a dilemma

[lagilman]

*sigh* Among the mail I got this weekend was a letter from Mass General Hospital. Not the first letter I've gotten on this topic, but it hit me at a time when I have no excuse but my own hesitations*.

See, I'm CMV-negative. Which means my platelets, in addition to my blood, are much in demand, specifically for premies and people with compromised immune systems.

Yeah, I give blood regularly -- I received transfusions when I was a kid, and this is the only way I know how to say thank you for that. But I really dislike doing it -- I don't recover easily, and just the sight of a needle makes me woozy. And apheresis? Takes two+ hours, one needle in each arm.

But.... my physical and emotional discomfort for a couple-three hours, against someone having access to 'safe' blood...

Damn it. I shouldn't have to think about this. But I do.

Anyone out there actually gone through platelet apheresis?



*usually I'm sick, or stressed from deadlines, or etc. Right now I'm healthy, working-but-not-that-stressed, and could manage to get the time off to do it, either there or a more local hospital.

Comments

[wishwords.livejournal.com]

How do you find out you are CMV negative?

ritual disclaimer: this is just what they tell me...

[lagilman]

The hospitals started coming after me a few years ago, after I donated, so I guess that's where someone checked off a ticky box on my chart. It's not something they test for in routine bloodwork because it's not a consideration for healthy adults (about 75% of the population is CMV positive and never knows it, because it's not an issue).

Re: ritual disclaimer: this is just what they tell me...

[neko-san.livejournal.com]

Yeah. My understanding is they don't bother for routine bloodwork, but they test every unit of blood donated (along with a slew of other things).

[elaine-brennan.livejournal.com]

One of my housemates regularly donates platelets. I can ask him to email you if you'd like. If you were still around Lunacon, I could put the two of you in the same place, but I suspect email will have to do!

[lagilman]

that would be lovely, thank you!

[mstein609.livejournal.com]

Hi, I'm Elaine's aforementioned housemate.

I'm also eagerly sought by the Red Cross vampires - O+, CMV-, lots of platelets. I was recruited for platelets in the '80s because I have good veins in both arms. They did first-level HLA typing; on rare occasion there are people who have trouble accepting general platelets and need platelets that are matched to their tissue type. I've been called three times for a tissue-matched donation. At the time I was recruited, they were just getting started with HLA typing, and IIRC they had funds for an initial pool of 5,000 for the region. I believe they now check your HLA A and B sites as a matter of course. (I was once called in for second-round testing as a potential marrow donor, but turned out not to be a good enough match.)

As others have already mentioned, there are one-arm machines where the same needle is used for both draw and return. For smaller people the two-arm machines usually produce a higher platelet yield, but you can ask them to try you on the one-arm machine if available at your donor center. The one-arm machines will permit you to read; for the two-arm machines you'll have to listen to your iPod or watch a video. (You can bring your own if you like.)

The needles for apheresis are smaller than those used for whole blood donations. However, they do still like you to have good veins. It's important to drink lots of fluids during the 24 hours before donation; it helps to keep the flow going. Unlike whole blood, which requires eight weeks between donations, platelets can be donated every two weeks. While in theory you can give platelets fairly soon after a whole blood donation, in practice few people recover iron levels that quickly. (For reasons nobody has been able to explain to me adequately, apheresis donors must have the same minimum hematocrit level as whole blood donors.)

At least one other person has mentioned the tingling lips; they'll give you Tums to help with that. Wear something warm; some people tend to get cold (since the return fluid is below body temperature) and this in turn creates a greater chance of the draw vein contracting and restricting the flow. They also have blankets to help with that.

The only real problem I've ever had is that twice (out of at least 40 platelet donations) the return needle has slipped or not been inserted correctly, and fluid went into the tissue instead of into the vein. If this happens, you'll feel some pressure and probably a slight stinging at the return site. Tell them immediately if that happens. If you have a good second vein in the arm, they can try it again there.

My Red Cross region gives out T-shirts (large) and in addition has frequent programs for apheresis donors where two donations in a quarter gets you a $5 Starbucks or other gift card, a third donation gets you a $10 gas card, and a fourth gets you entry into a raffle and an invitation to a donor appreciation luncheon. But the real reward, of course, is knowing that you've helped a cancer patient, trauma victim, or transplant recipient to recover.

[vcmw]

I admire anyone who gives blood at all. I tried to ease my way into it once by volunteering at the blood giving tent handing out snacks to the post-donees, and I had to go put my head down in the hall.

So I guess I meant to say I think you're brave whichever way you decide.

[lagilman]

Bloodletting is actually more disturbing to watch than to undergo, in my opinion. Queasy-making, yeah. Also, the aroma of antiseptics, bandages, and nervous sweat? Rightfully freaks a lot of us out.

And I'm not really brave -- I make the vamps distract me through the entire process, just to survive (I passed out once, when I made the mistake of looking at my arm, which made the donation useless).

[vcmw]

Thank you very much for your comment and the thread - I think it will give me the courage to actually try to give blood next time my work has a drive. Usually when I say I find the process scary folks just say "it's not really that bad." Hearing someone say "it freaked me out enough that I passed out, but I do it anyway" is oddly much more encouraging.

[lagilman]

Hah. Ask delkytlar about his experience at the Penguin blood drive many years ago....

*adjusts halo*

[marinarusalka.livejournal.com]

Anyone out there actually gone through platelet apheresis?

I've done it twice. It's very boring -- bring some music or, better yet, an audiobook. On the physical side of it, all I got was a tingling feeling in my fingers and a weird, unpleasant taste in my mouth. But it's hard for me to advise other people, since I'm unbothered by needles and never have any of the discomfort that most people have when they give blood.

But the thing about platelet donation is, you don't actually lose any blood, so any weakness or dizziness you might normally get from that shouldn't be an issue.

[neutronjockey.livejournal.com]

I made the mistake of giving blood once then going out later that evening for a round of drinks with the fellas.
I was a cheap date with one less pint of beer in me. ;) Pint of blood! Blood damnit. I'm not as thunk as you drink I am.

[lagilman]

we do warn people giving blood at conventions that they need to rethink their usual con-going bar experience...

Sometimes they listen. More often they don't.

[seimaisin.livejournal.com]

I give platelets on a regular basis - I was once told I have "enough platelets to clot a small village", so I figure giving some of them away occasionally won't hurt. ;) For me, it's mostly tedious, but someone donated a bunch of portable DVD players to my Red Cross a few years ago, so I can use the 2-3 hours to catch up on TV episodes! Physically, I feel a little tingly throughout the process - they feed me Tums every once in a while to keep up my calcium - but afterwards, it's a lot better than simply giving blood, I don't feel so completely wiped out when I'm done.

I'm not a person who's bothered by needles, so you can take that into account. But, needle stick aside, I don't find that apheresis causes that much discomfort for me! Mostly, it's just a couple of hours spent in a chair watching TV, with better results than when I spend those two hours on my couch at home. :)

[lagilman]

Yeah, it's my reaction to needles that is worrying me most of all -- I can distract myself (or be distracted) for the relatively short duation of a vamp-drain, but a longer time frame, and not being able to look at either arm.... ugh. Beside being embarassed when I pass out, I don't wnt to waste their time/efforts, either.

[seimaisin.livejournal.com]

For the visual part, I don't know if this is something that would help you or not - but, they focus a lot on keeping you warm while you donate, so they bundle you in a lot of blankets. Usually, the first thing they do is cover up my arms, so I really can't see anything at all. I don't know if that would make things easier for you or not!

But, I understand your problem. I know a lot of people who have tried to give blood, but just leaving the needle in their arm for even a short period of time has been too much. It does make the whole process hard on everyone!

[jonquil.livejournal.com]

One of the things I found, by the way, is that apheresis helped me get *rid* of my lifelong needle phobia. Your mileage may vary, of course.

But you don't HAVE to do it.

[spiziks.livejournal.com]

You may read each comment below with the heading you prefer. Select carefully, according to what will help your mood:

SYMPATHETIC
Yuck! I've done this, and it creeps me out, too. The only way I can survive it is to keep my eyes screwed shut the entire time and pretend I'm somewhere else.

COGNITIVE
It's often difficult to overcome this kind of gut reaction. An MP3 player helps, and maybe a sleep mask so you can't see what they're doing. Dab some vanilla or scented oil under your nose to ward off the antisceptic smells.

DRILL SERGEANT
You can save a life and you're sitting here muttering about a little discomfort? Suck it up! Get your furry meerkat butt down there now!

We are pleased to be of service.

[greatsword.livejournal.com]

I've done platelet donation. I don't know if I can help with the fear issue, because my reaction to being hooked up was curiosity, not fear. There was a bit of discomfort with the idea of having stuff pumped back into my arms - I have no issues with blood being drawn, thogh.

I can recommend not doing this on an empty stomach. Between no pre-donation coffee and no food, I was a bit woozy during the donation.

[jonquil.livejournal.com]

Apheresis has changed. When I started doing it in the 1990s it was a needle in each arm; by 1999 or so it was one needle in one arm. So you have the other free to turn pages.

Any decent apheresis center will also have a monitor hanging over your bed so you can watch TV. I brought a "Sharpe's" video and wound up with nurses making extra visits to my bedside. *g*

[lagilman]

Hrm. In the description I was given just a year ago, they took it out of one arm and returned it through the other....

Having only one arm out of commission for the duration would certainly help, yeah.

[jonquil.livejournal.com]

Hmm. I'd call and ask if they do single-needle. It made a big difference to my comfort.

[house-draven.livejournal.com]

Anyone out there actually gone through platelet apheresis?

writerkatie goes about once a month. She's not crazy about the process, but she said they recently changed the procedure so it was much more comfortable, and they've set up DVD players for each station.

[neko-san.livejournal.com]

I need to think about trying this again, too (O+, CMV-). The last time i did platelet donation, back before 2000, it was the "needle in each arm" thing. Even though my platelet count was "okay", I was hooked up to the machine for the max amount of time (2 hours? 3 hours?), and they just BARELY got enough for a unit. (They had a discussion if it was enough to use, or if they've had to toss it/use it for research for being too small.) There was this big guy who was next to me, and they got two big units from him in 45 minutes, so i felt kind of useless. They also had to hit me with (calcium?) every 15 minutes, since i kept on getting the uncontrollable shakes, and i was still cold under 5 blankets.

The blood center i go to now has the one-needle machines, with a TV/DVD at each station. They've been pestering me to do platelet donation, so i really should try again. FWIW, i'm also short (4'11.5") and weigh around 117 (i'm large framed). They claim my platelet count is high enough, but...

[otterdance.livejournal.com]

I don't think you have anything to feel guilty about; you're a regular donor and I admire that.

In recent years I haven't. I'm an ideal donor: needles don't bother me, I don't mind the process, my veins are a phelobotomist's dream, and I bounce back quite quickly. But every time I go in the past few years, my iron levels aren't high enough. Technically I'm not anemic, but the levels I do have wouldn't be beneficial to the people who need blood. I got really frustrated waiting for hours, filling out all the paperwork and then being sent away. It's been a while, and I need to go try again, but in the meantime I give $$.

[neko-san.livejournal.com]

For what it's worth, I used to be on the borderline for iron, and was turned away once. What really made the difference taking a full dose of multivitamins every single day. I used to take them "when it occurred to me", which was about once every other day, for two-pills-a-day vitamins. Since I've been really careful to keep taking those vitamins, i haven't had a problem with iron. YMMV. =)

[lyonessnyc.livejournal.com]

Hi! Popping by, as promised. Great seeing you Saturday -- where are you hiding your aging portrait, damn you? [g]

That said, I used to donate plasma fairly regularly. The process I went through only involved one needle -- they removed the blood, centrifuged it, and retransfused the formed elements mixed in sterile saline. They also took platelets once in a while, and there wasn't any change in technique. I tried to make sure they stuck my off-arm so I could use my right to hold a book, but an audiobook or DVD (if they have players) would be fine too. Sometimes, I'd sleep, but they got stricter on that after a while. (Gee, I wonder why...)

[lagilman]

where are you hiding your aging portrait, damn you?

Clean living and a lot of sleep.

(Hey, I typed that with a straight face!)

Genetic lottery, seriously. My dad, at 77, is only now starting to look his age, and my mom could pass for a decade younger than she is.

Thanks for the info about platelets. I've been given info about someone who needs my blood type, but they don't need platelets just yet (thankfully) so I'm keeping myself in reserve for now. Can't donate blood again for another month....