Question for Andy...

@ Pleasance:

One of the few times I got transfused, the nurses had a very difficult time starting the IV for the transfusion because, apparently, my veins kept wanting to "collapse".  The initial poke went okay, and then when they were going to flush and/or draw some blood before the transfusion, the vein collapsed around the needle and they couldn't proceed any further.

I was told at the time that it wasn't a serious problem - more of an inconvenience than anything else as this meant I would have to get poked more than once - and that having low blood pressure and being dehydrated can make the veins more prone to "collapse".

The reason for the "collapse" which results in either blood being unable to be drawn or the flow in an IV being unable to flow is usually because of the vein's response to pressure against the wall of the vein and for more sensitive/delicate veins, the suctioning pressure of a needle can prompt the vein to "collapse" around the needle.

I have low blood pressure and am easily dehydrated, so when I heard that my vein collapsed on me multiple times during that time I wasn't very surprised.  Furthermore, I am considered a "difficult draw" because it has never been easy to draw blood from me or start IVs even without problems related to my veins "collapsing" simply because I have small veins.

A larger vein is more promising when it comes to both venipunctures (blood draws) and IVs (including for transfusions) because in general, they are less sensitive to pressure/changes in pressure when they are being punctured.

Perhaps your daughter (I believe you are talking about your daughter?  If not please correct me!) is experiencing similar issues that I did?

If so, and this is just my gut feeling, I don't think you need to worry so much about the problem.

Drink lots of fluids before the transfusion and/or before blood draws and be patient as the nurses/doctors work with you and your daughter to find the best site for the transfusion.

For myself, the inside of my wrist (closest to my thumb) has been the best place for an IV if the inside of my forearm (bend of elbow) will not cooperate.  The top of my hand also works well, usually, but the inside of my wrist closest to my thumbs seems to have worked the best.

Also, I have been told by a blood draw specialist that the veins in the dominant arm (the arm that is used for writing - right handed, left handed, etc) are usually "stronger"/less prone to collapse compared to the less dominant arm because the muscles of the veins have had more exercise.

Perhaps this is something to be taken in consideration as well?

All the best!

so pls can u name any natural vit e that u know i can buy that frm medical store......

thanx HBh
   i was so confused with all this but lemme tell u tht my daughter never had any issues as in finding the veins or getting the blood from the veins .....if so the way u ve explained any dr could also have done that then y didnt he do tht i wrote a mail to him thrice cos as my daughter goes for transfusion twicwe a week and she had the issue thrice so i mailed him but no replies




   any ways thanx

can any body suggest me a good homeopath in india rather mumbai cos even thru the various posts i ve seen tht homeop[athy is a good way to minimise the issues

Dear Andy I have a question regarding beta thal trait. Could you please tell me if being aneamic with beta thal could this cause a fit?  How does this happen and can it be avoided/stopped?
 
HbH...both my boys are exactly the same as you with the veins but they do not have low blood pressure, theirs is always a little high before they start transfusions .

Hi Emby,

By fit I assume you mean seizure. Correct me if I'm wrong. I will refer you to a previous thread on this topic. This is one of those things where we know thal minors have them but there is uncertainty if there is any connection. Please go through the posts in this link and see if anything looks like it could be a possibility. Various things like hydration and medicines are possibly connected, as are sugar levels.

http://www.thalassemiapatientsandfriends.com/index.php?topic=1750.msg14546#msg14546

As it is almost always with thal minor, there is so little research that we can't say for sure. We always need to remember that thals are part of the general population and should be expected to have various conditions at the same rate as the general public, so it makes it difficult to say for sure that some things are the result of thal.

Thank you Andy....I needed to know because it happened to someone I know. They are beta thal trait, had blood tests done and waiting to have a head scan. 

Dear Andy...would like your opinion..

Our boys are taking vitamin D, the oral solution, and with this their levels pick up quicker. However, for BB once the levels are normal he switches to 1000iu daily but then it falls quite significantly in about 6 weeks- 2 months. LB's level maintains at satisfactory level longer before dropping again then they start with the colecalciferol solution again (10000iu daily).
Would you say this is a normal pattern and is it ok to take the vitamin like this continuously?

Both the boys copper levels tend to drop so they are taking supplements. When the levels pick up they stop taking the supplements and only start taking it when it drops again. 
I know it makes sense to take it this way but do you think thay should take the supplements continuously?

BB has also had reaction to blood at the time of transfusion sometimes severly though the last time was about 2 years ago. He always has pirriton and hydrocortosone (!) before tx...I am thinking that perhaps of the hydrocortosone his vitamin D level may drop faster. Is this a possibility?
Do you think he could just have pirriton through the vein instead as the other is a steroid and because he has not had a reaction recently?     

Its not fair to ask you so much when you have a painful elbow, hope you feel better soon.

Hi Emby,

If the vitamin D levels are dropping when switched to a lower level, you should probably raise the daily maintenance dose. Try doubling it. I am taking 5000 IU 5 days per week and my level is finally in an acceptable range after one year at that dose. My doctor said I should continue that dose, but in summer when I get a lot of sun and took no extra D, he told me to take 5000 IU once per week. Prior to that, 2000 IU daily had got my level up to only 19. My doctor wants a minimum of 35. I wouldn't be concerned about getting too much unless their levels get above 80. I also think it would be best if you found a maintenance dose of copper, rather than waiting for it to drop. Every other day of 3 times per week may prove to be adequate.
Vitamin D is depleted by steroids, so it makes sense that BB's D would drop while using hydrocortisone. Vitamin D plays a protective role in the bones when taking steroids, but that results in a vitamin D deficit, so it should be replaced. I can't say if you should stop the steroid. Talk to the doctor about this. Perhaps a trial without the steroid could be tried. In most cases, the antihistamine is enough to prevent the reaction.

Andy,

Little A's vitamin D was was 93 a few months ago.  I stopped the 50,000 IU a week - but continue to give him 3000IU daily.  Should I stop this dose for a while because his levels are so high?

Thanks Andy,

Sharmin

Thank you Andy for helping us to understand better.

Dear Andy And Friends

I m suffered with Thallassemia major .
 i have Osteoporoses and im Under weight cane you give the suggestion about exercise for my losing weight.

Hey Andy!

I have a question for you since i didn't found an answer on google!

In thallasemia major, does our bodies ( bone narrow ) produce stem cells ?

There is a drug named Stemulin, which acts like a stem cell activator to restore health of damaged organs. I thought it will be good for our spleen, liver, and why not to increase time between transfusions............ but the problem is that it only activates stem cells and multiply them; that's why I need to know if our bodies produce stem cells before i buy this thing!

Thank you!

Yes, the bodies of every living person produce stem cells constantly.

Daniel, you mean something as epo? I think so...
I do not know anyone who takes it, but it let me wonder daily of it would help...
Did we met by chance at the conference of Asociatia Romana A Persoanelor cu Talasemie Major (ARPTM?) held in Sinai in November 2010?