Last Chance to Dance Trance

Friday, November 03, 2006 | 3 comment(s)

As I have mentioned before, I had set some goals for myself when I made some New Year's Resolutions last year. One of these was to get my A1c below 7.0 (Although, like Zak, I too had a "public" goal, and a more aggressive "private" goal of below 6.5 (Note, however, that neither of these goals are as low as Zak has set for himself)).

I bitched and moaned when I had my last A1c done and I didn't hit my goal. I hardly had much room to complain, though. I got a 7.1 when I had the A1c done at one lab, and a 7.0 when I had it done at another lab a week later. Some would say that I hit my goal, but I certainly wouldn't (especially since I'm really aiming for a 6.5). But what really got me was that the A1c reading didn't jive with what I was getting out of my average meter readings
Data
I put together a table of my average readings over the last 7, 14, 30, 60, and 90 days right after I had my blood drawn for the A1c test so I could compare the A1c result with my average meter readings, but managed to leave it on my computer at work. So, I'll share that later when I get my A1c result to see how it compares. My recollection is that my averages were not all that different from before. Some were better, some were worse, but basically in the high 140s / low 150s ranges.

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(at least according to some research that I found that had produced a regression estimate of the relationship between average glucometer results and A1c results).

I'm a little behind schedule in getting my blood drawn for this A1c. My last A1c was in June. If I were to have stuck to the once-every-3-months schedule, I should have had this one drawn in September. And then I could have had another test done in December.

I had originally gone to get it done last month (which would have been 4 months since my last A1c), but the lab script that I was given by my doc didn't have her signature on it and the lab wouldn't take my blood. Basically, a wasted morning. I then had to contact my doc's office (which took me several weeks to do, for no good reason), wait for the lab script to arrive, and then get around to actually going to get the blood drawn (again, I dragged my heels on this, for no good reason). Since I didn't get my ass in gear sooner, I'm down to this one last test to see if I can hit my goal for the year.

I'm a bit anxious about it.
I want it so badly.
I don't ask for much, honest.
Just this one little thing.
Please, oh please, hemoglobin gods, please??

I finally got around to going and getting the blood work done this morning. I've been going to the same place to get my blood drawn for these tests for quite some time now, and I had never seen the phlebotomist who called me back before. She was obviously new to the lab, but she seemed so nervous that I wouldn't have surprised if I was the first person she'd ever drawn blood from. When it counted, she did a fine job in the end, but she was kinda lacking the procedural comfort and confidence one looks for in a phlebotomist. You want someone that is friendly, but also has a level of confidence that somehow signals that they've done this a thousand times before and puts the patient completely at ease and worry-free that they were in for a botched job.
True Story
I clearly remember the day I got hooked up on my insulin pump. It was July 31st, 2000. Megan had just come back from a year of teaching English in Japan a two days earlier, and I had to spend a night in the hospital for the first 24 hours on my pump (I get the sense they don't do that anymore with new pump patients, huh?).

They had to stick "a line" in me so the would be able to quickly administer a shot of glucagon if anything went wrong with my initial pump profiles and I had a severe hypo. Meg and I were chatting with the phlebotomist about whether it was more difficult to draw blood from elderly patients or infants while he was preping to put a line in on the top of my right hand. We must have thrown him off, but he did have a cocky attitude and I think he even said "I never have trouble getting blood."

Well he did this time.

I watched as he put the needle in under the skin on the top of my hand and could clearly see that he missed my vein. What surprised me most was that he wasn't a quiter. He actually started raking the needle back and forth under my skin! He knicked the vein, but didn't have the needle in it, and I could see blood starting to pool just under my skin.

I fainted.

Luckily I was already sitting on a hospital bed and I just fell onto my back. I don't think I was out long, but I remember coming to and Meg was close to my face asking if I was alright. I sat up slowly, and looked around, and the dude wasn't there. He bolted! We waited a few minutes, Meg looked up and down the hall for him, I got up and washed my face and he was nowhere to be found. Seriously one of the most unresponsible things a phlebotomist could do, if you ask me.

I've never fainted again, but I've never really been all that comfortable watching the needle work since then either.

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This one, however, was anything but confident and even had a slight tremble in her voice when she asked if I'd like to hang my coat up. Didn't really put me at ease, let me tell you. When I rolled up my sleeve and laid out my arm and there were no obvious veins bulging out, she said, "Is that the best you've got?" in a nervous voice.

She got out all the materials and spent a lot of time organizing them just so. She finally got into some surgical gloves and began to whipe down the crutch of my arm. Meanwhile, I've been squeezing my fist and flexing my forearm muscles to the best of my ability, hoping that I could produce a small blue line to help guide her.

Another (much more veteran) phlebotomist (who has "worked" on me before) was pacing behind her and watching every move over her shoulder. She mentioned that she should probably put a tourniquet on before going much further.

Good idea.

Since she placed the blue rubber tourniquet (which was neatly laid out next to my arm already) around my arm, sinched it down so tightly that she got her surgical gloves caught in the little knot. The tournequet was so damn tight, I literally lost sensation in my fingers. I was contemplating saying something to her, but didn't want to throw her off in any way. She stuck a vein on the first try and everything went smoothly. And I was very happy when pro-phlembotemist-watching-over-her-shoulder mentioned that she could undo the tourniquet now (she may have noticed my fingers turning blue from across the room).

So I drove to work on this sunny, crisp Fall morning with "Shake the Sheets" by Ted Leo + the Pharmacists blaring and I felt oddly optimistic. But I'm keeping my fingers crossed until I get my results back none-the-less.

Speaking of music... Any MMW fans out there?
(Perhaps)

3 Comment(s):

Blogger mel said...

Ooh, I've been in that same situation before! I actually heard the "pro" phlebotomist ask the new, "Are you ready? Want to try?"

I was sick and I don't have great luck with veins, so I politely told them that maybe it wasn't a good idea. I think I saved that poor girl a lot of trauma--any mistakes and I would have passed out or yelled or something!

Your experience in the hospital just sounds awful! And I spent just under 3 hrs at a CDE's office when I started the pump.

Blogger MileMasterSarah said...

HAHAHAHA

I would so never want to be a phlebotomist

I'm crossing my fingers for your a1c

Blogger Scott K. Johnson said...

Wow! The dude just split?! That's crazy!!

I've had a few times doing research studies at the U of M where they had to call the "expert" in for a line in my left arm.

These folks actually have a portable ultra sound machine or something, where they can actually look and see where the veins are! Very cool.

Too bad the rookies have to stab & jab a few times before they give up and call the experts in.

Good luck on the A1C. I'm due for one too and am procrastinating big time.

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