Any blood test advice?: I need regular bloods to be... - NRAS

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Any blood test advice?

Bakinglover profile image
Bakinglover

I need regular bloods to be taken because of my RA. It's becoming increasingly difficult for the nurse or phlebotomist at my surgery to take blood from me due to my small veins. I've tried drinking vast amounts of water but that no longer seems to help as the veins they use seem to have collapsed from being overused. It feels a minor thing in the grand scheme of living with RA but I would appreciate advice from anyone who's experienced this too. Thank you.

30 Replies

I had the same problem until I found one phlebotomist who can always do it first time. She uses a child's needle and the process is therefore a bit slow but it works. I know that is no help to you and I am lucky having a choice of phlebotomists. Do they use a child's needle on you? Hope you find the one who can do it and stick with them.

Bakinglover profile image
Bakinglover in reply to Wobbies

Thank you so much for your response. That's a really good point, I don't actually know if she uses a child's needle. The phlebotomist at my previous surgery did and I hadn't thought to check with this one. I've sent a message to my surgery to ask.

sule profile image
sule in reply to Wobbies

A child's butterfly needle works for me too.

Wobbies profile image
Wobbies in reply to sule

I have learnt something. It is called a butterfly needle. Thank you for that. Sounds much better than a child's needle.

Garnacha profile image
Garnacha in reply to Wobbies

I always have to have a butterfly needle I just have very small / invisible veins x

Knip profile image
Knip in reply to sule

That's how one of the nurses at my surgery gets my blood and it makes her feel better that she isn't having to go into both arms and back again...so it's good all round. The phlebotomy team can usually get it easily...but they know what they are feeling for when looking for a vein. Agree that Butterfly sounds better. I can imagine a child having a blood test, and being told that the butterfly is just going to take a little sample of your blood so that we can make sure that all is well with you. Much less frightening.

When I go for blood tests / give blood I used to tell them in advance that it might be difficult to get blood out - I had difficulty years ago with nurses at out local cottage hospital doing it, one tried then passed me on to her friend, they both failed miserably but by that time had pulled the needle half out of my arm - not out of the skin - and tried again from another angle! What an experience. Worse than that after all that they patted my arm and said to go back and get my doctor to do it ‘because you’ve got fat arms! I definitely didn’t, so I think saying I’ve got difficult veins makes them less gung ho when they start or that’s my theory.

I now offer up my right arm - I’m right handed - and it seems to work best, my most recent phlebotomist always used a child’s needle and she had no trouble. I also never have any trouble when I use the hospital phlebotomists who pile through patients at an amazing speed, they are very good at it. I also find the days I have a brisk walk before doing it makes the blood flow as does being warm and having a good drink of water but alas that hasn’t worked for you.

Thanks for your reply. Yes I had wondered whether to go up to the hospital instead of my surgery.

If you can go to the hospital I’d opt for that.

I don’t know how convenient it would be but holding your arm under warm running water often helps.

Ok thank you. I'll see if the nurse will let me do that next time.

I have the same problem - they hate me 😂 I try and drink a tonne of water the day before and the day of, but it doesn't seem to be very helpful. Sometimes they use a butterfly needle (child's needle as @Wobbies mentioned) and they often go in my hand. Today they took it from the side of my wrist. I know they can also do your feet as well.

I would just let them know next time you go in and ask them to try hands/feet/wrist with a butterfly needle and see if that helps. I also echo the point about going to the hospital instead. My GP were not great at taking my blood, but the phlebotomists at the hospital are amazing.

LoneEra profile image
LoneEra in reply to SlothSandpit

Ditto - and they always tell me off for not drinking enough. I drink at least 2 litres of water a day, plus herbal teas. And then I drink a good litre an hour before I go for the bloods...but it doesn't help and I'm just busting for a wee the whole way through :)

The nurses in my clinic suggest it if they don’t get into the vein first try.

Hi there

I have very rubbish veins too, and blood tests, cannula's etc are a nightmare and I always dread them! I think my suggestions are much the same as other people's. When I used to have Infliximab infusions they used to run my arm under hot water for a while, or rub my arm quite vigorously and sometimes even give my arm a gentle kind of slap (or perhaps they were just fed-up of me)! In the end my rheumatologist used to come and get the vein access as he'd done a neo-natal rotation when training so he could get tiny veins. Generally for blood tests I've got one tiny vein that I try and direct them towards (not always successfully). Like others, I always warn them upfront and as a result, they always use a butterfly needle which helps. One other thing one phlebotomist swore by, was having the tourniquet very tight on the arm.

I also agree with others on having a phlebotomist rather than a surgery nurse do it. They're so much more experienced

Good luck!

Hello Bakinglover, definitely always go to the hospital for my bloods they are really good and also I don't seem to bruise as much. They are very experienced 😉

I know what’s it like as well, I have small veins, I think as the others have said, drink loads and defo ask for a small needle, mines collapse with a big needle. When I had chemo I had to have bloods done every three weeks and actually getting the cannula in was a hit or miss and these nurses were experts. They used to bring a basin of hot water for me to put my arms in which helped. Towards the end of my treatment they had been given a marvellous machine which I can only describe as an old fashioned hairdryer with a hood but this was with a sleeve and they turned on the heat for a few minutes, this plumped up my veins, what a difference. Wish they had had it at the beginning. I can only suggest keep warm as well, I also took the little hand Warmers to keep me warm, the minute you are cold I think it makes your veins shrivel, well that’s my experience. Best wishes x

vonniesims profile image
vonniesims in reply to Lizard28

Yes, I used to take bloods sometimes and using the wrist, soaking in a bowl of hot water and heat pads all helped

Try a good brisk walk to the surgery.

It's not a small thing- I always think it's particularly unfair that I have an illness which needs so many blood tests and I have such rubbish veins! And have you found some HCPs get really tetchy with you when they cant get blood- like it's a personal insult?

And unfortunately I have Raynaud's and if I get stressed my veins disappear.

The nurse once had to use the needle they use for premature babies. ...

Sometimes it's the person taking the blood that is the problem and not veins. I've had blood tests for RA for over 50 years and when I was hospitalised with a THR infection in 2009, I needed cannulas changing every 3 days, blood transfusions, blood tests etc. etc. A Doctor on the ward told me that when you are the only Dr. available, on call, you have to get it right - the secret is to wait for the vein to plump up after torniquet tightened and not to rush it.

Years ago, it was always a qualified nurse taking bloods, but in recent years I've had a number of poorly trained Health Care Assistants at our GP Surgery mess up my veins - something you don't want when you need fortnightly or monthly bloods taken. I told the Practice Manager and she has marked my notes to allow me to book blood tests with a Practice Nurse instead. I told her I have to look after my veins and cannot allow them to be abused! Some of the HCA were going into the same vein! That's a no no!

Lizard28 profile image
Lizard28 in reply to BoneyC

I had a nurse that tried to put it in same vein when she she failed, I didn’t think that was right, the room was also very dark, I felt like saying to her to put a light on 🤔. Three nurses later one got it in, by this time I was ready to run. When the doctor saw me it wasn’t in right and the sedation med she put it missed the vein and dissipated into my arm, she had to do it again. I feel like saying if you are learning try on someone else. Keep away,!

Knip profile image
Knip in reply to Lizard28

What an awful experience Lizard28. Hope that never happens again to you.

I also have small veins that tend to collapse as soon as they find them but have one very good vein on right elbow which they always go for. It as it’s been used so much for over 20 years it’s very scarred so hurts a lot. I never go to our GP’s surgery as nurses are pretty rubbish at it so always go to hospital as that’s what they do all day. Sometimes they use a butterfly needle in the back of my hand. When having Rituximab infusions they brought a bucket of hot water to put my arm into for 30 mins beforehand. I do get worried a bit as it does hurt but definitely a smaller needle helps x

There must be hundreds of us with this problem!!!!!And the problem os often very inexperienced people trying to find a vein. If you get someone who knows what they are doing it works, but so many people are not good at it.I will no longer allow anyone who does not come across as confident anywhere near..............

I find the hospital phlebotomists much better than those at the GP surgery - and there is always another person to have a go if they are struggling, too. Butterfly needles too as everyone else has said.

Know what you mean about being busting for a wee while they keep trying 😂

I have a problem with my gp not been able to take my bloods. I've given up on them now. I ask straight away for a form to take to the hospital. The hospital phlebotomy team know what they are doing.

Same here! My vampires use a PINK needle now - normally used for babies or small children and it works like a dream 🧛🏼‍♀️

Morning. My veins exist but are very shy..My left arm is a no, no, but my right arm (I’m also right handed) can be used.

Instructions…

1. Keep very warm until last possible second.

2. Eliminate draughts… they think you are mad, but make sure windows and doors are closed.

3. Tourniquet.

4. ‘Baby’ needle

5. Go on an assertiveness training course.

God forbid we know how are own bodies work!! 😜

Good luck for next time😀

My worst experiences have been a practice nurse, and a hospital; my arm was so badly bruised and painful I couldn’t use it for a week afterwards… They knew better than me and didn’t listen…

Hi baking lover as well as having plenty of fluid make sure you sit with your arms down by your sides before having you test done and clench each fist a few times. This helps to pump the blood and so bring the vessels to the surface I'm told.

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