Preparing for bloodwork

Hydrate in advance:

Experts recommend starting hydrating the day before you know you’ll go in. You can drink water generally, even when you do an Advanced Wellman blood test “fasting”. But make sure to check with your medical provider beforehand.

Warm up your arms: 

Wearing long sleeves that you can roll up is a good idea, but I suggest going further. Rub some hand warmers up and down your arms to dilate the veins before the stick. You can also try running your forearms under warm water in a bathroom or ask if the lab has a hot towel you wrap around them.

Speak up about your veins: 

Certain people, especially those who are elderly or chronically ill. And they have “rolling veins”. Meaning the collagen in tissues that anchor veins in place are weakened. And thus causing the vessels to “roll” when approached by a needle. Tell the technician if that sounds like you. Some facilities might have technicians who are more accustomed to patients with difficult-to-find veins.  Or use tools like vein finders or ultrasounds that can help identify a good vessel.

If the technician got a needle in easily, ask them which vein they used so you’ll know for the future. Nothing is worse than undergoing a needle-stick only to discover the sample “hemolyzed,” meaning the blood cells burst, rendering testing inaccurate. It often happens because of how the tube is handled after the blood is drawn, but sticking a larger vein — like from the antecubital fossa in the crook of your elbow — we know has been shown to reduce the risk of hemolysis while having the tourniquet on for longer than a minute raises those odds.

Calm yourself with a breathing exercise:

Make sure you aren’t holding your breath. Instead, take deep breaths from your stomach rather than your chest. If that’s not for you, try distracting yourself by scrolling through TikTok or chatting with the technician. Some people deliberately pinch the opposite side of the body to distract their brains while the needle goes in, but if this will only stress you out further, I wouldn’t advise it.

Press on the bandage: 

You should be holding pressure over the dressing for a few minutes — not seconds — after the technician is done. Here you will prevent bruising. Avoid carrying anything heavy with that arm for an hour or two afterwards.

What to do if you feel faint:

Don’t hesitate to speak up if you’re feeling very nervous or faint before, during or after an advanced Wellman blood test. Be sure to inform the technician if you’ve fainted due to bloodwork in the past. They may use a butterfly needle. Thinner than the standard variety and tends to hurt less (though it’ll take longer to draw your blood). They can also bring in backup or have you recline during the needle-stick to protect you from grabbing some floor. So why does this happen?

If you faint at the sight of blood, we think it is caused by the vagus nerve, which we know is responsible for calming the body and aiding digestion: when it goes overboard, your heart rate and blood pressure plummet and your brain’s blood supply dips, leading to blurry vision, lightheadedness and loss of consciousness.Various theories have been proposed about how this reaction could have been evolutionarily beneficial: When struck by a predator, fainting can make you appear dead, shielding you from further attack. And if you sustain an injury from a sharp object, a drop in blood pressure and heart rate might mitigate the blood loss.

My theory is that fainting is self-protective against pain. If you’ve been mortally wounded, you losing consciousness would be less distressing in those last moments. You should make physical manoeuvres.  Such as crossing your legs and clenching your glute muscles — they have been shown to combat fainting tendencies during blood rapids draws. Just be careful not to bear down like you would during a bowel movement, as this can impede blood return to the heart. People with an extreme fear of blood or related blood-injury-injection phobia may benefit from cognitive behavioural therapy.

What I want my patients to know:

Not every advanced Wellman blood test I order is urgent. If you are seeing multiple physician visits in a month, don’t hesitate to ask your doctor if it’s safe to wait to get your blood drawn in one batch after all your appointments. If it’ll spare you an extra needle stick, waiting another week or two is often fine, but many people never ask.