Spent last week doing another Medrol infusion to kick this exacerbation. The steroid worked amazingly well this time, both physically and mentally, and not in small part due to a very understanding IV technician (he's actually the director of nursing) who treated me with kindness and respect. (And didn't tell me to fix my valve-y veined arms by losing weight or something. I'd have been like, "Haha, I dropped 15 pounds being sick already so there!" Well, not really, but I fantasize about saying stuff like that to less awesome people. Seriously, he was a dream.)
So, I have a question for all of you fat folks who spend time at the doctor's or the hospital - have you ever been told, before anyone's even looked at your veins or touched your skin, whether or not you'll be "hard to stick"? I had an experience with that this time around and it puzzled me - I've never had trouble giving blood, nor been told I have "rolling" veins or anything of the sort - and yet I was deemed troublesome before I'd even gone down to the lab! (They actually called my house to find this out - wtf?)
Why would one look at a fat person and automatically deem them difficult in the blood department? I mean, if you've got enough training to take someone's blood, shouldn't you also have enough to know that veins typically aren't smushed under three inches of impermeable fat or whatever it is you think you're looking at?
(Then again, who am I kidding? Read stories at First Do No Harm and see what doctors get away with. It's horrifying.)
So does anyone have anything similar to share? I asked a fat friend of mine and said she'd never experienced it herself, but would be mighty pissed if it had happened to her.
Thanks for reading and take care!
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21 comments:
I do remember a hospital stay many years back - I had to be fed via IV, and my veins kept collapsing, so they had to do it again, and again. One nurse complained that even though I had "fire hoses" under my skin, I was still giving her trouble!
Goodness, what did you say to that nurse? I'd probably have cried (and then my partner would have given her hell). That woman sounds like some of the impatient people I deal with during my Medrol drip days.
Also, hi and welcome, Yummy Rum!
I'm quite a "well-padded" girl, and just about EVERY time I need bloodwork done, the tech assumes my blood pressure is through the roof and nearly squeezes my arm off, then can't figure out why it's so difficult to get a reading.
Thankfully I've got excellent veins, and mentioning that is part of my usual trying-to-calm-my-nerves chatter, if the tech is even remotely the chatty sort.
I've been lucky, I guess. No one has ever told me that it was my fat giving them problems with getting blood or putting in an IV. My veins do roll, and that's what they've said to me when they've had to stick me more than once. A lot of it depends on the skill of the lab tech taking the blood, though. Some are just better than others.
Megan - Do you ask for a large size cuff? It shouldn't hurt so much if they do it properly (which it sounds like they aren't). Don't let anyone get away with saying "It's the same thing!" because for a lot of people it most certainly isn't.
I get that assumption about high blood pressure, too. Last time I was at the hospital, I was glad my blood pressure was normal (120/70 for me) because it had been inexplicably very low in the weeks before. When I told the nurse it had been 90/60 and then 70/50 before then, she said, "That's not so bad" and gave me this look like she meant "for someone your size." Like for being fat, I should have extra-low BP just in case or something. So I just ignored her and said, "It's bad when I'm fainting." She didn't say anything after that.
Awesome on the good veins - I've got 'em too, just not so good for IVs in the arm. (Like I said, I'm valve-y.) But drawing blood's okay, I just hate all the dumb assumptions people make about fat people in a doctor's office. Pisses me off.
Thanks for stopping by!
Vesta - Definitely. It seems I run into some pretty inexperienced/disgruntled nurses. The lab I go to regularly is filled with good people, but the ward I stay in to get my infusions isn't always so satisfactory. I never know who I'm going to run into (or up against).
As someone I finally know with this elusive rolling veins thing, could you tell me exactly what it means? I can never get a straight answer from anyone accusing me of it *G* and definitions on the internet are widely varied.
Thanks for coming by again! I always look forward to a comment from you. :)
Rolling veins: When someone aims at them with a needle, they wobble to one side or the other. (Imagine trying to write on an egg with a marker without holding it still... it'll go any which way.)
And yes, I've finally learned to ask them for the thigh cuff (and you're right, it is NOT the same, dangit!) and tell them my blood pressure is usually quite low, so be gentle. :)
I had the same as you for a while, Ruth, alarmingly low BP... but since I'm fat, that's great! Just means that heart disease I'm supposed to keel over from any day now will... uh... take a few extra minutes to hit or something? No idea. :D But fainting spells are fine, since I have teh fat to pad me when I hit the floor!
Amazing how... silly medical professionals can be, isn't it? ;P
I always know the tech/nurse/whatever is bad at it when they start hemming about "hard to stick". On the flip side of this, the kindest physician I've had is my obgyn who has never said anything about my weight. When his RN started on about "hard to stick", he started doing all my blood work personally.
The blood pressure cuff being pumped up to the max even when I tell the nurse my bp is usually on the low side is one of my pet peeves. Blood draws usually aren't an issue -- I've only had one technician make a comment, and that was when I went to donate at the Red Cross. He also really botched it -- went right through the vein -- so I think he was just flatout incompetent and looking for an advance excuse for screwing up again.
I have been told I have rolling veins and that I am hard to stick by nurses who have trouble getting blood.
However there have been quite a few nurses who have no problem taking my blood and they never said anything about rolling veins.
Perhaps it is experience in drawing blood from a fat person that makes the difference.
Cynth - I think you hit the nail on the head. Medical professionals need to a) be better trained in the care and treatment of fat people, and b) rethink their perceptions of what a fat patient needs and deserves from them. Medical care should be tailored to the patient in many ways, but standardized procedures like blood work or blood pressure readings shouldn't vary that much from tech to tech. Thanks for your very insightful comment and for stopping by!
Megan, Nan & Epiphany - I have responses for you three as well but I was just heading to bed when Cynth posted her comment. I'll get to you guys as soon as I wake up and have some yogurt! I like to respond to everyone when I can, so thanks for your patience :)
I do have rolling veins and I am fat, but my very thin (anorexic) grandmother also had rolling veins. My mom used to joke around that it was a protective measure because both of us were tough chicks, and hard to kill. Anyway, I've had phlebotomists yell at me for being too fat and that's why they couldn't draw blood, and I've also had phlebotomists just stick a needle in and take blood with no problem.
Echoing the statements that medical professionals always assume I have high blood pressure. They also assume that I'm diabetic and have high cholesterol as well. I have low/average blood pressure, regular cholesterol, and low/average blood sugar. But I waste a lot of time trying to convince doctors (and dentists!) that I'm not lying to them.
I am "hard to stick" in my right arm, so I always tell them to take from my left and it seems to go OK, though they still almost always complain. No one has ever successfully taken blood from my right arm.
This has absolutely nothing to do with my weight - I heard is much at 120 lbs as I do now at 180 lbs.
I'm hard to stick because I have small veins--definitely not related to weight. The last time I gave blood the nurse looked at my veins and asked me if I had ever successfully given blood, but then she got it on the first try and it flowed well. For a heart test in the hospital for which I needed an IV three people tried before they finally called in the expert, and she took several tries. I always tell them I am hard to stick. Being cold and being dehydrated make it harder, but I think part of how it comes out is skill and part is luck.
Another big girl with MS here, and I've also gotten the "hard to stick" comments from a nurse, even though I'm so dreadfully pale on my underarms that my veins show like roadmaps (even through all the layers of icky icky fat!) and even though other health professionals (oral surgeon, pcp) have no trouble drawing blood/doing an IV. Said nurse also said that IV steroids would "blow out" my veins (not the most comforting image in the world) but it was worth it because they would also give me some "energy" so I could "go out and exercise a little," as if my defining MS symptom was sheer laziness, and not the fact that I couldn't control my legs and torso enough to even stand on my own. Jeeze!
Ruth - Hi!
Don't get me wrong - I actually made friends with that nurse during the course of my stay. The problem was that, like other commenters here, my veins rolled, and since I had to get poked A LOT, I didn't take what she said personally.
A lot more recently, I've been giving blood. I've never had trouble, and they say I have good veins, but maybe it's that this time they're sticking me in the inside of my elbow and not the back of my hand (yes, during my hospital stay they ran out of veins in my wrists).
Oh my goodness, I didn't expect this many comments! Thanks everyone for coming over to share your experiences. I'm going to handle these in the order received! (It'll probably take more than just one of these.)
Megan - LOLOL. My partner Michele and I cracked up at your comment, especially about the fat padding us enough when we hit the floor from fainting! Hahaha. In all seriousness, though, it does does seem like low blood pressure is definitely okay for us fat people. But, hypothetically, if our pressure is so low, and other tests maybe even lower, and we're considered healthy by those standards, then why are we still so darned fat? I bet it kills them to think about.
Epiphany - It seems to be a good sign of someone either not experienced or patient enough. The best techs I've known just tie on the tourniquet, tap the vein, and put in the needle without any chatting or questions or anything. That's cool about your doctor doing your work himself. With my last week in the hospital, after the director of nurses (who installs my midline IVs) found out that the IV was occluding the first day (and had been occluding every single time I'd had an infusion) he decided to put IVs in my hands instead, and when I told him some of the other nurses in the ward were very bad at it (and had also been rude, not to mention dismissive of the occluding) he came back every day himself to put in a new IV. Just goes to show you that some medical professionals are real professional. Sounds like we seriously lucked out. Maybe you should put your doctor's name on the list of fat friendly health professionals?
Thanks for your comment and for coming over!
Nan - OMG, that kills me. They pump it up over 200 and I think afterward, "No wonder it's high, my arm was burning!" It's not so bad with the automatic ones they use at the hospital, but then machines usually don't judge a person by how they look. And that guy at the Red Cross sounds like a class act. A class he failed.
Thanks for visiting!
Brigid - I like your idea of tough chicks who are hard to kill, hehe. I guess rolling veins can be an advantage when it comes to certain things. Sorry to hear about yelling phlebotomists - that's unacceptable. I had one yell at me for being dehydrated, and it was for a test I didn't know I was going to take that day. (A doctor conned me into getting my cholesterol and sugar tested while she was giving me a pap smear - unacceptable x2). I was so mad afterward that I let someone talk me into something I didn't want to do, and then let someone yell at me for something that wasn't really my fault. Ugh.
Anyway, thanks for stopping by and take care! Hope you run into nice blood takers from now on!
(More responses on the way. Don't want to run out of room! - Ruth)
Nettle - It makes sense that some parts of the body are harder to get blood from than others. None of the veins on my arms are completely symmetrical. I'm glad you know it's not about your weight, either. The more fat people who know this, the better off we are when we have to enter a doctor's office or hospital. It's good to be empowered.
Thanks for your comment and take care! :)
Pem - Sorry that it's hard to draw blood from you. Doesn't sound like it's much fun. When they ran out of places on my hands to put an IV last week, I guess I got a little taste of that myself. It hurt! That's a rotten thing to have to deal with all the time. It's good that you tell them beforehand that you're tough at giving up the blood before they make a judgement about it, though!
Thank you for stopping by! Hope to see you around :)
saintpikachu - Hi, other fat girl with MS! *g* Nice to meet you. Your story about the nurse telling you things like steroids would "blow out" your veins, but it was okay so you could exercise and lose weight is fucking HORRIFYING. What did you say to her? Of all the weird and sometimes rude things people have said to me, I've never ever heard a thing like that. Did they have any idea why you were there? That a lot of people with MS don't have the energy to go out and exercise? That someone on steroids for an exacerbation doesn't need to be fed crap on their hospital tray? Lord, that's nasty. I'm so sorry that happened.
Re: being pale, I've got roadmappy veins too - they're pretty impossible to miss. What's up with people who can't even take a look before they start making assumptions?
Thanks for telling your story and visiting! Hope to see you again :)
Yummy Rum - Hi again! Glad to hear that you and the nurse made friends. Like I said up there, it makes sense that some veins give blood better than others, or show up better anyway. Like, I ran out of veins on my hands during my last week in the hospital so we had to do a wrist. I'm glad your elbows work better than mine do, and they found an alternative for you to give blood. (If they didn't, where else would they go? I wonder these things sometimes.)
Thanks to everyone again for reading and for your comments! Hope my next entry - when- and whatever it is - brings out such insightful people!
Take care.
- Ruth
Hi Ruth! You know, that nurse was dealing with me just hours after I had gotten my MS diagnosis, and I was in such shock about that I'm sure I didn't say anything besides "Ok" (I didn't say much besides "ok" for a few days after, anyway!). Yeah, I don't know what her problem was - I've (thankfully) not had an experience like that since. Maybe that's just because I've perfected my "Give me shit about my weight and I'll shove my cane up your ass sideways" look. :)
This happened at least over a year ago, yet I still remember it.
This woman couldn't find my vein, when I needed a blood test. So she kept whining at me like a petulant child, "I can't find your vein! I can't find your vein!" I told her to find someone else to do the test. I mean, does she really thing that whining like a brat is going to help her find a vein. Maybe had I gotten angry enough she certainly would've found a vein.
My dad who also is plus-sized, said when someone couldn't find his veins, they put a needle into a vein on his finger, and it hurt like hell.
It seems when it comes to hospitals, they resign their staff who have half the brain of a fast food employee to doing blood tests.
As it would happen, the guy who is really great at taking blood tests at the hospital I go to, also is plus-sized. Which is really cool. He looks like Penn Teller.
Yummy rum, after that happening multiple times, if the nurse complained, I would've accused her of being a sadist. Like, it's not bad enough your veins keep collapsing, she thinks somehow bitching about it is going to help?
Actually, out of sheer curiousity what does a collapsed vein feel like. It sounds awfully painful.
I'm glad you made friends with the nurse. I don't know if I would've. It seems alot of people think I have a chip on my shoulder about things, like I'm hard on forgiving. I think it's I can't really understand how people can be mean without some intent behind it. I mean, it's not like I get upset if someone calls me the b word.
If someone who's supposed to know what their doing during a painful procedure, like something in a hospital, and they don't. Then they get irritated with me about complaining cause I'm suffering. I think there just has to be something wrong with them. Maybe they've had too little sleep or something, I don't know. I just could never see myself getting angry at someone because it takes a little longer to get a painful procedure done with less pain.
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