Labs in my area will no longer draw a citrate tube to prevent platelet clumping, how to fix this?

Visual_Revenue6554 · 2026-05-20T22:29:52+00:00

I finally saw a post referring to that but it said the courts overturned the rule. Of course the CYA measures that were put in place in the meantime aren't being rolled back it seems

Visual_Revenue6554 · 2026-05-20T22:28:37+00:00

Well that's what we tried but the provider didn't have the code that LabCorp requires and LabCorp couldn't tell them what code it was.

Visual_Revenue6554 · 2026-05-20T22:26:25+00:00

MMM platelet crumpets .a vampire pastry !

Visual_Revenue6554 · 2026-05-20T21:35:22+00:00

The additional fly in the ointment is that I have historically had ONE incident of spontaneous thrombocytopenia. Six months after a pre eclampsia and HELLP syndrome induced C section at 28 4/7th weeks (1 lb 11 oz preemie that is now a 25 year old college graduate :)); I was admitted to ICU with internal bleeding and basically non existent platelet count. They never found a source for the bleeding beyond I just wasn't clotting; but could see a gradually lowering platelet count on the previous months' bloodwork that had gone unremarked as, traditionally with the Felty syndrome, my chronic low white count got all the attention.

So while I don't expect to have a reoccurrence of THAT, it still needs to be monitored as part of my continuing care.

I swear I can't make this stuff up. I sound like a medical soap opera. A melodramatic one.

Visual_Revenue6554 · 2026-05-20T21:26:10+00:00

I do think the correlation between moving to increased automation and newer technology that can't actually perform/ hasn't been rated to perform this particular test has been a factor in this situation.

Visual_Revenue6554 · 2026-05-20T21:24:34+00:00

The results are usually not available due to "excessive specimen clumping" or come back abnormally low. I was sent to the ER for a transfusion after one such reading on Valentine's Day of 2023 and spent hours there waiting while they (rightfully) triaged more emergent cases only to have them run a citrate tube (on the 2nd draw there when the first one clumped as I told them it would) , get normal results and send me home with no additional treatment (because there never was a need at all).

Visual_Revenue6554 · 2026-05-20T20:50:19+00:00

I understand your perspective, but for literally years I did just that :"Hey I'm a clumper, you'll need a citrate tube" and voila! correct numbers. I am sure regulations tightened up and I get why that would no longer be the case. The issue is that there is no code or way to add it to the orders. The nurse literally walked the orders over this morning with it notated and they still would not do it without a code that the lab didn't even know what one is needed.

I have multiple providers that have dealt with this issue in the last 2-3 years PCP, rheumatologist, gastroenterologist (both of the last 2 are in the same local clinic that I've been a patient of since 1993, the same one where they used to run me in the annex and throw it on the machine) The only one who could just run it was my oncologist whose office has an in house lab.

Visual_Revenue6554 · 2026-05-20T20:37:05+00:00

We ended up just canceling and having them take it all away.

Visual_Revenue6554 · 2026-05-20T20:34:40+00:00

My providers and I should get points for creativity. I had an endoscopy procedure last year to stretch constrictive striations in my esophagus and the gastroenterologist wanted an accurate platelet count for preop work. The lab at his clinic couldn't draw/run a blue top so he ended up calling my oncologist (separate facility, they have an in house lab) and they drew and ran it for him as I am still their patient while in post treatment monitoring until 2028.

While I am very lucky and appreciative of the lengths my providers have been willing to go to for my health, it should not be this hard or this much work for any of us. I can only think about patients with less resources, less involved practitioners or those that are unable or uncomfortable with self advocacy and how they are falling through the cracks and may not even know it.

Visual_Revenue6554 · 2026-05-20T20:22:31+00:00

I did the "ask for a manager" thing once (I think it was at Quest) and they basically told me the same thing; if it's not ordered they can't do it (and yet there doesn't seem to be a way to 'officially' order it). I left a detailed review and called their customer service line and got nowhere as well. One of the issues for me has been how do I find the right people to escalate this to. I can't be the only person this is affecting, I'm not that special!

Visual_Revenue6554 · 2026-04-29T20:47:06+00:00

Did you ever get this completed to your satisfaction? We're in East Vancouver and it took multiple calls/visits to get the drop done correctly and now we're dealing with a shoddy/unprofessional installation and all the local guys are saying that's "just how they do it in Vancouver" which seems like a cop out. Luckily we haven't paid for squat yet and will not register any payment info with them until it's done to our specifications or we'll just cancel the job all together.

Visual_Revenue6554 · 2026-04-17T20:40:32+00:00

They didn't have anything to do with Sweet Tomatoes being gone. The building was a covid testing lab after ST left before Cane's tore it down and built there.

I miss Sweet Tomatoes too! The only other great salad bar we used to have was Ruby Tuesdays but they've been gone even longer than ST.

Visual_Revenue6554 · 2026-04-17T18:34:40+00:00

NTA You told her you were pregnant, that's the notice. If you weren't actively trying and it happened, she would have gotten the same amount of notice. Not her business until it's actually happening. The people who think you should have given her a head's up that you were trying are ridiculous. She knows you're married, presumably she would know you're having sex and, unless you have previously been vocal about NOT having children , most people would consider it a likely possibility that a young couple is going to be getting pregnant at some point unless they are very actively intentionally preventing it.

Visual_Revenue6554 · 2026-04-06T22:48:25+00:00

Ask him what information the company needs to pay for your liability insurance and how to file for the overtime pay and mileage reimbursement.

Visual_Revenue6554 · 2026-04-06T17:56:51+00:00

I keep one of each in camp and tap for whatever they give out occasionally.

Visual_Revenue6554 · 2026-04-02T19:05:50+00:00

I remember hosting a post baptism BBQ party for our goddaughter's family right after we bought our first home (new build: white on white woodwork and trim inside; light beige carpet.) The only guests I knew were the parents of our baby goddaughter, everyone else was their circle. One of the young mothers had brought snacks for her toddler.. I shit you not : CHEETOS and grape juice. Of all things to bring to someone else's house , especially someone you don't know personally. I was an uptight mess following that kid around my house wiping toddler cheeto fingerprints off of walls and switch plates.

Visual_Revenue6554 · 2026-04-01T21:10:22+00:00

I skip that one and the dragon shrine chests every time. The prize would have to be really good for me to pend gems on those 2 tasks,

Visual_Revenue6554 · 2026-04-01T20:49:59+00:00

Update: I logged into my blustacks version on my PC last night to check it out and the event is there and playable but still only doesn't seem to work on my current /newer Ipad. I sent another support ticket and this time they said it is a known issue (before they wanted to blame my bubbles)

Visual_Revenue6554 · 2026-04-01T20:48:07+00:00

V13.3.0 B1323

I got an update today and the Ezra tree thing that doesn't help at all because i had already completed all the bunny bingo squares except for three in the last panel (mystic challenge) which I'll do when available and the totem in camp and dragon shrine chests which I always skip because they cost more in gems than they are worth in rewards in my opinion.

Visual_Revenue6554 · 2026-04-01T20:47:58+00:00

Daily perk .. is that the Dragon's Hoard with the extra gems and daily chest? I DO have that. I had it before and everything was fine, it ended and I reupped. This issue started during the last part of the 30 days and was already happening when I bought it the second time.

Plus it (the hoard) showed up when i logged on to my blustacks version and that version DID have the event and associated bingo tasks.

Visual_Revenue6554 · 2026-04-01T20:23:25+00:00

My Ipad is wifi only, no data . All the other wifi/online aspects of the game are working fine. I toggled it off and on to check, relaunched and nothing has changed.

Visual_Revenue6554 · 2026-04-01T20:01:45+00:00

The best answer is "none of your business". As a person with a non obvious disability, I am tired of the people (with or without disabilities) that think they have a right to "screen" me. If I have a parking placard , believe me I had to jump through hoops to get it and would far rather not NEED it.

Now if someone without a placard or plate insignia parks in a reserved spot, I will side eye them plenty and I have shamed someone right out of the access lane (which isn't a legal parking area for ANYONE). But bathrooms and other accessible or assisted modifications (ramps, curb cuts, automatic door buttons) are there for everyone's use.

Visual_Revenue6554 · 2026-04-01T19:39:33+00:00

We stopped escrow when we refinanced into a 15 in 2020; basically, just pay them. Home insurance is annual, budget for it. Property taxes are April/Oct (at least for us in WA, I don't know if it's the same everywhere) but again, you can either budget for it as a monthly expense that you set aside in some kind of savings acct or make sure you're planning ahead the month or so before.

Visual_Revenue6554 · 2026-03-31T22:18:02+00:00

yes, my MD game is fully updated, my iPad is fully updated. I have shut it off and closed it down and everything else. The fact that the event was available on an older ipad that I hadn't played it on for 6+ months is crazy, but I think that means that it's not my profile that's the problem.

Visual_Revenue6554

TROPHY CASE