Why is it so $@*% hard to get an IV in?

I have never been an easy stick when getting an IV. It most often takes about 3 sticks to get one to work, and that’s usually after 5 minutes of one of the needles being moved back and forth trying to figure out where the vein went. I think my record is 6 sticks before finding a vein, but I know that’s probably low compared to some of you.

img_4310Even the most confident IV … inputters (?) are surprised by how difficult my veins can be to find. I once ended one nurse’s streak of nearly 100 sticks on the first try. I always try to tell the person before hand that my veins are tricky and they like to play hide-and-seek, looking alright beforehand, but disappearing as soon as the needle goes in. They usually somewhat brush me off at first, but by the end they agree with me.

During my recent hospital stay, which started as a blockage, by the real reason I went in was due to severe dehydration. I’m sure you all know how much more difficult it becomes to get an IV when you’re dehydrated. The nurses could tell immediately that my veins were not going to make it easy, so I had 2 charge nurses each give it a try and both miss the vein. Then they called the IV team. And it was the same old story: Came in confident, but then not 1, but 2 blown veins later, we finally got a blood return on his third try, but fifth overall.

But what’s interesting about this, is what he asked me next.
He said, “What brought you in?”
“Dehydration,” I told him.
He replied, “Is that all?”
“I had an intestinal blockage.”
“Due to…?”
“I have an ileostomy.”
“Due to…?”
“Crohn’s disease.”
And he said, “There it is!”

ibd crohn's disease IV insertion veins ostomy stolen colonHe went on to tell me something that I am surprised nobody has ever told me before. He said that people with Crohn’s disease and ulcerative colitis have notoriously difficult veins to insert an IV into. (Please don’t quote me on some of the more technical aspects here, but this is what he told me.) He said it could be due to a number of things such as some of the medications taken for IBD, getting ongoing IV meds and veins being used frequently for blood draws and other IVs, among other things. He showed me how his veins are mostly straight, but when you look at mine, they are kind of curvy and they have extra little bumps in them, what he called valves. From what I understand, when valves are not working properly, they cause blood to pool is small sections of your veins. Basically, the point of all of this is showing that having IBD can make getting an IV inserted more difficult, since the veins aren’t as straight or smooth as they usually are.

He recommended that I let anyone trying to insert an IV know ahead of time that I have Crohn’s disease, because he said it would change his approach. He said he would likely have spent a little more time picking out a vein and would also start with a smaller needle. The needle he ended up using to get my IV in he said he rarely uses on anybody because it’s so small, but he often has to use it with IBD patients

I found all of this very interesting and wondered why nobody had ever told me this before. But now I’ll be sure to always give someone trying to insert an IV a heads up of what they’re dealing with. We’ll see if they take it more seriously than my warning of tricky veins!

14 thoughts on “Why is it so $@*% hard to get an IV in?

  1. Eve “Pickles” Sullivan

    This is really interesting! I will definitely mention UC next time I need an IV / blood draw.

    I recently switched hospitals for my Remicade infusions. The infusion nurse was familiar with IBD *and* had no problems placing the IV — which was a first. (My record was 13? 14? before they got the IV in for a recent lithotripsy.)

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  2. Kristi Graham

    I guess I’m one of the lucky ones. I know where my best veins are and quickly point then out to whomever is starting an IV on me. I also have the added benefit of being a paramedic, so I Stuart IVs on people all the time. I have threatened to start one on myself many times.

    I also had never been told that just having Crohn’s would cause difficulty in starting an IV. But it makes sense.

    Thank you for sharing you experiences and journey. I’ve only had my ileostomy for a year now and greatly appreciate all the information you have shared. It had been a great help.

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  3. Matthew Dobos

    Another great blog Stephanie! I may have a slightly different take on this- I think it’s all due to Prednisone. When I as very sick way back when and scheduled for surgery, it took about 10 times to get th needle into my vein. The problem was the needle was pushing the vein away. You could see the vein nice an clear, but then it just dove underneath and disappeared after being poked. After I stopped taking Pred I haven’t had too many issues. Sometimes it takes 2 or 3 pokes now, but that’s it- in the hospital it always took at least 3 or 4. I once thought being dehydrated would also make this problem worse, but since I had it the worst when I was on the IV in the hospital,- i doubt I was very dehydrated while hooked up to an IV.

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    1. Stephanie Hughes Post author

      You’re right, Matthew. And that was part of what he said was that it was due to medications, not simply IV meds, but I didn’t explain it properly here. I’m revising!

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      1. patsygazaleh

        Stephanie, another issue that causes the dehydration in Crohn’s & UC patients, is that most of your nutrition and hydration occurs in the last portion of our small intestine and the colon. These diseases keep us from getting necessary nutrients. That causes fairly chronic dehydration. I live on Smart Water 90% of a day.

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      2. Matthew Dobos

        All good Stephanie, no worries. 😉 This actually reminded me of something – it took a few years of not taking Prednisone for my veins to act “normal” again, instead of ducking and hiding when poked. I used to worry about all that, but my doctors said it wasn’t a problem and I haven’t had any other issues, so that’s good. Keep ’em coming- love reading your blog!

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    2. Aafke

      Yes, prednisone was definitely a problem for me.
      Even when you get an injection of prednisone, IT HURTS SND BURNS!!
      I am so glsd those days are over‼️

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  4. Nmtsaki

    I was told when nurses were having issues getting a needle in, is to ask for an anesthesiologist to do it. Supposedly they are the best. I don’t have Crohn’s disease, but had colon cancer, so have the Ostomy. I’ve been poked hundreds of times too, it really gets irritating. Sorry you have to go through all of this, and so glad you got some good advice. I’m going to pass it on to my friend who has UC. She’s on the Remicade.

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    1. Ceil

      I was stuck 9 times by- twice by a nurse and the other 7 were by two different anesthesiologists who apologized up and down saying this never happens to them:/

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  5. girlfromwva

    i ALWAYS tell them i have Crohn’s disease, a permanent ileostomy, and have trouble getting “stuck”. fortunately they use the tiniest needle they have and sometimes i can even talk them into getting me in on the inside of my wrist. i also try to drink as much water as i can (as long as i am not nauseous or “throwing up”).

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  6. Teddy Burr

    Well…..after having Crohns since I was 16, Ileostomy at age 21 – and I am now 66, you may well imagine I have, I guess, no “intravenous” quality veins left for transfusions. Last time I was in hospital, about 6 years ago, with a UTI – a horrific one that spread to my Kidneys, that left me severely dehydrated a DOCTOR could not find a vein to insert the Canula. After MANY attempts by him, after me telling him I had no strong veins left…..he sent for a Path Lab Technician (one of those that take blood in Outpatients Dept). After TWO attempts, she found one….fragile but it did last a day. I needed intra-veinous Antibiotics as it was a bad e-Coli infection!! After the collapse of that vein, they had to infuse me subcutaneously (via a small needle that sits just under the skin) on my upper chest area) Fortunately, the antibiotics drip had gone through on my “one vein the Technician” located. When I attend the Doctors, my nurse has ONE vein she can take a blood sample from!!

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  7. Holly

    I’ve had 57 brain and spinal cord surgeries and as a result, I have horrible veins. I once woke up from surgery to discover that they had such a hard time finding a vein, the only option they had was to STITCH an iv in my neck. I don’t know how often you need iv’s, if it’s quite often have you considered having a port placed? It is a surgery to put it in (mine was put in during a different surgery) though and surgery ALWAYS sucks. As I said, I don’t know how often you need them but it really has made a difference in my life. Also, I really enjoy reading your blog. You’re an excellent writer.

    Reply

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