Apheresis - the good, the bad, the ugly

The BBQ Pit
1

This evening I went to the Red Cross for my apheresis appointment. I’m a regular donor both of whole blood and platelets, and was looking forward to getting closer to the five gallon mark. I know the staff, the staff knows me, I get free cookies, it’s all good.

The Good: During the pre-donation screening, we found that my blood pressure is down to 120/76 from last time’s 122/90. Go team!

The Bad: The return needle wasn’t positioned properly, yet I felt no pain or sting beyond the initial insertion. As a result, the centrifuged blood that was returned to my arm wasn’t quite returned to a vein, but rather straight through a vein and into the arm itself. Red blood cells, white blood cells, plasma, but no platelets, nope indeed. Those were off to the collection bag.

The Ugly: My arm began to swell, unnoticed by me as I was covered by a blanket and everything felt fine. About a half hour in, the tech came to check on me and her eyes grew just a little wide. She called over the supervisor, while I wiggled my fingers to ensure that I hadn’t lost my arm.

Her eyes grew just a little wider and ordered the tech to pull the needle immediately. I wiggled my fingers a little more to ensure I hadn’t imagined them wiggling, as at that point I had no idea what may have gone wrong, and I became concerned that I hallucinated the previous wiggle.

I soon saw that my skin around the return needle had swelled and distended to nearly an inch high. The needle was pulled, ice was applied, I sat in the canteen and drank juice for half an hour with an icepack strapped to my left arm.

The result? Swelling which should go down in a few days, but a bruise which should appear and stretch from my elbow to nearly my wrist, and last for four to eight weeks.

Which, y’know, is just super, considering I get married in seven and a half weeks. They recommended I wear a long-sleeved tuxedo for the ceremony, and to keep it on for the honeymoon.

And, uh, Elenfair? They, uh, said that I can’t do any heavy lifting or housework for eight weeks. Honest. I’m sure you can take care of it, sweetie; I have faith in you.

But I have no faith in my faithless left arm, whose sneaky veins caused this entire tragedy.

Stupid arm.

2

This has happened to me not once but twice.

I’ve been a aphersis donor for years, although I’ve slacked off a bit recently.

On two separate (and highly memorable) occasions, the phlebotomist has missed my vein with the return line. Luckily (?) I became immediately aware of the situation as soon as they started pumping saline directly into my flesh. Hurts like a motherfucker is the phrase that jumps to mind.

Had big ol’ nasty looking bruises for about three weeks thereafter.

Ever since then I’ve insisted on a one-arm machine and things have worked just fine. I have a good vein in my left arm, not so good in my right.

All that being said, I have to ask:

Were you planning on being married in a Short Sleeved Tuxedo? If so, please post pictures when they’re available.

3

Ino- I don’t think your arm was at fault here.

I hope you are feeling better soon.

4

It’s mildly amusing that the OED Online defines “aphaeresis” as a “large and injurious extraction of blood”, for I can then say “Well what did you expect from an aphaeresis appointment?”

[sound of crickets chirping]

Hey, I said mildly, didn’t I?

(Congrats on the nuptuals!)

5

I give double reds. One arm. One machine. It does, however, suck whole blood out and return the plasma back in. The last time I was in, the whole extraction thing went fine. As soon as the machine started to pump the plasma back in, my arm started to swell. Luckily, the tech caught it quickly and stopped the machine before it got too bad.

I too had the pleasure of waiting in the canteen for 20 minutes with an icepack on my arm. The only thing that pissed me off was that they wouldn’t let me take the disposable icepack with me. :rolleyes:

6

Never heard of this before. I am a regular donor myself in the stick a needle in my arm and fill a bag kind of way. Whats the advantage of doing it this way?

7

lno I had this about a year ago. The bruise HURT like a motherfucker for a while, too. I have pictures if you wanna see. Seven and a half weeks after mine, it was fine. No bruise, no pain. But I called THEM over when I felt my arm getting tight, I have had a less severe case. Have a good wedding, and go somewhere where you can wear short sleeves on the honeymoon.

8

One And Only Wanderers, platelet apheresis is a donation of platelets rather than regular blood. To sum up, blood comes out one arm, is centrifuged, platelets removed, and then goes back in the other arm. Some setups use only one arm, but the process takes a little longer as the flow of blood isn’t continuous. The American Red Cross describes the process.

What annoys me the most about this is that there was nothing out of the ordinary, and a significant amount of blood and saline was returned without any pain. My layperson’s guess is that the tip of the needle was positioned in the vein correctly, but that it had shifted somehow, creating a slightly larger hole in the vein than the size of the needle, and it just gradually leaked contents into the surrounding arm.

I’d love to see the photos, Bill. Can you send them to the email address in my profile, or give me a link?

9

One, one advantage is that, since red blood cells are not taken out, but rather put back in, donations can be more frequent.

10

Don’t let lno fool you, folks. He’s milking this one for all it’s worth. :smiley:

It is an ugly bruise, but the blood will slowly be reabsorbed into his arm. It’s still swollen this morning… and I guess he’s not going to do housework this week. :wink: Convenient, no?

I get to go to my apherisis appointment next week and will get to tease the staff. I can’t WAIT! Hopefully we won’t come out of this with matching bruises. That wouldn’t be good. While lno can hide his in a tux, I’m not so sure that the wedding dress would be quite as forgiving (it does have bell sleeves, mind you…)

The ONLY upside to this is that poor lno can’t donate for a few months now - what with the double whammy of whole blood donations almost back to back AND the big bad bruise… so I may get a bit of a start catching up to him in pints and gallons o’ blood. Unfortunately for me, my gallons donated to the Canadian Blood Services (it used to be the Red Cross, damnit) don’t “transfer”. Poopy.

So far since I’ve been here, 2 whole blood donations, 1 apherisis (single). Next week, apherisis(double +). With my flexible schedule and my sticky O+ platelets, they want me back every 2 weeks on the dot. SO NYAH!

'Nyway, I’m being sympathetic to poor lno, not to worry. As for honeymoon travels, they’re likely taking us to middle-of-buttfucknowhere-Wisconsin. In the snow. I think we’ll be fiiiine… so long as no one sees the bruise and starts to think that I led him to the altar juts a little too forcefully…

Rawr. Fierce! :smiley:

Elly

11

I never had that happen cause you’d have to be blind to miss my veins but I did have a drunk phlebotomist once.
She smelled like stale wiskey so I figured that she’d been drinking the night before but since it was 7 am, she should be fine. Boy was I wrong. My alarm went off at least once every 5 minutes. I was donating for an hour and 45 minutes and I didn’t even get to finish a single batch. I usually do a double in about 65 minutes. They finally decided to shut me off when she went on her break. She came back early and flushed the tube into my veins. The tube had already been flushed of blood. The whole tube was filled with that nasty citric stuff they use to help keep the plasma normal. I get sick from small doses of that stuff and she flused it all into my arm.
I usually leave about 10 minutes after I’m done donating. This time, I couldn’t even get off the bed for 30 minutes and then I spent another 30 minutes drinking can after can of cranberry juice.
I haven’t gone back since. I’m really nervous. I had never had a bad experience before that and now I’m paranoid.