For the past year, Gina had been planning what was supposed to be the perfect getaway: a week of luxury, sightseeing, and hiking in British Columbia. The itinerary was flawless—half the week at the iconic Fairmont Empress in Victoria and the other half at the Fairmont Pacific Rim in Vancouver. First-class flights. Beautiful hotels. Great restaurants. A little romance. What could possibly go wrong?
Apparently… me.
Three days before our departure, I went in for my annual wellness exam. As a dentist who’s spent nearly five decades in healthcare, I don’t ignore checkups. I had an EKG, a complete blood panel, and walked out thinking I had earned another gold star for staying healthy. Fast forward to the moment our plane was taxiing down the runway. My phone rang. It was my primary care provider.
Her opening line was something along the lines of, “Your potassium is critically high. You’re on the verge of cardiac arrest. You need to go to the emergency room immediately.”
Timing, as they say, is everything. I politely explained that the emergency room was going to be difficult to reach since we were about thirty seconds from becoming airborne. Her final piece of advice? “If your heart even hiccups, tell the flight attendant to grab the AED and go straight to the ER in Vancouver.
Nothing spices up a vacation quite like being told to locate the defibrillator before takeoff. Fortunately, first-class Wi-Fi works surprisingly well. I forwarded my lab results to my son Mark, a physician assistant, hoping he’d tell me everyone was overreacting. He did not. Instead, he confirmed that the labs looked serious and told me to catch the very first flight back to the United States.
Now, I’ve worked in healthcare for 48 years. I know what critically ill people look like. I wasn’t one of them. I felt completely normal. My 12 lead EKG two days earlier had been perfect. My Apple Watch was blissfully unaware of any impending catastrophe. My Oura Ring thought I was doing just fine. To reassure myself, I recorded an EKG on my Apple Watch every hour during the five-hour flight. Every single one looked normal.
By the time we landed in Vancouver, Mark was already on the phone with Gina while we were clearing customs. She immediately shifted from “vacation mode” to “medical evacuation coordinator,” cancelling hotels, booking the earliest flight home, and locating emergency rooms. At that point, democracy officially ended. I no longer had a vote.
Early the next morning we were back on a plane headed home, and within hours I was checking into the Good Samaritan Emergency Department. When I handed the triage nurse my potassium result from three days earlier, things got exciting in a hurry. Within minutes I had two IVs in my arms, another EKG, multiple blood draws, an ultrasound, and enough people asking me how I felt that I started wondering if I was missing something. Four hours later, I was still laying there feeling perfectly healthy surfing instagram—although, admittedly, no one feels dignified wearing one of those backless hospital gowns.
Finally, the ER physician walked in with a smile. “Good news,” he said. “Everything is completely normal.” Every test. Every ultascan. Every lab. Normal.
His conclusion was that my original potassium result had almost certainly come from a hemolyzed blood sample—a lab artifact that occurs when red blood cells break apart after the blood draw. Since those cells contain large amounts of potassium, the test can report a dangerously high level even though your actual potassium is perfectly normal. In other words… I wasn’t almost dying. My blood sample was.
Looking back, the whole experience feels surreal. I lost a dream vacation, spent a day in the ER, terrified my wife and kids, and briefly became convinced that my next sightseeing destination might be the Pearly Gates. Instead, I got something far better. A clean bill of health. A renewed appreciation for modern medicine. A funny story to tell. And an unexpected week off work. Which, if you know me, could only mean one thing. It was time to hook up the boat, grab the fly rods, and head for Lake Margaret and Bidwell Ranch. After all, if you’re going to get a second chance, you might as well spend it chasing trout.
CHATGPT
It’s actually quite common. Hemolyzed blood samples are one of the most frequent reasons for a falsely elevated potassium result.
Here are some general estimates:
- 2–5% of all blood samples are hemolyzed enough to potentially affect one or more lab results.
- In busy emergency departments, ambulance draws, or difficult blood draws, the rate can be 10–20% or even higher.
- Potassium is one of the lab values most affected because red blood cells contain much more potassium than plasma.
Why does it happen?
It usually has nothing to do with the patient. It’s more often related to the blood draw or sample handling, such as:
- Using a small needle.
- A difficult or traumatic stick.
- Drawing blood through an IV catheter.
- Excessive suction into the tube.
- Vigorous shaking of the tube.
- Delay in processing the specimen.
- Keeping the tourniquet on too long or repeatedly pumping the fist.
Why doctors are cautious
A potassium of 6.3 mmol/L is high enough to raise concern because true hyperkalemia at that level can be dangerous. However, if:
- the patient feels well,
- the ECG/EKG is normal,
- kidney function is only mildly abnormal or normal,
- and the result doesn’t fit the overall clinical picture,
it’s common practice to repeat the potassium test immediately before concluding the level is truly elevated—provided there are no ECG changes or other signs requiring urgent treatment.
