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Your Good Health: How to make a blood draw more tolerable for the patient

The blood contains so many substances that give doctors information about health and diseases, so we rely on blood testing for a great deal.
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Dr. Keith Roach

Dear Dr. Roach: While most aspects of modern medical care don’t bother me, I despise blood draws from either arm. I always faint when it’s done, and I feel awful afterward for what seems like a long time. It’s a visceral response I can’t control.

There are many noninvasive medical technologies now, so why are doctors still relying on this brutal way of seeing what is happening inside our bodies? There has to be a better way. Please tell me this will happen soon. Meanwhile, is there anything I can do to make the experience more tolerable?

R.M.

I don’t think blood draws will be completely replaced anytime soon. The blood contains so many substances that give doctors information about health and diseases, so we rely on blood testing for a great deal.

You are quite right that there has been much work to develop new technologies to replace blood testing. Some of them are already here. Continuous glucose monitors get placed on the arm and can read blood sugar levels for weeks. In addition, oxygen sensors have largely replaced the truly brutal method of gathering arterial blood to check oxygen levels.

For people who faint with blood draws, there are several ways to help. The first is to get blood tests only when really necessary. For example, once a person is on cholesterol medicine and the number has been proven to be in the desired range, there is no reason to recheck it unless a person has a change in their health status.

When blood tests really need to be taken, warn your phlebotomist! They can sometimes take blood while a person lies down, sometimes with the head positioned below the heart. Also, make sure you’re hydrated (although, in rare cases, this might not be allowed). Readers have written to me about strategies they have used, including:

— Coughing, talking or smiling during the blood draw.

— Using a cold pack on the neck.

— Alternating between flexing and relaxing muscles before the blood draw (but keeping muscles relaxed during the actual blood draw).

Dear Dr. Roach: What is in a person’s makeup that determines if they are considered to be cold-blooded or warm-blooded?

I’m a 93-year-old man in good health. From a young age, I have considered myself cold-blooded. Here in Southern California, it can get to 40 degrees Fahrenheit in the winter, and for me, that’s cold. I play golf, and when I go to my club to play, I have five layers of clothing on, and I’m still cold. Meanwhile, there are other players dressed in shorts and a golf shirt. I have questioned a few of them, and they just shrug their shoulders and say that they’re fine.

D.H.

In general, younger people, men, people of above average weight and very active people tend to be warm-blooded and tolerate cool temperatures. Women, those who are older, people of below average weight, those who are less active, and smokers tend to be cool-blooded and prefer warm temperatures. Stress and fatigue can make many people less cold-tolerant. Thyroid levels may also play a role, along with where you grew up. But that doesn’t mean it’s always one of the factors listed above.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu