Blood Donation 4: At the Philippine General Hospital

Below are my facebook notes today when I went to the Philippine General Hospital (PGH) to donate blood to a patient who has been at the intensive care unit (ICU) for a month now…

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Arrived at the hospital around 7:30am. Guard at the entrance won't allow me because I don't have written authorization letter from the patient or his/her guardian that I am donating blood. I said I don't have one because the notice to ask for blood donors was done only via facebook.

Anyway, I went to the 6th floor, patient's room. I was told to go to 2/F, ICU, the patient is there. I saw Rosalie at the ICU, my heart sank. The staff there gave me a form to give to the blood bank as my authorization letter.

At the blood bank, there were many donors in a small room, air con. I arrived there around 7:50am. Guard gave me the form to fill up, medical questionnaire to prove that donor is indeed in good health (no HIV, no malaria, no tatoo, no body piercing, no maintenance drugs, etc.). Then guard said, "Balik na lang po kayo 10am, next batch na po kayo"

Aray ko, paano trabaho ko, sabi ko sarili ko. Pero andito na ako, hintayin ko na, as I remember the sorry condition of the patient. I went out for breakfast, then to an internet shop.

I have donated blood 3x to 3 different patients before. At Makati Med, Asian Hospital in Alabang, and Medical City Ortigas. Donors are treated well in all of them -- clean, air-con, big rooms with cable TV, but few donors. Clean CR is just nearby. The staff there are very friendly and courteous, they told me they really lack blood donors, the hospital has to buy blood somewhere sometimes.

Went back to blood bank section at 10am as instructed, guard said it's only for further interview of our response to the questionnaire, the doctor that will take our BP, heart rate, check any suspicious physical problem, will come at 11am, ouch, then blood sample extraction. All these were finished by 11:30am. We were told to come back after 1 1/2 hours (ie, 1pm) as they will analyze our blood for any impurities (ie, free of HIV, malaria, dengue, whatever viruses/bacteria).

I just got out of PGH compound and crossed Taft to eat and walk around, when the incoming President of the PGH Medical Foundation, JB Baylon, called me. He was in his car and he's going to the PGH, what a coincidence. He asked me to hop in, I did. He brought me to the Foundation office, we talked about many things about public health, PGH, private giving, the Foundation, etc. Thanks for the lunch treat and the chat, JB.

Went back to blood bank around 1:30pm, only to see that those who came ahead of me have never been called yet for the final blood letting. Waited till 2pm, still nothing...

When situation gives you lemon, make a lemonade, so they say. So I walked around and toured the various wards of PGH -- pedia, orthopedic, neurosciences, trauma, etc. My first tour of the hospital actually, by myself. The air around the hospital rooms and corridors seems suspiciously unhealthy. I remember the issue of anti-microbial resistance (AMR) and hospital rooms as nests of new and evolving diseases themselves.

Went back to blood bank around 2:30pm, no one was called for half hour for the actual bloodletting. Many fellow blood donors waiting outside getting more bored, like me.

I went inside and asked what's going on. I saw 6 empty chairs, the staff inside were chatting among themselves, I saw a lady trying to selli bags to the staff.

I controlled my anger as I was told by Andy of the PGH Medical Foundation that the hospital has only one "centrifuge", a machine that tests blood samples for any impurities, which then will be the basis whether to accept or reject a prospective blood donor. That's one major reason why things are soooo slow at the blood bank.

The staff inside, instead of chatting among themselves, at least one of them should have gone out and explain to the waiting blood donors outside, why things are slow, why an ordinary blood donation would ruin practically their whole day's work, but none of that. One male staff, the one who got my blood sample, looked irritated why I asked them when will they call again blood donors so we can go home or go to work.

Later, a lady explained to me that they have to perform 8 different tests to each blood sample. Even if a sample passes 7 of those but fails in one test, a potential donor will be rejected. Sometimes they repeat the tests if they doubt the results. I think it is a valid explanation, but if I didn't ask, she will not explain it to me or to anyone among the donors.

Sensing my impatience, she asked me to sit on the reclined chair for the actual blood letting. Which took me only about 5-7 minutes to fill one bag. Then 15 minutes mandatory rest period.

Went inside the Blood Bank around 7:50am, finished everything by 3:20pm, 7 1/2 hours!

Blood Donation 3: Apheresis

Last Thursday afternoon, I got a text message from a long time friend Joei V, if I can still donate my blood, I said Yes. The patient, a relative of her, was in Medical City in Ortigas, so I went there.

The last time I donated my blood was more than a year ago. I have tried donating twice between last year and this year, but I was rejected. In one case, I have sore mouth or "singaw". The patient, a cousin of my friend, was in serious or critical condition, she was at the ICU of St. Lukes QC for days. The second time, I tried donating blood to Joei herself, she has ovarian C and pregnant for her second child at the same time. Problem was that I came from a drinking party the night before. With delicate patients like her who will undergo surgery the next day, MMC's blood bank rejected my offer.

Unlike my previous blood donation, this time it will be an apheresis procedure. They will get only a particular platelet or blood cells and the rest of my blood will be returned back to my body. It's an efficient system but will be more time consuming compared to an ordinary blood donation. While the latter will take only about 15 minutes, apheresis will take about 2 hours or more.

Here is the machine that will separate the wanted platelet or blood cell and ordinary blood. In front of my inclined "bed" is a tv with cable.

The whole procedure actually took about four hours. First, they have to screen and test my blood to test for any impurity which might endanger the patient instead of helping him/her. It's more than an hour wait to get the result. The med tech guys at the blood bank said I could not eat anything "heavy", crackers was ideal, so Joei bought me skyflakes and water. I gobbled about 4 packs total :-)

Then when things were clear, no impurities (no HIV, no dengue, no malaria, etc.) in my blood, they set me up for the machine.

What I felt was when the machine was drawing blood from my arm, the cloth around my arm would inflate, I have to squeeze a small rubber ball to quicken the outflow of my blood. After sometime, the cloth will deflate, it's the process were the unneeded blood is returned back to my body while the needed platelet is deposited in a plastic container.

While waiting, I was able to watch BBC news update on the Olympics, then Bourne Supremacy on HBO, then motorcycle daredevil stunts on ESPN. Enough to entertain me as sleeping while undergoing apheresis is a big no-no.

There are many Nos and prohibitions for blood donors, if they wish to help patients. Like no alcohol at least 24 hours before blood donation, no tooth extraction for several weeks or months, no tatoo or body piercing over the past 12 months, not taking any maintenance drugs, no hypertension, no diabetes, no high blood, no fever or cough, no contact with a commercial sex worker for several days or weeks, should be at least 18 years old, at least 110 pounds in body weight, etc.

That is why I advice my younger friends, they should not have tatoo in their body, because they will never know when they will be required to donate their blood, say a family member or a dear friend of them would suddenly have an emergency need for it, they cannot donate their blood even if they are super-fit and healthy, within 12 months that those needles and ink were piercing their skin. Healthcare is mainly personal responsibility, not government responsibility.

This is Medical City in Ortigas. It is a modern hospital, possibly comparable to the modern St. Lukes Medical Center, Makati Medical Center, and Asian Hospital.

I have a brief chat with the med tech guys at the blood transfusion section. They narrated that there is really a big supply gap in blood. They estimate that for every 10 bags of blood that they dispense, only about four bags come in from some donors. So they have to buy blood somewhere else for their patients. I commented that the location of Medical City is rather "far" from populous areas, unlike say, St. Lukes QC, MMC, and Asian Hospital.

Anyway, back to my main point: healthcare is mainly personal and parental or guardian responsibility, not government's. Preventive healthcare more than curative healthcare. Have a healthy lifestyle, one can drink occasionally like I do, but not too often. Drink lots of water, do not believe the soda companies and their heavy ads. Have lots of fruits, veggies, fish, non-fried food, etc. All the essential vitamins and nutrients we need are found there, no need to buy probably those vitamins and supplements that are heavily advertised.

And no need for drug price control and related policies by the government to intervene in the competition among innovator pharma, among generics pharma, among drugstores and pharmacies.

Oopppss, I nearly forgot to mention. Joei herself is undergoing chemotheraphy for her ovarian C. She is a brave lady. With two young kids, aged 3 years and 3 months old, I pray for her full recovery in her battle against big C. I told her that my elder brother, his wife and my sis in law, died of cancer too.
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See also:
Tips in blood donation, December 23, 2010
Tips in blood donation, part 2, April 03, 2011

Tips in blood donation, part 2

Last week, I announced in my facebook status that I was ready to donate my blood again. That I'm blood type O and I will prioritize giving my blood to friends, their family members and close friends. The first time I donated blood was last December, I gave it to a dear wedding godmother who was in a life-and-death situation at the ICU in Makati Med and I wrote my experience there in Part 1 of this new series.

Early this week, I got a call from a friend, Kosha Villar, saying that her officemate knows someone urgently in need of blood, that the patient has been at the intensive care unit (ICU) for a week already. It broke my heart to hear this, so immediately said Yes to her. The patient though is at Asian Hospital in Muntinlupa, rather far from Makati and the blood donation section closes at 5pm. So the patient's friend said they can wait on Saturday.

About two days after I said Yes to the above patient, I got another call from another friend, asking if I can donate my blood to her friend who has leukemia, confined at the National Kidney Institute (NKI)in QC. Another sad news for me, but I told my friend that I already promised to give my blood to another patient at Asian Hospital. She understood.

This will be the second time that I will donate my blood and I realized just how important it is for other people. You are helping a patient in really critical, balancing between life and death conditions.

Yesterday morning, I went to Asian Hospital in Alabang, Muntinlupa. I just took the bus as it is expensive to go there (tollgate, fuel, parking). At the 3rd floor, the blood donation section, while filling up the information sheet, I realize how far I am in the friendship-link from the patient. It goes like this: the patient's husband is a close friend of the brother of the officemate of my friend.

Patient --> her husband --> his friend --> friend's brother --> my friend, Kosha --> me.

That's five connections away. So when I met the father of the patient, Celso, he should be 60s something, he was very happy to meet another stranger donating blood for her daughter. Except for my friend, I have not met any of them before.

Here I was, lying again as blood was pumped out from me. Some 450 ml or nearly half-liter was taken away from my body yesterday. As I was lying there, Celso was looking at me, he was all smiles, a picture of joy was very clear in his face. I asked him, "Sir, can you take my picture from my cellphone?" He readily agreed.

As I noted in Part 1, you should be in top shape you intend to donate blood. You should check NO to about 20 or 25 questions like:
* Do you have body piercing, permanent tatoo, etc. in your body?
* Do you have HIV or AIDS or STD?
* Do you have diabetes, had malaria, dengue, etc. recently?
* Do you have hypertension, other diseases of the heart...?
* Did you take alcohol the past 24 hours?
* Did you have tooth extraction the past week (or month?)?
* Did you engage in homosexual practice recently?
* Did you have contact with any commercial sex worker recently?
* Have you been to certain areas of Africa, certain provinces of the Philippines such as ...?
* Are you taking maintenance medication against hypertension, high cholesterol, etc.?

Boy, it's 2 pages, back to back, of checking NO to the above questions. But there are some questions that you should check YES. Like, "Are you aware that you are putting in danger the life of the patient who will get your blood if you give wrong information above?"

And after submitting the information sheet, to include your full name, age, address, your contact person, etc., a pathology department staff will again ask you those questions verbally to check if there's any hesitance in your answer. And then she will take your blood pressure, then get a sample of your blood for testing -- against any infection from malaria, dengue, HIV, STD, and other undesirable diseases.

I think those precautions should be strictly observed. A blood donor who lies in any of the questions above, like denying that he/she has high alcohol content in his/her blood (say, after a drinking binge the night before) will further imperil a patient who may be in a 50-50 situation already.

The pathology department staff noted that my blood pressure yesterday was rather high, 130/100. I told her that I lacked sleep, I worked until 12:30 midnight of Friday, went to bed at 1am, woke up at 7am. She said that's fine, they need a blood donor to have slept at least 6 hours before. I told her that my normal bp is 120/80 since about 20 years ago. And that I take zero medication, not even any multi-vitamin supplement. She smiled.

My blood, ba-bye! I was given a tetra pack juice for immediate rehydration. Then I remained lying down for 10 minutes after the huge syringe was pulled out from my left arm.

Like in my previous blood donation, I did not feel any dizziness, any weakness after, nothing. Then Celso told me about her daughter's condition. Yesterday was her 10th day at the ICU. Two weeks ago, she had bad LBM, she was severely dehydrated when she was brought to the hospital. The physicians suspect some form of blood poisoning, so the patient will need more blood infusion.

Celso offered to bring me to her daughter's room. The patient's sight broke my heart: a tube in her nose, a tube in her mouth, several tubes in her arms, she was sleeping in pain, several monitoring instruments beside her. She's only 34 years old, has 3 kids and her youngest is only 8 months old.

I did not like the sight of her pitiful condition, so after about 2 minutes, I bid Celso goodbye and again, he profusely thanked me.

Healthcare is mainly personal responsibility, it's not government responsibility. We should take care of our body. For our own health. For our kids and family. And for other people who someday, will be needing our blood.

Tips in blood donation

A dear friend to us, one of our wedding "ninang" (godmothers), is sick, and she badly needed blood donors. Yesterday, I donated blood for the first time in my life. I attempted to donate blood in the past, but on those occassions, either I just got back from illness myself, or was taking medications, so I did not qualify to donate blood.

Just two days from now, it will be Christmas. I feel very sad to see our ninang in the hospital, sick and weak. She has been there since last week. Like when my kid is sick, I wish that her pain can be transferred to me if only to alleviate her condition. The same feeling I had yesterday as I walked out of her room, going to the hospital blood bank to donate my blood.

Here are some tips for potential blood donors, whether donating a blod to a beloved friend or family member, or giving blood on a regular basis to anonymous beneficiary.

The following can NOT donate blood, despite deep desire to help:

1. Been sick lately, and taking medications
2. Lighter or thinner than 110 lbs
3. Below 18, above 60 years old
4. Had tooth extraction, major operation/surgery, tattoo, ear/body piercing the past year
5. Donated blood within the past 3 months
6. Taking maintenance medication except vitamins, hypertensive/high blood people on regular drugs
7. With history of illegal drug use in the past
8. Pregnant women, of course.
9. Have HIV/AIDS, or had unprotected sex with a commercial sex worker recently
10. Currently has a high blood or low blood, or had heavy high octane drinks in the body the past 24 hours.

There are other prohibitions, depending perhaps on the hospital that is taking the donated blood.

Donors go to the hospital blood bank, fill out a form, indicate the name of patient whom the donor wants to give his/her blood, sign the form.

Then a physician will interview the potential donor to verbally ask some questions that have been answered in the form, like "have you really not used a commercial sex worker recently, you really are not taking any maintenance medications, etc." The physician then takes your blood pressure, your pulse rate, then signals a staff whether you are indeed eligible to donate blood or not.

If you are, a staff will get your blood sample. To determine your blood type, to see if you have HIV or other communicable diseases, or whatever indicator. You go back to your chair and wait to be called if indeed you can donate blood.

When you're called, then you lie down on a bed to have the actual blood donation. In my experience yesterday, actual blood letting was only about 10 minutes or less, and 450 ml of blood was removed from my system. It was not painful for me, except the initial injection of the needle to penetrate a blood vessel in my arm. There is a tv in the room on a sports channel, so donors can watch a basketball game or other sports on the screen.

The staff comes back when the plastic bag is already full -- 450 ml of blood was taken out from my body within 10 minutes or less. Lie down for 5 to 10 minutes more to rest, applying some pressure on the part where the needle exited.

This was how my arms looked like yesterday, minutes after the blood donation. The right arm was for the blood test. The left arm was for the actual blood letting.

I did not feel any dizziness after, nor felt weak. I just felt dehydrated though. After blood donation, the staff gave me a tetrapack juice to rehydrate immediately. After consuming it while walking, within about 15 minutes, I got thirsty again. So if you donate blood, bring extra drinking water.

Lesson one: Be in good health always. For yourself and your loved ones. Because even if you are not sick but on maintenance drugs or have high blood/low blood, etc., and one person very dear to you will need your blood someday, even if you wish to help, you simply cannot.

Lesson two. Health is mainly personal (and parental) responsibility, not government responsibility. People should not over-smoke, over-drink, over-eat, ovet-sit (sedentary lifestyle), over-fight (and have stab wounds from time to time), then they run to the government to demand that "health is a right".

There are many cases of course, that people will get sick even if they do not abuse their body -- like our ninang in this case. Biology and human genetics also determine our health, aside from our lifestyle. But assuming more personal responsibility about our personal health is very important.