Blood Suckers

When you look up “phlebotomy” on Wikipedia, you are offered three disambiguated pages: one for “venipuncture,” or the medical procedure of puncturing veins; “bloodletting,” the gory old-school practice seldom repeated since ancient times; and “phlebotomy,” the Greek gothic-metal band from the nineties. (Now called On Thorns I Lay.)

not phlebotomists
not phlebotomists

For the sake of this blog, I’m going to write about phlebotomy with reference to venipuncture. After all, at least once a week since my mother’s cancer diagnosis I’ve experienced a bird’s-eye view of blood being drawn, and I’ve marveled at it since day one.

At the chemo clinic where she gets her Gemzar , they don’t just take a sample of blood and send it off to the lab. Before each round of treatment they prick my mom, drain a few drops of the good stuff, and run it through a computer, where my mother’s makeup comes up on a computer screen as a series of graphs. Then they print out her stats on a dot matrix printer, peel off those nostalgic perforated strips, and send us on our way with an up-to-the-minute reference point of my mom’s juice to show the doctor. The numbers and charts reveal a bunch of stuff, namely her white blood cell count, platelet count, hemoglobin, and on-base percentage. The nurse is in a perpetually good mood, even when handling bodily fluids, cancer patients, and their overly inquisitive daughters.

The word “phlebotomist” comes from the Greek words for “vein” and “cutting.” In light of the nursing shortage, and the fact that doctors are busy golfing, the art of tapping veins a la Sid Vicious has been left to technicians who are skilled in riding the red highway to the laboratory. Tasks of the phlebotomist include preparing stains, properly labeling all samples (check out this nifty blood-sample labeling pen that’s a tool of the trade), sterilizing equipment, recording blood pressure and pulse, and watching that Twilight movie. Some also imitate R. Kelly and handle urine specimens.

One of the main responsibilities of a phlebotomist is to explain the procedure to the patients. This is where things can get somewhat dangerous. One of my closest friends is a girl who measures about 5’4″ and weighs roughly as much as the average amount of cocaine rapper Plies’ manager keeps in his house. She’s afraid of having her blood drawn, and has had to be restrained by more than one nurse in order for a sample to be procured. This girl, who has defended me in a street fight, can’t even mention the word “blood” in an email without getting queasy. In a cruel twist of fate, she’s had to undergo several surgeries and countless medical tests in the past year, nearly all of which required a visit from a “vein cutter.” She attributes her phobia to three things: an irrational fear of having her wrists touched, the act of locating a vein, and the explanation. As she puts it, “I don’t want them to talk to me about it at all when I’m there. I don’t want them telling me what they’re doing. It’s actually the prep that is worse for me than the needle. I’m not afraid of needles. It’s the searching for the you-know-what that I hate. I can’t be more descriptive than that.”

It turns out that a lot of people have a serious queasiness about those things that rhyme with the state of Maine.

Fear of veins and wrists actually is called carpophobia. If you want to help someone get over this phobia, you don’t have to endure years and years of training to become a psychotherapist, after all that only inevitably leads to being paid ridiculous sums of money and having a few letters added to your name. You can become a phlebotomist.

Seems counter-intuitive, doesn’t it? It turns out that many who enter the lab tech field do so because they want to help people get over these fears, not compound them. “I want to help people. I love showing children the “blow away the pain” technique,” says technician Candice. Some phlebotomists even suffer from this squeamishness themselves. “I started doing this in order to overcome my fear of needles. That and I wanted to get closer to my nursing degree,” says Nate, who now is a registered nurse.

Although the requirements vary state by state, nearly all require copious training and a minimum of a GED. Most employers do demand some sort of certification, but there are cases where this can be obtained on the job. Accredited phlebotomist programs take at least a semester to complete, but some last as long as a year, and all phlebotomists are required to take multiple courses in anatomy, physiology of the circulatory system, and blood drawing techniques. Much like Louie from Interview With A Vampire, all phlebotomists will have to learn from hands-on training, and will practice multiple venipunctures on live humans who say ouch. Certification needs to be renewed on an annual basis, and Certified Phlebotomy Technician (CPT) and Registered Phlebotomy Technician (RPT) certificates are granted by The American Society for Clinical Pathology (ASCP), American Medical Technologists (AMT) and the American Society for Phlebotomy Technicians (ASPT).

The reward of being a phlebotomist is an annual salary of $24,350, according to The American Society of Clinical Pathologists.  This breaks down into roughly $11.71 per hour, forty hours a week. Allow me to point out that this salary is less than you’d make as a forklift operator. Though I’m sure working with warehouse cargo allows for a variety show’s worth of double-entendre, not many occupations can boast such an unintentionally smutty job warning: Phlebotomists-in-training and teenage boys alike, be warned, “avoid trauma and excessive probing.”

If you’d like to become a phlebotomist, check out this tutorial but do not watch it if you suffer from squeamishness or carpophobia. You can also check in with the American Society for Phlebotomy Technicians. They vant you to draw blood.

Drop me a line: AinsleyDrew at the gmail one.

Thank you for everyone who donates! (Money, not plasma.)

Ministry of Imagery: we tie the tourniquet and tap the word veins. Hire us.

I Pity The Doula

I’m no goddess worshiper, but sometimes I want to be. I’ll admit it, the new agey stuff intrigues me, as much as I scoff at it. No, I don’t want to dread my hair, or wear hemp pants, or own a cat named after an ancient goddess. But sometimes I do think that herbal supplements, meditation, and positive visualization can act as buttresses for conventional, i.e. Western, medicine. And I do think that the power of relaxation and being easygoing is understated. After all, I practice quite the opposite in my daily life, with its rigid system of lists, an ungodly early waking hour, and, currently, incessant trips to very level-headed, diploma-awarded doctors. (Both my mom’s oncologist and my gynecologist have been nearly social calls in their regularity of late.) So, in my head, doulas, or labor companions, are individuals who tread that fine line between bullshit-mongers and awesome-sauce.

In case you’re wondering, Kalma, Axomamma, and Nike would be the top three names for the patchouli-scented cat that my perpetually-barefoot, new age doppelganger would own. They’re the goddesses of decay, potatoes, and basketball sneakers, respectively. And I still snicker when people chant “om” before yoga classes, so don’t get your hopes — or tapestries — up.

“Doula” is a derivative of a word in Greek that translates into something like “really important female slave.” Though I can’t hire a doula to clean my toilet or lick my boot, I can give one a call when I get knocked up. (If I get knocked up. Aforementioned gynecologist visits potentially indicate a slim-to-none chance of that happening in this lifetime.) These “birthworkers” are brought along for the ride of pregnancy, not as bewildered hostages like many a husband and boyfriend, but as assistants. Coaches, if you will. Additional punching bags, perhaps. The technical definition, according to Klaus, Kennell and Klaus’s cleverly titled tome Mothering the Mother, is “a woman experienced in childbirth who provides continuous physical, emotional, and informational support to the mother before, during and just after childbirth.”

According to Childbirth.org, a doula does everything from explaining medical procedures, to assisting in the creation of a birth plan. They also offer support and guidance as new parents figure out how to get the baby to breastfeed with minimal discomfort for the mother and maximum consumption of liquid lunch for the infant. It seems like doulas are heavily relied on by women and couples looking to avoid pharmacological pain relief, surgical intervention, or a more “Americanized” version of childbirth. Hey, to each their own. If I discovered that I was pregnant I would demand an epidural before the piss dried on the stick. But that’s just me.

So you want natural childbirth, or maybe you want to shoot your reproductive tract all over the interior of a kiddie pool, or perhaps you’d like to forever taint your house with the memory of passing a several-pound person through a hole in your body smaller than a thimble? Then for you a doula is totally doable. These pregnancy cheerleaders are mainly walking birth dictionaries, providing information, support, and pain relief techniques for the woman about to pass a human being through her cervix. The doula will explain things to the family prior to the water breaking, and, if they’re a postpartum doula, they’ll help out around the house afterward. This is looked at as useful because introducing a brand-spankin’-new baby into the home is kind of like releasing a swarm of angry bees inside of a grade school girls’ locker-room, at least from what I’ve been told.

There are benefits to having a labor companion, and they’re not just ones for the husband or same-sex partner who can’t quite figure out how to make the screaming stop. Doulas have been noted to reduce the length of labor by 25%, reduce the split-me-open-like-a-watermelon cesarean rate by 50%, reduce the use of forceps in deliveries by 40%, and, unlike my high-school’s drug abuse prevention program, reduce the use of Oxycontin by 40%. These are just a few on the list of benefits, which have been studied for years by skeptics and fans alike. One has to think that midwives helped to keep the human species conveyor belt moving right along for years, what’s the harm in bringing old school birthing back? After all, history proves that once you take away the midwives, the maternal mortality ratio goes up.

Just as I go postal on people who rigidly argue that vaccinating their kids is dangerous without exception, and that tinctures can cure petrussis (“whooping cough”), being too stubborn about Western medicine can be just as close-minded and potentially detrimental. Again, this is simply my point of view, based off of my semi-comparative, non-scientific study over the course of several years where drinking, overeating dairy products, and reckless sex never helped my anxiety. These days yoga and meditation keeps me from curling up into a ball and writhing on the floor to Joy Division’s Substance…most of the time. Uniting doulas along with traditional labor assistance enjoyed by mothers in developing countries can’t be a wholly bad thing.

Typically doula services run about $500, though some can cost upwards of $1K. Hospital doulas and free/low-cost doulas are available for the practical pregnant person. In the case of hospital doulas, the mother wouldn’t know them prior to getting contractions, which, to me, would make labor kind of like an awkward one-night stand. Only backwards? Free doulas are still in training, which would not appeal to me, mainly ’cause I’d imagine delivering a baby is a pretty intense situation to learn-by-doing.

Are you the kind of person who thinks that a rice sock is an adequate pain-relieving measure for childbirth? Do you think that sounds crazy-bananas, but are a devoted believer in the healing power of breath? Do you like babies? Do you like babies with the placenta still attached? Then becoming a doula might be a viable career path for you. You can enroll in a workshop and get certified through one of the three internationally-recognized doula-making organizations: DONA, CAPPA, and ALACE. Network with other doulas in or near your community, offer to help them around their office (or house) in exchange for information and guidance. Mentoring is always useful, but when it comes to the viscera-covered nitty-gritty of birthing — especially if you’ve never been inside of a delivery room other than your arrival on this planet — the more hand-holding the better.

There are several reasons why I would make a better, oh, I don’t know, professional wrestler, snake charmer, conservative Republican lobbyist, anything than I would make a doula. One of these is the schedule. You’re on call, a la ER, 24/7 until that baby arrives, is home, is nursing, is pooping in its diapers, and the parents are slightly less than shell-shocked. It’s your anniversary and your honey has taken you to Blue Ribbon Sushi to celebrate your months of contraceptive-aided-sexual bliss and love, but your mother-to-be sprung a leak and appears to be in labor two weeks early? See ya sushi, too bad, boo, you’re off to the hospital, Ms. Doula. (Or off to the house, if your client is delivering at home.) As I’ve mentioned, I’m slightly-to-completely obsessive compulsive, prone to scheduling, list-making, and adding and subtracting from my spiral-bound day planner more intensely and often than Jim Zorn does to the Redskins’ playbook. Living on the edge of my seat, awaiting a phone call which would summon me to work, would be more stressful than actually being pregnant.

Moreover, truth be told, I’m vagina squeamish when it comes to the non-recreational aspects of the thing. I nearly gag every time a gynecologist inserts a speculum in my bits, and if I was forced to see the utilitarian functions of female genitalia up-close and personal, well, I’d be the one needing medical attention. I’m also not one who is, as they put it “comfortable with touch,” especially not with strangers. A non-touchy people pleaser in a room with a gaping, bloody hole, belonging to a screaming woman…it sounds like a PSA for birth control, or a scene in a film by Takashe Miike.

Take note that this is written by someone who is seriously ignorant, on top of being selfish. I’m a sexually overt twenty-something who is more in tune with the Lakers’ shot clock than her biological one. I’ve never had a kid and, like I said, it’s doubtful I will. As with the new age mumbo-jumbo that makes me chuckle and then think, I do believe that childbirth is a miracle, though it also kind of seems like a nightmare. But most new mothers, just like the Nag Champa burning granola munchers I pretend to roll my eyes at, seem to have a content glow and all-encompassing smile, the likes of which this cynic’s cheeks have never seen.

Drop me a line. Angry letters from doulas and mothers welcome. AinsleyDrew at gmail dot com.

Thanks to everyone who donates.

Hire me to birth some words.

Doula Resources:

American Pregnancy Association’s answers to why you may want a doula.

So you think you can doula? Here’s a checklist, just to make sure.

Birth Roots, which looks like you should get a bowl of Kashi with every click, is actually a really informative site about returning to the “roots of chilbirth.”

Very Emergency

“These are all these vague, feel-good ideas. The fact is none of these ideas address the real problem. If you’re going to save money in health care, you have to deliver fewer services. It’s that simple and it’s that hard.” Joseph Antos of the American Enterprise Institute.

I am not a brain surgeon. I don’t talk about politics or other assorted large issues on this blog. If I did perhaps I’d have more readers, or maybe more people would donate, or I would have already rocketed myself into the stratosphere of blogosphere super-stardom. I avoid the things that are A Really Big Deal. I do this, dear readers, ’cause I treat you all like potential bedmates, each and every one, and I know that the number one way to cockblock yourself is to seem like an ignorant loudmouth. Which is what I am, basically, but I don’t want you to know until after we share breakfast. Sometimes I discuss sports, which can be equally as offensive, but I just do that to prove I’m cute and a rough-and-tumble type of girl, which can only improve my potential.

You’d think that as a vegan who could see herself marrying a woman one day that I’d be a little bit more aggressive about my ideals in a public forum, but the truth is that I recognize that I’m pretty much misinformed about a lot of things, and selectively informed about others. And nothing is more dangerous — or irritating — than a person spouting nonsense on things that actually do matter. So I use this blog to whine about work, mainly. But something happened the other day that I need to get off of my very flat chest, and I can tie it into work since my business card these days reads: Ainsley Drew, copywriter, cancer caviler, and marginally-bored and underused home health aid. It’s the last one that got a bit of a slap in the face the other day, albeit with a simple, skinny piece of paper.

I’m not really sure where I stand when it comes to my views of the medical field and its assorted conundrums. Yes, yes, I know, Obama, universal healthcare, reform, Senate Finance Committee, blah blah blah. But all of that stuff falls on my little, selfish ears like Charlie Brown’s teacher explaining nuclear physics. If I explained my personal health insurance situation to you, chances are you wouldn’t believe me. But my mother works a minimum of twenty hours a week in a tiny, dirty landscaping office in order to cover her health insurance, if she doesn’t clock in for that many hours, she can’t get coverage. This still stands in spite of how much discomfort she’s in, how little time her prognosis leaves her to enjoy life outside of work, and how tired chemo makes her. That the work is what pays for that chemo, chemo makes work nearly impossible, chemo is impossible without work. It’s an ugly situation, but it’s better than most, and my mother has accepted it and tackled it like a tiny, metastases-motored machine.

Fine. So health insurance doesn’t care if you’re terminally ill and probably shouldn’t be at work in lieu of nice weather and a desire to play handball with your friends. Insurance companies figure that my mother can get COBRA‘d  if (otherwise known as when) the cancer finally goes all Floyd Mayweather on her ass. And, okay, sure, her particular insurance company rejected numerous referrals over the course of six months as her bizarre symptoms worsened, even though these referrals were for the exact test that eventually was administered and discovered Stage IV metastatic pancreatic cancer that had spread to her liver.

I get it, there are many cases, they don’t want the system to be abused, in order to keep astronomical costs just one shade shy of laughable they have to send out rejection letters, just like a booze-filled Ivy League university boasting Division I lacrosse. Moreover, they know, just as we now know, that there’s a reason pancreatic cancer is called “the silent killer,” and it’s not ’cause it creeps around in ballet slippers. I can’t allow myself to be so self-righteous as to believe that my mom’s illness is a singular case, and that the insurance company’s irritating bureaucracy has only bitch-slapped us. It’s a faulty system.

But my mom received an $800 bill for one session of chemo the other day in the mail that said her insurance wasn’t going to cover the treatment due to “a lack of information.” And although we were eventually able to straighten this momentary cataclysmic fiasco out (insurance will cover it), the idea of 7 sessions at $800 a pop was enough to lead my mother to quietly say, “I don’t know if I’ll keep going with this if insurance doesn’t cover it.”

My mother didn’t have to make the decision to give up her palliative care in light of the cost, and she’s able to at least receive some form of treatment due to the fact that she has a job that does provide her with insurance options and begonias. But many people in this country don’t have the same privilege. It dawned on me that there are those who make this decision every day. To leave behind families. To leave behind hope. To leave behind hamburgers. To take the shorter prognosis not because they want to embrace death, but because they simply do not have the means to make any other choice. And that frightens me.

Yes, I’m an educated white girl from the suburbs who often complains about being broke. I have no right to bellyache about the fact that there are patients stuck like pebbles in between the cogs of a system whose wheels aren’t turning. The emergency medical care in this country, which is what many under- or un-insured Americans rely on in order to get stitched up or have their sniffles cured, is leagues better than the care available in other parts of the world. Even though our system is backward and taxed, I find it comforting to live in a place where the medical services that are available in case of an emergency can actually save and improve my life. And although I am far too naive and unaware as to open my big fat mouth and say I have a solution, or now I want to be an activist, or even here’s what I think we should do, I can say that I’m upset. And as somebody who is watching a person die with a better healthcare and health insurance situation than most, I can say that it isn’t any easier.

I understand that insurance executives, representatives, and drug pushers all want the same thing as those of us with or without insurance. We all want to provide for ourselves, and our families. Self-preservation, no matter the cost, is what has made so many monolithic industries across the globe thrive. Not all are perfect. But not all leave bills in mailboxes saying that your body is a commodity whose price is too high to pay. I can only hope that by the time my bionic uterus rusts shut or my robot circuit-board-built heart breaks down that the health insurance companies will have figured out what the price is on my head. In the meantime, I’ll start saving my pennies for an unhealthy day.

If any of you actually understand the title of this post and what it references, please email me. I will use my limited funds to buy you a burrito if you’re in the New York City area. I’m not kidding. AinsleyDrew at gmail dot com. Also, if you don’t happen to know what Very Emergency pertains to, but you’d like to hang out, my social schedule is cancer-free, and I’m back in the Tri-State for the foreseeable.

Thanks to those of you who donate. And you can always hire me as word insurance.