The Trial of an Infusion

During my treatments and process of transfusions/infusions, I am routinely asked a myriad of questions that are sometimes to simple to answer and sometimes rather ponderous.

My last infusion (just the iron) took about 9-10 hours. When my infusion begins there is prep work done - the administering of Benedryl and corticosteroid to avoid anaphylactic shock, which is good because I do have allergic reactions to the iron; checking vital signs and of course, getting comfortable for the arduous process.

This most recent visit was my most difficult. Not because it took the nurse 3 attempts to lay the IV line; not because at the end of the infusion my veins collapsed leaving a visible scar; and not because even with the Benedryl/steroids I still had a terrible rash. But because for the entire 9-10 hour process I was amongst a constantly rotating group of individuals receiving chemotherapy.

With each new patient my heart went out to them and the less sick I felt. It wasn't until late in the day when another patient had taken her spot, began her treatment, subsequently ended her treatment, that I was then reminded about personal perspective.

She observantly noted that I had been there for a while. I could have been the plethora of magazines, rotation of water bottles, or the massive bag of "sludge" that was draining into my body. Iron is very reminiscent of molasses, which is why is takes so long to administer through IV. (Note: There are different forms, some of which are done in an hour or two, but it is a much lower dosage) After a few minutes of perplexing glances, this kind-hearted patient asked, "What are you doing here today and what time did you start?" I politely stated that I had begun at 8:30am (it was 5:30pm) and then explained the iron infusion and why I needed it. At that moment, she had this "Bless her heart" look on her face and exclaimed, "Oh my goodness! I would hate to have to do that! You are so sick and are so young, poor thing. I will keep you in my thoughts so you get better." I had no words to offer in response.

This sweet woman, who had already lost most of her hair and was certainly battling for her life thought what I was doing was a tragic affair - in that fleeting second, I saw that however bad a situation can be, there is always an opportunity to lift someone else up.

In her perspective, she was doing a treatment for herself which, sadly, had become - routine. I, on the other hand, was someone new, much younger, and looked perfectly healthy. What's that old saying, "Never judge a book by it's cover"? Well, this can be the case with Anemics - sometimes we look/feel sick, sometimes we don't.

Her seemingly simple question has been with me since I left and I doubt that I will forget her perspective of "how bad things can be." Afterall, this is "normal" to me.

Intraoperative Cell Salvage - Intra What?

Cell Salvage? Is that safe? Is that possible? And is it something I really want to consider. Short answer to all three: YES.

Intraoperative cell salvage, during which blood shed during trauma is collected and then transfused back into a patient, appears to be safe and cost-effective compared with standard alternatives in trauma patients, according to new research. (see diagram)



Now, this isn't necessarily recommended for someone, like myself, who has a failing blood system, however, in times of trauma - it's completely plausible.

A recent study included 47 patients undergoing surgery at a level 1 trauma center from 2006 to 2007. Patients received intraoperative cell salvage and autologous blood transfusion and were compared with 47 patients similar in age and sex who underwent similar surgeries (mostly laparotomies) and required transfusion, but who did not receive cell salvage as part of their resuscitation.

Patients who received cell salvage had an average intraoperative blood loss of 1795 mL but received an average return of 819 mL of their own blood (P < .001) compared with an intraoperative blood loss of 978 mL in patients who did not receive intraoperative cell salvage.

The researchers also found that patients who received cell salvage received fewer intraoperative and total units of allogeneic packed red blood cells compared with patients who did not receive the procedure (2 vs 4 units during surgery [P = .002]; and 4 vs 8 units [P < .001 total]). They also received fewer total units of plasma (3 vs 5 units; P = .03).

Costs were lower in the cell salvage compared with the comparison group ($1616 vs $2584; P = .004), although the average length of stay in the intensive care unit was similar (about 8 days), and was in the hospital overall (18 vs 20 days for cell salvage and comparison group, respectively; P = .75).

Death rates were 13% for the cell salvage group compared with 21% in the comparison group, which was not statistically significantly different between the 2 groups.

The researchers suggest that future studies should try to "preoperatively identify patients who would most benefit from autologous transfusion and to optimize cost-effectiveness."

They add that "centers with access to a cell salvage program should routinely use autologous transfusion as part of their intraoperative resuscitation," and that "centers not currently using intraoperative cell salvage and autotransfusion should identify and overcome barriers to implementing this life-saving technique."

This is a positive advancement in blood transfusions and during a time, like in the summer, when supplies are critically low, this may answer the question - Where will our blood supply come from for emergencies? Of course this doesn't resolve my constant need issue, however, it's a step in the right direction.


(Info from Medscape Medical News, 7/21)

Life Across America

Like to ride your bike? Take an afternoon ride to spend time with the family? What about riding with family for more than 4,000 miles? Seems a bit much right - well, not for Larry and his daughter Adella.

You see, in 1982, as an Oakland Police Officer in California, Larry was on a routine traffic stop, Larry was permanently disabled by a traffic accident. A DUI driver, speeding at 65 MPH, struck him as he was speaking to the stopped motorist. The outcome was a need for 110 units of blood and nine major surgeries to repair extensive injuries, plus mandatory retirement. He refused to let personal tragedy keep him down after his near-fatal traffic accident.

Over the years and through recovery, Larry has ridden in charity events, took a ride from CA to Washington DC with his son and now this journey all to raise awareness of the need for blood donors.

This summer, Larry will be embarking on a two-part journey across the country to raise awareness for the need for blood.

In Phase I of Life across America 2010, Larry and his daughter, Adella, will bike ride from California to New Hampshire stopping at blood centers along the way.

During Phase II, Larry and Adella will return home by driving cross country, down the east coast across the southwest. During this leg of their journey, Life across America will be working with America’s Blood Centers’ members in over 40 cities. From speaking to volunteers to hosting blood drives, Larry and Adella will raise awareness and promote blood donation throughout their summer journey, kicking off June 5 and culminating on September 14.

The map below highlights the trip and where they will be stopping. I am so excited that I will be seeing Larry and Adella when they arrive in Virginia. If you want to learn more or find out where you can see them on the trip, please visit www.lifeacrossamerica.com for more information.

Saving Lives Starts Here: 2010 Summer Challenge

My dear friends at the Blood Bank of Delmarva are at it again!

Between May 24 and September 4, local companies will compete in the 8th annual Summer Blood Challenge (SBC) to recruit the most new Blood Bank members and blood donors. The SBC was designed to raise awareness of the importance of blood donations, especially during the critical summer months when fewer people typically give blood.

SBC participants will earn chances to win exciting prizes, including one of two $50 VISA gift cards awarded weekly throughout the Challenge and the grand prizes: a $500 VISA gift card, a 3-day trip for two to Las Vegas and an all-inclusive week vacation for two to a luxury resort in Cancun, Mexico!

I am honored to once again be included in such an important regional campaign - blood donation knows no boundries and the need must be met.

What do you have to lose this summer by saving lives through donation? Nothing, except 1 pint of blood, and in my eyes, that's the best thing you could do this summer.

Much Love and Best Wishes!

Regular readers know that, sometimes, I have to take a quick break from "blogging for blood" to share some of life's little stories. Well today is one of those moments.

I want to send out lots of love and best wishes to a few friends that are competing this weekend for the title of Mrs. International 2010. These ladies have worked hard as state titleholders and are just as passionate as I am about a personal cause. Now is their time to shine and I hope that as preliminary night unfolds, they are able to show the judges just how magnificent and beautiful they are. Heather Thompson (Mrs. Virginia International 2010) and Angel McCoy (Mrs. Maryland International 2010) I wish you both best and will be cheering for you all the way!

I have in the past competed within this pageant system and it holds a special place in my heart. I had first competed for a state title in 2002 and while I have yet actually win the title, I'm sure that if the day ever occurs, you will hear me cry/laugh/cheer etc, from whatever corner of the world you are in. But don't hold your breath, because that won't be happening anytime soon.

Thank you to Arma Fitzgerald for being an incredible Mrs. International 2009, and to those that came before her. Each with their own style, grace, and purpose - they have all represented married women with a level of elegance and class that few could match.

As I look forward to the results tomorrow night, I know that with the elation of a winner comes the heartbreak of not winning. I thought I would share below something that I have had for a long time and I keep with me to remind me that it's not about the crown we wear, but about the crown of love within our heart. Best wishes ladies, you are greatly loved!


We Are All Queens

It’s not the title, nor the crown that counts.
It’s not the weight that’s lost that amounts.
It’s not the make-up or the gown that you wear,
Or the shape of your build or the length of your hair.

You see, the growth of a Queen is all done inside.
It’s nothing support hose or make-up can hide.
The real preparation is done in the mind.
It’s leaving your fear and your faults behind.
It’s lifting your soul to a place that’s far seen.
It’s molding a woman to the height of a Queen.

It’s hard and it’s work, and not easily done.
But when it’s all over, you’ll know who has won.
When the pageant it through and the lights are turned down.
You’ll know you’re a winner and you’ll have your crown.

You see, all crowns are made different.
It’s really an art…..
Yours can be rhinestones, or the growth of your heart.

I am SO sweet, mosquitoes love me!

During the summer, mosquitoes are my arch nemesis. Perhaps they are yours too, but in order to repel these irritating little beasts, I must use the most chemical filled bug spray I can find. I call it my "Summer Perfume". Really, I can't use those pretty, make-your-skin-soft sweet little bottles of bug fragrance - just full-on, commercial grade DEET.


Now, having said that, I can attract all the bugs in the world while standing next to someone else who won't receive one little bite. That's probably most irritating. I digress.

Some people have said, oh it must be your blood type; or it's because you have on perfume; or it's pheromones; or whatever other "bright" idea one could come up with. Really? I have gone without perfume, worn long pants, used un-fragranced soaps - you name it, I've done it. And I am still a human pin cushion to those little stinkers.

Well I learned a few things and quite frankly, I don't think I can change the fact they will bite me, but I now know it's because I'm such a sweetie! Mosquitoes belong to a group of insects that requires blood to develop fertile eggs. Males do not lay eggs, thus, male mosquitoes do not bite. (again, always blaming the women...) The females are the egg producers and "host-seek" for a blood meal. Female mosquitoes lay multiple batches of eggs and require a blood meal for every batch they lay. Few people realize that mosquitoes rely on sugar as their main source of energy. Both male and female mosquitoes feed on plant nectar, fruit juices, and liquids that ooze from plants. The sugar is burned as fuel for flight and is replenished on a daily basis. Blood is reserved for egg production and is imbibed less frequently. I guess the blood/sugar acts as red bull for bugs - who knew.

Mosquitoes have specific requirements to satisfy, and process many different factors before they feed. Female mosquitoes use the CO2 we exhale as their primary cue to our location. A hostseeking mosquito is guided to our skin by following the slip stream of CO2 that exudes from our breath. Once they have landed, they rely on a number of short-range attractants to determine if we are an acceptable blood meal host. Folic acid is one chemical that appears to be particularly important. Fragrances from hair sprays, perfumes, deodorants, and soap can cover these chemical cues. They can also function to either enhance or repel the hostseeking drive. Dark colors capture heat and make most people more attractive to mosquitoes. Light colors refract heat and are generally less attractive. Detergents, fabric softeners, perfumes, and body odor can counteract the effects of color. In most cases, only the mosquito knows why one person is more attractive than another.

So if they rely on my breath to determine I am a "host" then I can either stop talking (not likely) or just spray on more repellent and hope like heck they decide I'm not sweet enough.

So, in the end, all those little beasts are wrong about one thing - I can not be the supplier/host for others, and I need YOU to donate blood. Take a lesson from the mosquito and donate today - perhaps it will make us all a little sweeter (for the right reasons!)

The Nation's Capital: It's Critical

No, it's not a political statement or another comment on the state of our union - but in fact, like much of the east coast and regions across the country, the District of Columbia, is in critical need of blood donors.

At this time, the blood donor age is set at 17 in D.C. The Blood Donation Expansion Act of 2009 (B18-127) is currently under review with the DC Council to lower the limit to 16, with parental consent. This would be in-line with it's neighbors in Virgina and Maryland along with 35 other states.

Why is lowering the age limit so important? Younger donors are eager to come to the aid of those in need and are more willing to be returning donors. This bill, supported by various council members and mayoral candidates, is designed to alleviate the current shortage.

The bill is currently up for vote and is set to be ratified quickly if it passes. Let's hope that our Nation's Capital let's it's youth save more lives!

The B12 Bomber

Just before taking a break for the Independence Day celebrations, I had my monthly appointment with my hematologist. Typically this is not a big deal, and I treat as a necessary means to a healthy life. However, this visit, brought forth new, unsettling news.

During my infusion/transfusion in the spring, a new set of blood tests were ordered to see if there was an underlying condition that we just weren't seeing that would attribute to the iron deficiencies. When I arrived at my appointment, another round of blood tests were ordered - typically, it takes only 3 tubes of blood for all my tests to be run - this time, they took 14 tubes. (Now, I only mention that because it always makes me laugh when I need my own blood so much and then they take so much)

Amongst these tubes, lied an answer. Albeit, not one I really expected, or wanted, to hear. The doctors determined that in combination with the iron deficiency, I have Autoimmune Pernicious Anemia (PA). If you just said "What is that?" - good for you, I did the exact same thing. Well, sure the kind doctor explained it, but did I really understand it? So, like a good patient, I took all of the information that was provided and did a little research at home. What I can confirm, based upon the doctor's report, because of the severity of the PA it is caused by a genetic disposition and not a nutritional deficiency.

PA is a rare blood disorder characterized by the inability of the body to properly utilize vitamin B12, which is essential for the development of red blood cells. Most cases result from the lack of the gastric protein known as intrinsic factor, without which vitamin B12 cannot be absorbed. (My blood system is also producing antibodies to B12 which means it's killing the vitamin as fast as I am injecting it.) (PA is pictured at right)

The symptoms of PA may include weakness, fatigue, an upset stomach, an abnormally rapid heartbeat (tachycardia), and/or chest pains. Considered a neurological disease, if left untreated, PA can lead to dementia and is fatal. This is where the news become unsettling. I watched my grandmother pass away due to a long struggle with Alzheimer's Disease, and prior to her passing, we already knew that her mother and grandmother likely passed from the same disease. This caused immediate concern because we know that in our family, Alzheimer's does affect the women and now, we wonder if PA could be a direct link to this disease. While PA is not routinely screened for and is easily masked by many other disorders, including IDA, we will be doing more research to see if there is a connection.

Going forward, I am on a strict B12 regimen and while I don't like giving myself shots, it is necessary - along with more doctors appointments of course. The biggest issue is treating the PA while keeping the iron in the blood system stable. The red blood cells are having an extremely difficult time functioning and with two forms of anemia associated with the red cells, my body is working double time just to function.

Transfusions may increase or stay stable - there is no crystal ball at this point but more waiting, testing, watching, and praying will be taking place.