Lancet size

[watson524]

Hi all,

New to home testing on mom and wasted a strip this week because of not enough blood. 3 sticks later (and got smart about not even trying to touch the strip until I knew it was enough) I got a decent drop of blood out of her. We let her hand hang down (she's in a wheelchair so can't do jumping around or anything to get blood flowing) and used the rubber band the first time after I had her sit with a hot towel around her finger first. What finally did the trick was hot towel over whole hand while it was hanging down and then rubber band on while getting meter ready and release right stick.

Roche sent the accu check soft click and it's set on 5. I actually jabbed myself to make sure it was firing properly. I have read old posts here that diabetic testing doesn't need as big of a drop so I'm wondering if the accu check is too small and I should look for other lancets. The lab she used to go to uses some white things with a blue button on top that looks like a T.

What do the experts here suggest?

 

[pellicle]

See my reply here in your other thread

http://www.valvereplacement.org/for...e-recommended-lancet-size?p=873121#post873121

 

[dick0236]

Hi all,

Roche sent the accu check soft click and it's set on 5. I actually jabbed myself to make sure it was firing properly. I have read old posts here that diabetic testing doesn't need as big of a drop so I'm wondering if the accu check is too small and I should look for other lancets. The lab she used to go to uses some white things with a blue button on top that looks like a T.

What do the experts here suggest?

The "T" lancet with the "blue button" is exactly the one I currently use. It is made by Roche Diag. It is labeled Coaguchek Lancets, depth 1.8mm, width 23 gauge....Ref #04348150001. I started with the "pencil" but it would not penetrate enough. The "T" lancet does fine and I seldom have difficulty with a good droplet. I use warm water to help force blood into finger but the warm towel should be just as good.

 

[watson524]

Doh! Didnt realize it posted the first time before I logged in. I've studied your video and it just doesn't seem to cut it (no pun intended) for mom. Since I'm dealing with a neurological issue and movement problems to start I want to make this as easy as possible. I just saw in the Roche patient portal to order supplies there is the accu check lancets and also coagucheck lancets as an option. When I looked those up they're exactly what the lab used with no issue and no warming or anything and are 23ga so I'm thinking while the convenience of being able to store the pen and lancets in the case is nice maybe I'll just see if they can send tho or I'll get them online

 

[pellicle]

Hi

.... I've studied your video and it just doesn't seem to cut it (no pun intended) for mom. Since I'm dealing with a neurological issue and movement problems to start I want to make this as easy as possible.

restraining myself from following on the pun lines ;-) I'd say that I'm not sure I understand. Because no matter what you need to stick to the guidelines of Roche (at least approximately) if you want to get reliable measurements. Also (if you want consistent measurements not inconsitent ones) you'll also need to be consistent ...

What in particular is the problem, see if in discussion we can find an answer?

I'm sure we can find a pointed solution ;-) (drat ..)

 

[pellicle]

watson524

I've had these used on me in the hospital ...

The "T" lancet with the "blue button" is exactly the one I currently use.

they seemed good ... but I'm too cheap / lazy to go buy more and I've just stuck with the softclix

 

[watson524]

Hi
What in particular is the problem, see if in discussion we can find an answer?

I'm sure we can find a pointed solution ;-) (drat ..)

To cut to the chase, the point is (see what I did there? Lol!) she's not bleeding enough to form a useful sized drop of blood on the finger tip without a lot of squeezing over time which I know is not acceptable to do.

No matter how firmly I press the tip of the pen down on the side of her finger to ensure good contact before firing it and all that.

I'm thinking since ordering the other lancets&oq is an option I'll just call Roche and tell them the accu check ones aren't cutting it and can they drop ship me the coagucheck ones. Weird how they don't just send those to start since they match in brand line to the meter.

 

[pellicle]

Hi

To cut to the chase, the point is (see what I did there? Lol!)

I think we're both pretty sharp ...

she's not bleeding enough to form a useful sized drop of blood on the finger tip without a lot of squeezing over time which I know is not acceptable to do.

well it depends ... its hard to grasp (oh dear) qualitative metrics like "hard" without a baseline ... myself I think its a bit over blown but I've not done sufficient testing.

To me the biggest issue is how long the drop is exposed to air before it lands on the surface and is drawn into the chamber (by capillary action) .. oxidation is in my view a bigger issue than any potential theoretical "triggering" caused by milking. Indeed the roche documents at some points suggest it (go figga)

No matter how firmly I press the tip of the pen down on the side of her finger to ensure good contact before firing it and all that.

well once you have contact more firmly does nothing, the depth setting defines how far the point comes out past the mouth of the lancelet ... the pressure does nothing more.

do her fingers feel cold?

if you press her finger between your forefinger and thumb (with the pad on forefinger and nail on thumb) how long (compared to you) does it take for colour to come back? If a long time then the issue is perhaps her blood circulation is low.

have you tried putting a glove on her hand for 10 minutes before?

I'm thinking since ordering the other lancets&oq is an option I'll just call Roche and tell them the accu check ones aren't cutting it and can they drop ship me the coagucheck ones. Weird how they don't just send those to start since they match in brand line to the meter.

I'd just nip down to the chemist and ask for some 23 guage lancelets. My personal experience is that fatter is better than deeper.

 

[dick0236]

To cut to the chase, the point is (see what I did there? Lol!) she's not bleeding enough to form a useful sized drop of blood on the finger tip without a lot of squeezing over time which I know is not acceptable to do.

I used to be concerned about "milking" the finger to get a good droplet and have had professionals tell me not to worry about "pushing" enough blood into the finger stick. I seldom get a good droplet without some milking (squeezing) and it does not bother me. I am more concerned with clotting time of the droplet and the time limit on the strip.

 

[watson524]

Her fingers are cool to the touch to start but while I'm washing up and getting things ready she balls them up or puts them under her lap to get them super warm and when I feel them then, they're what I'd consider normal temp. But I figured the warm cloth would help as well. Her circulation seems ok as far as the press test and color coming back. Even with me squeezing the finger pretty darn hard (harder than I'd allow if it was my finger being squeezed but she's a trooper) it was taking ages for anything to come out and the exposure to air time would definitely concern me so it really seems like a 23 or 21ga is the way to go like they have in the lab I guess. She's older with thin skin and not a lot of fat on her fingers so I made sure I was in the "meatiest" part of the side there not completely to the side where the finger is "harder" but like half way between true middle of pad and "edge" of finger where it's good and soft. I went to two drugstores and no dice, they don't have anything but the 28ga ones we already have so I'll call Roche first since she'll get her supplies from them anyway and then just check online.

 

[watson524]

I called Roche and they'll be sending me the coagu lancets as well as a new thing of strips. Should be here in time for next week's test

 

[DachsieMom]

I know it's easy to say, but don't stress too much. I wasted so many strips the first several weeks! Roche was great about sending extras. I now rarely waste a strip. I use the blue accuchek soft click set on five. I just rub my finger towards the tip. Put pen on the side of my fingera d press - rub downward while pressing your finger - and put finger on side of the strip, while still rubbing my finger down towards the tip. One day, I just "got it".

 

[watson524]

SCORE!! Got the new "T" lancets from Roche yesterday (I jabbed myself and those suckers hurt - but I'm also a huge baby LOL!). Anyway, had mom sit her with her down wrapped in a hot washcloth, fired up the machine, when it was ready I wrapped the rubber band like in Pellicle's video, fire the lancet and didn't get what I'd call a "huge" drop of blood but it sucked it right up into the machine and said it had enough quicker than I expected. INR = 2.3, called in results, good to go. Thanks all for the advice!!!

 

[pellicle]

SCORE!! Got the new "T" lancets from Roche yesterday ... it sucked it right up into the machine and said it had enough quicker than I expected. INR = 2.3, called in results, good to go. Thanks all for the advice!!!

love to hear the success stories

 

[pellicle]

Hey ... just a quick point

... fire the lancet and didn't get what I'd call a "huge" drop of blood but it sucked it right up into the machine and said it had enough...

I just did my INR this morning (as is my ritual) and thought I'd photograph the drop (after the reading appeared so as not to tempt fate and accidentally bump it during its reading time)

It looked like this (of course after it had sucked the blood into the strip)

[IMG2=JSON]{"data-align":"none","data-size":"full","src":"https:\/\/c1.staticflickr.com\/3\/2698\/32583440900_d26e33f9cf_c.jpg"}[/IMG2]

I put this here because I've found that unless I get a good size (with blood to spare) I on occasion still get an error 5 for insufficient blood, if I see that the blood is almost completely sucked into the strip.

In fact I have developed via experience a feel for this and can "oh no" predict when the drop is not going to be sufficient.

This is just to let you know (cos being a tight wad I had loosing a strip to operator error) and a strip is worth 2 beers (Australian barter exchange basis).

 

[watson524]

Yeah when I do mom's, there's not that much left that hasn't been sucked up to cover the blue strip. We'll see how it goes tomorrow. To your point tho, at least I know how big I need to not waste a strip and I'll just *** her again (she loves me!) vs wasting a strip.

 

[lance]

We use a 21gsuge lancet with the Softclick set to the highest setting. Also in cold weather I put a mitt on the target hand for a few minutes too.

 

[Protimenow]

When I was using lancets and a lancing device (before getting the single use 21 gauge lancing devices), I use 21 gauge lancets. These are larger than the 23 gauge, and make a slightly bigger incision. (BTW - I have HUNDREDS that I don't expect to ever use - they're yours if you want them - just pay for shipping).

Also - although I may sound like an ad for the Coag-Sense - the meter that I use, testing is a two step process. You put a strip in the meter, then wait for it to warm the strip until it's ready for testing. Incise the finger, then draw blood into a small capillary tube/collection device, apply the tip of the tube to the strip, and squeeze the bulb to deposit the blood. This can result in fewer wasted strips - if you don't have enough blood in the collection device, you don't have to transfer the blood to the strip - just try another finger. Also, unlike Coaguchek XS, an opened Coag-Sense strip can be used hours later and still give an accurate result. This is another reason that my meter of choice is Coag-Sense.

(I hate that this may sound like a commercial. I don't work for Coagusense or have any financial relationships to the company - I just prefer my meter and try to let people know it.)

 

[zee112]

I've started to wrap the finger from which I want to draw some blood from with a rubber band, as recommended by Pelliccle. That's SO MUCH easier than simply rubbing your finger and TRYING hard to massage blood out of the finger.

 

[Protimenow]

A loop or two of dental floss will also work.