Blood, Appointments, and Fear

The appointment yesterday went alright. It was totally exhausting, mainly because of the time of day that it was scheduled (so I’d already worked a full day), the lengthy drive there, and the talking-intensive time with the doctor, which always is draining for me.

The integrative medicine facility was a much larger operation than I expected it to be. There were many providers, rooms, administrators, and stations including an infusion room and the dreaded blood draw laboratory site. I was on high alert the whole time after seeing the blood draw area and receiving verbal confirmation that yes, I was probably going to need blood work. I knew that was a likely scenario when making the appointment, and was a primary reason I dreaded going. I’ve been so phobic of getting my blood drawn lately that I’ve collected orders from three different doctors spanning back to November.

I felt anxious to the point of physical agitation while waiting and filling out the paperwork. I could barely sit still as I worked my way through the fifteen pages of intake and history forms. All I kept thinking about was they’re gonna stick you with a needle and take tubes and tubes of blood!

The doctor himself came out to the waiting room to retrieve me. Ben brought me to the facility but I wanted to talk to the doctor alone first about some personal things, so Ben went and called his mom. After discussing my history and undergoing a very brief physical exam, the doctor discussed diagnostic tests he thought would be helpful. Then we had to meet with the office administrators about my insurance coverage for the agreed upon testing. Several stool tests were ordered and the bane of my existence–blood tests, which they were indeed ready to do on site. My scheming mind had already developed a bargaining tactic to pitch to Ben though: I had my pile of previously ordered tests from other providers. I decided that it seemed fair and reasonable that if they could draw blood to fulfill all of the orders that I would comply, suck it up, and get it done. If not, I would take the new order, add it to my stack, and get drawn the next day at the hospital. This would consolidate the number of blood draw procedures to just the one (for now). Ben agreed that it seemed like a reasonable plan.

The staff consulted the phlebotomist and decided that they couldn’t run all of the tests there for numerous reasons, the most pressing was that I hadn’t fasted. Whew! I dodged the bullet and we took the order form, checked out, and headed home.

I was exhausted. To be honest, I’m not sure I would have even had enough emotional bandwidth remaining to bear the lab work anyway. I went to bed shortly after getting home and having some food.

Last night, I dreamed of a disastrous blood draw where when I was stuck, they struck my vein and it gushed all over my lap like a wild sprinkler. I couldn’t fall back to sleep after that and I spent three hours reading my book instead. However, I was committed to my side of the agreement that I myself pitched. This morning, I started calling all of the local labs to find out what time they opened and “what the usual wait time was” that early in the morning. There are several facilities in the area and my radius of potential sites was significantly greater this morning since we had to go to the main hospital in Springfield to see a surgeon this morning anyway. That opened up dozens of labs. The local hospital still seemed like the best option given the schedule of my appointment and the labs’ operating hours and the fact that I needed to fast.

I’m proud of myself. I honored my commitment and took my stack of orders and went to the hospital bright and early. We had to wait a while as the nurse looked up all the codes for the various (somewhat esoteric) tests being ordered and input everything into the computer system. I already found my conniving brain try to devise excuses or a new set of compromises (if she can’t find all the tests, we will leave; if she allows someone to cut in front of my position in line because his order is simpler, then we will leave; if she doesn’t have all the correct tubes for the variety of treats ordered, then we will leave). For better or worse, none of these glitches occurred. Although it took a long time to look up the procedure codes, print the labels, and prepare the tubes, the phlebotomist was highly skilled in keeping me calm and reassuring me that everything would be fine. I didn’t even need to ask to be put in the reclining chair; as soon as I voiced my anxiety about lab work, she said she’d have me lie down during the procedure. Another thing I liked about her was that she was very organized and efficient. Within a minute of taking my place in the chair, she had the tourniquet on, swabbed my arm with the rough alcohol wipe (my least favorite part), and pricked me with the needle. This left virtually no time for me to freak out and cry, though my eyes did start to well up when I first lay back in the chair.

Ben did a good job holding my hand and I asked the phlebotomist to tell me about her kids during the entire draw, which is my go-to blood draw distraction technique. It seems that every provider who has drawn my blood has had children and been happy to talk about them. I start to flirt with the red line of fainting territory when I’m not talking or being talked to as blood is coming out of me. These dead silences are when the anxiety swells. I become more aware of the pain and the visceral feeling of blood leaving my body. I don’t know if most people can, but I don’t just feel the painful prick of the needle, I feel the actual blood exiting from the puncture in the skin. It’s like those dermal and epidermal skin cells surrounding the tiny hole have sensory receptors that actually feel the movement of blood out of the body. It’s an awful feeling. Additionally, when all goes quiet, I worry something has gone awry. As such, my anxious brain seems to feel responsible for filling and quiet from a lull in conversation with yammering loud anxious thoughts in my head. I need to keep those at bay, silenced by the conversing interactions in the room instead. Otherwise, the panic overtakes me.

My phlebotomist today was a proud mother who spoke animatedly about her two grown daughters. As vial after vial was filled with my blood, she shared about their interests and career trajectories. One daughter is in training to become a chef and Ben asked the smart question about what her specialty dishes were. This spawned an elaborate answer and I found myself agreeing that dishes I’ve never heard of are “so delicious.” I believe I recall myself utterly the line, “you just can’t go wrong with chicken cacciatore!” (I have no idea what that is.) I kept my eyes closed and my free hand gripped around Ben’s strong, confident hand, which wraps my fearful fingers in a comforting hug the way his arms do around my body.

After about eight tubes were collected, I started flushing with heat, which is par for the course with me. I desperately wanted to be done, so I asked how many were tubes were left. She said “just two,” which was an answer I could tolerate, though it felt like it took a long time to collect the final two. I made it through though. In fact, I did remarkably well. I gritted my teeth when she retracted the needle and applied the clotting gauze with pressure. Another pro about the facility today is that she didn’t tape the gauze on my arm with that sticky opaque white tape, which really bothers my skin (sensory processing disorder) when it is pulled off. Instead, she used a stretchy self-adhering wrap that Ben was able to easily pull off later without needing to pry any adhesive material of my highly sensitive inner arm skin.

After a good drink and a few minutes if resting in the reclined chair and the upright, I was stable enough to walk out of there victorious. It’s funny how everyone has different fears and challenges and “standards” above which an accomplishment is noteworthy. For many people, getting blood drawn is uncomfortable but a tolerable procedure, a non-event in that it just is part of routine healthcare. For me, it’s a monumental obstacle. Making it through, especially without any sort of meltdown at all (which, to toot my own horn, I did with bravery today), is a major triumph. I mentally awarded myself a gold star in the private recesses of my mind as I headed home.

It was quite a lot of tubes and even though I was stoic and maturely composed today, it’s still physically and emotionally draining for me to go through the rigmarole of the lab work. I’m exhausted now.

We are on our way to see an ankle surgeon that I’ve been waiting to see since December. I’ve heard good things about him, so I’m hoping he’s worth the wait. I have a headache so I’m not looking forward to fluorescent lighting and the acrid smells of a doctor’s office. I must say, that was one pleasant aspect of the integrative medicine facility yesterday. It was a fragrance-free zone so I avoided being bombarded with every manner of perfume and chemical-laden products yesterday. I wish every healthcare facility subscribed to that policy. It’s such a sensory overloading nightmare otherwise, which, for someone with sensory issues, only acts to further add stress to an already trying event. At least I’m prepared for the worst, and I feel energized by my success at conquering the blood draw this morning.

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