Veinless Wonder

Due to recent events, I feel the need to make those of you out there with "good veins" aware of your excellent fortune. First, I will define the term "good veins" to encompass those lovely visible (or at least palpable) bluish-greenish vessels that sometimes protrude, rope-like, along the arms of you lucky ducks. I never thought I'd envy anyone who looks like this:

 Courtesy of Wikipedia 

But look at that vasculature! I am jealous. Jealous enough to have wondered if starting a serious weightlifting regimen would help push my seemingly non-existent veins closer to the surface. You see, my veins are the shy, retiring type. The nurses look, they feel, they tourniquet, they hot-pack, they cut off my circulation with a blood pressure cuff until my arm turns blue, but still, the introverted buggers can't be easily found. For a girl who requires IVs/ blood draws at least 6 times a month, this is highly ironic. Case in point: one day I ended up being poked 7 times before the IV team (I like to think of them as a SWAT team for IV placements) was called. And after all that the IV was finally inserted in my most used vein, which I'd been trying to avoid all along as it was starting to develop scar tissue from the repeated punctures. Now, at the Wilmot Cancer Center, where I go for my treatments, you are allowed to leave IVs in for 72 hours maximum, assuming you prove yourself trustworthy enough to not inject IV drugs in to your accessed vein... I passed this test with flying colors by apparently being so naive about this possible use that I was looking around in desperate confusion asking, "what do you mean I need permission to leave it in? I promise to wrap it up and not get it wet or dirty or pulled out just please let's not do the great vein hunt all over again tomorrow!" The nurses thought this was cute and I could hear them retelling the story of how the thought of shooting anything into my IV "didn't even cross my mind" to my doctor - which made me seriously wonder how many people actually did think of this nefarious usage on their own.

And so the IV was left in along the inside edge of my right wrist for the three remaining days of my infusion. Over this period of time it proceeded to ache like crazy, presumably because it was in such a sensitive spot, and I was forced to mount feeble attempts at washing my hair left-handed since any movement of my thumb intensified the pain. As I have a fairly large amount of hair, this did not go well, and ultimately I was left with an unconditioned frizzy mess and a healthy regard for opposable digits.

Anyway, I do tell this rambling story for a reason and it's because I hope that maybe I can offer some tips for those of you who have also experienced the joys of hard-to-find veins. This is what seems to work for me:

1) Hydrate - drink lots of water starting the day before your anticipated needle stick. When your dehydrated your veins can shrink down on you a bit and become more difficult to locate. This is fairly common advice.

2) Cut down on salt - Have you ever felt puffy after eating too much chinese food? Yes? Well part of that awesome feeling is due to water retention in your tissues from the excess sodium in that tasty lo mein. I find that making sure I stay away from anything salty helps my veins to be more visible.

3) Exercise - if you can, squeeze in a workout the day of your blood draw or IV placement. Exercise causes your blood vessels to dilate and helps to bring once hidden veins to pop up. I find that I stay rosy-cheeked for at least a few hours after exercise and my veins seem to stay up too.

4) Use heat to your advantage - ask for a hot pack to help further dilate veins once you get to the location of your stick. Doctors offices and labs usually have these on hand. I find that running my arm/ hand under very warm water works even better than using a hot pack.

5) Speak up - if you have tricky veins, say so! My aforementioned experience was primarily a result of me being stubborn. I've drawn blood before and I really don't find needle sticks too alarming, so I'm a pretty good sport about being poked and prodded. I know it can be nerve-wracking to draw blood. You don't want to hurt the patient, you don't want to look bad, etc... so I joke and laugh about my silly, reticent veins, try after try. That is, until I see a needle wiggling around so aggressively that it pokes back up through my skin. I didn't mind the pain so much as I minded the unnatural sight, which proceeded to immediately break me out into a cold sweat. However, this experience did result in the Santa Bruise - which made me feel pretty special:

 

 Can you spot Old St. Nick? Complete with white beard and hair? 

So moral of the story: unless you want a festive contusion, tell the nurse/ phlebotomist that you have difficult veins. This generally results in them calling over one of their eerily skilled colleagues who seem to have a sixth sense for finding blood, which means less bruising and pain for you. As long as you're not mean about it. As in don't yell about "only an attending being allowed to put your IV in" like a woman near me did. In that case, I can't guarantee anything...

This post is dedicated to my boyfriend. Who kindly put up with me as I gleefully plotted out locations where I could theoretically draw blood from his nice bouncy veins and simply accepted this as normal behavior.