Just curious. Had a guy basically fail in my left arm, gave up after a single vial, left a bruise and a lump, then moved on to the other arm for a second vial, which came easily to him.
Never had a bad draw before, as I'm skinny and veiny.
Should I be at all skeptical of the results?
--Dave!
Yes, you should be skeptical of some of your blood biochemistry results, particularly your potassium and Lactate Dehydrogenase results (LD or LDH, an independent measure of CLL activity). webmd.com/a-to-z-guides/lac...
Badly taken blood draws tend to result in blood cell membranes breaking, so that the cell contents spill into the blood, raising the plasma levels of biochemicals found in higher concentrations in your cells than in your blood plasma. CLL cells are more fragile than healthy white blood cells, so their cell membranes are more likely to fail under stress. That's why it's common to see the comment "smudge cells present" on your blood test result notes. Hence if you have a high lymphocyte count from your CLL, I would expect a more pronounced jump in your LDH, but it can happen with even quite low lymphocyte counts, because even healthy cells can be damaged in blood draws. Phlebotomists are taught how to take blood to minimise blood cell damage from the procedure, but sometimes they aren't successful, or forget their training, or don't want to put you through another blood draw.
Neil
Exactly Jammin_Me; It's why trends are so important, particularly in a chronic (slowly changing) condition such as CLL and why the default approach to worrying blood test results is to do a repeat. Thanks for making that very important point that I omitted.
I had blood taken yesterday, not for my usual checks but for my bi annual GP's check. Why they can't see all they need since the same results are posted, I shall never understand. However, I have a bruise on my arm this morning. I always know if I am going to bruise as the needle goes in. I don't know if it's the skill level or just me. Also sometimes when I have blood taken, it looks much darker than other times. My friend (retired oncology nurse) tells me that the lighter the colour the more oxygen is in the blood. I wonder if this has an effect on the result? As an aside yesterday, my blood pressure was normal but my pulse rate was 48 so a little slow. When it is cold, like now, I notice that I am more breathless. I will mention this to my consultant in April at my next consultation but just wondered if anyone had similar?
That's interesting about O2 and blood color. I think I'll use my O2 meter before blood draws to compare. I once had a phlebotomist comment on how deep rich red it was which I took as a compliment since I was running an hour per day on a hilly course. I would have expected a high O2 level from my fitness. I did not have CLL then.
I also can predict a bruise from the feel of the needle technique.
I don't have veins!!!!! the record for me - not at The Christie I hasten to add - was 19 attempts to draw blood - 6 different phlebotomists - and results were exactly as expected.
Liz in UK
Ouch xx
Just to add to AussieNeil comment about potassium. If the phlebotamist tells you to clench your fist (in order to make the veins stand out more), the muscles in your arm secrete potassium into the surrounding blood. They should tell you to relax your clenched fist, before starting the draw, but often forget. I was once recalled for a second blood test, because my potassium levels were 'worryingly high' - on that occasion the phlebotamist kept telling me to clench my fist. The repeat blood test, carried out by a serious looking young lady who clearly knew what she was doing, was perfect - no request to clench fist, and normal potassium levels.
I now regard it as encumbent on me to remember to relax my muscles just before the blood draw.
If I forget to over-hydrate an hour before a blood draw, it can be harder to get a flow out of me, plus I have some visible but sneaky veins that dodge a needle or put up a fight
What happens AFTER your blood draw can be equally important to the integrity of the results. I was hospitalized last month at a large university hospital and the staff went into a tizzy after seeing the results of my first blood draw because of the dangerously high potassium levels . When a repeated draw showed the same results the staff was about to initiate 'emergency' protocols (D50 and insulin (?) -- I am not a diabetic) when I remembered a similar event at this hospital a few years ago. At that time the culprit turned out to be the 'tube' delivery of my blood to the lab. After bringing this to the attention of the staff, they hand delivered the next sample to the lab and, like magic, my results were no longer so skewed. I was asked to remind technicians that my blood tubes had to be hand carried since that message wasn't getting thru the proper channels, which I faithfully did. Finally a note on my door got their attention.
Since this is a very large teaching hospital well known for it's oncology ward, I was surprised that this hadn't happened before -- except apparently to me. What a reminder of how important it is to be your own advocate, which isn't always easy when you're ill.
Hi MN1999 and Jmiah717 ,
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You might recall that some of our blood cells are more delicate as a result of CLL. This is also why some results mention "smudge cells". The white cells can break easily, so they release minerals like potassium. So rough handling of the blood tubes can elevate the potassium and other results, that don't bother patients with "normal" blood.
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Len
Wouldn't you assume that a large teaching university hospital would be aware of that?
Yes, but please remember we have a rare disease, and the phlebotomists and lab staff are not doctors. So when your get strange results- ask leading questions and advocate for yourself. You may know more about CLL than the person handling the tubes.
Len
Hello DRM18
Well, I must say your post produced a lot of useful information.
HI there, yes I had this exact scenario happen to me this week. When the blood draw was done it was very slow and quite 'watery' and the result came back with quite high potassium levels (I don't know the number) so the Doc ordered an urgent redraw of blood and those results came back as OK, it was only 2 hours difference between the blood draws.
CLL and Breast Lymph nodes
Blood results
blood results 
Blood test results 
