The Pediatric Blood Draw, (with A 2 Year Old on The Spectrum)

We have been through the ringer with Savanna, medically speaking. Her prognosis: good. Getting blood for labs: not good.

The lab technician looked at me like I was insane when I told her we were only going to get about 3-5 purple top vials of blood.  Once again, dismissed as someone who knows anything at all about my daughter. She had 20+ purple top vials and a few others sitting on the counter identified with Savanna’s credentials.

Has she had anything to eat or drink today? I knew she  was to fast for these tests. It was around noon, and she had some snacks and water recently.  I quickly said no, as I took the bag of goldfish away from her and wiped the goldfish remnants off her face as the lab tech turned around. I know she knew I was misleading her.

But what she didn’t know is that she is dealing with a seasoned professional parent of a special needs child. Here we go…

Savanna is not ever happy to go to the lab. Usually we have already been to clinic visit and this is the resultant action. I show up at the lab seemingly in a hurry to ‘just be done’ for the day. This is common as this lab serves the general and specialty clinics, so typically patients see a doctor and get lab orders that they fulfill that day. If it is a specialty clinic visit, they might not even live in Houston so it is important to stick it out and get the labs done here on that day.

Me:  Can I prioritize the labs in order of importance? She has had all of these test before, but the new doctor we are seeing thinks she needs more labs. I am okay with trying, but I am telling you, we won’t get the necessary blood to fulfill this wish list, and I can help make the process as fruitful as possible. Could we do this one, then this one, then all the others at your discretion.

Lab tech: What do you mean, don’t they have the records?

Me: Yes, the records are available to them. I have one record that they don’t have but intend to g—-

Lab tech: Which one?

Me: Well, the Baylor Test #6573 that is a targeted genetic test for primarily Fragile X syndrome. She doesn’t have this. This g—

Lab Tech: She doesn’t have what?

Me: She doesn’t have Fragile X syndrome. So could we put this vial at the e—

Lab Tech: But I can’t separate this as it is part of a panel.

Me: What panel? I see this genetic test ordered to go to Baylor. Everything else is processed here at Memorial Hermann the way I read the orders? Which vials are marked fo—

Lab Tech: I don’t understand what you are asking? I can’t do that. Some things go to Baylor and some don’t. The test orders and vials don’t necessarily match in that way.

Me: Well, okay? Which ones are you going to draw first?

Lab Tech: It’s all a panel, I just draw enough to cover the panel.

Me: I would like to fill the vials for the CBC, lead, and liver panel first, then everything else. You have 20 something vials identified for filling. We are not going to get this today.  Which ones are for the blood counts and metabolic panels?

Lab Tech: I just don’t understand what you want me to do? I can’t separate anything? It is all a panel.

Me: Okay. ????

Lab Tech: Silence.

Me: Just do what you have. But, we are only sticking her once. Whatever we don’t fulfill is going unfulfilled today.

Lab Tech: Silence.

She was successful with hitting a vein on the first stick. I tried to break the thick tension in the air.

Me: That was great! Most don’t get success nearly this quick.

Lab Tech: Silence.

She only managed to get 3 vials out. She was looking very confused at this point.

Lab Tech:  I don’t understand, it just stopped?

Me: Yeah, I see that.

Lab Tech: I will call the doctor and let them know how much we got and see which tests they want to run with what was collected today.

Me: Okay, good idea.

I tried to console and soothe my daughter who was in full meltdown mode at this point. Her face vividly displayed her new-found lack of trust for me (which is just temporary thank goodness).  Her entire body engulfed with pure anger from being forcefully restrained. And, the unforgettable look in her eyes demonstrating her complete lack of understanding of what is happening and why.

Great!

Disclaimer: I have nothing against laboratory technicians. I don’t loathe the experience, but I will admit it can be very hard with Savanna. Orders are placed as though there is an endless supply that is easily obtained. I wish some would pay closer attention to this.

-dad

2 thoughts on “The Pediatric Blood Draw, (with A 2 Year Old on The Spectrum)

  1. First thing every Phlebotomist/ Lab Tech should always listen, you know your situation better than any. Being that your daughter is two years old and so many test were ordered by the doctor, the lab tech should have first prioritize according to importance, then figured out the minimum amount for each test and a max of blood that can be drawn on a person a day, example if your daughter weighs 20 pounds any lab should only draw 20ml of blood from her, So to hear that she has so much blood taken from her on your visits is astounding. Have the doctor write the order of importance on the lab order.

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