Ewe and Your Bones, and the Art of Drawing Blood

Last week’s column was a blood extravaganza, but in the midst of the frenzy I neglected to write about the brave folks who actually take the blood out of us. Is there an art to blood-drawing?

We asked Helen Maxwell, director of the American Society of Phlebotomy Technicians and a big advocate of proper training. She proceeded to fax us page after page of blood-drawing do’s and don’ts and to tell us the many ways blood-draws can go wrong.

First step, she says: Make sure you’re taking blood from the right patient. Good lord! Shouldn’t this, at least, be a given? Maybe so, Maxwell says, but in fact 80% of phlebotomy mistakes come from misidentification of patients--leading to misdiagnosis, giving someone the wrong type of blood and other not-good stuff.

Next, you have to approach people in a nice, calming manner. Sure, there are folks like my pal Tina who simply love to have their blood drawn--and gleefully watch the containers fill up while they’re donating. Most of us aren’t so ghoulishly partial and view the approach of the needle-wielding technician much as our ancestors might have viewed the approach of a saber-toothed cat. Unless handled delicately, our bodies will course with hormones, preparing us for fight or flight--and our blood will get shunted away from surface vessels toward important inner organs like the heart. That means a poor blood flow.

What’s more, Maxwell says, you’re not supposed to stick the needle in and then wiggle it around until you finally hit the vein, leaving a big bruise and potentially tearing the vessel. “Some people call it ‘readjusting the needle,”’ she says. She has less kind terms. If you don’t get that vein with some pretty minor wiggling, it’s time to pull the needle out and try again.

Shake the tubes too zestily or use a too-narrow gauged needle and the blood cells will burst. Stick the needle in too far and you’ll go right through the vein and out the other side. Plus there’s an art to where you stick. The inner-arm vein is the most popular site because it’s nicely embedded in muscle that keeps it from rolling around while being jabbed.

But older people have less muscle, so sometimes you go for the hand or the wrist. And someone who’s had his or her underarm lymph nodes removed shouldn’t be stuck in that arm because they’ll get swelling and be more prone to infection there.

A lot in the blood-drawing biz has changed down the years, Maxwell says--and she’s not just talking fancy new needles. In days of yore, there was a blanket ban on parents in the blood-drawing room. As for the kids, there was none of this namby-pamby Barney Band-Aid business. “We used to papoose them or strap ‘em down,” Maxwell says. “If I’d been a kid having blood drawn that way, I would have just freaked out.”

How nice it was, after all this talk of blood, to switch to a less messy subject--bone. Sheep bone, specifically.

Flicking through the latest issue of Nature, we stumbled upon a great-sounding experiment done by Clinton Rubin, director of the center for biotechnology at the State University of New York, Stony Brook.

For 20 minutes a day, five days a week for a year, Rubin’s group made nine sheep rest their hind legs on a pizza-box-type contraption that vibrated at high speed. Another nine sheep were not so treated.

This may sound mad, but at the end of the year Rubin’s group found something not at all baaaad: The vibrated sheep had 35% denser hind bones than their non-vibrated peers.

This makes sense, says Rubin, because a lot of what keeps bones strong normally--strange though it may sound--is a similar, super-fast vibration from the muscles attached to our bones. And it could be great if the same trick worked in humans (Rubin has preliminary results suggesting it does).

Let’s face it, he says, people are far more likely to stand on a pizza box vibrating imperceptibly for 20 minutes--calling friends, donning makeup, while jiggling, reading improving literature--than do daily weight-bearing workouts such as jogging or walking.

Finally, Rubin would like us all to know that bone is very cool.

“Everybody thinks of it as being this dead, bleached, Georgia-O’Keeffe-painting-in-the-desert kind of thing,” he says. “But in reality it’s a live, viable tissue--the only one in the body that heals itself without leaving a scar.”

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If you have an idea for a Booster Shots topic, write or e-mail Rosie Mestel at the Los Angeles Times, 202 W. 1st St., Los Angeles, CA 90012, rosie.mestel@latimes.com.