#OurWorld: Every Two Seconds…

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For my first #OurWorld post, I thought it would be most appropriate to talk to you all about donating blood. As many of you know, I work at a blood bank. Not a day goes by that I don’t understand how fortunate I am to work there, either. I got this job in the dead of winter in Northern Michigan, the hardest time to find a new job (our state relies heavily on summer tourism). It also had a little something to do with a laboratory (my degree is in Cellular & Molecular Biology), so my degree wouldn’t go to complete waste. I walked through the building during my interview. Boss asked me how I was feeling. I shrugged and said, “It’s a lab. It’s a very comfortable, familiar environment for me. I’m not worried.”

“Are you squeamish?” he asks.

Flashback to about 18 years ago. I am a child, not even old enough to hunt yet. My father hands me the freshly removed heart of a deer with a gruff, “Hold this.” I’ve always been weird, morbid, and curious. I put my fingers into the ventricles and tip the heart over, spilling blood upon the ground. I found it utterly fascinating.

I sent a girl running away in tears. “She’s not normal!” she tells her dad.

“Nah,” I tell my boss. “I hunt deer.”

My job then was to take orders, pack and ship blood to hospitals. Our local hospital is sourced solely by our site. At first blush, it looks like a lab job. The moment it slides into routine, it feels more like a retail warehouse: take order, scan barcodes, put in box.

Until the phone rings when it isn’t scheduled to ring.

“We have an MTP.”

MTP stands for Massive Transfusion Protocol. It’s what happens when someone is on a downhill turn toward the end of their lives. It’s when a patient is fighting to stay alive and the hospital is in a calm yet insane scramble to do everything they can. In an MTP at our hospital, a patient could receive 15 units of red blood cells, 6 donors worth of plasma, 3 platelets, and 10 cryoprecipitate pools every hour. That’s 34 donors worth of life-saving products.

“We’re going to need 30 OPOS, 5 platelets, and 20 cryo pools as soon as you can get them here.”

Nothing feels better than calling back to check on the hospital and hearing, “The patient’s stable. We’re calling off the MTP. Thanks, Sam.”

Working in any kind of emergency medical situation is a humbling experience. I think that’s where a person is most human. Families cry, out of sadness or out of sheer relief. Emergency response personnel have set aside all personal affectations to focus on the task at hand: saving a complete and total stranger from the worst moment of their lives. I’ve learned two important things working for the blood bank:

  1. Although I am a self-confessed zealot of the “I hate people” club, somewhere, deep down, I truly love people and I go out of my way to do everything I can to help. When I look around at my coworkers, people who I disagree with, vehemently, on many things, at the core of it I’m seeing something else–no matter how much I disagree with these people, everyone who’s been there long enough is there for the same reason. We are all wholly committed to doing the most good we can for people who are, to us, complete strangers. We don’t know them, and yet we’re doing everything we can to save lives. No matter how I feel about my coworkers as people, they are one hundred percent redeemed by this shared principle in my heart. They are truly worthy of honor and respect, and I love them.
  2. Much in the spirit as above, no matter how often I have negative thoughts about humanity as a whole, nothing at all matters about a person’s character when you understand that they are dying and you are part of the solution to stop that from happening. If I knew the person dying, I might dislike them. But they’re dying…and none of that matters in that moment. I have to do everything I can to save them.

It’s a humbling experience. Even more so because it dawned on me one day that the donors fit this same mold. We have some avid donors that make their appointments like clockwork, even some who get upset when they can’t get in when they wanted. They come in to spend some of their precious free time literally bleeding for America, being the real heroes. They don’t expect recognition or money for this service. They only do it because they know it is right. People of every demographic do this.

Take that, labeled society.

Here’s a short video on the journey of a blood donation:

(I’m trying really hard not to be bothered by the fact that they aren’t wearing gloves, haha)

Now for some stats.

  • Fewer than 4 out of 10 people in the U.S. are eligible to give blood.
  • Fewer than 1 out of 10 people actually give blood.
  • Approximately 40,000 pints of blood are used each day in the U.S., about one every two seconds.
  • Approximately 1 out of every 7 people entering a hospital will need blood.
  • 1 donation can save up to 3 lives (plasma, platelets, red blood cells)
  • 3 teaspoons of blood can save a baby’s life.
  • It takes approximately 50 donors to save the life of the victim of a car accident.
  • It takes approximately 20 donors to help one burn victim.
  • Whole blood donors can give once every eight weeks.
  • Red blood cells last 42 days
  • Plasma can be preserved for up to a year.
  • Platelets last just five days.
  • At our center, you can give platelets once every two weeks
  • At our center, you can give plasma once every four weeks.

Take a second to appreciate what this means. There’s a high chance you could end up in the hospital someday. It’s nearly guaranteed someone you know will end up needing a blood transfusion at some point in your life. And yet, most people will never donate blood even once in their lives.

Why?

Here are some of the most common reasons people won’t:

  • “I don’t like needles”
    • As my husband (a phlebotomist [needle wielder]) is fond of saying, “Good. I’d be more concerned if you liked them!”
    • As I say (because I’m an asshole), “Yeah, but it sucks way worse to be the person in the hospital right now that needs what you’ve got.”
  • “My blood type is really common”
    • It is always preferred for a person to get their exact blood type, so we need blood in exactly the proportion it exists in the world. That’s:
      • 38% O+
      • 34% A+
      • 9% B+
      • 7% O-
      • 6% A-
      • 3% AB+
      • 2% B-
      • 1% AB-
    • All types have special purposes.
      • O- is the most commonly needed for trauma packs. It is known as the “Universal Donor” because anyone can receive this blood type, which is incredibly useful for a critical patient whose blood type is not yet known. For that reason, it’s often in short supply. People who are O- and have ever donated understand this, as it usually means their phone rings a lot, unfortunately.
      • A- and AB- are the only types that can give platelets to pediatric patients (babies and children). This is because plasma compatibility works the opposite way as it does for red blood cells. These people make up only 7% of the population in total, and platelets only have a shelf life of 5 days. Our hospitals take three of these units a week because they have to have one on their shelf constantly in case it is needed. No one wants to be responsible for the tragic death of a child or infant.
      • B- is the rarest of the red blood cell units that are usually needed (there are few AB- patients, and they often will receive a compatible type instead).
      • O+ and A+ we honestly just use A LOT of. PLEASE donate.
      • AB+ or AB- are critical donors for plasma. AB plasma is the “universal donor” of plasma, which is often used to bring up a patient’s blood volume and is also useful for burn patients. This, too, is often in short supply.
      • Plasma in general: every type is always needed for plasma. Plasma stays in the freezer for up to a year, so no matter what time of the year it is or what blood type you are, this is something we will always need.
  • Most people don’t give blood because they simply haven’t been asked. So, I’m asking you now: will you please find the nearest donation center and find it in your heart to go in and donate blood?

Some other facts most people don’t know about giving blood:

  1. When you donate, you’re donating “whole blood.” This is seldom, if ever, given directly to a patient. Blood contains critical components of your immune system unfiltered, so giving it to another person can cause harmful, life-threatening reactions. In the lab, we spin whole blood in a centrifuge to separate whole blood into red blood cells, platelets, and plasma and filter the white blood cells out of your blood in a process called leukoreduction. Giving whole blood only takes about 10 minutes once there’s a needle in your arm. The entire process, from registration to cookie-nomming, takes about an hour.
  2. Platelets only have a shelf life of five days, so we need these constantly. You can give only platelets by utilizing a process called apheresis. This takes blood out of your body, spins it inside the machine, removes certain components from your blood, and puts the rest back. Giving only plasma or platelets is easier on you if you’re the kind of person who reacts badly to giving blood. Reactions typically occur because you’ve lost your red blood cells. Apheresis lets you keep all of your red blood cells.
  3. When you sell your plasma, that is not plasma that goes to a patient. Plasma at these centers is used for research and drug development. It is a safety concern for the patient and regulated by a bunch of high-up regulatory institutions like the FDA. Patient safety is our number one priority. It’s much harder to guarantee that when you are paying your ‘donors’ for their blood products. (On a side note, it’s incredibly upsetting when someone comes in, asks if we pay for plasma, and then leaves when they find out we don’t. We’re here for the patients. It’s very hard to separate one’s emotions when you watch a lifesaving donation literally walk out because you won’t pay them to be a hero.)
  4.  It really doesn’t hurt all that much. It’s less painful than a bee sting. Most people that ‘react’ to the donation react for the following reasons: they haven’t seen blood before and it freaks them out, they haven’t eaten enough food/drank enough water, they psyche themselves out, or it’s their first time donating (it’s a bit of a shock to the body that first time). All trained phlebotomists know how to handle this situation.
  5. The ‘Baby Boomer’ generation has been an excellent source of blood donations for many years. However, they are now reaching the age where they are in need of more blood than they give. The newer generations have not been as regular. In my opinion, I think it was not made into a big enough deal when it mattered most. Blood donation has mostly fallen off the radar of busy adults with things to do. It simply doesn’t make it into our list of priorities.
  6. Most of our blood comes from the aforementioned Boomer generation, and most of the rest of it comes from high schools. That makes summer a very hard time on blood supply. The schools are out for vacation and we have a huge void to fill in their absence.
  7. Holidays are also a rough time for inventory. People spend time with their families and don’t make it in to donate as much. With the platelet inventory having an expiration date of five dates, having enough inventory on hand is incredibly delicate and the holidays are a hard time.

Apheresis

As I mentioned above, apheresis is a process that draws blood from a donor, separates it into it’s specific components–plasma, platelets, red blood cells–and puts back what is not needed. We can take any combination of platelets, plasma, and red blood cells. What we choose depends on your Complete Blood Count (CBC)–a measurement of the makeup of your blood–and your height and weight. This is an awesome procedure. Here are a number of reasons to do this:

  • I have a ‘boring’ blood type–A-positive–but my platelet count is awesome. With apheresis, I can give three units of platelets at a time, and I can do this every two weeks! Giving platelets can take anywhere from 45 minutes to two and a half hours depending on your CBC.
  • Giving a ‘double red’–the equivalent of two whole blood donations worth of red blood cells–gets you off the eligibility list for 112 days (16 weeks). This is awesome if you’re one of those rare types and you’re sick of the phone calls but still want to do some good in the world. This process takes about a half hour.
  • You can give plasma every four weeks! This only takes about an hour.
  • While you’re on the donation bed, they give you warm blankets and will talk to you for as long as you are there. You could also just put in an episode of House or catch up on some reading. It’s quite comfortable. I like to pretend I’m being pampered. Sometimes they give you tums (I call it candy). Afterwards I get cookies and juice.

I hope that I’ve affected you in some way. I know that since I started working here, my perspective on life, the world, and humans in general has changed drastically. I get teary-eyed when I hear sirens. I’m legitimately upset when someone in my community loses their fight against adversity. I’m angry when someone does something stupid like blasting through a stop sign and people are killed. There are good, selfless people that do amazing things without ever asking for a thank you. They deserve all of the credit.

The donors are the real heroes. Not all heroes have capes.

Please share this post to spread the word. Perhaps doing this will lead to even more lives saved, and that is a very good thing. Much love to all human beings.

S.K. Balk lives in the frozen wasteland of Northern Michigan. She is the author of the dystopian medical sci-fi THE BLOOD OF NERYS.

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About oneofthedragons

Samantha K. Balk and F. R. Donaldson met on An Archive of Our Own, one of the many fanfiction sites online, when Sam asked Frankie to illustrate the fanfiction that would one day lead to Sam's first novel. They've been friends ever since! This blog was created as a way to share the oftentimes difficult journey any new author experiences on the uncomfortable quest of an introvert for attention to his or her most personal work. It is meant to remind you that authors don't just appear fully fledged like a George R. R. Martin, that all of us start out unsure and feeling inadequate. Feel free to ask us anything. Sam: sammykaye9@gmail.com Frankie: reluctant.fraggle@gmail.com

Posted on May 25, 2016, in #OurWorld, Updates and tagged , , , , , , , , . Bookmark the permalink. Leave a comment.

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