Thursday, August 31, 2017

Butterfly needles, blood draws, and other things

Flebotomist: You are dehydrated that is why I can't find your vein.
Me: *Close eyes, take a deep breath and get ready for the dialogue*
F: If you don't drink coffee and drink a bottle of water we would not have this problem.
Me: I do not drink coffee actually.
F: *silence*
Me: I drank water yesterday and in the morning as you mentioned last time so this time it would be easier.
F: You are drinking too much water and diluting yourself. 

I have had this exact same dialogue with this one. I have had similar dialogues with other flebotomist. My entire life I have had problems where people can't find my veins. It has exasurbated after I came to US. In 2014 had a harrowing experience wher I was poked and proded 12 times on both hands, and back of my palms to the point where I was about to faint. I very curteously asked her to remove the needle (which was not drawing any blood) so that I can faint without hurting her. She was mad at me for botching her 12th attempt.

I thought it was because I am perpetually dehydrated since I moved to US or becaue I am now old. Untill I finally found a person who used to insert needle in a single swift movement and draw blood like it was no big deal. She also said encoragingly everytime - "you did really well". I really liked her. She moved to some other clinic and I am back to the dialogues. She told me to ask for butterfly needle. It hasn't helped with others.

In the meanwhile I went to India where my neighborhood doctor did a clean blood draw without any butterfly. with just a plain syringe that he emptied in the vial. It was one of the smoothest blood draws in a while.

Now that I have experienced two really good flebotomists, I have realized that it is not my age or being perpetually dehydrated, or the equipment. It is just plain skill. I wonder then if the whole back and forth about me doing this to myself by drinking coffee, not drinking water, or drinking too much of it, is their way to push the blame because they can't do their jobs to even a basic acceptable level.

The first one that made my hands black and blue, came to work after a weekend long training, I was told. I still can't get over the fact. Looks like she did not learn these Phlebotomist Commandments in her training. The most important for me - thou shall not prick more than twice. Back off and call somebody else.

I actually did not believe the weekend training thing. But just a quick google search opened my eyes. The site How to become phebotomist says that only two states need a certification to be a phlebotomist. what? 😨 So it is worse than I thought.  The certification, which is voluntury in other states, seems to be a simple 2 day training like this on phlb.com.

I cannot believe my eyes. My doctor looks at wikipedia to tell me about what ails me. My phlebotomists might be anybody that picked up the skill over the weekend. Who am I supposed to trust in this system?

Tuesday, August 8, 2017

Mobile Etiquette

I was surprised during my recent visit to India to see how ubiquitous mobiles have become. I am not talking about mobile telephony penetration but how many people are constantly talking, chatting, browsing on a mobile phone:

  • People on two wheelers and cars in heavy traffic are regularly seen talking on the phone. They are not even on handsfree mode, either managing the motorbike with one hand or keeping the phone pressed between sholder and ear. 
  • My friends, family, aquaintances regularly answer the phone even though we are in a middle of a conversation or a meal. 
  • In public places people watch whatsapp or facebook videos without headphones, sometimes while listening to something else such as public announcement, flight security presentation, or television program.  

I will be shocked if I see any of this in USA, at least on the east coast where I have lived and worked. Some of these behaviors will be considered extremly rude.

While talking with a family friend, I realized that he finds answering mobile phone at all times obvious and American custom of not answering the phone immediately when it rings, rude and perplexing. What makes technology related customs develop in certain ways in certain places? Is it about the core cultural values or phase in technology life cycle? In India mobile phones were used as a means for urgent or emergency communication. Keeping a voice mail was unheard of. Even today few people think of leaving a voice mail or know how to.