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August 09, 2005
The Blooddraw Saga
It seems that Dashiell has similar luck with phlebotomists/blood draws as I do, at least the luck I had with the blood the midwife attempted to draw, and then that stand-in phlebotomist who did one of my glucose blooddraws*.
When he was 2.5 days old we took him to the pediatrician for his 3 day check-up. At that check-up Dr. Liz mentioned that she didn't like the way his forehead slanted and that his front fontanelle (the soft spot) was extending into his forehead a lot further than she'd like, and told us that she'd like us to go to the hospital to do a blood draw to check for hypothyroidism.
Hypothyroidism, we were told, if it remains undiagnosed and untreated with medication, can have some serious repercussions, including mental retardation. This was not the kind of news that made me a happy camper, and I had this huge knot in my stomach as we sat there in the doctor's office. It didn't help of course that she'd worded things fairly bluntly, that I was sleep-deprived, sore, and that I was still in the throes of all kinds of pregnancy hormones. You just don't want to hear that the new little person you just brought into this world might have all kinds of problems, and receiving this news when in a more emotionally volatile state just added fuel to the fire. Doom and gloom scenarios were already running around in my brain at that point.
So, after the ped's office we went to the hospital, which was only about 2 blocks away. We went up to the outpatient lab and Dashiell got a heat pad applied to his heel, as that's where they routinely take blood from newborns. The heatpad is to increase bloodflow to make the heelstick easier. After about 15 minutes the phlebotomist fetched us from the waiting room and we brought him in. She stuck his heel and proceeded to milk his foot for blood. Newborn blooddraws basically involve puncturing the foot and then they have to squeeze the blood out a drop at a time which they collect into these tiny little vials that are about as thick as a drinking straw and an inch to an inch-and-a-half long. And not just one vial was needed, but three, one for the billirubin (jaundice) test and two for the two thyroid tests.
It's as torturous as it sounds. It broke my heart to have to sit there while they were doing this to him, and I had to fight back the tears too. They're so tiny at a few days old, you don't want them to have to deal with that, and it sucks that you can't even explain what's going on to them.
After what seemed like an eternity, the phlebotomist finally got all three vials and we were able to take Dashiell home.
Once home, we ate something, put Dash down to sleep, and were just about ready to take a nap ourselves because we were completely knackered, when the phone rang. It was Dr. Liz calling to say that the hospital's lab had called her saying that there wasn't enough blood for the second of the two thyroid tests (they do two tests at a time to determine thyroid function), and could we go back to the hospital before 3pm and do a second blooddraw.
After having tortured your newborn once, nothing's worse than hearing you have to go have him tortured again for the second time in one day. But, off we went back to the hospital, all bleary-eyed and droopy-tailed. This time around the phlebotomist had called in someone else, who was skilled in running butterfly IV's into infants. At this point I left the room to go find the bathroom, because I really couldn't be there to watch them stick an IV line into his arm. It took the three of them (including PreZ) to do the blooddraw, because someone also needs to hold his arm steady to keep the needle in. Going to the bathroom didn't really help much, I could hear him screaming down the hallway. So they got their vial, a bigger one than the ones they use with the heel sticks. Then they did a heel stick to get the regular newborn testing out of the way, which the phlebotomist had forgotten to do the first time we were there. Thankfully that wasn't too bad... it involves another heel stick, but instead of a vial, all that's needed is drops of blood in 5 circles on a card.
Mission accomplished. Or so we thought.
We got home once again, and once again the phone rang, and once again it was Dr. Liz... the hospital's lab had called to say there wasn't enough blood for that second thyroid test. PreZ was pretty pissed at this point, understandably so, and so was Dr. Liz when PreZ mentioned that they'd actually done a venous blooddraw this time, because it should have been more than enough. At that point though we let it all lie until Monday, because at least one of the two thyroid tests had come back normal, and if there had been a problem that test would have shown low levels and Dash had high levels. Also Monday was when we had another appointment with Dr. Nick, for a second weight check, to make sure Dashiell was gaining weight.
I managed to further freak myself out that Saturday by going online and looking up stuff about hypothyroidism and various other syndromes. It was that doom and gloom stuff coming into play. I noticed that one physical trait of Down's syndrome and a bunch of other syndromes is something called a "simian crease" which is one single horizontal line across the palm of the hand, when usually people have two lines, one coming from each side of the palm that kind of overlap but don't touch. Checking Dashiell's palms, I noticed he had one single crease across each one. Needless to say, this was not news that cheered me up any, and PreZ had to deal with a wife in tears. He tried to get me to look on the bright side, which was that the first thyroid test was normal and that 1 in 30 normal people also have a simian crease, so it's not necessarily indicative of anything.
So we had that Monday appointment with Dr. Nick, and after discussing the slanting forehead, the fontanelle and the simian crease, he gave us a prescription to go get an ultrasound done of his head, and yet another blooddraw, and we had a follow-up visit scheduled for the Tuesday a week later. Dr. Nick wasn't as worried about the fontanelle as Dr. Liz had been, or the forehead... some post-birth moulding could have also played a part in the difference between the two visits. We managed to get an appointment for the u/s the next Monday, when the most experienced radiologist or tech was on shift and scheduled the two week pediatrician visit for that Tuesday.
Third time's a charm, or so we hoped at least. We had the ultrasound done, and the tech was really nice. She then got the radiologist in to quickly review the results with her, and she told us later that unofficially he was fine, which was a real relief. After the u/s we went upstairs back to the outpatient lab for the blooddraw. A different phlebotomist was on shift this time, and a very cute young guy I might add... with phlebotomists like him I'm sure many people wouldn't mind blooddraws as much. PreZ made sure to explain what had happened the last time, and the phlebotomist even called down to Chemistry to find out what had happened etc. but they had no explanation. He did a heelstick and drew two vials from Dashiell, and we went back home.
The next day we had our 2 week pediatrician visit with Dr. Nick. You'll never guess... the hospital had called him to tell him they didn't have enough blood, AGAIN. For the THIRD TIME IN A ROW. Needless to say Dr. Nick was angry, and he had apparantly given the hospital a piece of his mind about the situation. For now we're not going to attempt to do the thyroid tests unless there's some indication. I think my son's had enough experience with being a little human pincushion for now.
In the meantime his regular newborn bloodwork (for PKU etc.) came back normal as well.
Tomorrow is his one month "well baby" visit, and then we'll see how much weight he's gained and growing he's done in the past 2 weeks. It's a visit with Dr. Liz, because Dr. Nick is on vacation, and so I'll have to save the geneticist question for the next time we see him. So this story might yet get a tail somewhere down the line.
*Both had problems finding veins in the crooks of my elbows for a blood draw.
Posted on 07:04 PM to: Dashiell