Lifesavers for Latasha

An arterial blood draw is done to measure the levels of oxygen and carbon dioxide in your blood.

I’m sure I’ve had arterial blood draws in the past, but I must’ve been unconscious during them or maybe they did it through a catheter, because I don’t remember any of them.

So, when I had to have one as part of my lung transplant evaluation earlier this year, I didn’t really know what to expect.

The nurse started with my right arm. She had to find my pulse in my arm to locate my brachial artery. My pulse is faint, so that in itself is a challenge.

When she found my pulse, she inserted the needle and…nothing…but pain for me. She missed the artery. She tried redirecting the needle to see if she could hit it, but all she ended up doing was grazing a nerve. I felt hot pain go straight down my arm for a second. She moved the needle and the nerve pain was gone. I didn’t say anything, because I didn’t know if that nerve pain was normal or not.

As she was redirecting the needle, she said, “Just let me know if you feel any pain going down your arm and into your hand,” just as I felt the hot pain again and tingling in my hand. She must’ve seen my face or maybe I twitched my hand, because she immediately said, “Oh, no, you feel pain don’t you?” I said yes as I did my best to hold back tears that started forming in my eyes. “I’m so sorry. Your nerve is right there with your artery. I am so sorry. Let’s try your other arm instead.”

She removed the needle, put a cotton pad on, and told me to apply pressure. Then, she wrapped it. On the other arm, she started to feel around my wrist to locate my radial artery. “Just relax. I’m not doing anything except feeling for your pulse,” she explained.

By this time, my anxiety was high. I am used to being poked and prodded, but it was really difficult for me to relax this time.

I looked away, trying to relax, but she must have sensed how tense I was because she repeated herself. “Try to relax. I will let you know when I’m going to stick you. Right now, I’m just feeling for your pulse. It keeps disappearing on me. I know you probably don’t believe me, but I won’t try to stick you again if this one doesn’t work. I am so sorry about your other arm. Is it still hurting? I am so sorry. Just try to relax.”

I started singing a song in my head and focused on my breathing to try to relax.

A few seconds later she said, “Okay, I got your pulse. Big stick. It’s filling up, so we’re good.”

Two days later, my right hand still had pain and was tingling and feeling numb. I Googled whether an arterial blood draw could cause permanent nerve damage, and it seemed like a pretty common topic of medical malpractice. I sent a MyChart message to the doctor who ordered the arterial blood draw, so I would at least have it documented in case the nerve pain didn’t go away. Thankfully, about a week later, the pain, numbness, and tingling stopped.

At my next follow-up appointment, I had to have the arterial blood draw again. Immediately, I flashed back to a few months previously and my anxiety rose. I expected the same nurse as before, so when a different nurse came in, I let out a small breath of relief.

Maybe this time won’t be as bad as the last time, I thought to myself.

This nurse rolled up a towel and had me position my left arm on it. This was already different from the last time, so I was hopeful that it would be a better experience.

Once she found my pulse, she said, “Okay, here comes a big poke.” She inserted the needle and…nothing. She started redirecting the needle. Still nothing. “Are you okay? I’m just trying to move the needle to see if I can hit it,” she explained. “I’m okay,” I replied.

“I’m not getting anything. I’m going to have to try another spot,” she confessed as she removed the needle.

She moved to my wrist.

“I feel your pulse and then it just disappears,” she mumbled. I can feel my anxiety starting to rise now.

After a minute, she said, “Okay. I have it. Big poke.”

And…again, nothing.

“I have never missed twice,” she blurted, as she began to redirect the needle to see if anything would happen.

“Nothing!” she squeaked. “I am so sorry. I’m going to have to get a backup person to come and try,” she admitted as she removed the needle.

She left the room and returned in a minute. About a minute later, another nurse came in to try. She repositioned my arm on the towel and began feeling for my pulse in my arm.

“Your pulse is very faint. Does your blood pressure run low, too?” the back-up nurse probed. “Yes,” I replied, doing my best to keep my arm still, even though it was starting to cramp due to its positioning on the towel.

“Hmm. Every time I think I have it, your pulse disappears,” she remarked.

I’ve heard that before, I thought to myself.

“That’s what it kept doing to me, too,” said the first nurse.

“I think I have it. Ready? Don’t move. Big stick,” she said and then inserted the needle.

“Nope! I didn’t get it!” she admitted. She moved the needle a little and still nothing. “I didn’t get it. I’m sorry,” she confessed as she removed the needle.

To the first nurse, she advised, “Get So-and-So. She’s pretty good with these,” as she left the room.

“How are you doing? Are you okay? You can relax your arm for a minute. I’m going to go find someone else,” the first nurse said.

“I’m okay,” I murmured as I started massaging my arm and flexing it to get blood flowing back down it.

A minute later, she returned with another nurse. By now, I’ve been stuck three times by two people.

The third nurse came over and rolled up the towel, but then said, “I think I’m going to try your other arm to give your left arm a break,” as she began positioning my right arm on the towel.

“Try to relax,” she encouraged as she began feeling for my pulse.

Her fingers slowly moved around the brachial artery on my arm. “I think I have it, and then your pulse moves,” she observed. “Let me just close my eyes and feel for a minute,” she whispered as she closed her eyes and concentrated on just the pulse.

“All right. I think I have it. Do not move your arm, okay?” she commanded and then inserted the needle.

“It’s filling!” she beamed.

“Oh, really!” the first nurse chirped. “How were you able to get it?”

The third nurse proceeded to share a story about working in the ER and having to do arterial blood draws on people who had very faint pulses or almost non-existent pulses. She said working on those patients helped her to visualize where to put the needle.

“I’m so glad you were able to get it. I missed twice, and that’s never happened to me before,” nurse one reiterated.

“I’m glad I got it, too. And,” she added looking at me, “I’m sure you’re glad you don’t have to be poked again and can continue with the rest of your tests.”

“Yes, thank you so much,” I responded.

After removing the needle and wrapping my arm to stop the bleeding, she left the room and the first nurse continued on with the rest of my tests.

I’ll have to have an arterial blood draw each time I have a follow-up appointment as a heart/lung transplant patient. It is something I now dread. Maybe if I just expect it to take a few tries, I’ll be pleasantly surprised if the next nurse gets it on the first poke.