Thursday, May 31, 2012

Thursday, May 26, 2011 Kathy D. asks

Q: How do I limit bruising during infusions?

What can I do to reduce bruising each time I receive my IV drugs?  At my previous rheumy's office, I received Orencia and the LVN infusion nurse had a hard time with my veins, and same goes for my current rheumy and the infusion center nurse (RN) who is now giving me Actemra (I failed Orencia after 7 infusions).  She even went to so far as to heat my veins with the heating pad and using a butterfly needle; I chugged water days before and the day of the infusion and I still ended up with a really bad bruise. 

 

The bruise usually lasts for a month and covers a large part of my arm til my next infusion.My rheumy says the Medrol plays a part in it, but that I also have really bad veins.  Is there anything I can do?  One nurse who does my blood work suggested lifting weights, but I can't due to my RA being extremely active.

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Answers (1)
Lisa Emrich, Health Guide
5/31/11 1:39pm

Hi Kathy,

 

Sounds like you have two things going on here.  Difficulty getting an IV started and then bleeding a little bit under the skin afterwards. 

 

I have extreme difficulty with veins as well.  You can read just a couple of my mis-adventures in these posts:


What does it take to feel "cared for" by medical professionals?

Living with RA: Infusions, Phlebitis, and Self-Advocacy

 

Heating the veins is a very good (and not so uncommon) way to try to get the veins to plump up a bit.  One thing a nurse suggested to me, in addition to drinkings lots of water every day for at least a week beforehand, is to eat something very salty the night before.  That helps to plump up the blood volume apparently.

 

Let the nurses know up front that you are a hard stick.  If you find someone who can get you started in under 2-3 tries (or so), be sure that they are called in first next time.  There is also a way to use a "vein light" to get a peek at where the veins are.

 

As far as bruising.  It would be important to avoid excess tries at getting an IV started in the first place.  If a try is unsuccessful, be sure that you put some pressure on that spot for a minute or so, even if it doesn't look like it's bleeding.  The steroids might make your blood less likely to clot quickly (not sure about that, but possibly) so you may not have any choice in the matter of whether you get bruising or not.

 

Good luck and I hope that your next infusion goes smoothly.

 

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By Kathy D.— Last Modified: 05/31/11, First Published: 05/26/11