Autologous Blood Donation

[briarrose]

Thanks again everyone! I decided to skip out on this last donation. I'm feeling a lot better today, but I still think it would be better to just forget about it. I don't mind receiving donor blood. It sounds safe.

Sherie - Thanks for sharing your experience. It helped me to make my final decision.

Sally - That's really interesting that people who give blood end up needing more for the surgery. Why do they even have us do it? I know that I want to give blood a few times a year now to help out other people with their surgeries.

Pam - Thanks so much for doing all of that research. My doctor did say red meat has the most bioavailability of all foods and even supplements. It's hard for me to eat it though. I didn't realize I would need to cook the spinach. It will probably get slimy. Yuck! I may forget about the molasses too. It sounds so gross. Your info was very helpful and I'm sure others will find it useful as well. Thanks again!

[Susie*Bee]

Good for you, Shell-- you've got a good plan.

Pam--that was good of you to post all that iron info. I had researched it a lot last spring, when I needed it... but of course didn't know about the forum or getting info from anywhere except by weeding through all I could find on the internet. As far as molasses goes-- I'll take blackstrap over cough syrup, if I have to take it as a medicine. I love molasses sugar cookies--and so does my family. They are made with a lighter molasses, mixed with plenty of other ingredients... But I agree, I don't think I'd like it on my food very much. One teacher at school said "YUM!" when I explained I was taking it... she eats it on biscuits, hot cereal, etc. It must be an acquired taste that neither of us has acquired... But still, it was do-able to take it by the spoonful (2 T) each evening, knowing it would help me. And my hematocrit did shoot back up to a donatable level.

Sally-- do you really think there's a correlation between amount of blood donated vs. needed, that has to do with being depleted rather than length of surgery and procedures being performed and all? My surgeon was sure I'd need at least 3 or 4 units or more, based on what he was going to be doing. And I did, even with the cell saver blood-- ~500 cc of that. I lost ~1800 cc. during the surgery. Or is it like comparing our surgeries? In the books I read (Wolpert and Neuwirth), most of the surgeries aren't as long (both extent and time-wise) as what many of us go through. So, many spinal fusion surgeries would not be as demanding on our blood supplies. Just wondering out loud here. But that might be why some that only required 2 units only used 2 units, etc. Those surgeries weren't as demanding...

[loves to skate]

loves to skate

Good for you Shell. You will be just fine for your surgery. I think that the Dr's order autologous blood donation to help out with chronic shortages in the blood supply. Also, people started to demand it because of fear of bank blood. At that time, it was justifiable because 20 years ago, people were getting HIV and HEP C from blood transfusions. Testing of bank blood is much more extensive now and the questionairs rule out many people who are at risk of having HIV and HEP C that don't even know they are at risk.
Pam, you are a wealth of information, plus being computer literate helps.
Susie, We used to get little old ladies in their 80's coming in to donate blood for total knee surgeries. We almost always ended up rejecting them because either their blood counts were too low or their veins too fragile or they were too anxious about donating, etc. You don't want to go into surgery with your veins destroyed because a nurse or tech had to fish around to try to get blood from delicate veins with a needle the size of a crowbar. Our hospital is a community hospital where mostly general surgery is preformed along with total knees and total hips, and the bloodiest being prostate surgery, so my experience is limited. But generally speaking, if you go into surgery with low blood counts, you will probably get back what you donated plus more and it will take you longer to recover. Scoliosis surgery in my case was a very bloody surgery even though my surgeon is very skilled. So even though I didn't donate, I still needed 8 pints between the two surgeries. They were very long surgeries, 12 hours for the posterior and 7 hours for the anterior. I think you are correct that there is a correlation to the length or the surgery and the amount of blood needed.
I hope I haven't freaked anyone out. Donating is great, just don't let your blood counts get too low. Sally

[txmarinemom]

Pam--that was good of you to post all that iron info. I had researched it a lot last spring, when I needed it... but of course didn't know about the forum or getting info from anywhere except by weeding through all I could find on the internet. As far as molasses goes-- I'll take blackstrap over cough syrup, if I have to take it as a medicine. ...

Yeah, if I needed it as "medicine", I'd have to choke it down too - LOL. I'm thinking a I might create a new thread that with just that post incase it might be of help to others in the future (title it something like "Boosting Hemoglobin Pre-op") and add some keywords to make it more likely to turn up in search results. All this info we never asked to learn might as well be documented, eh? ;-).

Sally-- do you really think there's a correlation between amount of blood donated vs. needed, that has to do with being depleted rather than length of surgery and procedures being performed and all? ... In the books I read (Wolpert and Neuwirth), most of the surgeries aren't as long (both extent and time-wise) as what many of us go through. ... Just wondering out loud here. ...

I know you addressed this to Sally, but it's an interesting question, and one I don't believe I've seen addressed here before. (and, geez ... I figured we'd covered it ALL - at least once - LOL!)

It seems to me that the closer to surgery you donate, the more likely the amount donated - and subsequently transfused - would be proportional (simply because your body hasn't had time to replenish the amount). In a healthy state, your body rebuilds most blood components pretty quickly: As you know, however, it's 8 weeks to completely restore components *and* volume.

Unless they freeze your pint(s), 30 days (at least as practiced by my doctor for autologous donation) pre-op is the earliest you can donate, and Hanson doesn't like it any closer to surgery than 10 days.

It stands to reason that losing more than a pint pre-op in that 30 day window (so much shorter than the normal donation interval) would almost guarantee you'd need it run back in during/after surgery to compensate for the loss.

My surgery - a "baby fusion" compared to some here - only lasted about 4 hours (if that). I didn't need the pint I donated during surgery (they were able to get by with recycling), but I got it afterwards. According to Hanson, my counts were so ~slightly~ off, if I'd not donated he wouldn't have even considered pulling from banked blood.

It really wouldn't surprise me if my counts were off because I donated about 16 days before surgery. With my size, I'm sure my body was still in deficit. I lost very little blood during surgery, and I think they only emptied my drain line collection twice afterwards.

All THAT considered, I also wouldn't doubt there's a correlation between blood loss/transfusion volume required and length/extent of surgery.

Those of you who've not only endured but thrived after A/P approach surgeries (and in some cases *several* A/P surgeries) have always left me awestruck. I suppose we all do what we must, but I have *such* a hard time even trying to fathom how I'd withstand two surgeries so close together: Just a posterior approach was trying enough.

The severity of the surgery (and "bonus" procedures like thoracoplasty) surely has *some* weight in the likelihood - and estimated/actual volume - of transfusion, IMHO.

That really is an intriguing view, however (that the amount donated is tied to the amount needed afterwards) ... and one that probably has quite a bit of merit. It does seem reasonable to assume some - if not all - of the blood donated pre-op will need to be returned at some point to right the deficit, you know?

Regards,
Pam

[Susie*Bee]

that bloody topic...

Here's a little more to muddy the waters... and no, I am not intelligent in this whole area, so I'm just looking and sharing...
(See what you started, Sally?)

Here's a link to an interesting article on pre-operative autologous donations (PAD):

http://www.uptodate.com/patients/con...LSZZIhWGhqlyA5

It includes this statement:
"An additional benefit is that erythropoiesis may be stimulated by repeated phlebotomies, thereby enabling the patient to regenerate hemoglobin at an accelerated rate after surgery."

But it also says: "The overall efficacy of PAD has been evaluated in both randomized trials and cohort studies [1] . A meta-analysis found that patients who underwent PAD were much less likely than controls to receive allogeneic blood (odds ratio 0.17) but were more likely to undergo any transfusion with autologous and/or allogeneic blood (odds ratio 3.0) [2] . The latter effect is due both to a lower hematocrit in patients undergoing PAD and a more liberal transfusion policy with autologous blood."

What I say is "Hey, whatever works for you will be fine!"

[txmarinemom]

What I say is "Hey, whatever works for you will be fine!"

Agreed. Some will always be hesitant (questioning the safety, religious reasons, etc.) about blood bank transfusions. It's a personal decision.

It doesn't bother me one bit, but unless I have surgery FOR someone (you know ... assuming science figured that out - and 'cause it was SO much fun - LOL!), it isn't my call .

Pam