Nick gets home draws one per month from Harrington plus any extra labs that a doctor may order. Dr. Verma (508-764-3666) is the nephrologist that orders his labs. Unfortunately, ever since Harrington and UMASS merged, the lab no longer accepts standing orders. This means that Dr. Verma’s office has to send over the paperwork every month, which typically does not get done. I have to call and ask for it to be sent over. If you sign into NIck’s online patient portal for MyChart, you can see what labs are waiting to be done. Once the lab gets the orders, Kristen (508-764-9771 x6410) at the lab will schedule an official appointment. I get a phone call the night before from the lab to tell me he’s been scheduled, and I’ll also get a text message once Kristen puts the appointment into the system saying that Nick has an appointment. The text doesn’t tell me what the appointment is for, so I have to sign into MyChart to see what it is. Typically home draw for North Brookfield is drawn on Tuesday or Thursday by Ella (860-460-8971). He needs to be fasting for the draw, and withhold the medication Sirolimus (in the refrigerator) until after his blood is drawn because that drug level will be checked.
If for some reason he cannot get his blood drawn at home, he goes to Harrington in Charlton, just off of Route 20, across from CVS. We get there at 6:20 am so we can get back home early for breakfast. I bring his medication, Sirolimus, with us so that I can give it to him before we leave the lab to go home. More details below.
His Sirolimus level and kidney function are two of the crucial draws that are done monthly. Ask for it to be done first if there is difficulty drawing blood.
After he gets his blood drawn, he can have his Sirolimus and then wait at least half an hour before he eats breakfast. He typically waits an hour, but it won’t hurt him this once to only wait for 30 minutes. He’ll be hungry.
HERE’S HOW NICK’S BLOOD GETS DRAWN
Obviously, Nick isn’t going to simply hold out his arm voluntarily and hold still while his blood is drawn. But he also doesn’t really fight it as a rule. He’s been doing this his entire life and it really isn’t a big deal for him. He knows exactly what’s going on.
He stays seated in his wheelchair.
Once the lab tech is ready to draw his blood, here’s are the steps:
- If Nick has a coat on, take out his right arm and pull up his shirt sleeve.
- Kneel down on his left.
- Slowly and gently extend his right arm. He doesn’t resist much, but don’t let the tech do it. They don’t all understand that he has cerebral palsy and severe osteoporosis and needs a minute to stretch his arm out. They have their hands full anyhow.
- Ask the tech to put the elastic on over his shirt.
- The tech draws his blood.
- Once she/he is done, she’ll take off the elastic and put a piece of gauze over the puncture site. I hold it there while she gets a bandage.
- They put on a self adhesive bandage.
That’s it.
If the elastic was on his arm for a long time and his potassium level came back high, it’s possible, but not definitely, because the elastic was on for a long time. The doctor will call to say his potassium level was too high, stop any supplements, and get the potassium level checked again. High potassium serum level can affect the heart and can be deadly, without warning.