Fiction - Revised Blood Donor Screening Questions

NOTE:  This post is Rated R for pervasive mature themes and mild strong language.

Introduction

This post is a work of fiction.  Certain brief passages are taken from an actual questionnaire given to blood donors, simply to provide context, but the rest are as absolutely fictional as you can get.  By the way, I highly encourage being a blood donor, and if you feel the need to connect the dots between this work of pure fiction and the act of donating blood, simply consider this a wacko commentary on the pre-donation questionnaires, which are arguably longer than is necessary.  Above all, don’t take this too seriously (i.e., don’t take it seriously at all).

BLOOD DONOR HISTORY QUESTIONNAIRE

Before you begin

Please read the this questionnaire carefully and do not just answer “no” to every question, even if nothing has changed since the last time you donated blood (and yes, we acknowledge that it is not possible that you lived for six months in the United Kingdom since you last donated three months ago).  Answer the questions carefully because we have made significant changes to this form.  For one thing, we have finally customized this version for male donors, acknowledging that questions regarding pregnancy and menstruation do not apply to you.  We have also added new questions as part of our ongoing effort to screen donors as thoroughly as possible, for the safety of blood transfusion recipients.

Are you… 

• Feeling healthy and well today?    Yes□    No□
• Currently taking an antibiotic?    Yes□    No□
• Currently high on anything that you injected?    Yes□    No□
• Currently a patient in a hospital who refuses to take your situation seriously, grins like Jack Nicholson, tried to grope the nurse earlier, and have sneaked out of your room to come here and donate blood?   Yes□    No□ 

In the past 48 hours… 

• Have you taken aspirin or anything that has aspirin in it?   Yes□    No□
• Have you even taken one of those “baby aspirins” that are so small you might be tempted not to count them?   Yes□    No□
• Have you suffered a hangover so bad you honestly can’t remember if you took any aspirin or not?   Yes□    No□
• Have you observed the “five-second rule” as regards food dropped on the kitchen floor?    Yes□    No□

 In the past month… 

• Have you donated platelets or plasma?   Yes□    No□
• Have you received 20 or more phone calls thanking you for your recent donation and asking if you will come donate again, perhaps on Monday?   Yes□    No□
• Had any vaccinations or other shots?   Yes□    No□
• Had any contact with someone who had a smallpox vaccination, even over Skype?   Yes□    No□
• Had any contact with one of those lunatic parents who refuse to vaccinate their kids, considering vaccination a matter of personal freedom rather than of public health, and who should be sent to a third world country to witness an outbreak of a horrible disease that used to be totally eradicated in the first world?   Yes□    No□
• Smoked a cigarette?   Yes□    No□
• Smoked a whole lot of cigarettes, and are donating blood because you are rightly convinced that one day you will be undergoing chemotherapy for your lung cancer, so instead of the altruistic good deed we thought this was, you cynically consider it a quasi-karmic quid pro quo, you Machiavellian bastard?   Yes□    No□

In the past 12 months have you… 

• Had a blood transfusion?   Yes□    No□
• Had a blood transfusion at a county hospital, in which case we feel so, so sorry for you?   Yes□    No□
• Had a blood transfusion from a WorldTour pro cycling team staffer such as a soigneur, masseuse, physical therapist, or “doctor”?   Yes□    No□
• Had an accidental (or, what the hell, an intentional) needle-stick?   Yes□    No□
• Had an ear or body piercing?   Yes□    No□ 
• Had a tattoo, even the pretend kind like kids get at summer camp or for Trick-Or-Treat?   Yes□    No□
• Had sexual contact with anyone who is HIV-positive?   Yes□    No□
• Had sexual contact with a prostitute or anybody else who takes money or drugs or other payment for sex?   Yes□    No□
• Had sexual contact with anyone who has ever used needles to take drugs or steroids or anything not prescribed by their doctor?   Yes□    No□
• Had sexual contact with a UCI WorldTour professional cyclist?   Yes□    No□
• Had sexual contact with any cyclist who has placed in the top 20 in a UCI WorldTour sanctioned bicycle race?   Yes□    No□
• Had sexual contact with anybody whose blood has been analyzed by the Châtenay-Malabry laboratory?   Yes□    No□
• Had sexual contact with another male, even once?   Yes□    No□
• Had a wife or girlfriend with an ear or body piercing?   Yes□    No□
• Had sexual contact with this wife or girlfriend, even once?   Yes□    No□

From 1980 through 1996… 

• Did you spend time that adds up to 3 months or more in the United Kingdom?   Yes□    No□
• Were you a member of the U.S. military, a civilian military employee, an ROTC dropout, a dependent of the U.S. military, or in a co-dependent relationship with an ROTC dropout?   Yes□    No□
• Did you allow a citizen or national from the UK to sleep on your couch while he or she was visiting the United States to attend a music festival or Burning Man?   Yes□    No□
• Did you eat any beef product that spent time that adds up to 20 minutes or more in the UK or in UK airspace?   Yes□    No□
• Did you eat in a steakhouse in the UK, even a high-end steakhouse in Bath where the waitress assured you all their beef was from Spain?   Yes□    No□
• Were you a member of a British cycling team?   Yes□    No□
• Did you ever have a bicycle race bib number pinned to your jersey by a British cycling team masseuse, soigneur, director, or other staffer?   Yes□    No□
• If “yes” to previous question, were you wearing the jersey at the time?   Yes□    No□
• Did you spend time that adds up to 3 months or more self-identifying as an Anglophile and using words like “peckish,” “brilliant,” “poxy,” “nosh,” and “dosh”?   Yes□    No□

Have you EVER… 

• Had a positive test for HIV?   Yes□    No□
• Used needles to take drugs, steroids, or anything not prescribed by your doctor?   Yes□    No□
• Used needles to receive blood transfusions or take drugs, steroids, or anything that was prescribed by your UCI WorldTour team doctor or his overworked, undertrained lackey?   Yes□    No□
• Infused blood that you stored in a mini-fridge that (unbeknownst to you) your girlfriend often unplugged at night because the buzzing kept her awake?   Yes□    No□
• Suffered scrapes or abrasions (aka “road rash”) after crashing a bicycle on a roadway used by a UCI WorldTour bicycle race?   Yes□    No□
• Had hepatitis, malaria, Chagas’ disease, cancer, blood disease, or babesiosis (which is an actual disease, not a cute name for the crushing fatigue that comes from being a first-time parent)?   Yes□    No□
• Had sexual contact with anyone who was born or lived in Africa?   Yes□    No□
• Seen “Out of Africa” with Robert Redford and Meryl Streep?   Yes□    No□
• Seen “Top Gun,” with Tom Cruise and Val Kilmer, in the presence of other males, who all agreed it was a great movie with ruggedly handsome characters who were “bigger than life”?   Yes□    No□
• Had sexual contact with one of those punk rocker chicks who claims not to shoot up but does all kinda crazy shit and probably wouldn’t even remember if she did?   Yes□    No□
• Fantasized during intercourse about the punk rocker chick you know in high school who maybe didn’t do as much crazy shit as everybody said but definitely had body piercings?   Yes□    No□
• Fantasized during intercourse about being, or being with, a UCI WorldTour cyclist, team masseuse, soigneur, director, or other staffer?   Yes□    No□
• Fantasized during intercourse about eating steak tartare at that high-end steakhouse in Bath between 1980 and 1996?   Yes□    No□

Donating Blood

Introduction

I try to donate blood twice a year. By “try” I don’t mean I try and fail, as in getting lost on the way to the blood center, but rather than I don’t always make good on my intentions. But they’re good intentions.

Don’t worry, this post won’t be a harangue about how if you’re not a pointy-headed do-gooder that it’s high time you changed your ways. Would I do that to you? This is a light-hearted exploration of blood donation, intended to fascinate and amuse you. I will discuss why people should donate blood; who should do it; who shouldn’t. I’ll also give a blow-by-blow account of my recent experience of donating two units of red cells.

(For anyone interested in knowing what effect donating blood has on athletic performance, I’ve written a separate post on that.)

Why give blood?

Blood transfusions save lives. Countless accident victims would die without them. I personally know five women who had late-term miscarriages and would have bled to death without transfusions. There are also people who have diseases requiring them to get regular transfusions throughout their lifetimes.

For all intents and purposes, blood transfusions cannot be carried out without a supply of blood. There have been attempts to make synthetic blood; a recent version, made from plastic, was tried out in England, but yielded a 30% increase in the risk of death and tripled the chance of heart attack. Here in the US, DARPA is working on a version based on stem cells. (I’m not that optimistic of their success, based on our best effort at synthetic cheese: Velveeta.)

It seems a waste of time and money to make synthetic blood, when hundreds of millions of healthy people can so easily donate and replace their own. Our bodies are really good at making fresh blood: bone marrow produces something like 200 billion red cells per day. It’s kind of amazing, like how a lizard can grow a new tail.

As important as blood is, it can only feasibly be obtained from volunteer donors. My mom, a hospital laboratory technologist, has worked with blood for decades, and recalls that in the early 1960s, the medical industry tried to get blood through paid contributors. This didn’t work at all, because so many of these contributors were severely hard up—homeless or on the verge of it—and so much of the blood was unusable. What a disaster: hospitals got nothing for their money while depriving already sick people of their blood. Needless to say this practice has been mostly abandoned.

For me personally, donating blood is an opportunity for a selfless act that does some real good. I don’t do much volunteering, because too often I feel like my time isn’t being put to good enough use. (Volunteering at my kids’ preschool years ago, it struck me as absurd that I was sitting on the floor dusting wooden blocks instead of being at home spending time with my actual kids.) When I give blood, I know it will be put to good use. It’s too valuable not to: the cost of obtaining, storing, and transfusing a unit of blood, I've read, is about $5,000.

I can give you three more reasons to donate blood:

1. A free cholesterol test;
2. Free food (sometimes even doughnuts!);
3. Cool swag.

My local outfit even has a point scheme like frequent flier miles. (I now have enough points to take my wife to a movie and then get a pint of Baskin-Robbins ice cream afterward.) For achieving “Gold” status I got this groovy personalized calendar:

Who should donate blood?

Healthy adults with access to a blood center are obviously good candidates for giving blood. People with rare blood types may be particularly good candidates; for example, those with B negative blood comprise only 1.7% of the population, so the likelihood of somebody needing this blood type and finding a compatible donor is only 1 in 12. For hospitals to keep an ample supply of this blood type has got to be difficult.

Having Type O negative blood makes a person a “universal donor.” Only 6.5% of the population have this blood type; if you’re one of them, it would be a great idea for you to donate, because your blood could be given to other O negative recipients (whose chance of finding a compatible donor is only 1 in 15) or, in an emergency, to people with other rare blood types, such as the B negative recipients I already mentioned.

I hope my cycling friends read this post, because I think athletes are great candidates for giving blood. Why us? First of all, most of us are interested to find out our hemoglobin and/or hematocrit values, as these are a measure of athletic talent—so we get an extra benefit from giving blood. Second, athletes are more likely to have particularly good blood—that is, the right levels of blood fats. I had a full workup recently and my HDL and LDL cholesterol, triglycerides, CHOL/HDLC ratio, and glucose numbers were among the best my mom has seen in her work. (I make no effort to shy away from saturated fats, so I assume it’s the exercise that’s keeping my blood in good shape.) Finally, cyclists’ veins are usually really easy to find, which makes the process go extra smoothly. Several times I’ve been praised by blood centers for my veins:

Who shouldn’t donate blood?

Junkies and prostitutes should not donate blood. There is a written questionnaire and an interview required before giving blood, and those are the two biggies. Having lived in certain overseas locales can also disqualify you.

In my opinion, people who are generally freaked out by needles shouldn’t be expected to donate blood. I myself am claustrophobic, and am very glad society doesn’t expect me to venture into mines or crawl spaces. Presumably the need for blood donations could be met by the large sector of the population who don’t mind needles.

A fitness blogger warned that donating blood can temporarily weaken you. After donating, she estimated it would be a couple of weeks until she was back to full workout strength. A reader commented, “Why did you do that? There are plenty of non-athletes for that aren’t there?” I cannot abide this attitude. If you’re a professional athlete, supporting a family, and your team has invested money, coaching, and supporting staff toward your success, then fine: save your blood (but begin donating upon retirement). Short of that, who cares how strong you are? Is it worth letting accident victims bleed to death so you can get 12th instead of 14th in the next few weekend races? I hold that one of the great benefits of sport is learning humility: how better to do this than to be off your game for awhile?

The blood donation experience

A week or so ago, I made an appointment to give double red cells. This is done via apheresis, a process that takes two units of blood (about two pints, double the amount taken for whole blood donations), and then returns the platelets and plasma to the donor, along with some saline. The brand name of the system used where I give blood is ALYX. The benefit of this kind of donation is that twice the red blood cells can be harvested without any extra discomfort to the donor. Recovery time isn’t significantly increased either.

I arrived and was given some paperwork to fill out. Refreshingly, they didn’t want proof of insurance and there was obviously no talk of billing me and no co-pay. In fact, I got a free bottle of water. As I filled out the questionnaire, a guy came through the lobby on his way out. He paused to snatch another bottle of water for the road, and gave me a squinty Clint Eastwood grin. As he went through the door I saw his jacket had a big NRA logo on the back. All kinds of people donate blood.

As I proceeded to the main area of the clinic, I was struck—as I am each time—by the distinct smell. It’s a little different than the standard bleachy/sterile/chemical smell of a hospital, and takes me back to my childhood when I would visit my mom at work. It took me awhile to figure out what is so unique about this smell: it’s the faint smell of blood. It must be. (I’m not trying to suggest that the smell is strong or that you’ll be grossed out by it, or in fact even notice it. I have a very strong sense of smell.)

That’s not a picture of the blood bank, by the way. That’s my mom in her hospital lab, some years back.

Next I had a brief interview, a blood pressure and pulse measurement, and a hemoglobin measurement (the details of which I’ve included in a later post). Then I was shown to a big cushy reclining chair, a bit like those Craftmatic things you see advertised on daytime TV. Settling into the chair, my right arm carefully propped up on pillows, I entered that rarefied realm of pure passivity, where I do essentially nothing and am expertly fussed over. I can think of only three scenarios where I’m coddled like this. One is when I’ve been in a bad accident and am in the ER—not anything I’d care to schedule. The other is when I’m at a spa. Needless to say, I enjoy getting a mud bath and massage, but the experience is always tempered by a rumination on socioeconomic inequality—that is, the inescapable knowledge that only an accident of fate has made it possible for me to afford this needless pampering while a relatively low-paid valet must minister to me, and my ilk, all day long. (This inequality was the basis for an albertnet short story awhile back.) Only when donating blood can I feel fully entitled to such expert care without actually being sick or injured.

It’s impressive to watch the technician go through his procedures. I was obviously being attended to by a real pro. His movements were precise, his hands steady. I even forgot to be the slightest bit nervous, and just before putting the needle into my vein he said, “You may wish to look away for a moment.” Good point: as relaxed as I am around needles, I don’t care to watch one being inserted in a major vein. But that was over in a moment—the needle was so sharp it didn’t even hurt—and then I was back to watching closely as the technician filled two test tubes with blood (to be tested before my blood is transfused to anybody) and then began the apherisis process proper. (His expert technique was the opposite of a terribly disconcerting blood harvesting scene in “Let the Right One In,” the creepiest vampire movie ever made.)

How apheresis systems like ALYX work is this: a single line goes from your arm. It’s a small clear line of soft tubing, maybe 3/16-inch in diameter. It leads to a machine that is connected to two (initially) empty plastic blood bags. A cuff is put on your biceps that tightens a bit to help your blood flow out through the line. The machine separates the red blood cells from the plasma, so one bag begins to fill with each. After 3½ minutes, the machine reverses direction, the cuff relaxes, and plasma (mixed with saline) flows back into your body through the line for 3½ minutes. This 7-minute cycle repeats four times, after which two units’ worth of red cells have been gathered, and all the plasma has returned to your body. The red cells collected can be given to an accident victim mixed with however much plasma the doctor decides to add, so the victim gets super-rich blood.

Of course, it’s entirely possible to donate blood without watching anything or having any awareness of what is going on. You could simply lean back in the chair and flip through a magazine. (When I donated platelets last year, which is a much more time-intensive process, I watched a video. No, it wasn’t “Let the Right One In.”) All in all, donating blood is less unpleasant than a trip to the dentist.

Myself, I like to watch everything. It’s fascinating. I watched the blood shoot down the tube, which—zip!—went from clear (i.e., empty) to being so dark red it was almost black. Every ten seconds I gave a squeeze on a red foam ball the shape of a blood drop. The blood bags began to fill with fluid: one dark-cherry red, the other somewhere between the color of weak chamomile tea and Mountain Dew. This went on for awhile and I started reading my book. Then I felt the cuff on my biceps relax, and I looked up to watch as the line changed from dark red to a brighter red, then the pink-red of fruit punch, then the color of watermelon Jolly Ranchers, then eventually to yellow, as plasma was returned to my body. I could feel the pronounced coolness of the plasma/saline mixture flowing in through the line. After 3½ minutes of this, the cuff tightened again, I went back to squeezing the ball, and I watched the dark red blood flow out through the tube again.

Four cycles of this—just half an hour total—and I was done. The technician closed off the line with this thing that looks like a pair of pliers, withdrew the needle, put a big cotton ball on my arm, had me hold it above my head for half a minute, then fixed the cotton to my arm with a big stretchy cloth bandage. (This bandage, rather than the “I Gave Blood” sticker, is the real badge of courage if you’re looking to impress your kids.) I waited a few minutes in the chair, then stood up. No head-rush, no weak-in-the-knees, no dizziness.

Just to fulfill my role and not alarm the technician, I walked very slowly, like an old person, over to the recovery area, where during my fifteen-minute recovery period I enjoyed three or four cups of cranberry juice cocktail, a bag of those insanely tasty corn-syrup/salt-encrusted dry-roasted Planters peanuts, and a little bag of Lorna Doone cookies, which I’ve never had before and which made me feel all retro. I’d dreamed of a big puffy raised doughnut with chocolate icing, but there weren’t any this time. I suppose I could just go buy one now … but without having donated blood beforehand, it just wouldn’t feel right.

Afterword

From the perspective of day-to-day activity, I was back to normal by the next day. I had a good dinner, replete with red meat, as a hedge and because I had a good excuse. I drank some extra water. The entire process had taken a little over an hour (including paperwork, etc.); I had no bruise, no hole in my arm, no side effects. (I worked out the next day, and did feel a difference in my strength. But that’s another topic entirely.)

I hope this post inspires a reader or two to donate blood. Feel free to comment below and/or e-mail me at feedback@albertnet.us.

dana albert blog