Death to Quest

It’s time for a full-blown Deemster_Diva Split Open and Melt Down, readers. Wait for it…. Wait for it… Wait for it….

I am so sick to death and passed my wits end with Quest Diagnostic and all corporate chain blood drawing centers I can barely contain my disgust. First, let me give you a little backstory. Before this need to have bloodwork arose, there’s been three other times over the last, say 8 years that I’ve needed IV injections. None of them have been pleasant and only one successful. That one time was during an ER visit when I woke to find my right arm was inexplicably paralyzed. Turned out I had suffered extreme nerve damage by sleeping on my neck wrong had radial neuropathy. It left me paralyzed from well over six-months. It was a very harrowing and depressing period of my life. Especially because all the doctors told me it was likely never going to heal. And for six months, it didn’t. There was no improvement whatsoever. I began to lose hope, until suddenly like magic overnight it started to get better. There was zero improvement for six months, then full recovery in two weeks. I’ve thank God for my recovery each and every day since then. But when I initial went to the ER to get it checked out, the doctor took one look at me, sneered and walked away. The phlebotomist eventually came over and told me he needed to draw blood. I explained that I was an IV drug user and that this might be challenging, but he never once made me feel subhuman tried to tell me that I brought this all on myself (which had been my usual experience with medical staff). He was extremely patient and took his time. We had to try a few odd place, but he took my advice and worked with me on it and eventually, yes, we were able to draw blood. Shortly after as I was waiting for the doctor, I heard him pull the phlebotomist aside and ask, “Does she use drugs?” He answered very matter-a-factly that yes “I was an IV drug user.” When the doctor finally did make his way over to me. He told me that I had a stroke due to the containments of heroin and I needed to stay in the ER overnight for evaluation and that it was probably building up in my heart causing an infection (despite the fact that I had no signs of infection). He didn’t once touch me or try to gauge the seriousness of the paralysis, or even look at my arm at all. Even when my CAT scan came back negative, he said there was no other possible explanation. Every word was laced with disgust and ugliness, like I had the plague and was the dirtiest person he had yet to come across during his medical profession. When I tried to explain that it wasn’t my right side that was paralyzed it was just my arm, not even my fingers, a clear indicator that I absolutely didn’t suffer a stroke, as the medical evidence supported, he snarled something like “Well you can leave if you want, but you’ll probably just have another stroke. And then launched into what filth heroin is and walked away, without even dismissing me. I got up and walked out of that hospital and have never even seen a bill for any of the tests they ran. I’m hoping that’s because when the people in billing or administrative staff saw what a poor job this doctor had done and what a mess he made out of the situation, they decided I didn’t deserve to be billed. If a bill had come I would have fought it tooth and nail.

But that incident forced me to seek further medical attention, because I still couldn’t move my arm. So I went to my boyfriend’s family doctor. Although he doesn’t support or condone my drug use, he knew of my history and told me flat out that he would try his very best to not let his personal opinions about my heroin use interfere with his diagnosis and treatment, which I was very thankful for.  He was the one who correctly diagnosed me with radial neuropathy. But in order to prove his diagnosis, I needed to have a couple of MRI’s done, one with contrast (the second time I’ve need a test with die running through the veins for better definition in the scan) and one without. The one without went fine. But the one with contrast never happened. During that period of time, I was not using. I was taking some time off so I hoped my veins would have had time to heal. But unfortunately the phlebotomist (or whoever is responsible for injecting you with dye) wasn’t all that experienced, and although neither him nor the doctor on staff made me feel responsible or treated me subhuman, I could tell this guy was just about to break. He felt so uncomfortable having to stick me so many times, I felt bad for him. I offered to try myself, but of course they turned me down and I eventually had to leave when the next patient was scheduled.

So, when I found out I needed blood work done yet again, I was less than enthused about the idea. But as it turns out, my boyfriend who I have repeatedly shared needles with has Hep C. So for the time being I’m working under the assumption that I have it as well and have actually already been to the doctor about it multiple times. One of the best Hep C specialist in Los Angeles eventually agreed to take me on as a patient. He wanted to start treating me right away, despite the lack of official evidence, but the insurance companies won’t pay for the treatment unless they have the proof of bloodwork. So off I went to Quest, blood work prescription held tightly in my hot little hand to try my luck one more time and get the insurance companies the proof they so adamantly need.

The first day I went, I had a girl who was clearly very capable, but like the MRI guy, was also clearly uncomfortable with the fact that she had to stick me so many times. Kind of a funny thing to note, they were both clearly Asian immigrants and both clearly had hearts of gold and just didn’t want to hurt me. But she was tenacious and she took my advice and it was the only time during this whole ordeal that we actually did get blood drawn, it just wasn’t enough blood to do a full test. After a while, she even gave me the needle and let me do it myself. Over the course of an hour or more, we got a significant amount of blood. She would take a turn, then I would. Then a patient would come and I’d rest with a hot pack on my arm and we’d try again. I really thought we were going to get it done. That is, until her boss came in. As sweet as she was, my situation had clearly pushed her to her limits and when her boss came in, she was immensely relieved to hand me over to someone more capable. Unfortunately, her boss was not as patient and had no tolerance for letting me do it myself. I feel bad, because I think I got her in trouble when he found out. But I didn’t know he would react that way. Once he heard the whole story, he said “Well I’ll stick you one more time. But we have rules about this. We can’t stick you more than six times and it looks like you’ve clearly had more than that.” He tried one more time in a spot she had already attempted, despite my protests and told me I had to leave and to go to another Quest that had more experienced phlebotomists.

Well, that same guy runs both Quests downtown. So they all follow his rules. But, I need this bloodwork done, so I went over there a couple days later. And sure enough, he’s there. He watches me like a hawk the whole time, afraid I’m going to rip the needle out of the girls hand and gab it on my own arm, no doubt, and after six attempts he kicks me out. I go back again a few days later. This time he’s the phlebotomists on duty. It was like he was accepting not to get it done. He went through the motions, gave it 6 half-hearted attempts and I was out of there in under 10 minutes. Now I’m pissed. I’ve been three times, I’m not getting anywhere with these guys, nobody is skilled enough to handle a patient with problem veins. They don’t have any needles smaller than a 25 gauge. They won’t go anywhere but the arms. And they only give it six attempts before kicking you out. But I had heard there was a good phlebotomists at a Pasadena Quest. I made an appointment at that location for this past Tuesday. This time, I’m really hopeful. I’m psyching myself up for actually getting it done. I should mention, this entire time, I’ve stopped IVing in my arms. I’ve haven’t touched them for weeks now, in hopes that it would give them a better chance at finding a good vein. I’ve even resorted to IMing when necessary. So I’m taking this very seriously and trying to do my part as well. I’m not spending hours in the morning digging around trying to find a vein, making it futile for any phlebotomist to get any blood. I’m really trying to make this as easy as possible.

So I show up at the Pasadena location and I’m the only patient there. I’m nervous, but as I said, hopeful. When I get in the room he asks me what arm I think he should try. I give him my right arm and tell him that the best bet is probably going to be the vein running down the back. He ignores me and starts poking the main vein in the crook of the elbow. Well, I have really bad nerve damage there. The guy from the ER tried that one too, but if a needle goes in that area anymore, it’s like 1,000 bolts of lightning surging through my body and I literally convulse.  I tell him this, but he wants to try it anyway. Within 2 second of the needle going in, I’m convulsing. And he asks, “Do you want me to pull it out?” No, this is cool. You shouldn’t have a probably getting blood while I’m seizing in the chair, right? I mean? What the fuck? So he pulls out and looks at my arm. Then looks at the other one – only the two main veins in the elbow crooks again – mind you. He mumbling, Oh, I don’t know. I don’t see anything. I don’t know where I can go on you.” So I mention again, “I know that blood can be drawn from the one on the back of my right arm.” He looks at it and say “Oh, I can’t go there. You’re going to have to go somewhere else. I can’t do you.” What? One attempt? In a vein you knew wouldn’t work and you kick me out? And it really confused me because this guy was recommended from a fellow IV drug user who said that he took his time, was patient and I know he didn’t use one of those two main veins. What happened to this guy? Even rookie phlebotomists know you can go in other veins when necessary. They usually still stick to the arms, but I’m okay with that.

I’m just so frustrated with Quest. They’ve taken over an entire market. Put all the ma and pop shops out of business, most doctors don’t even do in house blood work these days. They’re run like a brain dead corporation, with their stupid 6-attempts only rule. That’s for the protection of the patient. If you’ve got a patient like me who needs more than six attempts and does more than 6 attempts a day on my own, and I’m saying I don’t mind, do more than six. They would be perfectly willing to make an exception for “corporate procedure” and do whatever it takes to get my blood work done. Period. I want to walk in there and not walk out until the vile is completely full. Instead they act like they don’t have the time, they’re just too damn busy for me (huge eye roll) and pass me back and forth like a hot potato between locations, pawning me off to the next guy just so they don’t have to do something that’s hard. I think they’d be perfectly fine doing that for the rest of my life without anyone ever getting the job done. Where is the sense of duty, the work ethic, the patient empathy, the pride in work? They could care less that I have Hep C and will eventually die if I don’t get treated. And I can’t get treated without their help. I know that’s extreme and I’m a long way from dying. It may be extreme, but at the core, it’s also the truth. In addition to their total lack of care or customer service, 99% of their locations aren’t equipped to handle anything more than urine test and blood work for the easiest of patients. I think it’s a stupid rule that I’m not allowed to attempt it myself while supervised. I mean I do this 6 or 8 times a day sometimes on my own and am always successful. But whatever, I’ll won’t go down on them too hard for that one. But they don’t carry small needles, in fact the first woman I had was shocked to hear I used a 29 gauge. She believed, and I can only assume she told this bit of nonsense from Quest, that using anything smaller than a 25 could cause ruptured veins. They don’t have specialist who have experience with difficult patients. And anytime it gets hard, they send them somewhere else, so they’ll never have specialists. They aren’t allowed to go anywhere else but the arms. Even hospitals go into the legs when necessary. They don’t offer any service other than the bare basics. I know you get can hemoglobin finger-prick testing, which I’m going to need every two week for 7-8 months when treatment starts. I asked and they said “No, we need the full vile for testing.” No, you don’t. My Hep C doctor told me these tests were available, you only need like two drops of blood. I’m sure some Quest out there is up-to-date enough to offer that service. I just pray I can find one close to me. Because it’s taken me a month and I still haven’t got the blood drawn for the first round of tests. There is not a snowball’s chance in hell that I would be able to get it done every two weeks. If you are going to monopolize an entire industry, at least have the decency to offer every single service and be equipped to handle every type of patient.

Is my frustration coming through clearly? I just want to make sure you get the magnitude of my contempt for this situation.

So we’ve been brainstorming ideas for moving forward. Because I clearly can’t keep spinning around this hamster wheel. There is a Mega-Quest over in the Pasadena or Altadena area near a hospital that does actually offer like every service. People who need to have bloodwork down three times a day, or stool samples, things like that. And my boyfriend during his tweek years (so his veins were in REALLY bad shape) went there and got a doctor to draw his blood who had been practicing medicine for like 30 years and was also an IV drug user for many years. That’s the guy I want. We called over there today and the receptionist thought she knew who he was talking about and that yes, he did in fact still work there. As another alternative, I found out my Suboxone doctor’s office does in-house bloodwork. Who better to go to than a doctor who specializes in IV drug users? I hope beyond hope that one of these two options pans out. I know that one of them is still a Quest, but if any Quest can do it, it should be that one (the way they all should be). Also, I think they are by far my best bet for the finger-prick hemoglobin testing.

So keep your fingers crossed for me! I can’t believe what a nightmare this has been. I never thought I’d be sick of getting stuck by needles.