I've just had my regular blood tests done, which prompted this post. (My routine is to go to a pathology collection centre for the blood draw, then two days later pick up my results from my GP after he has checked them. I schedule the test prior to my haematology appointment so I'm prepared with questions if there are any changes of note.)
This morning didn't start well. The results hadn't come through, then my doctor was on leave and the receptionist said the relieving doctor might get time to check them today, if not, I could pick them up tomorrow. I'm getting better at not worrying about how things are going between blood tests, but once the sample has been taken, I really want to know how I'm going! Finally, this afternoon I received a call from one of the more patient centred receptionists to say that I could collect my results and what's more they were good! My platelets were well up and just back into the normal range - the best they've been for almost 2 years. I had to check the date was correct - it wouldn't be the first time I'd been given old results. Thankfully I haven't had the experience that someone on the CLL Forum had. He picked up his results and his lymphocyte count had skyrocketed! Turns out he was given old results from before chemotherapy!
Here are my tips for getting through this necessary experience with minimal discomfort and obtaining the most accurate results possible.
If you can, find a collection centre that has plenty of room so you can avoid the risk of infection. These are not places healthy people frequent! Where I go they have face masks and gel hand wash at the counter and more hand wash outside the collection room.
Avoid the morning rush of people that have been fasting, or are squeezing in a test on the way to work.
Use the same pathology service - different pathology services use different test equipment and these can cause notable differences in the results on the same blood sample. (I've seen instances where a testing machine is being replaced and the pathology service provides tests on both machines for 3 to 6 months so medical staff can familiarise themselves with the different spread of measurements.)
Try to have your blood draw done at the same time of the day and try to follow the same routine prior to collection. Some blood components follow a diurnal cycle.
Don't be alarmed by some variation in your results. Test measurements have a known repeatability error, that is, measuring the same sample will give slightly different results within a known range. Long term trends are what is important.
Make sure you are well hydrated before visiting the pathology service - it will make it easier to draw the blood sample. You need to drink more a few hours before attending.
Avoid strenuous physical exercise before your blood draw. This can boost your neutrophil levels which may give you a false sense of security if you are nearing levels where you need to be on a neutropenic diet.
Try to share the blood draw locations around to avoid a build up of scar tissue; swap arms, etc, If you are finding the process painful, you can apply a local anaesthetic cream like Emla cream for 30 to 60 minutes beforehand. (This is also great prior to IVIG transfusions.)
Avoid lifting any heavy weights for a while after the blood draw, particularly if your platelets are low or clotting takes a while for you.
Some blood test results are influenced by the way the blood sample is taken and how it is treated afterwards. Of particular importance to us is the LD (or LDH) test, which indicates how rapidly our lymphocytes are growing. More seriously, an out of range result here may indicate a progression to Richter's Transformation, something that we are at increasing risk of developing the longer that we live with CLL. It can also just mean that the phlebotomist struggled to obtain a sample and bruised the already fragile CLL cells, releasing the LDH into the sample.
More tips on what to do afterwards can be found here:
I've been fortunate in that a couple of years ago, a new collection centre opened within walking distance (though I usually cycle there). Amazingly it is about three times as large as the other nearby centres - they must have been given a great deal on the rent. Thus there's plenty of room for me to keep my distance from others attending and frequently I don't even have to wait!
What are your tips and experiences?