Sunday, June 30, 2013

Lab Tests: Which to Request, What they Mean and How to Get a Good Blood Draw

What lab testing should I request from my child's physician?

Your child's physician is likely to be following these 2011 guidelines for "health supervision" of Down syndrome. Some physicians don't even do that much, so if your child hasn't had all of these tests, request them. These are the tests that Medicaid and your insurance will definitely cover. Keep in mind, they are the bare minimum tests that are recommended. Much more health supervision is actually needed for your child.

Qadoshyah Fish explains additional, important lab tests to request and why at her Got Down Syndrome Blog.

I'd also recommend getting vitamin D3 levels tested because it's a fat soluble vitamin so you don't want to over supplement and tax his liver, but vitamin D3 is vital and usually low. See How Much Vitamin D3? for optimal lab values and why.

Additionally, more thyroid testing is needed, since 100% of our kids will eventually (most sooner than later) have life-altering thyroid issues and the majority of physicians don't know how to properly monitor.  Here is more guidance on recommended thyroid labs from Stop the Thyroid Madness.

I'm worried about Leukemia, what lab tests do I need to request?

How do I know what the lab results mean?

I'd love to say that your child's physician will know, but s/he probably won't know how to read your child's lab results properly and the lab tech may not be up to date on optimal lab values so it's up to you to be your child's advocate. Please consult: 

This guide for thyroid lab results.
A helpful link on blood test results that gives the explanation of the test and healthy ranges, not just the average range.

Also look to how to understand lab tests, ranges etc.

How do I get a good draw for my child?

Drawing blood... not my favorite thing! Just the idea makes me queasy...

Check out this great post on how to get a good blood draw from an infant and child. Excerpt:
Newborns should get blood drawn from their heel. This was done on my son with no problems the first week of his life. They pricked his heel, and then collected the blood as it came out from the prick. Once your child starts standing, they develop thicker skin and callouses so the heel is no longer an option.

Babies and children have smaller veins than adults. A butterfly needle makes the procedure for drawing blood more manageable because the needle is thinner to accommodate for the smaller vein. It is common practice to use a butterfly needle as opposed to a small bore needle which is used for adults...
Help your child help the technician:

• Keep your baby hydrated. Dehydration makes the veins harder to find. 
• Make sure your baby is relaxed and stress free. Play soothing music on the way to the office and give yourself plenty of time to make the appointment. There is usually a wait in many of these labs. A baby will pick up the signals from a stressed out parent. Stress increases the blood flow and constricts the veins. 
• During the blood draw, soothe your baby. Cuddle and sing favorite songs. Let him/her know how proud you are of them for being strong.
My Tips

Jett was used to me singing to him so that was super helpful in calming him and distracting him during blood draws. To prepare, I'd pick at least three songs to sing to him when he's feeling calm and happy so he can have positive associations to you singing those songs during times of stress. I swear that when I sang, he was an angel during the longest blood draw right before his heart surgery.

Jett and I have our favorite phlebologist to draw his blood. She thinks before she acts and so only pricks him once and gets the job done quickly. Don't settle for a bad phlebologist!! Ask around and even ask at the lab or pediatric hospital before they assign you someone. Tell them your child has very small veins so you need an expert. When other phlebologist hear this, they will gladly direct you the person who will be most successful. (No one wants to be the one to repeatedly jab a screaming child!)

Surprisingly, Medicaid paid for the phlembologist to come to our house!! It was a 45 minute drive and made things so much easier. I would ask the lab company if they can provide that service if you feel it would benefit your child in keeping the ordeal as stress free as possible.

Related Posts

Thyroid & DS Go Hand in Hand

Anemia Causes & Cures

The Heart & Down Syndrome