Went for bloodwork, had an experience

[MTRJ75]

Woke up, didn't eat anything because I had to fast, but had my electrolytes, meds and supplements plus a couple of cups of water in the 2 hours before I left for blood work. 

Thankfully didn't have to wait in the car long because the weather is ugly today. 

Went in to have my blood drawn. She couldn't get anything from the left arm, which was weird, so she had to stick me in both arms. After a few vials, she asks if I'm okay because I'm sweating a lot. Yup, that's just my condition. A few more and I'm drenched in sweat, very nauseas and light headed. She has this horrified look on her face. Grabs me an ice pack and water. 

They couldn't even get the band aids or tape to stick. I really need a place to lie down, but they don't have one. The bathroom isn't a short walk and anyone I encounter on the way looks like they're encountering something from the Walking Dead. They must have been terrified I had COVID. 

Instead of throwing up, I actually end up having to evacuate and then feel at least a better enough to sit upright, stop sweating and attempt to escape and drive home.

A few hours later and I'm still having difficulty being upright. Taking some more electrolytes, not sure what else I can do to get through work today. 

I think I've learned something about my body today, but not sure what. Well, definitely that bloodwork is something else I certainly can't attempt on my own anymore. But I've had similar symptoms before. In fact, fairly frequently. Does this mean it's due blood volume whenever it gets like this? Because I had even thought it might have been blood sugar in the past. 

Wonder if this will affect how the bloodwork turns out too. 

[Rexie]

Hi! Hope you did ok at work and are now resting comfortably at home after a scary, icky start to the day. 

Many years ago during Lyme disease I had panic attacks which have symptoms similar to those you had going during your blood work adventure. Just knowing that these glitches were just panic attacks was helpful, as was some prescribed rescue alprozolam (Xanax). If I knew I was going for testing or something else that might trigger an attack, I'd take the Xanax ahead of time. Now the ashwagandha I take helps smooth my way and helps prevent panic attacks which I rarely have anymore. It all does really get better with time and help. 

Loved your Walking Dead reference - people use to walk way around me or give me the evil eye while stopped at a stop light. Whatever. Bet I've outlived many of them. 

Panic attacks and panic disorder (Mayo Clinic):

https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021 

[MomtoGiuliana]

it's possible to have a vasovagal reaction to the needle stick IMO.  It's a bit like a panic attack I guess (in terms of symptoms).  I know when I am in a flare up I am super sensitive to many normally small triggers, such as getting my blood drawn.

Vasovagal syncope - Symptoms and causes - Mayo Clinic

[MTRJ75]

45 minutes ago, MomtoGiuliana said:

it's possible to have a vasovagal reaction to the needle stick IMO.  It's a bit like a panic attack I guess.  I know when I am in a flare up I am super sensitive to many normally small triggers, such as getting my blood drawn.

Vasovagal syncope - Symptoms and causes - Mayo Clinic

That's interesting because she was wiggling the d*** needle around in the left arm very uncomfortably before pulling it out and sticking the right arm. I'm usually okay with needles if the person is quick and clean, but this was kind of a mess. I had just assumed it was the loss of so much blood. 

[Rexie]

Sasovagal syncope is interesting. I always have to turn away for blood draws for me or if I take kittens for shots. I just always called it a 'needle phobia' that makes me feel like fainting is imminent causing me to reach out for something to lean on; no other symptoms. 

I always learn something new here. 

[Sushi]

14 hours ago, MTRJ75 said:

That's interesting because she was wiggling the d*** needle around in the left arm very uncomfortably before pulling it out and sticking the right arm. I'm usually okay with needles if the person is quick and clean, but this was kind of a mess. I had just assumed it was the loss of so much blood. 

I’ve had vasovagal syncope from blood draws and the experience was similar. I always lie down now. Most labs at least have a recliner. I also drink hot water right up to the draw and wear a down jacket which is uncomfortable but the combo plumps up my veins so less needle wiggling. Hope you are feeling better. 

[CallieAndToby]

Every time I get blood drawn I get very very ill. I just come home and collapse and stay like that for days and it can only be 3 vials. If you have this issue I would suggest getting somebody to drive you after bloodwork. I started getting cabs because I was shaking and ill. Sounds like a horrible experience, sorry you went through that, I know it all too well. I even mentioned it in my UAB autonomic results post because they keep sending me back for more labs and I cancelled today's lab work because I've been so under the weather. For me it has nothing to do with seeing needles or blood, my mother is a nurse, I get saline infusions 2x's week with needles, I did a bone marrow biopsy completely wide awake with no sedation... etc. so the issue for me actually losing blood. I have heard some ME patients say "I feel better after getting blood drawn" and others say they feel absolutely horrific so I really don't have an answer for this issue. I know with polycythemia vera they will take large amounts of blood as treatment and it helps.... odd. 

[MikeO]

Had this conversation with my nurse morning. low blood volume (being dehydrated) has more  to do with a hard poke than anything else. not sure what the panic attack is about but i am glad you got over it.

[POTSie78]

I'm sorry this happened. I have similar episodes but it doesn't seem to be triggered by blood draws.  My worst episodes happen to me in the middle of the night when I am asleep.  It's terrifying because i wake up feeling really really sick and my heart pounds so hard I'm scared I'm going to have a heart attack.  I get super hot and sweat pours off of me. I feel the urge to throw up and eliminate at the same time but I'm to weak and dizzy to do anything but lay on the cold tile floor and wait for it to pass.  My cardiologist says it is vagal nerve stimulation but I'm not sure why the really bad episodes happen in my sleep.

[MTRJ75]

Yes, @POTSie78I completely get that. This is something I've felt before, but not often this intensely, though this episode came on much more quickly (almost instantly) than usual. I'm still wondering if the blood loss was the prevailing factor and the other episodes are in times of lower blood volume too. Or maybe I was just in a state where the fuss with the needle triggered it and the blood loss just complicated issues. Anyway, I was back to "my normal" the next day. That's not saying much, but better than the original post. 

[Pistol]

@MTRJ75 - the needlestick episode you described does sound exactly like  a vaso-vagal event. I have - in addition to POTS - vasovagal syncope, or neuro-cardiogenic syncooe. Thei gets triggered by a certain event and causes sudden and severe vasodilation, leading to drops in BP, increase in HR, sweating, weakness, excitement, paleness and eventually syncope. Public speaking for example is a common trigger to many people, so are blood draws or shots. The best non-medication strategy to prevent these episodes known to me are ample fluid and salt intake and compression garments. I know of a lawyer that used to pass out in court all of the time and now wears very tight pantyhose, never passed out again. 

I also really would recommend to have someone take you to any lab draws from now on! 

[MTRJ75]

Had another episode today, almost exactly like the last one except not as light-headed and no needle involved. 

Have actually been feeling a bit above my normal baseline last few days. Had a doctor's appt today. Few minutes from the house. Just a check up. No big deal. One flight of stairs up. On the way out, the receptionist asks me to update some new paperwork and for my ins. card. I'd left it in the car. One quick trip out to get it. Down & up stairs again, sit down to fill out paper work and notice I'm drenched in sweat & heart pounding. 

Now, I know this is the most out of shape I've been in my life, but it was a single trip up and down stairs. I do that all day long at home. Not even hot outside. Mid-70s. 

On the way home, had to drop off lap top at repair place (hard drive went). Barely got through that conversation. Got home, straight to the bathroom. In and out several times. From drenching sweats to chills and back and forth. Nausea to a sense of urgency back and forth too. 

The only thing I can think of is that I was wearing a mask the whole time at the doctor's office. Can the trip up and down the stairs w/ the mask on have caused the event? Was this vaso-vagal or something else? It's also "that time of year", but I'd been recently feeling better than my baseline, as I said. I'm guessing some sort of panic set in when my heart rate elevated and started skipping too. Been sweating and freezing at the same time ever since. 

[Pistol]

@MTRJ75 - what you describe happens to me everytime I overdo things.  Having to run up and down steps AND then having to fill out papers, then making another stop to drop off the lap top ... this would totally get me into sympathetic overdrive! I would be sweaty AND chilled, palpitations, chest pain, tremors, most likely high BP .. and it would take me days to get over it. 

[MTRJ75]

Yeah, so on the other hand, I guess I should feel good that I'm just about back to my baseline already, even if that baseline isn't ideal itself. 

It's still hard for me to think about those combination of things as being an exorbitantly exertive series of tasks, but when you put it like that....

It's funny, my family generally thinks of me as always sitting on my butt and not even trying to do enough, yet on here, I'm always talking about trying to get away with what is probably too much. 

I'm thinking there was some combination of wearing a mask while doing all those things in addition to the allergies that complicated matter. 

[toomanyproblems]

On 9/12/2021 at 10:09 PM, MTRJ75 said:

Yes, @POTSie78I completely get that. This is something I've felt before, but not often this intensely, though this episode came on much more quickly (almost instantly) than usual. I'm still wondering if the blood loss was the prevailing factor and the other episodes are in times of lower blood volume too. Or maybe I was just in a state where the fuss with the needle triggered it and the blood loss just complicated issues. Anyway, I was back to "my normal" the next day. That's not saying much, but better than the original post. 

As someone who worked in a clinical lab for many years and drew blood on the hospital floor as part of those jobs, the amount of blood they draw is very, very minimal wrt your total blood volume. There are many reasons you might have had the problems you did with the blood draw. Many people get stressed when it doesn't go smoothly and many get stressed even when it does. But the amount of blood even in many vials is not nearly as much as it looks like. Compared even to just donating a unit of blood, the amount of blood taken in a blood draw is very small and shouldn't cause any problems even in your situation. 

I do have low blood volume and polycythemia that is almost certainly a relative polycythemia (what appears to be too many red blood cells due to a low plasma volume). Taking a unit of blood off to lower the red cell count has even been tried and it did not affect me as you describe. BUT I do have what you describe due to overstimulation or stress in a ridiculous number of normal situations. I think some of the responders here are describing this problem in many situations, some common, and some specific to the individual for various reasons.

In short, most people do not like to have blood drawn and it stresses many people out even when things go smoothly but blood loss is not an issue. I mean, maybe if you were a chihuahua...Calculating how much blood can safely be drawn wrt total blood volume is done in small animals and babies but is not an issue in adults even though it can look like a lot of blood in the tubes.

[MikeO]

11 hours ago, MTRJ75 said:

I'm thinking there was some combination of wearing a mask while doing all those things in addition to the allergies that complicated matter. 

if it is any comfort we all wear masks in cardio rehab. Most have other issues like (allergies, COPD, diabetes, ect...) we all sweat and palpitate like we would normally do while exerting ourselves while not wearing one. No one has had a reaction to wearing the mask. RN's also monitor our O2 and you can clearly no change in the readings with the mask on. 

[MTRJ75]

Welp, I'm at a loss then. Back to square one. 

Lab called yesterday and said they didn't even get enough blood, they have to redo the CBC count just to add another kick in the ***. Told them I'll have to think about it. Both arms are still black and blue nearly two weeks later. 

[toomanyproblems]

15 hours ago, MTRJ75 said:

Welp, I'm at a loss then. Back to square one. 

Lab called yesterday and said they didn't even get enough blood, they have to redo the CBC count just to add another kick in the ***. Told them I'll have to think about it. Both arms are still black and blue nearly two weeks later. 

If I were you and you decide to go back, after one stick and they don't get it, ask for someone else. It sounds like they had someone either not very good at drawing blood, or very inexperienced since it sounds like it's never been a problem before. Or better yet, call ahead and make sure you have the best person draw you because of the problems you had. People do that all the time for difficult sticks.

[MTRJ75]

6 hours ago, toomanyproblems said:

If I were you and you decide to go back, after one stick and they don't get it, ask for someone else. It sounds like they had someone either not very good at drawing blood, or very inexperienced since it sounds like it's never been a problem before. Or better yet, call ahead and make sure you have the best person draw you because of the problems you had. People do that all the time for difficult sticks.

This wasn't a new person. She'd been there as long as I've been going and looked about ready for retirement. One of the things that has always been remarked about when going for bloodwork is that I have suck big, easy veins. I have no idea what happened. 

Broke into a drenching sweat picking up the laptop today. A little bit warmer, but sitting at home with the air conditioner turned all the way down, still sweating profusely. I think a lot of it may be about the reaction to it too (though not all). If I can somehow stop the anxiety from setting in, I can hold off some associated symptoms, though there was probably nothing I could have done with the bloodwork situation. 

[RecipeForDisaster]

You can try to plump up your veins with warm packs beforehand. I’m going to do that for my iron infusions because I don’t seem to bring my veins to those.

[Rexie]

MTRJ75, I always have to decompress after an outing, especially ones with multiple steps or errands in unfamiliar places, even if they have been all pleasant and not really a big deal. I love getting stuff done, and praise myself lavishly when home, but the cost does seem high sometimes. Overstimulation brought on by simply moving, coupled with bright light, vivid colors, temperature, sounds, any associated stress while driving or shopping or at a lab or vet's, etc. makes for lots of neuromuscular pain, spasms, stiffness, and sometimes chills, low blood pressure, and exhaustion when I get home. Over the years the time to regroup after an adventure has gotten far less, from days to at most an hour, usually now within 20-30 minutes.  I take an ashwagandha tab (with maybe a toke or two) and sit still and quiet, often playing a simple phone game or if not too head-spun, I'll read a novel. It helps not to dwell on my state which is why I like a quiet distraction. The ashwagandha puts the brakes on run-away sensations and overstimulation by increasing GABA, our inhibitor neurotransmitter. I remind myself of an electrical system shorting out - the downtime with herbs is a reset. A 5-20 minute nap can also be useful; it helps me reset systems. The day may go on then pretty normally (my norm) or I may drag a little or a lot but be ok in general, and be able to eat and do the things I need to do. 

I am very glad sometimes I don't have a partner or family now. What I might consider making a heroic effort to get the stuff I need done done, and done well, does not much impress normal folks at all. And frankly, sometimes I come back so badly head-spun and body-sprung. I would not be what I call "present" to anyone anyway. I do recall how much this bothers other folks and how reluctant they could be to allow me some time to myself to achieve homeostasis again. I have learned over the years to set limits to interactions and activities with others or to not be so bothered by their reactions. 

With my pets, if they have no immediate needs, I'll just announce "Rest! I need rest!" and they get it without hurt feelings. I do like people, perhaps this would work with normal humans... (it never worked with my troubled mom, she could storm for days behind one of my "failures")