Is there a way to prevent haemolysis of finger prick blood draws?

[Alanna012]

Not greatly important, but interested in your thoughts.

This has happened to me only 2 times over the past few years, and one of those times I delayed sending the kit back by a day (I was new to taking home tests then) so understandable. But this month it has happened twice in a row whilst trying to do an iron panel.

Each time, I posted the kit back within a few hours of taking the blood draw.

The first time early this month, by guaranteed next day. They confirmed it arrived next day, then received email next morning that they were able to get half the results (iron and ferritin) but not the transferrin or TIBC, because the blood test failed.

(Incidentally the ferritin was low, but the iron creeping up to high. Thanks @humanbean as I took your advice)

So waited for retest kit to arrive, waited few days then took again.

When I took again, I also filled a MMH kit for thyroid panel at the same time, then sent both kits back at same time via priority post box.

MMH gave me the results next day. No problems with haemolysis.

Other company confirmed they had received test next morning after posting. But then said today that the test has haemolysed again.

I'm trying to figure out what I have done differently between both tests the second time?

I used two different fingers in both. I did both in the same time frame, and both were received at the time. I did need a lot of pricking as blood was not easily forthcoming. Soaked hands in hot water beforehand and a did a few star jumps. Rubbed them etc. Used side of finger as opposed to pad.

Now I've been advised to go for the venous draw at extra cost.

I want to minimise this happening again as testing and meds and consultations are all adding up and I'm a poor gyal.

Is there some techniques that can be used/avoided to prevent it? I'm wondering if the transferrin and TIBC results are truly necessary, though I would like some context for the low ferritin, high iron.

[SeasideSusie Remembering]

Alanna012

This is the information I give about haemolysis:

Sometimes the sample has haemolysed, ie the red cells rupture. This may be due to:

* bacteria (so clean area thoroughly and allow to dry)

* intense exercise (so don't go mad trying to get the blood to flow prior to the test)

* squeezing the finger to get the blood out (you can gently "milk" the finger but don't squeeze)

* shaking the tube vigourously instead of gently inverting it.

It can also become haemolysed if:

* sample collection was prolonged

* there was a long delay between sample collection and analysis

* there is too little blood in the tube and too much coagulant for the amount of blood

[Alanna012 in reply to SeasideSusie]

Thanks Seaside!

It's possible I've committed 3 of the sins

Trying to warm up beforehand (although I didn't do anything too strenuous as I physically can't without consequences)

Sample collection prolonged - most probable. I did have times when blood was just too stubborn. My blood was like wallpaper paste.

Milking the finger vigorously - moderate possibility - although I follow instructions gently stroke upwards along side of finger from wrist.

Oh well it's just one of those frustrating things! It's going to cost me an extra £30!

[BB001]

Just wondering... does drinking more water in the hour before the test help with blood flow?

[Alanna012 in reply to BB001]

Yes you're right. On the kit it does say 'make sure you are well hydrated' - which I'm not always - not a water lover, especially in winter, but I drank well the day before and again in the morning, but it is entirely possible it wasn't enough as I haven't been consistent.

[humanbean in reply to Alanna012]

Alanna012 BB001

Dehydration is reduced if you drink generous amounts of water the day before you prick your fingers. It isn't something that can be fixed with just a glass of water in the morning. Believe me, I know from experience!

[Alanna012 in reply to humanbean]

Thanks. I do drink the odd herbal tea. But I am not a lover of drinking water in the day, then I wonder why I'm dying of thirst and my tongue is cleaving to my mouth in the night! But will bear in mind for future.

[Alanna012]

Thanks. Yes it is stressful. I start panicking if I've used 2 of the lancets and am now down to only one with a tube not even quarter filled. This time I had an old disused kit and used the extra lancets. Went through six!

Yes, an at home venous draw would be a great solution, but as you say it's extra money. I'm having to take quite a few tests at the moment due to trialing different meds and a new doctor who wants updates. It all adds up. I use Medichecks for more arcane and expansive tests and MMH for basic thyroid status. If only MMH offered more!

There is the option of going to their partner hospitals for £30 - £35 but they require a bit of travel, and I had to wait 2 weeks the one time I did it before and get a lift there and back as traveling is exhausting.

The personal blood draw service sounds brill though. If only. I guess that might be a more feasible option for me during their super sales.

[Sparklingsunshine]

Hi

I'm going to confess something now, I've tried two finger prick tests in the past 5 years both were a dismal failure. Both for thyroid. I did my last one in December, followed all the advice religiously. Even stood on a stool. I just don't get enough blood flowing rom my fingers to fill a test tube.

Those kits aren't cheap, so I cheated, tied my dressing belt around my arm, swabbed it, used the tourniquet, in the area phlebotomists use and voila, plenty of blood. Too much really, my bathroom looked like a horror movie lol.

But seriously I got more than enough. It was a bit fiddly and a second pair of hands might have come in very handy to stick, on a plaster and so on but if I have to do another home test I shall do it again.

I'm not recommending it but I have issues with circulation in my extremities, always have cold hands and feet and I wondering if this is why I can't get blood out of my fingers as I've certainly never had any issues with professional blood tests.

I sent the test back and got my results the next day.

[Alanna012]

Honestly the horror movie scenario is much more preferable than trying to extract blood from a finger that's turned into a cold corpse!