Thursday, April 17, 2008

Blood donations

I went yesterday to have some blood drawn for testing, and it led me to remember other times when I had blood sucked out of me.

I started donating blood many years ago. I think my first donation was when I was in the Navy, even though they said it was something you could volunteer to do for some reason anytime that is said when you are in the military means that everyone is expected to. Well, you didn’t have to, but those that didn’t were usually permitted to clean out the toilets with their toothbrushes or engage in other similar activities while the rest of the guys went off to donate. It was also something expected of sailors, because if an emergency happened when out at sea blood would probably be required, and there is no local blood bank to call on when out in the middle of the ocean except for other people on the same boat. When in the military you always have to be prepared for bad things.

When in college the Red Cross would come through with campus blood drives periodically. I usually signed up, and I remember one session in a high ceiling room full of cots, where the organizers had put posters up on the ceiling for you to look at while you were laying down.

It picked up again when we moved to San Diego. For some reason I felt it would be nice if I donated something; I put some time in at Father Joe’s Vincent de Paul shelter but that took too much time, and I had a problem putting up with some of the people we dealt with. So I figured donating blood would be something I could do to ‘give back’ to the community. I started hitting the San Diego Blood Bank on a regular basis. Full blood donations were limited to one every six weeks, and I made an appointment for my next after every draw.

After going in a few times a nurse suggested that I sign up as a ‘Super Donor’, using an apheresis system for donation. Inquiring into this I found it entailed being tied to some type of machine for two hours that extracted platelets and different blood components, rather than giving whole blood, and that I could donate every two weeks instead of every six. This sounded like such a marvelous offer that I just could not refuse it. At the time I was running my own consulting business, and thus could set my own schedule and take time off in the middle of the day for things like this.

The San Diego Blood Bank is in a four story building that was close to downtown. Standard blood donations were taken on the first floor, but the super donor center was up on the top floor. Large windows wrapped around two sides with marvelous views of the bay and downtown. Instead of laying on a cot for fifteen minutes staring at the ceiling while blood drained into a plastic bag you were in a fancy chair with TV sets on the opposite wall while you were hooked up to a device that looked like a washing machine. A needle was inserted into each arm; one pulled your blood out and fed it into the machine, which then did some magic and extracted specific components, added a little saline solution, and then fed it back into you via the other arm. Depending on how the machine was set and what components were extracted you could be hooked up for between and hour and two hours. Since the standard location for inserting needles for blood donation was the inside of your elbow and you had a needle in each arm this meant that you could not bend your arms for the entire period: no nose scratching, no adjusting earphones, no turning pages in a book, not much movement at all.

The process started out with the same interview given before every blood donation. It was the same stack of questions: have you visited an area where malaria is present, have you injected any drugs, do you feel well today, have you ever been to jail, have you ever had sex with a man, even once, and on and on and on. They never changed the order of the questions, so you eventually got used to the same sequence of no, no, yes, no . . . and when a new question was added it threw your whole memorized path off. Eventually they approved a new procedure for regular donors where it changed to ‘since your last donation’ and then to just a single ‘any changes since the last time’ which made the Q&A part a lot faster.

There was a big cabinet filled with videos, and you would normally pick one out to watch while hooked up. Most of the time the movie ran for ten minutes longer than the draw took, so you usually just missed the end; it didn’t matter what video you picked, I think the machines were calibrated to the videos to go just a little quicker. But I did see a lot of old movies (what, you think they had the latest releases?)

The apheresis machines did not work on a continuous basis, they extracted some blood from one arm, then went through a small batch procedure to perform the extraction, then mixed in some saline solution and anti-coagulants and then shot that batch back into you in the other arm. Many people had a strange reaction to the anti-coagulants that were added, for me it just made me feel tingly all over and cold. The cycles seemed to take several minutes, you couldn’t hear any difference between phases, but I just noticed that strange feeling when the blood mixture was pumped back in.

At that time the machines could be adjusted to take an assortment of components; I believe they were platelets, plasma, white cells, red cells, or a combination of any two or double of one. Usually they asked how much time you had, and tried to talk you into whatever took the longest to extract, as that was usually what they were in short supply of. Since I usually booked my session and scheduled other activities around it I normally just let them take whatever they wanted. Evidently I was a good platelet provider, so they usually extracted that component.

I don’t know if it was just a line used to keep you coming back, but at that time supposedly there was extensive blood testing and matching, and I was told that I was a very good match for some young girl with cancer that required frequent platelet transfusions. So each time I came in and donated the usual procedure was for the nurse to come by with the appointment book to schedule me for my next donation, with a little comment about how nice it was that I kept donating and how that poor little girl’s life depended on my coming by regularly. Well, it worked, along with my wanting to do something, so I kept going back. By the time we moved from SD to Vegas I got my name on the wall for having more than 80 donations. The top name on the wall had several hundred, so I had a way to go. I don’t know if the number of ‘regulars’ in San Diego has pushed me down the list and off the wall, I haven’t been back to look.

Over the years there were equipment changes, and eventually there was a switch from using a needle in each arm to using just one needle, with double piping which let the machine put blood back into the same arm it was drawing from. The internal extraction process also was improved, so it took less time for the overall donation and I wasn’t stuck there for over two hours each time.

One of the benefits to me of donating was that I discovered I had a high blood pressure problem. Several times when I went to donate I was turned down because of high blood pressure. This led me to find a doctor and try to figure out why my pressure was so high. After quite a few tried with different prescriptions a combination of drugs was found that brought my pressure down to the recommended levels. I’m told that this is a good thing, especially since almost all of my relatives have died from heart problems. And now many years later it seems that I have lived longer than all of my uncles on both sides.

So when we moved to Vegas I thought that I would continue the donation tradition. I went down to the blood bank that was not too far from my house and gave a regular full blood donation, and checked out the super donor program. When they heard that I donated frequently back in SD I was quickly signed up for their program. Unfortunately it seemed that the people performing extractions at this location were not the highest quality people available. The San Diego Blood Bank used nurses in the apheresis unit, and they were all pretty good at sticking needles in you. I evidently also had good veins, as there were needles going into both arms every two weeks, but I was told that my veins ‘rolled’, or moved when attempting to insert the needles. I don’t think that all of the people sticking you here in Vegas are nurses, and some are not very good at their job.

The equipment used for platelet and cell donations has changed greatly. Instead of a big washing machine sized device it’s now down to suitcase size, and the extraction is a lot faster. At the local location here whole blood was extracted at about a dozen chairs in the front of the room, more explicit donations were in a half dozen chairs to the back.

The second time I donated I was stuck by someone that did a pretty poor job. As usual, I told her that I was told my veins rolled, and to be careful. Usually the nurses appreciate being told this and I assume that they work a little differently, perhaps holding the vein down or something (please, tell me if it makes a difference if you know). Usually needle insertion is quick and you just feel a short sting. This time was a little different, it hurt and I heard an ‘uh oh’. Not a good sign. Evidently she missed the vein, or went through it or something. She then proceeded to move the needle around while stuck in my arm, trying to hit the vein. This procedure was very painful. After about a minute I told her to stop and pull the needle out as I had enough of the poking. (OK ladies, no snide sexual comments here). I didn’t want her to try in my other arm, or have somebody else try, I just left without donating.

The next day my arm was swollen up to twice it’s normal size, and I could not bend it. There was a huge bruise inside my elbow where she was working. I was not pleased, and called the blood bank asking what to do. They just suggested applying an ice pack (should have told me that right after she butchered me) and waiting to see if it went down. It took several days for the bruising to recede and the swelling to go down. This hindered my computer keyboard activities, and I did have some things to for clients.

I waited a while to go back. I did go back for a whole blood donation but then when the same thing happened to me again while up in the front donation stations I figured that at that point the negatives were overcoming the positives in the entire process and I just stopped going. I did donate several times when I was working at places where a bloodmobile came by, but I haven’t been back to that donation location since.

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