“KEEP IT WARM” Blood Draw & Lab Technique

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CAD”s that have become more Reactive to cold Temperatures, than a normal person.  Often progress into needing a special blood test method of collection and Lab cooperation.

Many CAD’s are already at this point when they first become aware or even suspect they have CAD.  Often failing RBC/CBC  blood tests may even be their first alert.

See in depth information on Blood Draw Problems and Techniques

Link to Printable Phlebotomist – Lab advisory.

The Standard Protocol for CBC/RBC Tests may start failing often, or fail all the time.  It has to do with the Agglutination/Clumping of Red Blood Cells when the blood is removed from body temperature.

Without getting into details.  “Most” other routine blood tests will result just fine.

Initially the patient may experience hit and miss CBC/RBC tests that fail or are inaccurate.  Where you as a patient have to give another sample and they test again.  You may not suspect what is going on yet.  Not tie it to the possibility you are becoming more cold sensitive.

Your Dr may not even be aware, let alone the blood facility techs or Lab personnel, you are being tested through.  The lab/techs may not even start catching on after they are aware test after test fails.  Necessitating a phlebotomist to return to the CAD patient, and asking for another sample/blood draw.

This is a common problem that numerous CAD’s have experienced over and over.

If you are getting resistance from a phlebotomist listening to you.  That warming techniques may be necessary.  It is time to  bump this up to the lab manager/administrator.  It is best to be armed with documentation from your Hematologist, rather than internet info.

This is also encountered often with Emergency Room personnel, techs, nurses, PA’s and doctors.

If you have moved into this group of CAD’s.  The CBC/RBC blood specimen will start requiring special handling to produce consistent, accurate test results.  Without poking your arm numerous times.

CADs, in this scenario,  may eventually require a “Keep it Warm” process performed all the time, for a CBC/RBC.

By the way.  This is not an official medical term.  While it is well known amongst CAD Patients, CAD support groups, CAD Social Media groups, and CAD literate Hematologists.  Most  phlebotomists will not have a clue.  Unless they have run into CAD patients in the past.

In the “Keep it Warm” process.  The specimen tubes must be pre-warmed, the drawn specimen kept warm, and the lab testing done “stat” [meaning immediately].   So that tech person back in the lab needs to be on board too.

Ideally the sample needs to maintain  body temperature 98.6°F/37°C.   Remember this does not apply to most routine blood tests.  It does for a CBC/RBC.

If your are in this stage and that sample sits back on the counter in the lab, it will not result correctly.

Reheating the specimen as labs will often tell you initially.   May, or may not, work.  Not if the CAD is in this stage.   From numerous CAD’s input.  It appears this reheating concept is partially BS due to the fact they are not informed about CAD?

For the really sensitive CAD’s (even more rare, even as a CAD).  Some facilities use a non-standard protocol to result a Cold Agglutinin Disease affected CBC/RBC.   I must stress this is very very rare even for a confirmed CAD.

It is difficult to find a facility the will accommodate this method.  Go to link that discusses alternate blood draw techniques and specifically “Plasma Replacement Technique”.

Getting a facility to do the Plasma Replacement is most likely going the be at a facility your insurance won’t initially approve.  Government Health Care services are most likely an even higher hurdle to clear?

That becomes another battle to fight.  It most likely will require involvement by your doctor, and personal contact by you with your insurance carrier supervisors.  But you should be able to make it happen?  Especially if you document evidence that your RBC/CBC’s are failing.  [So ….. Be sure to accumulate all test results.  Even those that fail or result incorrectly].  You may need this paper trail to prove your case.

Your particular Medical Care Providers, Phlebotomist, and or lab, may or may not be up to speed on any of these CAD related issues.  Your lab/tech contacts may have been doing their job for years or decades.  They may have never been confronted with this.  You can imagine their disbelief.  Or their resistance to listening to you.

Satellite specimen collection where the sample is later shipped to a lab, reheated at the lab later, may not successfully result for the CBC/RBC.  It may do just fine with many of the other routine blood tests.

Repeating; “keep it warm” is another CAD Patient made up term used by many CADs.  But to our knowledge it is certainly not an official medical term.  So if you start throwing that term around at a blood testing facility or ER room, you might encounter a blank stare.   You will  have to explain.  Expect to be met with doubt.  Having written documents explaining this, will become most helpful.

This “Keep it Warm” technique will often be talked about or recommended on CAD types of social media or support forums.  Perhaps your doctor will  know enough to advise you?  If they are familiar with CAD, they will most likely explain this to you.

Once you are in this scenario.  It’s best to have written and signed documentation (By your Dr on their letterhead) detailing the steps to the “keep it warm” technique.  Carry this with you to present at any blood facility, ER Room etc.  Believe me, it will prove invaluable to you.  It will prevent lots of conflicts or even being disbelieved, looked at as a problem person, etc.  Ultimately the goal is, it will eliminate multiple arm poking for re-doing the test.  To also get you an accurate result.

Some CADs may never have had any previous health symptoms to trigger any type of blood testing, when they were healthy, and not troubled by CAD.