Possibly Blown Out, Painful Vein from Blood Draw

[Duff Man]

Hey guys, want to pick your brain on this- I had a blood draw a few days ago by a student (it hurt pretty bad at the time) and now my arm is unusually sore... in weird ways.

When I extend my arm, it hurts up and down my arm. When I touch my arm anywhere within 4" above the puncture site, it kills. When I touch where the vein WAS, I don't feel the vein anymore... and it was a seriously giant vein.

Is this something I should do anything about?

 

[lance]

Hi Duff
During right sided catheterization done through the vein in the elbow the doctor tore the vein and it is now and forever well tied shut and the area where this occurred is covered by a 2" scar in a depression. My arm was black and blue from shoulder to wrist.
Except for the absence of the scar you're describing the same scenario.
Did you experience bruising? I wouldn't think it possible for the vein to be stuck together top to bottom to impede blood flow and leave a depression.
This is really weird. I wonder if there are nerves in the area of the vein that could have been impacted causing the pain.
Maybe someone else will come up with more information

 

[DebbyA]

It may be phlebitis. I had it after a particularly clumsy blood draw. You can try warm compresses several times a day, and take tylenol. But your arm sounds much worse than mine. Was this at a doctor's office? You should probably call even if it is the weekend, especially if it gets worse. Did you volunteer to let a student practice on you?

 

[Greg a]

If it is getting worse as time goes on (more than the 4 inches) I would worry about infection or you may want to consult a vascular specialist

 

[Duff Man]

Thanks for the responses folks. There's no large bruise (very small one), and it's just tender and swollen. I'm hoping it's just a nerve thing. I called the lab and they said that it's common, and that a nerve was probably nicked in the process of the draw. He said it's even common for it to swell up and be painful to the touch. I just hope the lab guy is right, as opposed to phlebitis or infection. I guess one positive factor is that I'm already on coumadin, so I'm kind of protected from a clot from phlebitis by that very fact... kind of. The infection thing is also a good point, and I'll be watching for worsening of any symptoms.

I'm starting to think the benefits of home testing far outweigh the benefits of testing at a lab, if only because of the risks associated with venipuncture, the drive there/back and the wait time involved. I would be a seriously unhappy camper if this turned out to be phlebitis. Some day I will pop for the acchuchek xs... just not very soon.

 

[Duff Man]

@Debby: they kind of pushed the student on me by assigning me to her. She disclaimed right away that she was a student, and asked if I was comfortable allowing her do the draw... I have a hard time saying no sometimes, especially to nice people. I guess I was also a little naive in thinking that it's pretty hard to mess up a blood draw - but damn! I was wrong. Who knows, maybe it's not really her fault... maybe it just happens. I really think she was just too unsteady and probably did nick something, because it hurt more and more as I felt the needle move around in my arm while she grabbed more vials, set the vials down, etc.

Never again will I let a student draw my blood. Sorry.

 

[Protimenow]

I'm a strong proponent of self testing. It doesn't have to be done with a CoaguChek XS, either.
I know that there are people here who absolutely do NOT trust eBay for such things as meters, but I have been well served by using meters that probably came from facilities that 'upgraded' to newer meters and sold the last generation meters to dealers that resell items like these.

I've used the Protime (and there are a few for less than $50 right now), and the ProTime 3. What I liked about these was that they have built in quality control in the strips. I would NOT recommend the CoaguChek S - even for free - because the CoaguChek S requires quality control for each day you use it - and this is a real hassle. Also, there won't be any strips available after April 2012.

You may be able to get an InRatio for under $200 or so. I think I personally prefer the InRatio over the ProTime meters -- the strips don't require refrigeration, they don't require as much blood, and the strips also seem to be less expensive. Quality control is built into the strips, and you can use 21 gauge lancets and a standard lancing device.

Doing your own testing - using just the blood from a fingertip - is a lot safer than a clumsy student and venipuncture.

You may consider a used meter if you can't get a new one.

Anyway -- I do my own testing, and a lot here do, also. Most are using meters that they bought new. Personally, I couldn't afford new, and the used meters and new strips I bought are working fine for me. Self testing empowers me to do self testing - and lets me avoid the drive to a lab, waiting to be tested, waiting for results, etc.

 

[Duff Man]

Protimenow, much props on the writeup. I really thought I was going to be investing 500+ in any monitoring system, but it looks like I might be able to achieve this on the (somewhat) cheap.

Crazy question, but will an insurance company like blue cross pay for any of it?

 

[Protimenow]

As far as I know, you'll probably have to go through a source other than eBay - although some of these sellers are licensed medical equipment sellers. You may have problems with an insurance company paying for a meter bought this way. You may be able to get them to pay for the test strips if you have your own machine - but, not being insured, I haven't any experience with the insurance providers.

There are also testing services - Alere and Philips, and they are quite good in convincing the insurance companies to pay for testing. They send you the meter and strips, you do the test and give them a call, and they notify the doctor (at least, this is how I believe it works). This service isn't cheap - and I'm not sure of the co-pay involved - but it's probably easier than driving to a lab and getting stuck again.

It probably wouldn't hurt to call your provider and ask about self-testing -- if you find a person there who knows the difference between INR testing and blood glucose monitoring, you may be able to have them get a machine for you, or reimburse you for a machine - though it may not be real easy.

In my case -- I got set up for under $200.

This forum doesn't condone purchasing from unauthorized sources, so I won't suggest that you do this in your case. I can only say that, from personal experience, I was able to get a ProTime and a ProTime 3 on eBay and all worked. I was also able to get an InRatio - which also works. InRatio strips are being sold on eBay for about $150 - 200 for a box of 48.

 

[Kathy McCain]

If it doesn't seem ANY BETTER in 24 hrs, I would let the Dr look at it.

 

[normofthenorth]

Not the same, but 2.5 wks post-op, my main injuries other than the obvious two (sternum and heart) are bruised forearms and neck, all from needles during the surgery. Shortly before I went into the OR, I had to to be "stuck" maybe 5 times in both forearms before the nice young folks found an artery that would stay open with the "art line" in it -- NIGHTMARE! And soon after I was knocked out (I think), they stuck a big metal line ("trip-alum"?) into my jugular, which stayed for a day or so post-op.

I don't think most of us think of these numerous "piercings" as a source of pain or complication risk, but maybe we should re-think. Good luck, Duff.

 

[Philip B]

Missed!

Missed!

The individual who missed may have nicked all kinds of things in your arm while "digging" to get the needle in. A nerve could have been hit. It's also common to have tendons nicked or stabbed during the effort.

Incompetence at my local hospital's lab back in 2007 was a major factor in me becoming a home tester. Often it would take a tech six tries to get a hit and do a good draw. BTW, my veins aren't small or difficult to see. I used to stick myself while practicing IV sticks back in the days when I used to run as a volunteer EMT in a rural mountain community.

-Philip

 

[bigsidster]

Had the same thing happen to me 2 weeks before my angiogram.My arm swelled from the elbow to my shoulder and turned black and blue.They did an emergency echocardiogram on a saturday to ensure no blood clots or deep vein thrombosis and put me on antibiotic right away.It ended up not being a blood clot but rather surface thrombosis from a poor blood draw.

 

[yotphix]

I really thought I was going to be investing 500+...

Crazy question, but will an insurance company like blue cross pay for any of it?

If your insurance company doesn't cover it, and you want an actual Coaguchek XS, you can still watch ebay. Two brand new in box units with the tube of strips and lancet device, carrying case, instructions etc. Just what you would get if you bought through the pharmacy just sold one for under 400, the other (I think) was just over. I have no idea about the warranty and it would mean that you wouldn't have the 'training' but it is an option.

 

[Lily]

Ouch. I've had too many inexperienced techs hurt my arms, literally rummaging around with the needle trying to find the vein that they missed :eek2:

I have always tried to be patient and pleasant with them but I finally had enough and have decided in the future to just ask for the most experienced tech.

BTW, if you're cleared for it, try drinking a large glass of water an hour before any blood draws. A nurse recommended that to me and it can help. But even that can't help some techs :frown2:

 

[Duff Man]

Thanks for all the great input folks. I'm a home testing proponent for life now. Never even heard of a person having a real problem on a blood draw/venipuncture until your stories.

Doing a heck of a lot better... I'm pretty sure now that she nicked a tendon as opposed to a nerve, just because of the way it swelled up and hurt when i extended/flexed it. The pain was very to a sports injury to the tendons in my bicep I had a while back. Just so glad it's not phlebitis.

I'm about where you were at in 07, Philip... tired of the multiple attempts before a successful draw, and now this. I feel burned and I'm looking real hard at home testing. Ebay seems fine to me.

 

[DebbyA]

"...multiple attempts before a successful draw"--at your clinic? It's terrible that it's not a one-time thing. One thing that does help is to drink lots of water the day and hours before. A nurse told me one time to use a blood pressure cuff and pump it to 40, but I've never gotten anyone to take input from a mere patient. Sometimes I tell them, "you only get one chance, so make sure you think the vein looks good". (I'm don't have a need for regular testing, but do have small veins, and do give blood regularly.)

 

[Protimenow]

Problems with a vein draw? Yeah, they definitely occur. I've been pretty lucky -- large, prominent artery and experience with techs who knew what they were doing. My wife wasnt so lucky -- years ago, after a car accident, they decided that they wanted to take some x-rays with contrast. Normally, this contrast is injected into the artery just before the X-Ray. In my wife's case, the 'tech' completely missed the artery (or went through it), and injected directly into the muscle. It made her arm balloon - almost bursting out of the skin. It's been probably 40 years and that arm is STILL swollen. This kind of incompetence almost makes a botched blood draw look tame (although I am NOT trying to discount the hassles with blood draws -- just to point out what such venipuncture errors can cause).

Duffman -- I hope you find a good test unit soon -- you WON'T miss the hassles of lab testing, by comparison (unless, I guess, there's a REALLY cute lab tech that you go to the lab just to visit).