Difficulty carrying out growth hormone blood test - hidden veins! Any advice?

[StarsAreShining]

The hospital suspect that my son has a growth hormone deficiency. To determine exactly what's going on, he needs a fairly lengthy blood test. It involves having a cannula fitted and blood taken from it every half hour for a few hours. The problem is that my son's veins seem to be incredibly well hidden. The first time they tried to take blood (when he was a baby in the neonatal unit), they had to try for a few days, even attempting to get it into his head. The last blood test he had took six hours and that was just a normal blood test, no cannula needed. They tried to take from his wrist (the 5th of 6th area that day) with no numbing cream and even slit his thumb and tried to squeeze it into the tubes. The only areas where there are visible veins are his feet.

They tried to do this test using the veins on his feet, but the veins were not strong enough for the cannula and both broke. They also stabbed around in his arms and hands for what seemed like an age, just hoping that they'd come across one. As you can imagine, hospital visits are now becoming very traumatic for my three year old son, but the hospital don't seem willing to do anything about it. I had warned them that I suspected it would be very difficult, but they brushed off my concerns as though I was an over worried mother. I asked the doctor what would happen if they simply could not get blood and he couldn't give me a straight answer. He eventually admitted that he'd never had this problem trying to carry out this test in his ten years there. They brought in more and more experienced people to try and locate a vein on every occasion, but it made no difference. They also heated his arms with warm water, but again, no difference.

Unsurprisingly, the test was unsuccessful. We've been given another appointment, but they haven't made any changes. I'm really not happy about just going along with it (we even had to request the play therapists because they didn't seem to think that being held down and poked with a needle for hours at a time was that big a deal for a three year old ) and I'm fairly certain that 'just trying again', as they worded it, will be pointless. They have made no changes, so the outcome will not be any different. I'm not willing to put him through that again for absolutely no reason.

So, any suggestions? What can you do in this situation? Somebody must have come across this before and still managed to complete the test!

That sounds like torture and not reasonable. Is this a normal district general? If so I might ask for him to be referred to your nearest children's hospital. Get stroppy if you need to.

I would be exploring options like an oral sedative to keep him calmer and stop him remembering the experience.

I have appalling veins (similar experiences of being prodded with needles for extended periods without success) and so does my DD1. One thing which does seem to help a bit is to get really warm. I don't mean just warming hands or arms but getting the whole body really overheated so you're wanting to strip clothes off. That opens up the peripheral circulation and makes those veins more accessible. It is hard to do at this time of year but blankets and hot water bottles on the way to the hospital could help.

I really hope you find a way to solve this because you're going to end up with a child with a phobia of it continues.

Thanks for the reply. Yes, it is a normal district general. There is a children's hospital in the city, but I don't know whether they'd have him there. I had a look on their website today and they don't have a paediatric endocrinology department. Although, I suppose it'd only be the initial test which was carried out there. He has to have the test repeated to check the results and then blood tests every six months afterwards to see how he's getting on. I feel sick when I think about it. He's already very scared of going to the hospital and I can't stand hearing him screaming and pleading with us to stop.

As far as the oral sedative goes, I'm not sure that he'd be allowed to take one. He's nil by mouth for about twelve hours before the test and mustn't be on any medication or ill. They said it would affect the results of the test and they'd have to do it again. I did suggest having a hot bath when he was there, but the doctors didn't seem very enthusiastic about trying anything different. It takes two buses to get there, so I'm not sure how long the blankets and hot water bottles would last!

I'm just really feeling ill now. I do have/had a phobia of needles in the past. Quite severe actually. And the treatment for this condition requires that I inject him at home :( I did pass out at the last hospital appointment. It makes it all so much worse when I am desperately trying to be soothing and strong for him but can't stay conscious! It is better than it was, though. I passed out countless times as a teenager. Crying, screaming, hitting was normal for me. The school had to make special arrangements so that I could have mine before everyone else and my parents could come and hold me still. They had to have the nurse in the background because I always managed to faint.

I suppose the thing to do is call the hospital and discuss it with them again. The only problem is that I don't know who to call as there seem to be so many names and people, but I'm not sure of who's really doing what. I'm not expecting them to be very helpful. I was really hoping that somebody on here would have some sort of miracle cure.

Sorry, I have no patience to type on this phone so will be brief:

Y y to being v warm.
Also make sure he is well hydrated - even the day before is better than nothing.
Ask for an anaesthesist or, even better, a paediatric anaesthesist to site your DS's cannula.
Do not just let them try again, it is unnecessarily cruel. There ARE other ways.

V best of luck :)

If he can't have an oral sedative perhaps he could have Entonox (gas and air). There could well be other options we wouldn't think of.

I think you've done enough cooperating with how they want to do it. They need to find a different way now, especially if it will have to be repeated regularly.

Call the hospital tomorrow and every time someone says they can't help ask them to give you the name of someone who can. Keep going on and up until someone takes some responsibility.

If he needs to be kept warm on the way you could ask for hospital transport although you'd probably have to push hard. You could also suggest that he's admitted as a day patient so you can give him a warm bath on the ward just before they try.

I soooo feel for you. I've had some awful experiences with DD2 and blood tests recently and know what a traumatic experience it is.

OP, you could tackle it a different way.

One of the causes of poor growth is zinc deficiency and you can test hair sample for that, they don't do it in NHS, I paid about £20 to do it for my ds, but no needles involved .
And yes, he was Zn def (coz he was vegeterian (! my fault) and gluten intolerant.
Adding Zinc and meat and going gf has helped his growth and overall development.