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Donating blood ... giving the gift of life

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This week marks the beginning of a season when blood banks seem to teeter on the edge of crisis — need goes up in summer as active people are injured; donations dwindle with the distractions of travel and outdoor activities. The winter holiday season has similar shortfalls.

Still, in nearly two decades with ARUP Blood Services, Karen Nielsen, technical vice president, says they seem to always squeak by. "We were calling around two weeks ago and brought in about 150 units (of blood) from around the country."

After 9/11, Utahns lined up to give blood. Catastrophe is like that, blood bank experts say. The problem is, if a lot of blood is needed, there's no time to wait for donations. Because of the testing process, it takes about two days to ready a unit of blood for distribution. If the reservoir's not full, the pipeline won't flow. And few people who need blood can wait.

As for those willing donors after 9/11, "most of those donors have never come back," Nielsen says.

"People forget that the only place we're able to get blood is from donors," says Julia Wulf, CEO of Utah's chapter of the American Red Cross. "There are no proven substitutes right now, though blood-substitute products are being tested. "And we have to be ahead of the curve — anticipate, not react."

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There are donors — and lots of them — who can always be counted on to give. Just not enough, the blood services folks say.

Lisa Madsen's one. When her grandma needed platelets because chemotherapy had weakened her immune system, Madsen had the wrong blood type. She still became a platelet donor. It was a small gesture, she says, to give to others what someone else was providing for the grandmother she loved so much.

She still donates at least 12 times a year, relaxing in the chair while blood is removed, the platelets separated out and the remainder reinfused into her arm.

That blood and the components like platelets it can be broken into forms a flowing river of life was driven home a year ago when Lisa was out hiking and fell more than 150 feet.

Three blood, two platelet and two plasma transfusions later, she knows blood donation doesn't just help someone. It can be the difference between survival and death. She was hospitalized for 11 days, then in a nursing home for rehab for six weeks to heal from 10 fractures, nerve exposure and nerve damage.

When she was well enough, she climbed back in the chair, rolled up her sleeve and gave some more.

Too often, the reservoir has "some" but not enough. A comfort zone is rare.

Consider these numbers: The American Red Cross blood service in Utah collects just under 200,000 units a year, not counting the platelets it collects separately. And it uses most of it, too.

ARUP and MountainStar blood service programs each have their own donors and goals. And each one serves as the primary supplier to different hospitals, overlap occurring when one runs short, and they bail each other out. If they can't help, the National Blood Exchange helps programs with extra blood and those with shortfalls find each other.

Numbers from a sampling of hospitals is staggering. Chantelle Turner of University Hospital says they use between 25,000 and 26,000 blood products a year. The number's about the same at Utah's other Trauma 1 center, LDS Hospital, according to Jess Gomez, spokesman.

Even a smaller, nontrauma center uses a lot of blood. Spokeswoman Tammy Clark at Salt Lake Regional Medical Center says on a busy day with lots of surgeries, they may go through 30 units of blood. Gomez says Cottonwood uses about 6,000 units a year, Alta View about 1,000.

New York used to get a third of its blood from Europe, until mad cow disease put an end to that. Utah is usually able to take care of its own and supply some nearby hospitals in neighboring states.

"Utah is amazing because it's such a volunteer-based community," says Cyndee Holden, an ARUP spokeswoman. "We're lucky in that sense. But there are times where need goes up and donations go down."

Nationally, experts say fewer than 5 percent of eligible, healthy adults actually give. The number's slightly higher in Utah, local experts agree. Barely.

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The average adult has about five liters of blood in his body, and how much you can afford to lose depends on your general health, says Dr. Kurt Bernhisel, an emergency room physician at University Hospital. An elderly patient cannot afford to lose as much blood as a young, elite athlete. Anyone losing 30 to 40 percent is in big trouble, and above that it's always life-endangering.

When someone is bleeding profusely, the flow must be stopped and the blood replaced. "We can buy a little time with intravenous fluids — saline and lactate ringers — while waiting," he says. "They help increase blood pressure."

Utah traumas are more apt to come from accidents than from knives or guns, he says. But massive bleeding can result from anything from car crashes to leaking ulcers. People on blood thinners may need transfusions.

In the ER, the doctor orders a complete blood count, bolstering pressure with fluids while they wait. In the most obvious, dire trauma, universal-donor blood (O-negative) may be given before typing's even finished.

Blood can be infused fast or slow, depending on what's needed. "With a level one transfuser, we can crank in five or six units in less than an hour," Bernhisel says.

Operating rooms may use an autotransfuser if they're falling behind, collecting the blood and putting it back in, he says.

Premature babies get the freshest blood available, says Arlene Sparrow of MountainStar Blood Services.

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Sometimes it takes a personal crisis to prompt someone to donate. Erin Boyle started donating blood regularly after her son received dozens of pints of blood from other donors.

Bryan Burch doesn't know what his blood type is, but he knows it's popular. He gets called "a lot" by ARUP, and he always rolls up his sleeve because he's been told there's "something in my blood that babies can accept." For six years the operations manager for a local shipping company has been a regular, although "I usually don't think about it until they call."

Asked if he's ever needed a transfusion, he says, "Not yet." Like most donors, he knows that it can happen to anyone.

A lot of longtime, reliable blood donors get started with high school blood drives. Amanda Pierce, 18, a freshman at Utah State University, didn't let the fact that the "first time didn't go so good" stop her. She fainted.

"I was really scared the second time," but she gave just fine. "I think it's pretty fun" and a social experience, she says. She chats with other donors or the technicians during the few minutes it takes to actually fill the bag with blood.

Joy Lloyd also started years ago with a school blood drive. She donated about once a year for a while, then took a few years off while she was pregnant with her four children. But she's back, donating every eight weeks. "They call me the day before I'm eligible to give blood to remind me," because she has sought-after O-positive blood that can help all the other positives. She times herself. Last week, she filled a bag in 5 minutes and 13 seconds, not her best time but "pretty fast."

"None of us have ever needed blood, but if I ever do need it, I'd be grateful that someone had given it. For me, it's a gratitude thing. I've been blessed and I give because I can."

Ditto Stuart McDonald, an editor and webmaster. "It's one donation I can afford that's valuable. I can give blood and not everyone can."

He started when he was in the Coast Guard in the 1960s, driven in part by the fact that it meant an afternoon off, "too good to pass up."

His father was a blood donor, too, so "I grew up thinking it was a good thing." It didn't hurt that his mom always served steak after her men gave blood. "It has a lot of positive associations." When he left the Coast Guard, he kept the habit.

E-mail: lois@desnews.com