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Friday, April 11, 2008

Ooh Ohh Pick Me! Pick Me!!

Yes! I want to be the guinea pig pin cushion for the phlebotomist in training!!

(warning - if you have an aversion to needles, ie they make you queasy this post may not be for you)

Having once been a phlebotomist I know what the word means. Don't feel bad if you don't. I've found that the majority of people I've come in contact with have no idea what a phlebotomist is or does, so I'll explain.

Have you ever been to the doctor's office or hospital and had to have blood drawn? The gal or guy who stabs you with a needle and drains your blood into tiny glass tubes. They're phlebotomists. *Pholebotomy is the act or practice of opening a vein by incision or puncture to remove blood. *Thank you for that enthralling definition!

Back in 2000 I worked at a plasma center in Mississippi. I was a phlebotomist. I stuck people with needles the size of coffee stirrers all day. I was pretty damn good at it too and I met a ton of interesting people and made some pretty good friends. The center I worked at was centrally located between both a Naval and Air Force base, so the majority of our clientel were young military guys.

They'd come in and donate for some quick and easy weekend beer money. Unlike donating blood, you get paid to donate plasma. There are a few other differences (like the size of the needle) but that's the one that results in pulling in most of the donors.

Before I tell you about my latest adventure as the recipient of some rather questionable phlebotomy skills, I'd like to take a moment to talk to you about plasma donation. Think of it as a bit of background info that will make my story more uhh interesting. Ok maybe interesting is the wrong word, but if you have no idea what phlebotomy or plasma is then my story might not make a lot of sense. Well except for the picture part. There will be pictures. Beautiful multi-colored pictures. Woohoo.

Instead of trying to strain my brain and come up with an educated articulate way to describe what plasma donation is and why it's important (it's Friday, my brain is officially on vacation) I'm plagiarizing copying info from a plasma center website. Oh hush.. I'll give them credit!

*What is Plasma?

Your body contains approximately 12 pints of whole blood.

Plasma is the pale yellow liquid portion of your blood that can be easily replaced by the body. It consists mainly of water and proteins, which help your body control bleeding and infection.

The plasma functions as an aid in the circulation of red and white blood cells and platelets. It also makes possible natural chemical communication among different parts of the body by carrying minerals, hormones, vitamins, and antibodies.

*How is Plasma used? (or why you should donate!)

Plasma is used in the treatment of serious disorders such as hemophilia and immune system deficiencies, and to make products used to help treat and prevent diseases like tetanus, rabies, measles, rubella and hepatitis B.

For example, those who suffer from certain forms of hemophilia lack or are deficient in the natural clotting factors that help stop bleeding after sustaining acute or other injuries. Plasma-based products are used to treat people with this disorder so that they may lead normal, active lives.

In addition, hospitals and emergency rooms all over the world use plasma-derived albumin in the treatment of traumatic injuries such as shock and severe burns.

It is important to remember that plasma is not a substance that can be produced in a laboratory or some other artificial environment. It can only be obtained from healthy adults. When you donate plasma, you are helping save lives.

*How often can I donate plasma?

The body replaces the plasma removed during the donation process quickly; therefore, healthy individuals can donate as often as twice in a seven-day period, with at least 48 hours between donations.

**The above information is courtesy of Biolife Plasma Services website

Here's a little video I found that offers a very simple but effective explanation of the plasma donation process. The length of time it takes to donate varies on the center, the donor and a few other factors, but usually only the first visit (which includes a basic physical and health screening) takes between two to three hours. After than you can expect subsequent donations to take anywhere from 45 minutes to an hour and a half. that we've covered what a phlebotomist does, what plasma is, and why you should donate, on to my story!!

When I worked at the plasma center we were encouraged to donate at least once a month. I'm guessing it was so we could have first hand knowledge of the experience and would be able to better relate to the donors. I've continued to donate throughout the years, although not as often.

This past Tuesday I decided to donate. Having worked in the plasma industry I have a very good understanding and respect for how important it is for people to donate, but I'll be honest with you, every once in a while (as in the case of my most recent donation) I'll do it because I'm in a pinch and need a few bucks to tide me over till payday. Let's do the math. Donating takes about 45 minutes. The time differs from person to person. Depending on the center, you receive anywhere from $20 to $35 per donation. That's a minimum twenty bucks in less than an hour, AND I'm saving a life in the process. Sounds like a no-brainer to me.

So Tuesday after work I head to the local Plasma Donation Center. I sign in, get my pre-screening done and head back to the donation area. Every visit you get weighed, your blood pressure and temp taken, and finger stuck. Your blood has to have a certain protein and hematocrit (red blood cell) level for you to donate. People who are anemic or iron deficient are usually unable to donate.

The donation area looks somewhat like this-

Every center varies but for the most part it's rows of semi-reclining beds in a room. The centers usually have televisions mounted around the room. Some centers will play movies while others show local progamming.

So I'm lying on my bed, my autopheresis machine is hooked up and I'm waiting for whoever gets the honor of stabbing me with a 17g needle to come over. Other than the money one of the significant differences (well it's significant to me!) between donating blood and donating plasma is the size of the needle. Blood donations use a 19 or 20 guage needle. Plasma uses 16 or 17 guage. With needles the smaller the number, the bigger the needle. Here's a picture so you can get an idea.

Donating blood would get you stuck with probably the orange or purple needle. Plasma.. closer to the black or turquoise one. I'm not going to lie. It's a big needle, but honestly the finger stick usually hurts worse than the actual donation process.


This was not the case on Tuesday. While I'm waiting a lady comes over, says hi, checks my chart then calls another girl over to my bed. "I want you to stick this one", she says. I took a deep breath, closed my eyes for a second then tried to prepare myself. In a plasma center during your training you have to have 50 supervised sticks before you're put on the donor floor by yourself. This means you get to practice sticking 50 people with someone watching you to make sure you don't totally SUCK at it.

I could barely contain my excitement! In case you didn't figure it out, that last statement was made with a rediculously large amount of sarcasm.

Veins are coded in 3 ways. Red, Yellow and Green. Green is a good healthy vein that a blind person with twitchy hands could stick. Yellow are smaller veins or veins that have a weird angle or tend to roll. Red is.. well you get the idea. I have green veins. Very healthy, easy to feel, I could hit that sucker with an dart from across the room veins.

Yea.. well.

Although I don't donate often I've built up a bit of scar tissue on my right arm from 8 years of periodic donating so I decided to go with my left. Still a good vein, it dips a bit, but shouldn't be any problem for her to stick. Shouldn't be..

She gets ready, I make a tight fist and... she infiltrated it. Infiltrating a vein is when the needle goes in through one side and out through the other. She basically stuck the needs through my vein instead of in it. I'm not sure if everyone can tell what it feels like or I know because sticking people used to be my job, but when the needle goes through the vein or is lying at a bad angle against the vein wall it feels different than if it's in right. In right isn't exactly comfortable but it doesn't really hurt. Through or against... hurts.

So after a few minutes of the machine beeping at me because it can't get the blood to come out the way it's supposed to, (That tends to happen when the needle is outside of the vein!) another lady comes over and tells me I'll need a restick. In 8, I repeat EIGHT years of donating plasma and blood I've never had to get stuck twice. They take the needle out, slap a bandaid on the venipuncture site and prep the other arm. The chic that stuck my right arm has been a phlebotomist for a while, I'm not sure how long but the first time I went to that particular center was close to 6 months ago and she was there then. So, logic would say she'd have no problem. Whatever.

She didn't go through the vein in my other arm but she sure as heck didn't have the needle positioned right. After about an hour of more machine beeping and holding my arm at a highly unnatural angle to try and ease some of the pressure of the needle pressing against my vein I tell her I'm done. The muscle in my right arm had started to knot up and it was all I could do not to bend my arm with the needle still in it. Oh ya, in blood, they usually use the needle for the stick then replace that with a catheter or little plastic sheeth for the actual donation process. With plasma they leave the needle in the entire time. Since they are pulling out whole blood then returning the red cells through the same vein the hole in the vein has to stay open big enough that it doesn't clot when the red blood cells are returned.

She finally came over and unhooked me and bandaided me up. I had to have her physically bend my right arm for me because the muscle had knotted up so bad I couldn't do it myself. If you've ever broken your arm and had to wear a cast that covered your elbow, it felt kind of like it did when you finally got your cast off and tried to bend your arm. Stiff and painful.

The next day I looked like this

Three days later it only looks worse. I told my boss yesterday that I hoped no one looked too closely at me while I was at the gym. I look like a freaking junkie. I'm meeting some friends tonight for a few games of pool and I will most definitely be wearing a long sleeve shirt.

Thankfully I don't donate that often so I won't be back at the mercy of phlebotomists in training any time soon. I do want to say though not to let my story discourage you from donating. What happened to me is a rare event and is more often the exception than the rule.

Donating plasma does truly save lives and is most definitely a worthy thing to do. Look in your local yellow pages or online to find a center near you!

1 People who coughed on a furball:

LadyBanana said...

I worked as a phlebotomist for a while.. not at the moment though..

I donate blood as often as I can and luckily I have the best veins (ugly) but great for sticking!