Donating Blood Is Not Enough

On the eve of my birthday in 2021, as I had resolved to do earlier that year, I walked in to a blood bank and donated blood for the first time in my life. The resolution was to do it every year around my birthday but here I walked in a day earlier just to get a feel, to enquire how to go about it and to check if at all I needed any kind of preparation or consideration. Turns out, you don’t need any kind of preparation. As long as you are healthy, have your blood pressure in the normal range (90/60-120/80), have a good haemoglobin count (12-17), and have had a decent meal 2-3 hours ago, you are good to be pricked.

After filling a long form answering detailed questions about my health, I laid back on a blood donor couch and let the phlebotomist draw blood from my left arm, thanks to the more-than-superficial availability of an artery there as compared to in the right. Take a moment to consider this. If you’ve ever donated blood or taken a blood test, the easy availability of an artery on the inside of your elbow is crucial for a smooth draw or flow. My left arm has never let a nurse down.

The needle used to draw blood for a donation is larger than the usual size of a syringe’s. That is why it took only about 15 minutes to draw 450 ml of whole blood from my body. It felt good and I quickly made another resolution: donate blood every four months. (Technically, you are fit to donate whole blood every three months.) During this process, and thanks to a brochure that one of the nurses handed me and no thanks to switching on the television and putting on a Hindi-dubbed Telugu movie even after I said no, is when I learned that there are three to four types of blood donations. Till that moment, I had no idea about this. According to the Red Cross, there are four types: whole blood, red cells, platelets, and plasma.

The difference lies in what is drawn from your body. In simple words, a whole blood donation collects everything i.e. every component of your blood as a whole. In red cells, platelets, and plasma, only the red cells, platelets, and plasma are drawn respectively. This is done using a centrifugal-driven system that first collects the whole blood, separates the desired component, and then sends the remaining components back to your body. This is why these donation processes take longer, often extending to about two to three hours.

I know it takes longer because I spent nearly that much time when I went in for a single donor platelets (SDP) donation at the same blood bank the following month. Unlike my voluntary walk-in the first time, this one came in as a response to a request. (Apparently, you can donate platelets every week.) Last time, the phlebotomist had educated me about blood donation, its different types, and how the Covid-19 pandemic has reduced the number of blood donation camps and donors willing to walk in. I hence agreed to add my name to their registry so that they could call me in case of an emergency requirement. So, when the guy called me for an SDP, I couldn’t refuse. I like to see blood donation as a selfless act. My left arm was ready once again. I donated 500 ml of blood platelets that day.

Only, SDP is both a time-consuming and physically-demanding exercise. Not only does it take two to three hours, but it also gives you cramps, gives you tingles in your lips, and bores the heck out of you even if there’s a Hindi-dubbed Telugu movie playing on a screen. The equipment that does the magic has a very low error margin but it’s not zero. Although it troubled me a little, I had a more critical issue to worry about.

After the SDP drawing, my left arm was incredibly sore for over a week. This troubled me more than anything that year because it also affected my work, and I ended up deciding not to accept SDP donation requests henceforth. The phlebotomist called a few times after that but I politely refused, giving both the reason of the sore arm and my schedule. Yet, he persisted.

Owing to my resolution of donating blood every four months, I decided to say yes to him when he called me around four months after my maiden donation. I was not willing to make an SDP donation and offered to make whole blood instead. There was something in his reply that made me say yes anyway. We scheduled for the following day.

This is where it gets interesting. After the preparation (they make you pop a calcium tablet to avoid cramps), I lied back on the couch and we started the process, again with my left arm playing the courageous warrior. Only this time, either the machine malfunctioned or my left arm let us down or both. I am still not sure what happened because 20 minutes into the process, I developed a bulge around the pricked area. To avoid aborting lest we lose the already collected platelets, we moved the needle to the right arm. The same thing happened and we had to abort the procedure, wasting an entire collection kit in the process. About 200 ml platelets were collected.

On the ride back home, I began thinking about the series of events that led to this incident. All was fine after that first one. I was happy, my arms were happy, my body was happily regenerating blood, and my donated blood was making at least two other people happy. Trouble started with the second donation, the SDP donation. Not to even mention what happened the third time. That day, the bulge flattened immediately after I left the blood bank. But it left a bluish mark slightly below the pierced area, which then took its own sweet time to disappear. I didn’t have a sore arm that third time but it did give me a sore feeling. Add to that the cold response of the phlebotomist just before I agreed for the SDP donation, and I realize that donating blood is sometimes not enough. It doesn’t take much time for a voluntary blood donor to become a commodity, regardless of how altruistic the deed may be.

“Whole blood is fine. You can do it anytime, but we need platelet(s) for an emergency requirement.” That is what I fell for that day. I later confirmed with that guy about SDP vs whole blood. I think you know the answer. And it’s technically true because an SDP donation can serve about four patients suffering from diseases like cancer and dengue. Whereas, a whole blood donation has a very low volume of usable platelets. It can only be used for a single transfusion on a maximum of two patients. Ask any phlebotomist and I’m certain they’ll tell you that an SDP donation is more important than a whole blood one.

But my quandary stems from the fact that once you have made an SDP donation at a blood bank, that blood bank will only expect SDP from you thereon. If you want to continue donating whole blood, go to another blood bank. And that is what I plan to do from next month.

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