Monthly Blood Draws

[Rerun]

I'm at a Davita Clinic.  We have always had blood draws on the first Sunday of the month which is right after a weekend for me.  Now they are going to draw on the first Tuesday of the month which would be my second dialysis session of the week.  That seems wrong to me.  My blood theoretically would be cleaner.  Doesn't Medicare look at the labs and reward clinics with good labs?  Wouldn't this be a blatant violation trying to screw Medicare. 

I just got my lab results and WOW they look great!  Well, they were taken after I had dialysis just 2 days before not 3 days.  Big difference.

What do you guys think.  Should I report this new lab procedure to Medicare?

[noahvale]

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[iolaire]

I believe my davita center does it Wednesday and Thursday.

[Michael Murphy]

Fresinius in New Jersey always on a Monday after a weekend.

[Charlie B53]

I can see valid points for both days.  A few phone calls to Medicare couldn't hurt, it may be difficult to find the right person, or office, that may have any opinion either way.

If it is true that clinics are rewarded in any way from the seemingly 'improved' labs then it could be an issue.  But then again as Noah has pointed out, if the labs were to indicate a trend then early warning could be a benefit for the patient, and by extension also for the clinic in treating that patient.

Need a lot more information before passing judgement either way.

[iolaire]

I believe my davita center does it Wednesday and Thursday.

I can state for a fact now that my DaVita center does it on W and Thursday.

[Rerun]

The thing is... the doc needs to see your worst blood to treat you correctly.  Take labs 48 hours after I dialyze or 72 after I dialize. 

After 48 hours my potassium is 4.5 looks great... but what was it after a weekend after 72 hours.  That is what we want to know.

[Rerun]

My potassium was 4.3 for April.  The doctor came in last night and wanted to change my bath to a 3K.  I reminded her that our labs were drawn mid-week instead of the first of the week and she didn't change it.  This is BS.  Our basis for lab numbers have been changed.  This could really screw up people who are use to eating a certain way.  I could think oh, I can eat more potassium and it could get really high by Sunday but I'd never know until it killed me because my labs show a Tuesday level.

I'm calling Someone on this.  Plus I wrote a letter to the Medical Director and the FA and District Director.  I requested my labs be drawn on Sunday.  No other patient seems concerned.  Dah!

[noahvale]

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[Rerun]

Thank you, I did talk to someone named Barbara at the NWRenal Network and she said what you did.  There is no specified day to draw blood but she understood my concern.  I guess the labs are just so overworked.  Boo Hoo

I will just refuse labs on Tuesday and Thursday and When it gets around to Sunday I'll do it. 

Medicare doesn't look at potassium but does look at KTV and Hemoglobin.  She told me that. 

She says they are not trying to screw Medicare.  I'll wait to see what they tell me at the clinic.

[Zach]

Dear Rerun,

You are on to something.

Monthly bloods taken on Thursdays will show a slightly higher hemoglobin and a slightly lower Phosphorus (and as you stated, Potassium).
Blood taken on Mondays & Tuesdays (as well as your Sundays) reflect the worst case for these three values as far as a weekend goes —higher Phosphorus and Potassium and lower hemoglobin.

 

[Rerun]

I looked at the Fresenius clinic down the road but they are not nocturnal.  They could give me a six hour shift but it would be during the day so I would lose my freedom.  I tired doing six hours last night at my current CRAP Clinic and they could not get all my fluid off.  My bp is so low it takes 8 hours to get it off.  I don't think I can move clinics.  No one seems to think it is a big deal that they are changing blood draw days.  Idiots!

[iolaire]

I looked at the Fresenius clinic down the road but they are not nocturnal.  They could give me a six hour shift but it would be during the day so I would lose my freedom.  I tired doing six hours last night at my current CRAP Clinic and they could not get all my fluid off.  My bp is so low it takes 8 hours to get it off.  I don't think I can move clinics.  No one seems to think it is a big deal that they are changing blood draw days.  Idiots!

I'd be interested to know if the Fresenius (US) center does haemodiafiltration.  The Irish center I was in last week did it and claimed its much easier on the body and I do think it was easier.

[noahvale]

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