Not even a vampire could tap me.
February 10, 2011 4:21 PM   Subscribe

Is there a lancet-based or bloodless herpes, hep-c, and/or syphilis test?

I just got back from the clinic. I went through one phlebotomist and one RN, one needle in my arm, and one butterfly in each hand. I threw up a little, and I almost passed out. And they didn't get so much as a flash of blood. Tapping a vein has consistently been a problem throughout my life. It's definitely not the pain that's the issue, so I'll happily stick each freakin' finger. Or, hell, just cut me open. But, when they go digging around with the needle looking for it... it's traumatic--like, nightmare-grade traumatic.

So, is there a test for any of the diseases I mention above that relies on lower volumes of blood or on some other more easily-accessed fluid?

(Please note, I'm asking a specific question about the availability of such testing. I am already exploring other avenues, such as finding a pediatric phlebotomist that might have more experience with squirrely, tiny veins.)
posted by Netzapper to Health & Fitness (7 answers total)
When I needed a Herpes test they stuck a swab up my penis. I don't think you'd like that either.
posted by Mr. Yuck at 4:50 PM on February 10, 2011

No, I'm totally down for a urethral swab, if they can do asymptomatic herpes tests with it. But, it was my understanding the swab only worked if you had symptoms.

This is not about discomfort or displeasure. This is about they literally cannot draw my blood without heroic effort.
posted by Netzapper at 4:54 PM on February 10, 2011

Did you have low blood pressure? Did they say anything about possible dehydration? (Maybe even chronic dehydration since it's always like this?)

If you down a lot of salt and a LOT of fluid, it'll temporarily up your blood pressure and make it easier to find veins. Talk to a medical person for details, though. You might even want something like salt pills. And something for nausea.

Also, I have an arm from which no one, ever, has been able to draw blood; it's my right arm, which most phlebotomists go for without thinking; their equipment is set up for right arms, and most people are right-handed--I am right-handed, in fact, but the veins in my right arm are still invisible. (Thanks to lab techs hunting for WAY too long when I was a kid, I have a needle phobia on top of the hard-to-find vein.) The other arm has a lovely accessible vein; I just have to catch them as they get started and ask them to please, please use my left arm instead. Since you mentioned "one arm" I wonder if you might have a similar issue, but surely someone would have thought of that before...
posted by galadriel at 6:10 PM on February 10, 2011

galadriel, that's one of the avenues I'm exploring at the moment. But, google is yielding all sorts of useful information in that, heh, vein.

I'm specifically asking here about alternative testing, not ways to make the regular test work for me, because google gives me nothing but links to the regular testing methodology. I was hoping somebody here would know if such a thing existed.
posted by Netzapper at 6:44 PM on February 10, 2011

Orasure is in the process of getting FDA approval for an oral swab hepatitis C test, but it's not out yet. Right now the only rapid test is whole blood. They have a fingerstick, oral swab, and a couple of other ones in the approval process, so at some point you'll be able to get this done without taking blood, but not quite yet. (They keep saying "in a year" but have been saying that for more than a year and I haven't followed it very closely.)
posted by gingerbeer at 8:13 PM on February 10, 2011

So, is there a test for any of the diseases I mention above that relies on lower volumes of blood or on some other more easily-accessed fluid?

You can have your syphilis tested via spinal fluid: test name is VDRL. Of course, that involves a spinal tap but if pain and inconvenience and cost isn't a problem, that may work as an alternative.

However, the regular screen for syphilis (RPR) requires only a small amount of serum, easily obtained from a fingerstick.

EIA IgG HerpeSelect testing requires* only 10 microliters of serum which is easily obtained from a small microtainer of blood from a fingerstick. And alternatively, Herpes I/II IgG/IgM by IFA requires* 100 microliters of serum, also pretty easily obtained from a small microtainer of blood from a fingerstick.

I'm not positive, but I think the requirements for hep C aren't much more than 100 microliters of serum for many of the automated methods out there, so add one more fingerstick microtainer for that.

We're talking a total of about two, maybe three at the most, fingerstick microtainers to adequately cover all the testing you want. It's amazing these days how much testing can be done off of a small amount of blood.

Unfortunately, your sample will probably be sent out to a national reference lab which will require a much larger amount of serum as a minimum (for legitimate reasons, but still will probably prevent you from being able to send fingerstick samples..)

It really sounds like you need to find a local hospital lab that will work directly with you instead of relying on a clinic that is at the mercy of sending out their samples to an outside reference lab.

Good luck - I know it's tough to be a hard stick.
posted by ourroute at 8:39 PM on February 10, 2011

Sorry, meant to clarify the asterik *: different methodologies/manufacturers require different amounts of serum so the amounts required may differ slightly. Still, they shouldn't vary too much.
posted by ourroute at 8:47 PM on February 10, 2011

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