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Transfusions 101

Home forums Patient Message Board Transfusions 101

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    RBC Transfusions 101

    This is what I’ve learned and experienced during 2006 when I was diagnosed with MDS, became transfusion dependent, and consumed 23 pints of RBCs.

    What is transfused blood?
    In a nutshell, transfused blood is usually packed, leuko-reduced and irradiated. Each 300ml packed is equivalent to 500ml unpacked. What is packed? They take the donors blood and pour it into a big wooden tub and have an Italian family stomp on it wearing nothing but shorts and tank tops. That packs it down a bit. To finish the packing process they run it thru uncle Jed’s moonshine ‘still’ to remove about 40% of the H2O. Finally they stick it in a GE 1000watt microwave oven to ‘irradiate’ it. The end product is guaranteed to be 151% proof, redder than normal blood and free of common household pests.

    The pint bags of blood are, of course, donated from kind people. The questions for xfusers like us are, who, when and where? The why, how, and the what are pretty well documented. The answers we seek will remain a closely guarded secret by the industry. Obviously, xfusers having answers to these questions will serve no purpose other than to make us nervous, paranoid, and litigious. We have to trust the medical industry to maintain the integrity and purity of the blood supply. They seem to do a pretty good job at that. So I wont alarm you by passing on idle speculations and rumors about what I’ve heard about the identity of donors.

    Transportation to the Chemo room
    The donated blood is rushed from the local prisons to the processing centers located very close to the facilities. There, the blood is processed as outlined above. After processing, the blood is poured into small plastic bags with a dozen little tubes hanging out the bottom. One of these tubes will eventually lead into your arm. The other little tubes are from the bag’s previous escapades with other patients. The bags are stuffed into an old igloo cooler packed with mystery ice. The cooler is rushed over to your clinic in an old truck very much like the one they use for public transportation at toon-town in Disneyland. The truck shakes up the blood, infusing vast amounts of oxygen; enough to support an small aquarium full of saltwater blow-fish for up to 3 weeks. Doctors say the extra oxygen is good for you.

    The Chemo room. (The info from here on is actually from personal experience)
    Once you arrive at the chemo room, which, if you are lucky, will be in a hospital, but in my case is directly behind the Pfizer plant in a run-down section of SE San Diego, grimacing nurses will direct you to a very old tweed recliner. I’m sure I’ve seen that recliner under Carroll O’Connor’s butt on TV years ago. When you sit down, metal straps appear out of the chair’s arms to restrain your arms. Naw! Just kidding about that. The nurses actually use plain old cloth straps. The nurses get to work. They open their red tackle box and pull out special needles made by Gamakatsu, the leading fish hook manufacturer in the world. I think the needles have serrated edges in order to keep them from sliding out during the transfusion. After several minutes of slapping your arm looking for, and eventually producing, bulging veins, a nurse somehow gets one of the large, serrated needles into your arm. I’m not exactly sure how that happens cuz this is where I always black out. When I come to, there is a needle and tube protruding from my arm and it is secured by duct-tape that seems to cover my whole arm. My entire left arm was rendered hairless months ago. The nurses say hair just ‘gets in the way’ and besides, hair removal with tape works so much faster than shaving. Before they get to the blood, the nurse first insists on transfusing you with some kind of clear liquid, which I believe is cheap Vodka. I dont know this for sure but I feel very woozy once they switch the turn cocks to let the blood start dripping through the plastic tubing. I think the Vodka is also supposed to lessen the impact of you having to slowly watch Charlie Manson’s (bless his heart for donating from the prison) blood slowly make its way through 37 feet of clear plastic hose. I understand they have shorter and opaquer hoses handy but they get a kick out of watching patients fidget as they watch the bright red blood make its 10 minute journey through the clear hose into your arm. By the time the blood has reaches the point of no return near the entry point you could swear you see things swimming in it. I suppose the nurses deserve to have their fun.

    The Transfusion
    The speed of the transusion depends upon your age and how much the nurses like you. If you are older they slow down the pump so that ‘bad things dont suddenly happen’. The nurse takes your pulse and blood pressure frequently just in case, well, that the blood got mixed up somewhere during the packing or labeling process. If you are younger or they just don’t like you they will put the pump in turbo mode. This is cool if you want to get out of there fast, which most everyone does. But this is not cool if you are accidentally receiving type B negative blood when you are A positive. If you survive the first 20 minutes or so, when the nurses temporarily leave the room you can press a couple buttons on the pump, speeding it up so you can make your 3pm shrink appointment. The whole process takes around 2 hours per pint, so bring plenty of reading material. What with the Vodka flush, the benedryl and the Tylenol they give you up front, time passes pretty quick. Don’t be surprised if you fall asleep. To snap you out of your tranquility when the transfusion is over, the nurse will gleefully remove the duct tape wrapped around your arm… very slowly. Then she will yank the fish hook from your arm. Finally, for no apparent reason, she will slap the insertion area on your arm. I’ve learned to yank my arm away before the slapping begins, and have been none the worse off for it. Your choice.

    The Aftermath
    Its probably different for everyone. But you should feel more energetic since the oxygen carrying capacity of your blood has been greatly enhanced by Charlie’s kind donation. As the oxygen makes it way into your brain, your brain suddenly wakes up, remembering where you left your wallet, your keys, your dog. Its quite euphoric actually. You feel like you can actually climb that flight of stairs now, and get past ‘2 across’ on the crossword puzzles.

    Side Effects
    Yes, there can be unwelcome side effects. After 23 pints in 2006 I only had a slight rash on my wrist and ankle after 1 transfusion. In regards to other side effects, do *NOT* look on the internet for side effects, especially do not look on any Mormon web sites! Ok, I’ll break it to you easy. The Mormon position is that when you get a blood transfusion you get ‘traits’ from the donor. So, for example, if the donor was a murderer… you may start thinking very… dark… thoughts. Obviously hogwash. Strangely enough though, I’ve taken up humming to myself in the last few months. And, my handwriting has gotten a lot better. Mmmmm… Then, these 2 words keep popping into my head lately: “helter skelter”. What does it mean?

    Hope this helps!


    Immediate followup…
    Sometimes, I get pretty depressed reading here about the reality of our lives with mds. So, I thought I’d throw in some reality humor. Some of you may consider the above inappropriate and maybe irreverent. I apologize in advance. To me, thinking about the absurdity of my new life with mds seems to help me deal. Regards, jim


    Jim, THanks for the good laugh. I did find some truth in more than you will know.I am going to print it off and take it to the infusion dept. the nurses will enjoy it
    Take care Ellie



    This was a hoot! I too am going to print it. Gotta show it to mom. She’ll get a kick out of it. Some of it there’s just enough truth to be scary! smile Thanks again for the laugh. It’s was terrific.

    Wishing you less then 23 pints in 2007!



    Yes we always need the laughter, it keeps me going. As a care giver I try to donate blood as much as I can. Tried Plts one time and boy did I have a doozy of an attendant who did not know what she was doing.

    Thanks jim for brightening my day


    I loved your take on the transfusions ,,,, I just have one question … I receive 2 Units of blood about every 10 to 14 days … how long can this go on … My doctor seems to have a concern about all the antigens that I’m receiving ..he says that it can affect the success of the BMT that I’m currently looking for a donor for ……. anybody have any thoughts????


    “My doctor seems to have a concern about all the antigens that I’m receiving … affect the success of the BMT”
    I havent heard that. I’ll ask my doc.


    This is great! My dad is also xfusion dependent and you’ve captured the essence of many of our days! My dad is not a candidate for a BMT so he does not receive irradiated blood. To date he has 3 antigens, A,E and K. According to the blood bank these are common and so far no issues. Good luck.


    Thanks for this humor…………. a good laugh is always good……I personally have had a kidney transplant, dialysis for 1 1/5 yrs prior to transplant,abdonial hernia surgery and a bilaterial kidney nephrectomy of my native kidneys all over the past 2.5 yrs and add to this my husband has been diagnosed with MDS. I am such a firm believer in finding humor in all the bad…….. it has got me through so much… don’t get me wrong there are tears but God has always managed to let me find the humor in all of the trials. This is great and THANK YOU….

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