Friday, April 1, 2011

Bloodthirsty Doctor, Six Year-Old Ghost

My mother-in-law came Wednesday night to sit at the house as I took Naomi for a late-night blood draw. The doctor wanted to check her melatonin level because it is produced in the pineal gland where she has a cyst, and this had to be done after 10:00pm. Naomi trudged into the ER in her pajamas with her head buried in "Little Town on the Prairie" and we waited for the phlebotomist. She only cried a little as two tubes were drawn. Then it was back to the cold car and off to dream land by 11:00pm. Unfortunately for Naomi, that was only the beginning of a long 24 hours.

We were back up and out the door by 6:30 the next morning for an A.M. cortisol level blood draw. This was followed by a trip to a specialized lab in the next town that afternoon to give another 17 tubes of blood. And by Thursday afternoon, at our third blood draw, Naomi had had just about enough.

"Are you sure that's a safe amount for her weight?" I questioned the phlebotomist as she lined up tube after tube meant to check hormone levels of every possible kind. I was thankful this pediatrician was being thorough, but I had to wonder if this wasn't a bit of overkill. Then I reminded myself that this was the doctor who caught Naomi's celiac disease because she was thorough, and where would we be if we hadn't caught that?

The phlebotomist raised an eyebrow at me. "I once drew 22 tubes from a one year old," she declared. And I guess that was supposed to reassure me. Naomi sat in my lap and didn't move as they drew tube after tube, but she did break down crying. I tried to reassure her. I tried to crack jokes, but it takes a long time to draw 17 tubes, and nothing seemed to console her--until she looked up and saw Toby, strapped in his stroller, rolling up his sleeve and inspecting the inside of his elbow with great concern. He looked solemnly up at Naomi, then down at his elbow again, then back up at Naomi's tear-streaked face.

"I think Toby's worried that he's next, Naomi," I whispered in her ear. Looking at his little face she had to laugh, blood still pouring from her arm.

"No, Toby, you don't need any blood draws today," Naomi reassured him, "It's just me." Hannah and Emma quietly joined in the giggles from the other side of the room. Finally, the last tube trickled full, the needle was removed, and I breathed a sigh of relief. But that was premature. Naomi lay back against me and stared at the ceiling, white as a ghost.

"You, OK, honey?" the phlebotomist questioned.

"I feel tired, and my tummy hurts," Naomi nearly whispered. The phelbotomist quickly ran for a can of orange juice, but Naomi wouldn't touch it. I was urging her to drink it and explaining the ins and outs of rehydration and blood sugar when Naomi sat up, belched, and heaved. The phlebotomist instantly grabbed the garbage can and I pointed Naomi's head toward it just in time. Unbelievably, it all hit the target. After a few minutes Naomi was able to drink some water and recover some energy. She still felt dizzy as we walked together out to the car.

"Just rest now, sweetie," I coaxed her as I buckled her in for the trip home. "No more blood draws for a long time."

"Yeah, like for a couple weeks," she said happily. I truly hope it's longer than that.


  1. Oh my, what a brave little soul she is. Obviously I don't know what tubes they used but calculating volume of the average sized tubes, the volume she would have donated was equal to about 80 mls or about 5% of her blood volume..calculating 70mls/kg...and I am guessing her weight just at 50 pounds. And adult is estimated to have 16 a blood donation would take 6.5%, and they can sometimes get very whoozy afterwards.
    I liked Toby's response, he was thinking very hard about what he was observing. Hmmmm....
    I hope that all the results will be positive...

  2. Most of the tubes were large gold ones, bigger than what I normally see. So they may have drawn more than you estimated. But Naomi weighs a hefty 67lbs now. Whatever the percentage, it certainly made her woozy.

    Her sudden weight gain is one of the things that prompted the tests for cortisol and thyroid levels. Most likely though, it's because she got used to eating a lot when she wasn't gluten free and she absorbed very little of it since her intestines were so damaged. Now she still likes to eat a lot, but she's absorbing every bit. It is hard to change those ingrained eating habits. I am under orders to limit her calorie intatke now to 1400/day (she was about 1600/day). The last thing her body needs to deal with is obesity.

    Yes, normal results would mean that we just need to limit her calorie intake and that the mass in her brain is functioning like a cyst and not a tumor--which would be very good news.