, to expect a highly lipemic (read: greasy) sample.  They might have to do fancy dilutions to figure out how many triglycerides are really in the sample, because the TGs of many folks with LPLD are literally off the chart.
-our typical supplies for blood draws include: ipad or portable DVD player, new toys (or ones hidden months ago and taken out as a surprise), water, granola bar for immediate post-draw calories, candy for just in case bribes.

How do you survive blood draws?

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