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Blood Transfusion or Blood Confusion

March 28, 2009

BEFORE  you read this post. GOOGLE   the words, blood transfusion symptoms. You can read some OTHER people’s information about this topic first. Some have indicated that we have other things to worry about. Blood transfusions are big deals. The Jehovah Witnesses will not accept blood even if it means death. They take Blood and blood products very seriously and SO SHOULD YOU.

Isa sits on the bed to watch TV as the chemo infuses.

Isa sits on the bed to watch TV as the chemo infuses.

 

 

Last week, we had the option of postponing Isa’s transfusion of packed red blood cells. (The packed RBC has no plasma included, which contains most of the proteins that could lead to a problem, but not all, the red blood cells alone can create reactions.)

 

Thursday March 19

  • Hgb 7.8
  • RBC 2.57
  • ANC 950

Hemeglobin is a red protein that carries oxygen. Each of its four subunits contains to an iron atom bound to a heme group. The Cincinnati Children’s hospital has a good description of transfusions and the risks involved.

Monday, March 23

  • Hgb 7.8
  • RBC 2.53
  • ANC 600

Thursday, March 26

  • Hgb 7.7
  • RBC 2.52
  • ANC 848

Every single blood transfusion carries a risk. 

  1. Allergic Reactions—immune related reactions are caused by a patient’s immune system AGAINST the  blood OR the immune system of the donated BLOOD against the patient.  
  2. Fevers—could be caused by a reaction to the donated blood’s proteins found in the white blood cells or plasma. Most often these fevers can be treated.
  3. Transfusion Related Acute Lung Injury—happens quickly  either during the infusion or  within six hours afterward.

The SUPER DOOPER important number to worry about is around Hgb of around 4. That being said, the amount of oxygen in the system helps fight the cancer cells. Remember CANCER HATES OXYGEN. 

At this point, we have decided to wait again on any transfusion. The more of other people’s blood that she gets the greater the risk . Because we have declined the transfusion we will have an extra blood draw to watch her hemolobin. If it drops to about 5, the doctor recommended that we get  a transfusion on Tuesday. If not then we will wait until Thursday, the next day that they access the port. From now until Monday we will research alternatives.

In addition to the blood transfusion Isa has received Zofran—an anti-nausea drug, Cytoxan (cyclophoshamide) a bunch of fluid, with potassium and glucose, Mesna—a drug to protect the urinary bladder from the Cytoxan, and Ara-C. We will give Ara-C at home for the next three days along with 6-MP for the next two weeks.. Her port will remain accessed.

What the doctors don’t tell you, there are alternatives to blood transfusions, but they come with their own risks, and sometimes insurance won’t pay for them. They also won’t tell you that you don’t HAVE TO take the transfusion, and they can’t tell you of other non-allopathic alternatives.

Although some may feel that blood transfusions are the least of our worries, there are those who have seen that blood transfusions have an unexpected effect on people. Check out this Time article.

This study describes the usage of transfusions in one oncology practice. Basically the transfusions in the institution studied gave blood around 7.9. Isa was at 7.7 on Thursday. BUT, it was stressing the use of a preemptive medicine to boost red-blood cells Procrit. The drug the doctor mentioned to us was called, Aranesp. We decided against using that medication. One it is not covered by insurance, (so we didn’t really have access to it then did we?) and two, it required many many shots. 

RBC are produced based on the amount of oxygen used by the body. The greater the demand for oxygen, the greater the demand for RBCs to carry oxygen. Interestingly the kidneys play a huge role in making this happen. 

Another interesting thing, is how the government agencies, like Medicare and Medicaid set standards that can not be met. For example, this article details how medicare states that the medicines that stimulate blood can only be used when the Hgb <10, BUT, YES THIS IS A BIG BUT, the product labeling says that it shouldn’t be used when the Hgb is <10.  Hmmmm… Do you see what I see?

 

And just for fun…click on this link for a surprise.

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5 Comments leave one →
  1. Anonymous permalink
    April 6, 2009 4:09 pm

    Your right, doctors dont tell you that you have other options to blood transfusions. But trust me, there are other options! I know you love Isa very much and want the best for her so look for those other options. You might not like what I tell you but I’m gonna tell you anyway. You need to talk to Jehovah’s Witnesses. Remember they dont take blood. They use the alternatives. Yes there are alternatives. You dont have to change your faith and they can really really help Isa. Think about it. You did all the research on blood transfusions whats a little more research on bloodless alternatives. Thanks for reading this and I hope I didnt affend anyone.

    • April 6, 2009 5:01 pm

      Thank you so much for your post. The Jehovah’s have a great point. Taking other people’s body parts, blood included, brings some interesting side effects. I have seen blogs where recipients of organs send “open letters” to the family that say, how grateful they are. Donor families do not find out who gets the organs immediately. STILL, people have forgotten that this type of surgery, or procedure was thought of as science fiction at one point, and impossible before there was science fiction.

      To answer you more specifically, we researched the erythropoetin, red blood cell making drugs. Several considerations for those of you who want to avoid blood transfusions. These drugs come with their own side effects. These have been used most commonly with breast cancer patients, according to the article I read. The major factor for us, these medications are hard to get approved by insurance. They cost A LOT MORE than a pint or two of donated and irradiated blood. Secondly, they must be used, according to the manufacturer, when the hemoglobin levels are basically normal…around 10. Lastly, they deliver this by injection, into a muscle rather than into her already accessed port. Three strikes against it. We went with blood. I was quite disturbed by it, but am working to get her blood levels up to avoid as many as possible. Some patients lose count of how many they get. I expect to remember each one! Thanks for posting. You brought up a good point.

  2. Jo Ash permalink
    April 4, 2009 9:49 am

    Wow! I knew blood tranfusions were risky, but I did not realize how risky. Glad you do your research.

  3. Natascha permalink
    March 27, 2009 10:11 am

    Would it help if family members donated blood for her to use? If you decide to go ahead with the transfusion, i would be happy to donate. I’ve never donated before, but would come down to Indy for her….

    • March 27, 2009 7:43 pm

      No, it doesn’t matter who donates the blood. It is still someone else’s blood. She will be getting plenty of blood during Delayed Intensification. More than one person will give.

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