Doping Journalists, and "Un-Boosting"

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

Introduction

This month’s “Outside” magazine has an article written by a guy named Andrew Tillin who decided to cheat at bike races—by taking synthetic testosterone—so he could write about the experience. (Kind of like a stand-up comic going to a strip club “ironically” to “gather material.”) What perfect timing: in this post, I document my own cycling performance experiment, which is similar and yet opposite. Over the last two weeks I’ve tried a more novel approach: un-cheating.

I could call my process un-doping, but that term has been taken already, by me. What I mean by un-cheating is doing the opposite of blood-boosting. Blood-boosting is among the most popular methods by which pro bike racers cheat. It consists of taking blood out of your body during the early cycling season, letting your body replace that blood over the months, and then putting back in the original blood right before an important bike race. This gives you extra red blood cells, which means an enhanced ability to carry oxygen to the muscles. The methodology—which is both illegal and highly dangerous—is known to be highly effective.

What I have done, in contrast, is to have blood—specifically, two units of red cells—taken out of my body so that it can be given to somebody who really needs it: not a pro athlete, but an accident victim. (For details about my recent blood donation, click here.) While my body is gradually replacing the red cells, I experience a loss of strength that is the mirror opposite of what an athlete gains from blood-boosting or using EPO. Instead of measuring the performance increase of doping, I measure the performance decrease of its polar opposite. I’m really out to show the same thing as the “Outside” writer: that is, the delta between supercharged and worn-down, between doped and clean. I’m just coming at the matter from the other direction.

In this post I shall examine the existing literature on journalists doping to get their stories; describe my methodology for measuring my performance before and after giving blood; describe subjectively the experience of hard riding with two units of red cells missing; and document my performance during the two weeks prior to donating blood vs. the two weeks afterward. There are charts and graphs. Finally, I will describe the epiphany I’ve had in the process of this rather odd experiment. Surprisingly, the experience has given me hope for the sport.

A flawed journalistic approach

There is so much wrong with Andrew Tillin’s “Outside” article. The very first sentence shows how out-of-touch the guy is: “Now I know how Floyd Landis feels.” Like hell he does! Floyd Landis has lost everything. Landis dedicated his life to cycling; won (or appeared to win) the Tour de France, the greatest bike race on the planet; was the first rider in history to have his Tour title stripped for doping; went broke and suffered worldwide infamy by trying to defend himself; was humiliated all over again when he finally admitted his defense was a lie; was abandoned by his wife; has no obvious career prospects; and is being sued for defamation by the international governing body of cycling. Tillin, through cheating, has gotten himself a book deal, while only suffering the wrath of a few blogger-types, along with a slap on the wrist from USA Cycling. (They’ve banned him from competition for two years, but he was only a casual weekend racer anyway.) For Tillin to compare himself to Landis almost smacks of narcissism.

Tillin decided to dope with synthetic testosterone “in part because it was the same stuff Landis apparently used to win the 2006 Tour de France.” Tillin selected it, he says, despite the opinion he cites of some scientists who deny that synthetic testosterone would be particularly useful during a stage race. He snorts, “Could’ve fooled Landis.” What Tillin is not realizing or acknowledging is that Landis wasn’t just taking testosterone; by his own admission, he was also blood-boosting and taking EPO. The other reason Tillin chose testosterone, he says, is for “the general health effects it might bestow.” As I read, I began to think this was a guy who just liked the idea of jacking up his manliness, and used the journalistic project as an excuse.

This impression was only reinforced when I got to the part where Tillin drops a bunch of (local 45+ year old) guys in a race and thinks to himself, “Take that, you motherfuckers. There’s more.” That Tillin would even have such a thought is bad enough; to freely admit to having thought this is just bizarre. On what grounds does he deserve to call his non-doping rivals “motherfuckers”? He blames the testosterone for his outburst. Yeah, right. I highly suspect he’s just a jerk.

Then, Tillin ended up only getting seventeenth place in the race because, he says, he was “strong enough but not smart enough.” Well, isn’t smart riding the whole point of bicycle racing? In describing his motivation to do the doping experiment, Tillin cited his suspicion that many in the peloton were doping, complaining, “Scumbags. Who can hold down a job and ride like these jerks?” The answer is, people who have been racing for two or three decades and actually know what they’re doing. Ultimately, Tillin is just a wanker. He has no expert insight into the physiology of the sport and how much of his improvement was from the drugs. Perhaps his book gives a lot more detail than the handful of anecdotes in his “Outside” article, but based on what I’ve seen of this guy I’m not inclined to read it.

The other problem

The other problem with this article is that it’s not much different from another doping-journalist article that “Outside” already ran, back in 2003. Did the “Outside” editors forget about that article, or were they just counting on their readers forgetting it (like how “Cosmopolitan” runs the same “ten secret sex tips” article every other month)? In “Outside” magazine’s original doping-journalist article, a guy named Stuart Stevens spent eight months taking synthetic testosterone, synthetic human growth hormone, anabolic steroids, and EPO. His article provides a lot more detail than Tillin’s, giving us a few numbers (e.g., his hematocrit—a measure of the oxygen-carrying red cell concentration in his blood—went from a decent 43.8% to a stellar 48.3%). He also gives some nice history and background about doping.

But Stevens’ article ends up with the same problem as Tillin’s: Stevens doesn’t really quantify the benefit of all those drugs. Okay, he got all huge. He gained weight while his body fat percentage dropped. He felt fine, for once, following a double-century (i.e., 200-mile) ride. But the big race Stevens was working toward with all these drugs was a tandem race. He was sharing a bike with another guy who wasn’t doping! It’s almost like he went out of his way to make sure there could be no objective measurement of the benefit he got from the drugs. What a waste!

My approach

There are many differences between my approach and that of the “Outside” writers:

• I did not do anything illegal;
• I did not do anything unsafe;
• My level of performance is not subject to the natural improvement that relative beginners can make so easily—after thirty years of competitive cycling I’m about as good as I’m going to get;
• For many years I have been carefully documenting specific performance measurements, taken over fixed routes up some favorite climbs, and have a very solid benchmark of pre-blood-donation performance;
• I have analyzed the two weeks before and after the blood donation very carefully;
• I present hard data that makes the effect of my experiment very easy to quantify.

There are several facets of performance that I measured before and after giving blood. They include the following:

• Immediate impact on power output after donating blood;
• Impact on heart rate of having donating blood;
• Endurance over a difficult course (i.e., power output, heart rate changes over several hours) pre- and post-donation;
• Day-to-day recovery, pre- and post-donation (i.e., power output on second consecutive day of riding);
• Rudimentary measurement of athletic efficiency (ratio of heart rate to power output);
• Recovery over time from having given blood.

I should note that my power measurements are taken from a fairly rudimentary device. Rather than measuring the actual force put into my drivetrain, my bike computer measures rate of vertical gain (based on changes in barometric pressure) and calculates power using the equation f=mgh, where m is my mass (a constant I programmed into the device), g is the force of gravity, and h is the elevation gain. As a power meter it’s pretty useless on the flats, but fairly useful when comparing relative output on climbs, especially the consistently steep ones I favor. My two favorite climbs are South Park Road (just under a mile at an average grade of 11.1%) and Lomas Cantadas (just over two miles at 10.6%). (Vanity compels me to tell you that the power numbers calculated by this device are a lot lower than a real strain-gauge power meter would give).

The origin of my study

It is not the case that I gave blood in order to conduct this experiment. Rather, it was the other way around. I was giving blood simply because it’s a good thing to do, and when the technician measured my hemoglobin—which the clinic must do to make sure I’m healthy enough to give blood—my idea was born. My hemoglobin came out at 14 grams per deciliter (gm/dl), which roughly equates to a hematocrit of 42%, the low end of normal but high enough for donating double red cells. What got me thinking was that the last time I’d given blood, about six months before, my hemoglobin was only 13 gm/dl (a hematocrit of about 39%, which no athlete would want).

One’s hemoglobin/hematocrit levels are generally assumed to be God-given—a measure of talent—though they can be affected by external factors. Why the difference in my last two readings? Probably because the last time I gave blood was about two weeks after a grueling two-day stage race. It’s well established that intense endurance events can erode even a very fit cyclist’s hematocrit, which is precisely why the cheaters micro-dose themselves with EPO during a three week stage race. They don’t use enough EPO to measurably increase their hematocrit, which could get them busted, but just enough to keep it from declining as it otherwise would. Blood-boosting achieves the same effect.

After learning of my hemoglobin number, I was immediately curious what giving up two units of red cells would do to it. But it would have seemed strange to ask the lab to measure me again right after my donation, or the next day; after all, these are professionals with real work to do, and anyway they wouldn’t have understood the nature of my request. But I could always study the effect empirically. For no real reason, I am very meticulous about recording all kinds of cycling performance data anyway, so it wouldn’t be much extra work to study the performance implications of being down a few trillion red cells. It’s a great simulation, I think, of having raced a week or two in a Grand Tour.

(How long does it take to get back to normal after donating double red cells? Depends on what you mean by “normal.” The folks at the blood bank said I’d feel fine the next day. When I asked specifically about hard exercise, they shrugged, and said “Maybe a few days or a week; get plenty of food and drink, you’ll be fine.” They’re coming it at from the perspective of normal good health, not of obsessive athletic performance. How long until every last red cell has been replaced? Sixteen weeks. That’s right, 112 days; that’s when they tell me I’m eligible to donate blood again.)

First ride after donating blood

I was told to avoid strenuous exercise for twenty-four hours after giving blood. After doing a little Internet research to make sure that hard-core cycling truly was safe at this point, I mounted my bike: twenty-four hours almost to the minute after giving blood. I didn’t expect to feel good, and I didn’t. But what surprised me was my heart rate. It was a lot higher than usual, and yet I was going slower. On South Park, my main climb, my heart rate averaged 161 bpm, which is 7 bpm higher than the 154 bpm I’d averaged on the same climb two days before. That may not seem like much, but it really is—on that same climb, over the 24 trips up the hill I did between Jan 1 through April 26 of this year (that is, up until giving blood), I averaged 155 bpm. Last year, across the 86 times I did that climb, I averaged 156 bpm. You can see how consistent my heart rate normally is; to be at 161, at this lowly pace, was really weird.

I’ve studied my heart rate for years, and find that when my legs are tired, my heart rate doesn’t go as high. It’s as though my heart is stronger than my legs, so when they’re tired, the heart gets to loaf. As a rule of thumb, when I feel great one day, and my heart rate is really high, I’ll feel pretty blown the next day and the heart rate will be a lot lower. I was curious to see how my legs would feel, and how fast my heart would go, the second day after giving blood. On the one hand, I’d have generated about 200 billion more red blood cells by the next day; on the other hand, I’d probably be tired from this strange ride.

Second ride after giving blood

I took a rest day after that first post-donation ride: not because it had been a particularly hard ride (it was in fact a bit shorter than my normal loop) but because I was tired and I’m a busy person. So the following day, I figured I’d be that much more rested, and have that many more blood cells. This time, it being a weekend, I rode with my buddy Craig. We’re normally fairly evenly matched—he’s a bit better so far this season—so I figured riding with him would motivate me to dig deep.

Not that I had any choice. We decided to do the Hill Climb Extravagaaanza (HCE), a route we’ve been tinkering with over the years that tackles the toughest climbs in the area. Over about 50 miles we racked up over 7,000 feet of vertical gain. Here is the route:

My heart rate was back to normal for the first few climbs: I averaged 153 bpm on both South Park and Lomas Cantadas. I was certainly slower than usual—almost a minute slower than average on South Park, and 2-3 minutes slower on Lomas—but I was getting’ ‘er done. Then, as the ride wore on, I just started to peter out. My heart rate began to slide, along with my power output, until I was wallowing in the mid 140s heart range, putting out power in the low 200s. (You can see all this in the graph above.) Pretty pathetic. I felt bad for Craig, who after all was looking for a workout and was occasionally dropping me by accident because he forgot to hold back. Fortunately, he’s a good guy to chat with. We joked around about how I should see a doctor: “I don’t know why, I just feel kind of tired lately!”

We met up with our bike club and did one more climb, Tunnel Road. This is everybody else’s warm-up climb, so the pace normally seems tediously slow to me (since I tend to do a few climbs before meeting the group). This time, I was on the ropes, having trouble just hanging on.

You could blame my fatigue on the brutal route, but actually I often seem to get stronger as a ride goes on. (My best time of the year up Lomas, a 17:07, was when I’d already ridden than eighty miles.) Clearly, the lower red cell concentration hugely affects endurance. From now on, when I see a clean Tour rider cracking in the last week, I’ll have that much more empathy.

Day-to-day recovery after giving blood

I really didn’t feel much like riding the next day, but I was committed to my research project, and besides, it was a glorious sunny day. Wow, what a travesty. I managed to make it up South Park, but just barely. My power output for this climb, a mere 240 watts, was a whopping 20% below my pre-blood-donation average for this climb for 2011. My heart rate was also down, 9 bpm below my average. Further study was impossible: at the top of the climb I was a broken man, and just coasted on home like a dog who is ashamed of making a mess on the carpet and slinks miserably out of the room.

Again, it’s not the case that this fatigue was solely due to the brutal ride I’d done the day before. I refer you again to my best Lomas time of the year: it was on a Sunday following a Saturday HCE with Craig. Continuing to train, post-donation, felt like digging myself into a deep hole.

Measurement of efficiency

Surely you could speculate about the extent to which morale and other psychological factors might play into this. You could say I expected to go slower, so I did—a reverse-placebo effect. Could it be that I’ve just been loafing, using my blood donation as an excuse to become my laziest self?

I have three reasons to believe that my fatigue is real, not psychosomatic. First, I’ve been riding long enough (thirty years) that I don’t think my psyche is as malleable as that of a newcomer. For a veteran cyclist, suffering on the bike is just an instinct—it’s not something that only happens when the conditions are just right. (Describing a cyclist as a “robot” can be taken as praise: despite the rigor of the sport, you keep climbing on the bike, day after day, and go put in your suffering like turning on a faucet.) Second, a couple of these post-donation rides were with my pals, which pits my vanity against my laziness—who can bear to get dropped without giving it his best? Third, I’ve been tinkering, over the last five years, with an objective measurement of efficiency.

My efficiency measurement is pretty simple: over a known climb, I’ll simply compare my heart rate to my average power output and express this as a ratio. For example, if I averaged 160 bpm on a climb while putting out an average of 320 watts, my ratio would be 2.0. This number will of course vary from person to person, and all kinds of things can affect heart rate, but as a relative measurement I’ve found it’s pretty consistent. If I’m doing anything close to 2, I’ve got good form and was having a good day. If I’m out of shape, the number is closer to 1.7. For the purposes of my current study, this ratio is useful because if I were simply loafing, both my heart rate and my power would go down together and the ratio wouldn’t be hugely affected.

In this case, my power/HR ratio went from 1.88 pre-donation down to 1.71 post-donation: a drop of 9.8%. My heart rate on these climbs did drop, but not much: on South Park, for which I have the most data points, the difference was only 2 bpm average, pre- vs. post-donation. And yet the power output delta is 29 watts, or 11.2%, for this climb—a major difference. I wasn’t loafing: my body just wasn’t as efficient during the two weeks following my blood donation. Which I’d expected: more red cell means better transport of oxygen to the muscles; fewer red cells means less efficient transport of oxygen.

Data crunching

The closest thing all the data come to producing a punch line is this: my lowered hematocrit dropped my power between 9.6 and 9.8% (9.6% across all measured climbs, 9.8% across South Park rides). Imagine if instead of taking two units of red cells out of my body, I’d added two units. I’m not sure if the effect would be equivalent in either direction, but assuming it were, I could put out 9.6% more power if I blood-boosted.

Applying this power increase factor to my best time on, say, the ten-mile climb up Mount Diablo (i.e., multiplying my best time by 0.904), I could theoretically go five minutes faster and be in range of a top-ten finish in the big race they have up there. Not bad for a big heavy guy whose specialty is much longer events. Of course, this is only a hypothetical result, not nearly as convincing as empirical results gained through doping—but isn’t it better to make an educated guess, based on the blood-donating data I can gather honorably, then to cheat at sport while needlessly endangering my body?

For the real nerds out there, here are all the data I’ve crunched about my rides, presented in handy tables and charts. (Not all the pre-blood-donation rides are shown; I left out a couple of flat and indoor ones because they don't yield any power data.) Needless to say, you’ll want to click on these charts to zoom in. If you’re not into data mining, scroll past them because there’s more to my story below.

Gradual recovery

It’s not obvious from the data, but I am gradually recovering, performance-wise, from my blood donation as my red cells gradually get replaced by my bone marrow. (From a non-cycling standpoint I feel completely normal, as I had within a day or two of donating.) Last Saturday, I got up before dawn and rode up Mount Diablo. It’s about an 83-mile ride door-to-door, with 7,500 feet of cumulative gain. This ride is never easy, especially solo, and especially on a windy day, which Saturday certainly was.

What I found was that, unlike my first post-donation HCE with Craig, I felt increasingly better as the ride went on, which trend I associate with solid fitness. I didn’t feel very good on Mount Diablo itself, but that’s partly because it was so cold. Later in the ride, I (needlessly) tackled a monstrous grade on Reliez Road, and on the steepest section was putting out 286 watts at only 150 bpm, for a very solid power/HR ratio of 1.91. Not bad for 65 miles into the ride. I felt even better on the next climb, halfway up Happy Valley Road (or “Half-Happy” as we call it); on the steepest section I put out 290 watts at 152 bpm for the same power/HR ratio. Here’s the graph of my ride:

It was really heartening to feel better as I went. This was completely the opposite of what had happened on my first really hard ride after donating blood. My recovery has been gradual, but unmistakable.

On the last climb of the day, Wildcat Canyon, I went easy because I was no longer worried about getting home in time to take my daughter to her soccer game. Moreover, I was tired and wasn’t entirely sure I wouldn’t suddenly blow up. (You can only know your body so well.) But at the top, I ended up hammering. Let’s look at my training diary entry for details:

Toward the top of Wildcat I passed some novice-type and said hi. He returned the greeting but then tried to drop me! I mean, what kind of desperate ego did this guy have that he could delude himself into thinking he could best me somehow by getting to the top first, after I’d already passed him? But I wasn’t really irked or anything. Normally I wouldn’t respond at all to such a thing, maybe I’d just shake my head. But I was feeling ornery, and my legs felt good, so I figured I’d just accelerate slightly and put the guy in his place, like a powerful government quietly squashes a tiny rebellion without firing a single shot. But to my great surprise, the guy surged again, this time getting out of the saddle and trying to sprint, with this ineffectual, mincing little pedaling motion that gravely insulted my male ego. I mean, just with whom the hell did this dude think he was dealing? Without giving him the satisfaction of getting out of the saddle myself, I upshifted two gears, increased my cadence, and just obliterated him. I Cancellara’d that little poser so bad that not only did he cease to exist, but his entire ancestral line was expunged from history. I guess I was a bit grumpy from all the wind.

I include this bit because long after the ride was over I kept marveling at how inordinately ticked I’d been at this guy’s antics. They were certainly nothing new; guys do this kind of thing all the time. But then it dawned on me that the problem with this guy’s attitude is exactly the same as with the doping journalists and dopers in general. He had indulged an ugly willingness to believe a lie, in the service of his ego. He could ignore the fact that I’d passed him, just as dopers ignore the fact that they’re cheating; both manage to get an ego boost from an achievement that is an illusion. This willful delusion is, to quote Poe, the “lie thy soul hath spoken!”

Obviously the guy I dropped on Wildcat had committed only the slightest misdemeanor—a victimless crime. At the other end of the spectrum are the pro cyclists who cheat, who are essentially robbing the clean cyclists of their full earning potential, not to mention of glory. How can these cheaters actually pump their fists after winning a race? Have they managed to blot out the giant asterisk that accompanies every instance of their success?

Between these extremes fall our doping journalists. They’re making money off doping, just like the cheating cyclists. They’re also enjoying a level of strength they didn’t earn, just like the cheaters. Ultimately, they’re giving in to the temptation to know what it’s like to have an unfair advantage. Particularly in the case of Tillin, it’s an enjoyable game; he had, after all, complained about being beaten in Masters races, and in the heat of competition—“Take that, you motherfuckers, there’s more!”—savored the illusion of being better than his rivals.

Journalistic ambitions aside, these two are bullies whose meager analysis isn’t worth the risks they took with their health.

Conclusion – the upside

I had a small epiphany toward the end of my experiment. Whereas the journalists only ask “what can be achieved through doping?” my experience led me to ponder what can be achieved by not doping, or in my case putting myself at a disadvantage by hobbling my blood while my cycling pals are at full strength. As much extra suffering as I did in the two weeks following my blood donation, I couldn’t help but appreciate that I was still doing some pretty gnarly rides, and with passable grace. Whereas cheating cyclists and doping journalists are cowards, I have felt courageous. It’s not easy facing the HCE or a solo Mount Diablo when my hematocrit may well be brushing up against actual anemia, but I’ve been doing it, and enjoying it.

Perhaps this satisfaction, in the face of terrible odds, is what keeps the clean bike racers going. It cannot be easy lining up at the start of a brutal road rice alongside riders you know are doping, but the honorable riders keep on showing up. In the process, they are literally keeping their sport alive—rescuing it from the bullies. Next time I watch my heroes lose, rolling over the finish line well behind the winner, perhaps I’ll feel that I’m just a little bit closer to knowing what they’re feeling.

dana albert blog

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