Sunday, April 18, 2010

Donate Blood: It's a Positive Experience

As the daughter of a man who has given close to 8 gallons (yes, Gallons) of blood over the course of his life, I've become a believer myself in the value and importance of donating blood.
For some reason, I used to go along with my dad to donate blood. He did so every 56 days at the City Hall, or wherever the local blood drive happened to be. I'm not sure whether he asked me to come along to encourage me to one day do the same, or If I went with him because I was just bored. In any case, when the time came for me to make my own decision, (as a senior in High school, at the High School Blood drive,) I decided to give. I've given about 12 pints now, to date. I've been turned down a few times because my iron was too low, or because I've traveled to places where there was a Malaria Risk. I'm disappointed when I get turned down. I think My Dad was too. He's been permanently turned down now because these days, he's chronically anemic. Giving Blood is how he found out he was anemic.

My youngest child Avery was anemic once too. Life threateningly anemic. But we didn't know it until one day, when we were on a cruise ship in the middle of the Gulf of Mexico. We woke up that morning and were eager to go to breakfast. Our kids, in the room across the hall from us weren't ready to go. But Avery had gotten up and said she'd meet us upstairs at the restaurant.

We went to get our coffee, as we had become accustomed to doing, and had just sat down at one of the tables along the window, when our friend Cam who we'd been traveling with, came to us, telling us that Avery had collapsed. By the time we got to her side, a medic had already arrived, and had gotten her into a wheel chair. A waiter had seen her collapse, and had gone to her side, alerting the medical center five floors below to come to her aid. Our friend Cam had been nearby, and observing the commotion, had come near, only to realize it was Avery, a child he had known since her birth.

The Nurse, whom we soon came to know as Constantine, asked her some questions:
How long had it been since she'd last eaten?
Had she had many fluids yesterday?
Had she been feeling well?
When had she started to feel not so well?

Avery's Complexion was a combination of green and gray. She was staring blankly, but responding to Constantine's questions. She told him that she had fallen down twice on her way upstairs to the dining hall, after she had gotten off the elevator.

He told us that he suspected that she was either dehydrated or that her blood sugar was low, but that he wanted to do some blood work, and get her a bag of fluids. Once she got some fluids in her she began to feel better, but the blood work began to tell another story. Her hemoglobin, the iron containing and oxygen transporting portion of the blood, was found to be exceedingly low. So low in fact, they retested her again and again to be sure. Gina, the doctor, is from Columbia. She asks us if Avery is anemic. My response was "No. Not that I know of." She asked if any of her check ups have ever revealed low hemoglobin before. As far as I knew, she'd never been tested for that.

Avery had a hemoglobin, at it's lowest point, there on the ship of 4.5. Healthy Hemoglobin levels should be any where from 12-18. Red blood cells contain iron-rich oxygen delivering hemoglobin. Red Blood cells are the most numerous of any in the body.Having a hemoglobin level that low meant that her body was being deprived of oxygen. It also meant that she needed a transfusion. And we were in the middle of the gulf of Mexico. A Cruise ship medical facility is not equipped to provide a blood transfusion. Dr. Gina relays to us that Avery's condition is serious. She is baffled as to why a perfectly healthy 14 year old girl would fall so ill so quickly. She asks is she can sample her siblings blood to see if there is some familial tendency toward lower than normal hemoglobin. Still, a hemoglobin that at first check was 5, and that is now 4.5, needs to be addressed as soon as possible.

She checks Terrence and Lindsey's blood. They are both within normal range. She asks whether there are any blood disorders in the family. I know of a niece and a nephew who had suspected cases. Gina asks if we know Avery's blood type. We do not.
I know that my blood type is B+ because My blood donor card says so.

My Husband is unsure of his type, but thinks he is A. Our son Terrence has donated blood for the first time at his School Blood drive and knows his blood type is A+. We do not know Lindsey's blood type.

Dr. Gina Tells us that Avery will need to be life flighted by the Coast Guard to a Hospital within range. It may be New Orleans, It may Be Houston. She is unsure as to whether one of us will be allowed to accompany her. She asks me how much I weigh. Weight will be a factor. We have taken a helicopter ride before as a family--over the Grand Canyon. They arranged us in the seats according to our weight. Lindsey, our 16 year old offers to go if weight is an issue. She weighs less than I. In the mean time, Gina makes us sign a Waiver to allow for Avery's treatment in our absence. She tells us that the Coast Guard is the decision maker.

They continue taking samples of Avery's blood every 15 minutes. They check her stool, they check her urine. They wonder if she is having any internal bleeding. They ask her when her last Period was Avery relates that it was that morning. They ask about her cycles. How often do they occur? How many days long? How heavy? It is hard to know whether these will be factors.

We ask, Why might she have gotten so anemic so quickly? They do not have an answer for us. There may be internal bleeding of some sort, she may have a bleeding disorder which until now has gone unrealized. It is many hours since the Coast Guard was called. The Helicopter only carries enough fuel to travel 200 miles. We are 250 miles from land.The Ship's Captain speeds up to shorten the distance the helicopter must travel.

Gina has the nurses, also from Romania, send for nail polish remover to remove the nail polish from Avery's toe nails. They need to check the blood flow to her extremities. They repeatedly press on her toenails to see how quickly the blood returns to her toes. We are all in shock. It is two hours before the helicopter arrives. I have prepared myself as if I am accompanying her. I've packed a bag. We must bring our passports as a US customs agent will be there to greet us as soon as we arrive at the hospital.

We all ride up on the elevator together. Our whole family is surrounding Avery on her stretcher. We are reassuring her, although tension is building. She has been brave thus far. They have stuck her so many times with a needle, we've lost count. As we get to the deck with the helipad, we see the Helicopter land. Passengers are lining every deck. We are awaiting the Coast Guard Personnel. Avery's fear and concern come to the surface. She begins to cry. The nurses and Doctor haven't been able to hide their concern. The heaviness is thick in the air. A Ship personnel has greeted the Coast Guard on the Deck and has turned around to come inside.

When the Ship's personnel opens the door, there seems to be a drawn out pause. He says, "One guardian." We breathe a Collective sigh. Constantine, the nurse who originally came to Avery's aid, will be coming with us. I say goodbye to My husband Terry and my kids, and the large man who delivered the good news wraps his arm around me, shielding me from the overwhelming wind of the helicopter blades, and we follow Avery and our Coast Guard Heros onto the helicopter. I don't think I've ever felt such relief or gratitude. They show me where to sit. I gather myself into a tight ball on the floor so that I take up the least amount of room--so that I'm not in the way. They tell me that our flight to Houston's Herman Memorial Children's Hospital will be two hours, but that we will be stopping for fuel in about twenty minutes. Stopping for fuel? in the Middle of the ocean, we stopped for fuel on a platform. I never knew such a fueling station existed.

As we fly, the medics and Constantine are continually monitoring Avery's blood pressure, heart rate and vital signs. At times the readings appear in very serious range although Avery looks OK. They surmise that the finger pulse reading device must be misreading, but when they use it on me, it seems to be working fine.

When we finally land in Houston, it is dark. It is now 6 PM. The US Customs agent greets us, and they take us to a room. Constantine accompanies us and remains with us until Avery is assigned to a room some two hours later. She is stable now, and actually sits up in the emergency room. I try to reach Terry and the kids to touch base with them. It's a good two hours before Avery is given her transfusion. Her blood type is AB+, the Universal Recipient. She can receive blood of any type. I think to myself, that anyone of us in our family could give blood to Avery. This is a relief to me.

One of the Doctors suggests that they may have to do a bone marrow test. Red blood cells are manufactured in the bones. There could be a problem with the manufacture of these cells, or of the platelets, which allow the blood to clot. He mentions von Willebrand's Disease, and Thalassemia. Not knowing anything about any of these disorders, or their prognosis, I am worried.

The transfusion is given very slowly. It will take a few hours. She is given O+ blood. After she receives the transfusion--two units, that is, two pints-- of blood, we wait for her hemoglobin to rise, and to see that she stabilizes--that her hemoglobin remains up. They tell us that they'd like to see her hemoglobin at 8. She gets to 7.5. They continue doing more tests. In the meantime, My Family finally arrives, after a delayed ship arrival due to fog. They are 5 hours late upon return. Then next day, they allow Avery to leave the hospital, to follow up with her Pediatrician at home.

She is given a prescription for iron supplements, to rebuild the iron stores in her body and to raise the hemoglobin level. After we get home, her pediatrician instructs us to pay very close attention to her menstrual cycles. How often are they occurring, how long are they lasting? We check her stool for two months to make sure there is no subtle bleeding in the gastrointestinal tract. She continued to take the Iron supplements and her hemoglobin level slowly rises, however we soon come to realize that her Menstrual Cycles are the culprit. The Gynecologist puts her on the pill to supply the needed hormones to control her bleeding, and her Hemoglobin levels continue to rise. Apparently, over the course of many months time, Avery was becoming more and more anemic--her blood deprived of the iron rich blood cells that
carry oxygen to all of the body's tissues. Anemia can be caused by either excessive destruction of Red Blood Cells, excessive blood loss, or inadequate production of Red Blood Cells.

How lucky she was to be airlifted to the Hospital and receive that transfusion. How lucky she was that two individuals, who will remain unknown to us, felt inclined to donate blood. Every Day, countless individuals donate blood to the American Red Cross, and every day, countless individuals like Avery receive that life giving blood. It was a full year before I could donate blood again after that Cruise to Mexico, because of the Malaria Risk. But as soon as that year was up, I happily donated my B positive blood again, this time with an even greater dedication. The last time I was eligible to donate, I took my now 17 year old daughter Lindsey with me, also B positive and she donated for the first time. Yesterday, she signed up for her High School's Blood Drive. When Avery is old enough, as long as her hemoglobin remains stable, which it has now for over a year, I'll encourage her to also. I'm positive she will. AB positive.


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