Advice please

[Dadof5]

Hi all

Just spent the past hour trying to do my first home test and I just couldn’t bleed enough. Well I bled but the blood would not run into the tube it would just stick to my finger.

I’m not sure what to do now

Can I retry next week or have I ruined the sample tube?

I have a diabetes finger kit so I can still prick my finger even though I used all the lancets.

Any advice would be great

[Thyroid_Northerner]

if there’s no blood in the tube I think you’d be ok- to help the blood flow it’s best to have a glass of water half an hour before the sample, make sure you’re warm and soak your hands in hot water (not burning hot obvs)- then make sure you had is dry before lancing

[SeasideSusie Remembering]

Dadof5

Can I retry next week or have I ruined the sample tube?

I would contact whoever you bought the test from and ask that question. If it's not possible to use the same tube then they should send you another test kit free of charge (you can check that by reading their Ts and Cs). I'm sure you could change it to a venous blood draw kit if you wish and arrange the blood draw at certain Superdrugs or some clinics (website will have details).

I have a diabetes finger kit so I can still prick my finger even though I used all the lancets.

I think the blade in the lancets are different from the diabetes ones so I think the diabetes one may not give a big enough cut. I'm sure you realise that you need far more blood than when doing a diabetes test.

Here are my tips if you try the fingerprick test again:

* Be well hydrated, drink plenty of water the day before, and before you do the test.

* Some people take a shower before hand, some run up and down the stairs to get blood flowing. Personally, as I can't run up and down the stairs, I circle my arm round, windmill style.

* Have a bowl full of hot water, dip hand in and out, swish around, hand needs to go red. If blood flow stops, you can always swish round in the hot water again.

* Stand up to do the test. Make sure your arm is straight down when collecting the blood. Either use a small step stool to raise yourself well above the work surface, or put the collection tube on a lowish shelf or use an ironing board to get the perfect height.

* Prick finger on the side, not the tip. I find that half way between the nail bed and tip is about right, or maybe slightly nearer the nail bed rather than the tip. Middle finger seems to be best for me, if flow stops I then go on to ring finger.

* Do not squeeze your finger to get the blood out, it can damage the blood and it may not be usable

I've recently done 2 tests. The first one there was very little blood coming out which was unusual for me so I used a second finger and between the two I gradually filled the tube. However, when I checked the prick site for the first finger the actual cut was very small and as I've had some of these lancets fail before I put it down to that. When I did the second test this is what I did:

* Prick my finger as usual, at the same time try and make a very slight twist with the lancet (the blade retracts very quickly so you have like a nano second to twist the lancet). I'm not talking 90 degrees or anything, just a very slight twist to make the cut just slightly bigger, it doesn't hurt or cause a blood bath! This made a big difference, 11 generous drops of blood filled the tube in less 2 minutes.

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.

* sample collection was prolonged

* if 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

Remember to always do thyroid tests as follows:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.

In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:

healthunlocked.com/thyroidu...

If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw. If taking NDT or T3 then last dose should be 8-12 hours before blood draw, split dose and adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

[Dadof5 in reply to SeasideSusie]

Thank you this is just the kind of advice I needed. I will contact Monitor my Health today and see what they say about sending out another kit.

[SeasideSusie Remembering in reply to Dadof5]

OK, so Monitor My Health don't do venous blood draw kits, they only do fingerprick kits. This is in their Ts and Cs:

8.7.2 Occasionally a customer will not be able to collect sufficient blood for some or all tests to be analysed. This is a very uncommon situation where the instructions for preparation to collect the sample have been strictly followed. If this situation occurs we will contact you via the e-mail address provided to confirm that we will dispatch a second kit free of charge and further advice to complete a successful blood collection. We are often able to produce results on small samples, so please always return whatever you have managed to collect, so that we may attempt the analysis.

Obviously you'll need to explain that you didn't manage to get any blood at all. It sounds like your blood was thick and sticky so you need to be really well hydrated and hope that will thin your blood a bit.

Do be aware of timing when returning the sample, in their Ts and Cs:

8.7.3. Samples arriving in the laboratory more than 5 days after blood collection will be unsuitable for analysis, due to degradation of the analytes for which we test. If this situation occurs due to a postal delay, we will dispatch a second kit free of charge.

Check for postal strikes but I would suggest that you take the envelope to the Post Office counter and pay for Special Delivery Guaranteed Next Day by 1pm. Even though they include a business post envelope it's not guaranteed to get there next day, so it's worth paying for Special Delivery as that does take priority over any other service. The Post Office clerk should hopefully reduce the cost of Special Delivery by the cost of the Business Post, my P.O. always does, reduces it by about a £1 or so I think.

Do test on a Monday or Tuesday only, post back same day. Get receipt with tracking number for Special Delivery. If it doesn't arrive the next day you can claim your fee back. If it is delayed then it would arrive the day after which is still plenty of time for the sample to be viable.

Hopefully your second attempt will be fine, these companies tend to only send out one replacement kit free of charge.

[Dadof5]

Well I have emailed them and hopefully they will send out another tube and some lancets at least.

Then I will follow all the great advice given here.

It’s funny I never used to have a problem getting bloods done until after I started taking Levothyroxine and getting older. Even the nurse at my doctors struggles sometimes lol.

Thanks

[Jazz80]

I found the same, but have found the secret for me is to use the lancet that comes with the kit, they are the best I've ever used. In addition as soon as you have lanced your finger wipe any blood off so that the finger tip is completely dry, hold your finger downwards so the blood cannot run anywhere onto your finger tip, when the droplet is big enough it just drops into the bottle. If it doesn't drop naturally I just gently touch it on the inside edge of the bottle and it slides in. If blood starts smearing over the finger tip again wipe it dry, just keep it dry throughout.

It seems to me that when the fingertip is wet / smeared blood drops cannot form it just takes the path of least resistance and spreads everywhere instead of forming a droplet. Just my experience, before I had blood everywhere except in the bottle!

[Catlover3]

Hi. Really hydrate the day before the test. Drink a glass of water an hour or so before you try and keep warm. I wash my hands thoroughly under very warm water and shake them about to get the blood moving. Make sure you don't scrape the blood drops on the edge of the tube, its tempting to do that if you have a big sticky blob but it could damage the sample. Good luck.