the donor - winter 2006

NEWS AND INFORMATION FOR BLOOD DONORS WINTER 2006NEWS AND INFORMATION FOR BLOOD DONORS WINTER 2006

HOW’S YOUR HAEMOGLOBIN?

Making donating easier for youHow we’re updating our services to you

Making donating easier for youHow we’re updating our services to you

PLUS F NEWS F LETTERS F AND MORE...

GABBY LOGAN INTERVIEW“We take blood for granted”GABBY LOGAN INTERVIEW“We take blood for granted”

4 “We take blood for granted – like water”Gabby Logan talks about life as a busy working mum, and why she’sbacking our Christmas Give Blood campaign

8 Making donating easier for youWe’re about to make some changes to where, when and how we runsessions. Read about how we’re updating our services to you

9 Why Hamzah’s happy to helpMeet Hamzah Khaled, one of the country’s youngest bone marrow donors

10 Understanding sickle cell anaemiaAbout 12,000 people live with sickle cell anaemia in this country, and theyall rely on donated blood to stay well

12 Grateful for every dayHow leukaemia changed Jane’s life – for the better (pictured below)

14 Keeping baby safe Every mother wants a healthy baby. But some pregnancies need a littlemore help for a happy outcome, and blood products play a vital role

16 How’s your haemoglobin?We explain the importance of the miracle molecule

20 Over to youCatch up with readers’ letters, plus health Q&As

21 All together now!How one family is making blood donation a tradition

23 Keeping supplies flowingHospitals throughout the country rely on us to supply the blood they need. Here’s how it happens

26 The chance of lifeCould a donated liver be found to save Shohanna?

28 A safe pair of hands Meet consultant anaesthetist Dr Helen Smith

30 Ask The DoctorMoji Gesinde answers your questions about arm cleaning

31 CrosswordAnother prize-winning puzzle

3WINTER 2006 THE DONOR

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In this issueIn this issue

The price of producing, printing and posting each copy of this magazine is less than the price of a first class stamp.The Donor is published by the National Blood Service (NBS) which is part of NHS Blood and Transplant. Reproduction in whole or part isstrictly forbidden without the prior permission of NHSBT. Larger print versions are available via the website. Design and production –Ant Creative (London). Reproduction: Portland Media (London). Printed by Apple Web Offset on 100% recycled paper.

COVER STORIES

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WRITE AND TELL USyour news, viewsand interesting

or unusual donor stories.

Write to Rachel Roberts,

Editor,The Donor, NBS,

Colindale Avenue,London NW9 5BG

or email [email protected]

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4 THE DONOR WINTER 2006 5WINTER 2006 THE DONOR

can’t donate, but my auntie has received her award for 50donations. But what I can do when anyone asks me about what happened with the twins is encourage them to give blood. There’s a good chance thatthose people who gave bloodand saved your life are reading this interview. Whatwould you say to them?I’d say that what they did was a

“We take blood forgranted – like water”“We take blood forgranted – like water”

An emergency blood transfusion helped ITVsports presenter Gabby Logan through the birth ofher twins last year. Now she’s asking everyonethat can to give blood this Christmas

brilliant thing. Withoutthem Reuben and Lois wouldn’thave their mummy and Kennywouldn’t have a wife. I am sograteful for the chance thosedonors gave me to live and havethis time with my family.What was it like becoming a parent?Parenthood changes everything;the way you view the world, other

It sounds like the birth ofyour twins, Reuben andLois, was rather dramatic.What happened? After giving birth I was on a high. Iwas bleeding a bit, but nothingabnormal. Suddenly the obste-trician asked for the relaxing musicto be turned off and the lights to beturned up. I felt the tension and Iheard someone mention orderingblood. What happened next is a bitunclear because I was losingconsciousness, but I rememberbeing wheeled into theatre andhooked up to a bag of blood.Fortunately the doctors managedto stop the

COVER STORY

bleeding, and after many bloodtransfusions I woke up hours laterin the recovery room.How much blood did you lose?About 40 per cent of my body’s, I think! I really wasn’t aware howmuch I was losing at the time, butmy husband Kenny recently toldme it was flowing like water. I certainly needed a lot of

transfusions before my ears turnedfrom white to pink, which isapparently a good sign.What was going through your head? I actually wasn’t scared. There wasa moment when I thought perhapsthe purpose of my life was to givebirth to the babies, and at thatpoint I calmly asked the midwife if Iwas going to die. It helped thatKenny was very calm and kepttalking to me. He said he knew thebabies were absolutely fine, so hecould focus on me.How long was it before youwere able to go home?Thanks to the blood I was given Iwas out in a week. I was startingto really enjoy being looked after!What amazed me was howquickly my body recovered. I hadthe twins on a Friday, and by thenext day I was having a showerand drying my hair.Have you ever given blood?I did try at university, but couldn’teither because I was anaemic or they couldn’t find a vein. As I have received blood I now

Gabby with husband Kenny andnewborn twins Reuben and Lois

people… it’s a huge experience.For the first few weeks we worriedall the time – were they warmenough, cool enough, hungry?After a while we relaxed a bit, butit’s still a huge responsibility. It’s brilliant though, they amaze meevery day with all the things theylearn.You’re a regular on ourscreens as part of the ITV sports presenting team.How much time off work did you take after having the children?I took about six weeks off and thenwent back to do a show. It helpsthat I don’t have a normal job in

the sense that I don’t work every day. I mightpresent a programme,and then not workagain for a few weeksor even months. Thatfits in really well withbeing a mum.What would you sayto anyone consider-ing giving blood thisChristmas?If you can give blood,please do. After you’vehad your tea and biscuitsyou might even forget

you’ve done it, but your donationcould save someone’s life.Although you’ll never meet them,they and their family will thank youforever. We take the fact that blood will be there for granted, likethe water supply. Actually, it is onlythere thanks to a lot of amazingpeople who take time out to helpothers to live. l

LIFE STORYLIFE STORYl Born on 12th April 1973 in Leeds,

daughter of footballer Terry Yorath

l 1987 – 1990 represented Great

Britain as a rhythmic gymnast

l 1995 received BA (Honours) in

Law from Durham University

l 1998 – 2004 presented ITV

football show ‘On the Ball’

l 1999 onwards, presented ITV

coverage of UEFA Champions League

l 2001 presented various ITV Premiership shows

l January 2002 became the first woman to present a live terrestrial

football match (Chelsea v Spurs)

l Presented ITV coverage of World Cup in 2002 and 2006

l Currently presents ITV coverage of UEFA Cup. l

“I am so grateful forthe chance thosedonors gave me to live and have this time with my family”

We’ve joined forces withsome of the country’s lead-

ing black and asian celebrities tofront a new campaign highlightingthe shortage of black and minorityethnic (BME) blood donors.

The ‘Circle of Life’ campaign is aseries of artworks designed byblack, asian and mixed-race celebrities. Each has created a circular design which shows theirown interpretation of the ‘GiveBlood’ message. Designs rangefrom the touching to the tongue-in-cheek, with famous faces pullingtogether to raise awareness of the importance of blood donation within their communities.

Celebrity artists taking partincluded Radio 1 and MTV presenter Trevor Nelson,TV presenter Reggie Yates, boxingchampion Amir Khan, singer Jamelia,celebrity fitness guru HarveyWalden, and many many more.

Following an exhibition, theworks of art were auctioned onEbay to raise money for the AfricanCaribbean Leukaemia Trust, SickleCell Society, UK ThalassaemiaSociety and Ibrahim’s Appeal. l

The Circle of Life

6 THE DONOR WINTER 2006

News Update • News Update • News Update • News Update • News Update • News Update • News Update •

As we’ve moved into the winter monthsyou may have noticed some new

advertising alongside our established TV and radio adverts, to emphasise the messagethat donors are always needed to help savepatients’ lives.

We have recently run an online campaignbased around the common frustrations of everyday items running out. This was compared withthe very serious idea of running out of blood.The campaign ran on a range of websites including Jazz FM, Capital FM and iVillage.

As we approach Christmas and New Year, traditionally times of the year when the numberof people donating blood falls by around ten

Campaign Update

Two of Emmerdale’s actors,Tom Lister (pictured above – who plays Carl King)

and Lucy Pargeter (Chastity Dingle) attended the opening of the new Blood Donor Centre inSeacroft Hospital,Leeds.

Tom and Lucy went along to spread the ‘GiveBlood’message and encourage the people ofLeeds to think seriously about helping even moreby donating platelets at the centre.

Tom gave a blood sample on the day to findout if he has enough platelets in his blood tobecome a platelet donor. Who knows,if youdonate at Seacroft,you could see Tom taking abreak from filming and popping in to donatesome platelets. l


If you’ve ever wished you could go online to book or changea session appointment or simply to update your personal

details, well, now you can. Blood Donor Online is the first suchinternet service provided by any blood service in the world.

Our secure interactive website lets you view and amend your personal details held on our database, make and viewyour appointments, and check whether travel or medicationmay prevent you from donating.

Using thenew service issimple. Justregister onour websiteand wait toreceive adonor token(with youruniqueregistrationdetails) inthe post.Once itarrives you can sign on and start using the service.

Website access is provided by the Government Gatewaywhich provides a high level of security to safeguard access todonors’ records.

More control really is just a click away. To find out more andregister go to www.blood.co.uk and click on the Blood DonorOnline link. l

Celebrity reminderTop chef Gordon Ramsay and TV presenters Davina McCall

and Craig Doyle teamed up with us to help boost bloodstocks over the summer holiday period.

A combination of sunny weather, the World Cup, and the annualholiday season all contributed to a fall in the number of peopleattending their local blood donor sessions.

The celebrities urged donors to “Give before you go” to raiseawareness of this annual challenge to keep people donating bloodthroughout the summer. A huge thank you to all those who answeredthe call and rolled up their sleeves to give a life-saving unit. l

You may have heard recently about the open-ing or closing of blood centres around the

country. Our newest centre is the Liverpool tissuebank, and work has started on Filton, a brandnew blood centre to be completed in 2008/9.

Our aim is to have fewer, larger processing andtesting labs, while keeping the services that need tobe local, locally based. To develop these plans,we’re talking to staff, hospitals and the public.

Many of our buildings are old and were built fora different era. Changes such as more complexblood safety rules and new types of bloodprocessing and testing mean our blood centresneed more space. Put simply, what we have todaywill not easily meet the needs of tomorrow.

We hope to have three large processing andtesting centres: in the North, the South East andFilton in the South West. However, blood willcontinue to be held and delivered to hospitals frommost of our present locations. And of course, youwill continue to see your local collection teamswhen you next go to give blood. l

Emmerdale stars open centre Centres on the moveNew internet service for donors

per cent, we will keep on encouraging everyoneto do something amazing to help save andimprove lives. l


Over the last few years it’s been increasinglydifficult to collect blood.

And while blood demand isdecreasing as a result of betterusage in hospitals, the decline indonation is running faster thanthe decline in demand, and atsome point in the future this willbegin to spell real troublefor patients.

The ‘where, when andhow’ we hold donorsessions has not changedsignificantly for nearly 60years. It worked in the past,but at sessions we holdtoday donor numbers aredropping to a point wheresome of our sessions simply donot attract enough people to justify holding them.

We are clearly doingsomething wrong. So, to help usunderstand how to attract morepeople, we’ve gone out andconducted some research.

Need to changeThe results are in, and we need to change. Giving blood iscompeting with other activitiesfor your time. We need to usenew forms of communication.

Sessions are not always atconvenient times or venues.Whilst average waiting timeshave halved, they are still toolong and queues are still a causefor complaints.

We need to make it easier andmore convenient for you to giveblood; in turn we hope to attract

new donors. We need a widerrange of venues and openingtimes. So we are looking atwhether more frequent, butsmaller, sessions in local facilitiessuch as schools and GP practiceswould be popular with donors.

You also want the option tobook an appointment and to be seen immediately. To do thiswe need to forecast moreaccurately donor numbers for asession, staff accordingly andcommunicate with you in the way you prefer. We believe

that by getting a betterunderstanding of who will turnup and at what time, we canminimise queuing.

At the moment only about a quarter of donations are made by pre-bookedappointments. This createsdifficulties on session between

those with and those withoutappointments.

AppointmentsSo we have been busydeveloping our appointmentsystem to make it easier foryou to make one.

In the Spring you will see anew appointment booking

system on session. You will beable to make an appointmentthere for the next session. To dothis you will need your donornumber, so please remember tobring your donor card, or letterand questionnaire with you.

Not all of these ideas will beintroduced immediately, but wehope you will all see changes andimprovements soon. We will ofcourse keep you updated on howthe changes progress, and pleaselet us know any comments youhave about our plans. l

We’ve been looking at how to improve our donation service to avoid potential blood supply problems. Here we explain the changes you’ll see

Making donatingeasier for you

Making donatingeasier for you

APPOINTMENTS


Why Hamzah’s happy to helpHamzah Khaled, 20, has been a regular donor ever since he saw a presentation about blood donation at school.It was at his fourth blood donor session, held at his school, that he decided to join the British Bone MarrowRegister. “Staff at the session told me how more people from diverse ethnic backgrounds are needed toincrease the chances of matching patients with a donor.” Within a month, Hamzah – who by now was on a gap-year placement at Rolls Royce in Derby - was asked to become one of the country’s youngest bone marrowdonors. "I was surprised to be contacted, especially so soon. I decided to do it because I knew it would only befew days out of my life to save someone else.” Proud of the life-saving difference he made, he says, “I woulddo it again, and I’d encourage more people from ethnic communities to register.”

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means they won’t suffer fromsickle cell anaemia.

People of African or African-Caribbean descent are the groupmost likely to have sickle cellanaemia or sickle cell trait. InJamaica for example, about ten

groups and will often have ararer blood group. Notsurprisingly, most suitable blooddonors will come from a similarethnic background.

Sickle cell traitSome people have somethingcalled sickle cell trait. Thishappens when someone hasinherited one normal gene fromone parent and one abnormalgene from the other parent (seediagram, left).

In the UK an estimated300,000 people carry this trait.They will have enough normalhaemoglobin present to keeptheir red cells flexible which

Awele Nwosu-Akeh, 17, was diagnosed withsickle cell anaemia when she was ten. She hasbeen in hospital many times because of hercondition but is determined not to let it affecther life, despite the obvious challenges.

“Being a teenager with sickle cell can bedifficult. I sat my GCSE exams in hospital but I couldn’t write myself so someone wrote forme. It was hard but I am glad I did the exams as I earned the grades I needed to study BTECMedia at college.”

Awele hopes to finish her college course next summer so she can go to university. As shereceives regular blood transfusions, and couldpotentially spend longer in hospital if shebecomes unwell, her tutors have allowed herextra time to finish the course should she findthat she needs it.

“I have a blood transfusion every four weeksto keep my haemoglobin levels healthy. I amvery grateful to all the people who give up theirtime to donate the blood I need to survive.” l

Living with sickle cellLiving with sickle cell

Around 12,000 people in the UK live with sickle cell anaemia, one of the most common

inherited blood disorders.There is no cure and many sufferers rely

on regular blood transfusions to keep them well

BLOOD FACTS

Our bodies get theoxygen they needthrough the red cells

in the blood system. These cells contain haemoglobin, amolecule which is perfectlyshaped to both pick up andrelease oxygen easily.

People with sickle cell havehaemoglobin with a differentshape. When this haemoglobinreleases oxygen, it tends tocrystallise. This in turn deformsthe shape of the red cells whichbecome rigid and sickle-shaped,hence the name.

Unlike normal red cells, whichare flexible and doughnut-shaped, these sickled cells can’tget through the body’s narrowblood vessels easily. This causesblockages and leads to a ‘sicklecell crisis’ which can beagonising for sufferers, whooften need hospital treatment.

TreatmentSome people may only have asickle cell crisis every few years,while others have many in a year.Sometimes attacks can be

Understanding sickle cell anaemia

Understanding sickle cell anaemia


triggered by an acute respiratoryinfection or other viral infection,so sufferers are advised to try andstay in good health. Sadly,repeated crises can causeirreparable damage to thekidneys, lungs, bones, eyes, andthe central nervous system.

If someone with sickle cellanaemia does end up in hospital,then their treatments mightinclude pain control, intravenousfluids to treat and preventdehydration, as well as red cellexchange which replaces someof the sickled cells with donatednormal healthy red cells. Inaddition a top-up transfusion ofblood can be given to correctand prevent life-threateningcomplications such asthrombosis or anaemia.

Most people with sickle cellcome from minority ethnic

How the trait is passed onHow the trait is passed on

Left: If one parent has sickle cell trait and the other does not then none ofthe children will have sickle cell anaemia. But there is a one in twochance that any child will have the sickle cell trait. Right: If both parentshave the sickle trait, they have a one-in-four chance of having a child withsickle cell anaemia and a one-in-two chance of having a child unaffectedby sickle cell anaemia but who will carry the sickle cell trait. They alsohave a one in four chance of having a child with normal haemoglobin. l

Trait TraitTrait TraitNormalNormal Normal Anaemia

The good news is people with sickle cell trait can donate. Just tellone of our staff at your first donor session. We need to know thisbecause back at our labs the blood is treated slightly differently.Sickle cell trait donors are especially valuable because they areoften people with rarer blood groups. Unfortunately sickle cellsufferers cannot give blood for obvious health reasons. l

Can people with sickle celltrait be blood donors?Can people with sickle celltrait be blood donors?

per cent of the population carriesthe trait. One unexpectedbenefit of sickle cell anaemia isthat it offers some protectionfrom malaria, which helpsexplain its prevalence in malarial regions. l


Grateful for every dayGrateful for every dayPATIENT STORY

her mouth. The illness was back.Says Jane, “Friends who came tosee me in hospital that Januarythought that would be the lasttime they saw me alive, so I musthave looked really bad.”

Determined“I certainly felt bad but I honestlynever thought for a moment I was going to die. I wasdetermined that I was going tobeat this disease.”

Jane’s doctors startedsearching all the bone marrowregisters for a donor. Fortunatelythey found one and in April1999, just over a year after she’d

where the white blood cellsoverproduce, filling up the bone marrow and preventing itfrom making healthy blood cells such as red cells andplatelets. The white cells do notmature into ‘working’ cells andso are no use for preventing andfighting infections.

ShatteredJane says: “When I found out, Iwas shattered. I‘ve never smokedin my life or eaten badly, so whydid I end up with leukaemia? Iwas in limbo for six weeks justgetting over the shock.

“It was terribly hard on mythree children, too. I had one atuniversity and the other twowere doing their A levels. When Iwas diagnosed I think I was more worried about them andabout how my elderly motherwould cope, than about myself.”

From day one of her treatment,Jane relied on blood. She neededtwo packs of platelets after eachchemotherapy session.

Then in June 1998, Jane’s ownstem cells were collected fromher blood. She was then givenTotal Body Irradiation (TBI) to killoff her leftover bone marrow andimmune system, so that her bodycould ‘start from scratch’ withher own healthy cells, whichwere transplanted back into her.

But by New Year, Jane noticedlots of bruises, and black spots on

been diagnosed, Jane had twobouts of strong chemotherapyfollowed by her second stem celltransplant.

After these treatments Janeneeded a lot of platelets and red cells as well as ‘top-up’transfusions. After a month or so,to the huge relief of Jane and herfamily, she found out thetransplant had been a success.

GratefulNow, seven years on, Jane is stillgrateful for every day.

“I used to be terriblycompetitive at golf but now I justenjoy the fresh air and beingclose to nature. If I’m tired, I letmyself sleep and I do things likeyoga and Pilates to de-stress.” l

Jane Barker’s leukaemiajourney began one coldFebruary day back in 1998.

The self-confessed sports addicthad just played 18 holes of golfand thought her achy legs were

just a sign of her ``getting older’’. It wasn’t until she noticed

what looked like cold sores allround her mouth that she paid avisit to her GP, who ordered ablood test. Five days later she wasin Birmingham HeartlandsHospital having chemotherapy.

“It was that quick,” says Jane.“One day I was the golf captainat my local club, the next I wasbeing treated for a life-threatening disease.”

Jane, who’s now 51, hadAcute Myeloid Leukaemia (AML), a rare type of cancer

Jane,left and above, now takes ita bit easier out on the course

“I certainly felt bad butI honestly never thought

for a moment I wasgoing to die.

I was determined that I was going

to beat this disease.”

Jane Barker was shattered to discovershe had leukaemia. But, she says,

her life-threatening illness has made her appreciate every day

group and another looks forsomething called D antigens(proteins) on the surface of thered cells. If they are present, themother is D positive; if not sheis D negative.

Further tests also check for anyother red cell antibodies thatcould be harmful to the baby.

Antibodies are usually a goodthing – they protect the body byfighting any ‘foreign’ invaders.But during pregnancy or, moreusually, birth, the baby’s red cellssometimes leak into the mother’sblood. This isn’t usually aproblem, unless the mother is D negative and her baby is D positive. In that situation, themother may develop antibodiesto the baby’s ‘foreign’ red cells.The antibodies remove the cells


Having a healthy baby is what every mum-to-be wants. But some pregnancies need

a little more help for a happy outcome,and blood products can play a vital role

MOTHER AND BABY

Keeping baby safeKeeping baby safe

Over 600,000 babies areborn every year in thiscountry. While most

pregnancies and births gosmoothly, a small proportion ofmothers need blood productswhen things go wrong.

Most bleeding risks forpregnant women are associated,not surprisingly, with the placenta(which nourishes the baby in thewomb) and the womb itself.Some women who smoke orwho have previously givenbirth by caesarean section(C-section), are at higher risk.

Sometimes the placentalies in the wrong place, or itseparates from the wall ofthe womb too soon, or it isdeeply embedded in thewomb tissue and doesn’tcome away after the birth.Occasionally, the scar from aprevious C-section canrupture, with potentially fatalconsequences.

Even with good antenatalcare and monitoring duringlabour, not all of thesecomplications can be foreseenor detected in time to avoidcatastrophic bleeding.

When that happens, it’s a racefor the doctors to save themother and baby. Emergencytransfusions of red cells, plateletsand plasma can all be vital. In factevery year obstetrics andgynaecology patients need about89,000 units of blood.

While it’s generally motherswho need blood during and afterbirth, many babies rely on it too.

Sometimes a baby developsanaemia whilst still in the womb,or is born anaemic. Treatmentincludes tiny transfusions (oftenjust a few teaspoons) of speciallymatched blood. Prematurebabies often need red cells andplatelets when they are born toprevent anaemia and help theirblood to clot. Some babies mayreceive up to 50 transfusions.

Important testThere’s another way in whichblood can be vital for a motherand her baby. Early in pregnancyevery woman is offered bloodtests. One checks the ABO blood

from the mother’s system,but also create a ‘memory’of them.

Future problemsIf the baby in a laterpregnancy also happens tobe D positive, the mother’santibodies ‘remember’these cells and attack thebaby’s blood system.

This causes haemolyticdisease of the newborn(HDN) and can make thebaby anaemic andjaundiced. In the worstcases the baby may bestillborn, or die shortlyafter birth or have severedisabilities.

Fortunately, this rarelyhappens, thanks to aproduct called anti-D whichis made from plasma, the

yellow liquid that carries the bloodcells. In the past anti-D came fromUK donors. Sadly, due to thepotential risk of vCJD beingcarried by our donors, anti-D isnow made from plasma given byvoluntary donors in the US.

Once in the UK, it is processedat our Bio Products Laboratorythen stored, ready for use inhospitals and clinics.

Anti-D injections work bymopping up any D positive redcells that may leak into themother’s circulation, stopping herimmune system from makingantibodies against her baby’sblood. Thanks to this simpleinjection made from blood,thousands of babies have beensaved from the seriousconsequences of HDN. l


Laura Witjens, a loyal blood donor, hastaken an enormous extra step in helpingothers in a different way. She knew herblood donations may well have helpedsave the lives of many people,including mothers and babies. But shedecided she wanted to help further bydonating her eggs to give anotherwoman the chance to have a family.

She and her husband had themselvesfaced problems conceiving andconsidered using donated sperm oreggs, before Laura became pregnantnaturally with twins.Says Laura,“Havingbeen lucky, I wanted someone else tohave the chance to have a family.”

Following a consultation and tests,

All egg donors in the UK arealtruistic volunteers. To be a donor you should be a healthy womanaged 18-35. For more informationcontact the National GameteDonation Trust on 0845 226 9193or www.ngdt.co.uk

Laura started having hormoneinjections to boost her egg production.She was able to donate 13 eggs. Shesays, “From that day onwards I havealways felt immensely proud that Idonated my eggs – I can honestly sayit’s one of the best things I’ve done.”l

Helping others tohave a familyHelping others tohave a family

A. This baby has a different blood group from the mother

C. These antibodies cross the placenta into the baby’s blood. The antibodies can damage the baby’s red blood cells if they have the corresponding blood group.

B. Sometimes some baby’s blood crosses the placenta into the mother’s blood. In rare cases, her body recognises the baby’s red cells as being foreign and makes antibodies against them. Or antibodies may have been produced in previous pregnancies or after blood transfusions.

Mother’s red blood cellsBaby’s red blood cellsMother’s antibody

How red cell antibodies are formed during pregnancy

Laura with twins Sam and Tessa

17WINTER 2006 THE DONOR 16 THE DONOR WINTER 2006

BLOOD FACTS

How’s your haemoglobin?How’s your haemoglobin?Many people find at

some time or anotherthey can’t give blood

because their haemoglobin levels are too low. In fact it’s normal for people’s levels to fluctuate for all kinds of reasons –diet, general health, even theweather, have an effect.

Occasionally there’s apermanent health problem that will mean you cannot giveblood at all, but for most, havinglow haemoglobin will only be atemporary state.

What is haemoglobin?Haemoglobin is a protein foundin the red blood cells. Every redcell contains about 270 millionmolecules of haemoglobin, andeach molecule can carry up tofour oxygen molecules.

In the lungs, oxygen attachesto the haem part (which containsiron) of the haemoglobinmolecule, and is then taken by the body’s circulatory system to the tissues and organswhere cells use the oxygen torelease energy.

The body makes red bloodcells in the bones that contain bone marrow – the ribs,vertebrae, sternum and cranium.If not enough red blood cells areproduced, or they don’t contain

enough haemoglobin to bindwith oxygen, anaemia may occur.Anaemia means the body can’tsupply enough oxygen to itstissues, causing symptoms likesevere tiredness. One of thecauses of anaemia can be lowiron levels, which affect theproduction of haemoglobin.

How we test As each blood donation removesapproximately 200mg of iron, wemust ensure that you haveenough iron before giving blood,so that your haemoglobin levelsdo not fall too much.

To prevent this, we testeveryone’s iron and haemoglobinlevels by taking a small drop ofblood from their finger andputting it into a copper sulphatesolution, to see if it sinks or floats.

If your blood is heavier than

Every donor takes the haemoglobin test before giving blood. But why is the test so important?

What does it mean if your haemoglobin levels are too low? And just what is haemoglobin anyway?

Haemoglobin is a protein found in the red blood cells.

Every red cell contains about 270million molecules of haemoglobin,and each molecule can carry up to

four oxygen molecules

An amazing molecule:the red cell protein,haemoglobin,transports oxygen around the body.It has four iron-containing haem groups (shown above as the colouredspheres). The rest of the haemoglobin structure consists offour globin proteins (amino acid chains,shown as coils).

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the liquid, it will sink, showingthat it contains enoughhaemoglobin to make donatingsafe. If the blood floats or doesnot sink completely, then thelevel is too low to allow you togive blood that day. If the dropsinks to the bottom too slowly, anadditional test can then be

A single drop of blood is enoughto tell us if you have a highenough level of haemoglobin todonate at that session

19WINTER 2006 THE DONOR 18 THE DONOR WINTER 2006

performed, using a devicecalled a Hemocue. This takes adrop of blood from a vein in yourarm and confirms thehaemoglobin level electronically.

We make a slightly morediluted solution of coppersulphate for women than men.This is because women naturallytolerate a lower haemoglobinlevel in their blood than men, sotheir safe minimum level ofhaemoglobin is lower.

The concentration levels in thetests reflect this. For women, the

test is set at 125g/l and is blue,the natural colour of coppersulphate. For men, the test is setat 135g/l, and is dyed green tomake each solution lookdistinctly different.

Recent changesContrary to widespread belief,our minimum haemoglobinlevels have not increasedrecently. The copper sulphatesolution test has been the samefor many years.

What has changed is the flexibility around thosemeasurements. Before, we couldallow a slightly lower level ofhaemoglobin (120g/l for womenand 130g/l for men) if the test

Men naturally have a higherlevel of haemoglobin thanwomen, which is partly down tomale hormones that stimulatethe bone marrow to make morered cells which then raiseshaemoglobin levels.

Some people suffer from arare genetic disorder calledhaemochromatosis. Suffererscan’t control the amount of ironthey absorb from their diet,making their iron levels soar. The treatment includes takingblood to lower iron levels.

Danger signsHaemoglobin levels can also be affected by disease, so it’simportant that any low readings are investigated. If yourhaemoglobin levels are low at thesession, we will take a bloodsample and send it to ourlaboratory for further tests.

We will then write to you withthe results and offer you furtheradvice which may includeconsulting your GP and havingfurther tests.

We do not give iron tablets toincrease your iron levels as thesecan be harmful and are notrecommended for healthypeople with a satisfactory diet.They should only be prescribed ifa person is known to have lowbodily iron stores.

Your haemoglobin levelschange naturally throughout theyear, so don’t be discouraged ifyour levels are too low to donateat one session. By the next timeyou come, they may havecompletely recovered and you’llbe able to donate. l

Everyone needs iron in their diet to maintain healthy levels of

haemoglobin. Keep up your levels by eating three portions of

food containing iron every day and go easy on sugary foods,

which tend to contain very little.

All the following are good sources of iron:

l Lean red meat, turkey and chicken

l Fish (including frozen and canned fish such as tuna,

sardines and salmon)

l Eggs

l Breakfast cereals (whole wheat and/or fortified with iron)

l Canned baked beans, other beans, chickpeas and lentils

l Nuts (including peanut butter)

l Brown rice

l Tofu

l All whole wheat breads

l Leafy green vegetables especially spinach and broccoli

l Dried apricots, raisins, prunes

l Avocado

Drinking tea with your meals makes it harder for the body to absorb iron. Instead, try a glass of fruit juice rich in vitamin C toboost iron up-take.

Boost your levelsBoost your levelswas taken from a vein, where theblood is slightly more dilutedthan in the finger’s capillaries.Under the Blood Safety andQuality Regulations, brought induring November 2005, there isno flexibility.

All haemoglobin levels mustreach 125g/l for women and135g/l, regardless of the methodof measurement. The new ruleincreases the protection againstanaemia for all donors, especiallywomen, and those who regularlygive three times a year. The levels

also take into account theadditional samples we now takefrom you.

Haemoglobin levelsYou may find your haemoglobinlevels vary slightly each time yougive blood. This is normal, andcan be down to general health, aslight change in diet, even theweather. Women’s levels alsovary with their menstrual cycle.

Haemoglobin levels can evenchange slightly during the day.This is down to how hydratedyou are. If you are dehydrated,you have less fluid in your bloodand this can cause an apparentincrease in haemoglobin levels.That’s why we recommend that

you always drink plenty of fluidsand keep fully hydrated beforegiving blood.

Haemoglobin levels can varybetween different ethnic groups.They can also vary according toyour diet, for example if you arevegetarian or vegan.

Your haemoglobin levels change

naturally throughout the year,so don’t be

discouraged if your levels are too low to

donate at one session.By the next session

they may have completely recovered! The solution that the blood isdropped into is water mixedwith a chemical called coppersulphate. The concentration ofthis solution depends on howmuch chemical is dissolved in it.The more copper sulphate itcontains, the ‘thicker’ theresulting solution. The thickerthe solution the heavier bloodneeds to be to fall to thebottom. The heavier the bloodthe more haemoglobin itcontains. Simple!

The iron testThe iron test

AB

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OVER TO YOU

This is your chance to tell us your news, views and interesting or unusual donor stories. Write to Rachel Roberts, Editor, The Donor, NBS ColindaleAvenue, London NW9 5BG or email [email protected]

THANK YOU, BLOOD DONORSMay I introduce my first grandchild, Oscar, born 24th May this year?

His mother had a bad time at his birth and lost a lot of blood. Thehospital had to give her four units, andthis letter is a big Thank You to thedonors who were responsible for savingmy darling daughter-in-law’s life. Asyou can imagine, I am having the timeof my life being a ‘Nanna’. Thank youonce again.LINDA PAYNE

MAIDSTONE

EDITOR’S RESPONSE: We're delighted to hear the story ofOscar's birth had a happy ending. Your letter shows

perfectly why donated blood is so important.

HHHHHHHHHHHHSTAR LETTERHHHHHHHHHHHH

HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

Age limitMy wife had leukaemia andreceived a successful bone marrow transplant from her sister nine years ago. Needless tosay I’ve been a regular blooddonor since my wife’s illness. I’mnow too old to become a bone marrow donor, but surely if itwere a matter of life and deathfor someone I should be able todonate my bone marrow?PHIL GRAHAM, WIMBLEDON

EDITOR’S RESPONSE: Good news –recognising that many older

people are fit, well, and wouldlike to register as potentialbone marrow donors, we’recurrently reviewing the upper age limit of 44 for theBritish Bone Marrow Register(BBMR). We hope to havesome news on this in the nextedition of The Donor.

Really risky?With reference to the article‘Taming Risk’ in the last issue ofThe Donor, do you really meanthat there is a daily risk of falling inthe home of one in 60? Accordingto the ‘Law of Averages’ I seem tobe due an awful lot. Do you reallymean that I am likely to burn orscald myself in the home every 20months or so? PETER WHIPPS, BY E-MAIL

EDITOR’S RESPONSE: We usedthese statistics, which camefrom sources including the

Royal Society for thePrevention of Accidents, toshow the chance of an accident occurring duringday-to-day activities. We wanted to illustrate the riskspeople are prepared to acceptwhen taking part in normalactivities, and how these compare with the far remoterrisks associated with receivinga life-saving blood transfusion.

Needless fearsWill Carling is not the only onewho hates needles. One of thereasons I started giving bloodlong ago was to conquer myown fear. The other was toshow appreciation for my goodhealth. I think fear is the mainreason why folk fail to volunteer.A great pity because anyonewho has ever been stung by awasp or horsefly knows that the

A STAR LETTER ischosen for every issue.The winner will beinvited to a behind-the-scenes tour of a BloodCentre. He or she willdon a white coat andsee what happens to adonation of blood. (Youmust be 16 or over.)


All together now! Gail Carswell, from Huntington, Chester, works for the YMCA andsays she sees blood donation as something of a family tradition.“One of my earliest childhood memories is of sitting on a chairswinging my legs at a blood donor session with my Uncle Harry.I thought then this is something I’m going to do some day, and Ihave. I’ve been donating for 23 years, and have just received anaward for my fiftieth donation, which I actually gave on the day Icelebrated my own big five – O last year! My children, Matthew, andtwins Emma and Rachel (far right) have grown up watching me givemy ‘pint of the red stuff’, every four months, which has inspired themto become donors. It really hit home just how vital all our donationshave been when my mum needed two units of blood after a hipoperation last summer. Anyone can need blood at any time.”l

FFFFFFFFFFFFFFFFFFFFFFFFFFFF

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OVER TO YOU

IS IT TRUE THAT...

needle ain’t that bad after all!TONY HALL, BY E-MAIL

EDITOR’S RESPONSE: Even thoughgiving blood really isn’tpainful, lots of our donorsaren’t huge needle fans.If you are feeling a bit nervous before donatingplease mention it to our staff.They’ll talk you through any worries beforehand.

Happy readerThank you for The Donor. In acynical and selfish world it iscomforting and humbling toread of altruism and selflessness.As a keen supporter of Englishcricket and Rugby Union Ienjoyed the summer ‘06 edition

more than usual. Both WillCarling and Michael Vaughanare great heroes of mine, and Iwas more than interested inwhat they had to say.JULIAN BOTT, BRIGHTON

EDITOR’S RESPONSE: We’redelighted to hear that youenjoy The Donor. We reallyappreciate all feedback, sokeep your letters, stories andsuggestions coming in.

More answersI am aware of the brooches givenfor 10, 25 and 50 donations, plusthe different colour donor cardsthat we are issued with. Are therefurther goals for us donors to aim for? Thanks for another

interesting issue of The Donor. EILEEN LARGE, MALDON

EDITOR’S RESPONSE: There are a few of you who go on to reach the incredible figure of75 or even a 100 whole blooddonations. To thank those of you who reach these milestones we invite you to aspecial awards ceremony toenjoy a meal, and present youwith engraved crystal awards.We hope to see you therepicking up your award in thefuture! You can find out more about our awardsscheme at www.blood.co.uk –under ‘What happens’. We’realso pleased to hear you enjoy the magazine. l

QSome time ago you had an article in The Donor

which explained how bloodgroups are inherited.It wasfascinating, could it berepeated?

AYou don’t have to wait for us torepeat it.Back issues of The

Donor can be found on our website,www.blood.co.uk in the section‘About Us’,‘Publications’.

QI have recently visitedNorth America and was

told at my last session that Icouldn’t donate for 28 daysdue to the risk of West NileVirus.Surely this should bemore widely publicised?

AUntil recently we testeddonations from donors who

had returned from areas where West Nile Virus is a risk.However,we

We reply to some of your questions about donatingare currently re-evaluating ourtesting procedure and during thistime have taken the decision to askpeople not to donate for 28 daysfollowing their return.We are sorryyou did not know beforehand. Wewill try to get the message out morewidely in future.

QCan you give moreinformation in invitation

letters and leaflets aboutmedical conditions whichmay prevent people fromgiving blood, to save me awasted journey to a session?

AThere are many and variedreasons that determine who

can and cannot give blood; in fact the guidelines are many pageslong.We do include some of thesedetails on the back of our invitationletters and leaflets,but it is difficult to

decide what is relevant for themajority of people.Due to the limited space,and medical criteria being continuallyupdated,we have found it best topublicise the age and general good health criteria, and then ask people to contact our helpline 0845 7 711 711 for detailedinformation.

QI can't make the sessionmentioned on my

invitation letter;can thedonor health check be used atanother session?

AThe donor health check that wehave sent you in the post can

actually be used at any donationsession,provided it is the currentversion.We will be happy to welcomeyou at whichever session you findconvenient to attend.l

One of our biggest challenges is makingsure we have the right

blood, at the right time, at the right place. It’s a tricky balancing act – having toomuch is wasteful, while having too little could have serious consequences for patients.

So how do we do it?Everything depends on carefulplanning and being able to rely


Keeping suppliesflowing

BEHIND THE SCENES

Keeping suppliesflowing

Managing blood stocks is a huge challenge.Hospitals throughout the country rely on us tosupply the blood group they need when theyneed it. Here’s how it happens

on you, our loyal donors, todonate when we need you to.

Sharing the loadOnce a year, a specialist team sitsdown to work out how manydonations will be needed in the coming year. It will look athow much blood was needed in previous years and analyseinformation from hospitals abouttheir planned work.

Next our demand planninggroup works out the number ofdonations we need in eachregion. These vary to take intoaccount seasonal effects such asholidays and ‘flu. Once we’vedone that, we get busy, bookinghalls, working out staff rotas, andplanning publicity.

Inviting donorsOnce we have our sessionsbooked we start to look at you,the donor. And you’re all sodifferent! Some of you donate inthe same place three times a yearwithout fail. Some of you can’tmake it quite so often. And ofcourse, you have different bloodgroups that are needed atdifferent rates.

We try and make sure we inviteenough people, with a range ofblood types, to every session toensure we get enough donationseach day to supply hospitalsaround the country.

When blood stocks start to runa little low we also increase our publicity. This could meananything from running our TVads, or sending out moreinvitations, to putting up a

A member of our staff makingsure blood is ready to supply to hospitals


banner in the localsupermarket to recruit newdonors.

It’s no coincidence that you’llsee more adverts or articles inyour local paper over publicholidays and throughout thesummer. We know that many ofyou may not be able to donatewhen you come back from yourholidays, because of our travelrules. So we ask you to comealong before you go away to helpboost our stocks.

If you see our ads, it’s becausewe really need people to donate.If we need a particular type, Onegative for example, we willalso send out letters to just thosedonors reminding them to goalong and give blood.

There is a down side to all thisextra promotion. You see we canmake a fairly accurate prediction

of how this activity will affectblood stocks across the country.But it is almost impossible topredict what happens at anindividual session.

All it takes is a stronger thannormal turn out from localpeople, or a bit of staff sickness,and the result is a session wherewaiting times are way too high.

Managing supplyOnce we have your donations,the challenge is to make surethere is enough blood of eachgroup available in all parts of thecountry where it is needed.

Every single day our nationalstock manager checks on ourcomputer system, Pulse, to seehow much blood we have. Ifthere is a shortfall or excess of aparticular group in one part ofthe country, or some of it isnearing its ‘use-by’ date, wemight move some blood about.

An important part of theequation is the shelf-life of blood.Red cells can be stored for up to35 days, but platelets for onlyfive. Hospitals prefer red cells thatare no more than 12 to 14 daysold. It’s a fine balancing actmaking sure our stocks aren’t toohigh so the red cells are near theiruse-by date, but not too low sothat we run short in a possibleemergency. Making sure bloodproducts are used on a first in,first out basis is obviously crucialin avoiding waste.

Best use of bloodIt’s vital we make the very bestuse of every donation we collect,so even after it leaves our hands,

We know that you don’t like to wait. We often get asked, why is it thatyou can be in and out in 30 minutes at one session, yet spend twice aslong at the same session six months later?

The simple explanation is that you are free to either turn up or notturn up. Weather, holidays, local conditions, not to mention personalcommitments all play a part in influencing how many invited donorsattend a session. That’s why we try and encourage those of you whocan to make an appointment to donate, because it really helps uswhen we know how many people to expect.

If you arrive at a session and do have to queue, please accept ourapologies. It is important that we have enough blood for patients –and we can’t do that without you. l

there is more work to do byhospitals in their blood banks.

The Blood Stocks Manage-ment Scheme is a partnershipwith hospitals to help collect andanalyse information about howthey use blood, in order tominimise waste. We also workwith transfusion specialists towork out ways to ensure patientsare given blood only when theyreally need it.

If we ever faced a serious bloodshortage, these schemes wouldbe crucial because hospitals

might be asked to temporarilyhold lower blood stocks whilstwe asked more of you to donate.

Getting betterWe never stop trying to improveevery step of the donationprocess. When it comes tosessions, we look carefully athow successful each one is, and,when there are problems, learnlessons. Only that way can weensure we offer you, the donor,the best service we can, and inturn manage supplies efficiently

Why do I have to wait?Why do I have to wait?

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APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB

BLOOD STOCKS APRIL 2005 – APRIL 2006

MAR

Num

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f Day

s Sup

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APR

Our summer ‘Give before you go’ campaign led to the rise in stocks

Stocks fell due to travel rules and autumn/winter sickness

Ruth Bainbridge manages one of our teams inthe Manchester area. A big part of her job is

making sure sessions run as smoothly as possible.“We plan each session very carefully, but our

sessions, like life, don’t always run to plan! “Our team may be delayed getting to a venue

because of a road traffic incident. And when we getto the hall we may find that it is not ready for us toset up. I’ve arrived at a village hall to find the chairsleft out from the previous night’s theatre production.This will make us late starting the session andunfortunately our donors have to wait.

“We are always delighted to see new peoplecoming for the first time. But we do have to spend alittle more time with them than we do with ourregular donors. This can mean that others have to

To queue or not to queueTo queue or not to queue?wait a little longer beforethey can donate.

“If queues build upthen all we can do is saysorry, and try to let peopleknow what’s happening.We ask them if they’d liketo book an available appointment for later in theday, or visit another session in the area. We’ll also askpeople to let us know if they think they may not beable to donate, just to save them waiting.

“If all else fails, we have been known to come up with some novel ways of passing the time,including funny quizzes or games – one member ofour team has even been known to sing to entertainthose waiting to give blood!” l

The graph (right) shows how ourstocks fluctuate during a year

The Human Tissue Act, which came into force in September, has givennew hope to patients waiting for an organ transplant. The Act statesthat where an individual has recorded a wish to donate organs andtissues after their death, their wishes should take precedence overthose of the family. This is important because at present after death,four out of ten relatives refuse consent for donation and one in tenrefuse even when the deceased was registered with the Organ DonorRegister. At a very difficult time for families we hope the Act will makeany decision easier. l

New rules on organ donationNew rules on organ donation


Two-year-old Shohanna urgently needed a life-saving liver transplant.

But could a donated organ be found in time?

ORGAN TRANSPLANT

It was six years ago thatthe Newman-Kidd familyfound themselves praying

for a donated liver for their littlegirl, Shohanna. It was the desperate last stage of a longseries of treatments for theirdaughter; without a new liver,she would die.

Shohanna was born without abile duct, a condition calledbiliary atresia, which meant herliver couldn’t work properly,causing poisons to build up inher system. When she was fourweeks old, Shohanna had thefirst of two operations designedto correct the problem.

The surgery helped butcouldn’t cure Shohanna. MumDeloris says, “She was on 12medications, some three times aday, and I had to mix a specialfeed for her and insert herfeeding tube through her noseand into her stomach. We hardlygot out at all. As a result of her

liver problems she developedrickets, and she cried when herlegs ached. But most of the timeshe was bright.”

Urgent transplantWhen Shohanna was two and a


Simon, “She loves being with herlittle sisters, but she loves goingto school too and hates missing itwhen her health is poor.”

Deloris says that whenShohanna was in hospital for heroperations it was hard toimagine her going on outings, or taking part in school sportsdays. “Every day was a bonusthen. The doctors didn’t expecther to do so well, but sheshowed us all.”

Shohanna has been lucky.More than 8,000 people in theUK are waiting for a transplant tosave or dramatically improvetheir lives.

But a shortage of organsmeans only 3,000 transplants arecarried out each year. About 400people die annually because asuitable organ was not found intime. So there’s an urgent needfor more people to join theOrgan Donor Register and, justas important, to discuss theirwishes with their family. l

“The operation

went well,and we

owe Shohanna’s

life to a 12-year-old

girl whose family

agreed to donate

her organs”

The chance of lifeThe chance of life

Shohanna, above left, playingwith Alexis, one of her littlesisters

She’s even fine with the bitter taste of the steroids

and immunosuppressants she takes.”

Organ shortageShohanna now hastwo younger sisters,Alexia and Ella. Says

The vast majority of people can.Having a medical condition does notnecessarily prevent someone frombecoming an organ or tissue donor.The decision about whether some orall organs or tissues are suitable fortransplant is made by doctors, takinginto account the person’s medicalhistory. To join the NHS Organ DonorRegister call the NHS Organ DonorLine: 0845 60 60 400 or visitwww.uktransplant.org.uk l

Who can be anorgan donor?Who can be anorgan donor?

half, her health deteriorated.“The doctors said a livertransplant was urgently needed.Then, within five days of hergoing on the transplant list, we had a late night call to saythere was a liver available forher,” says Deloris.

“We’d thought we mighthave to wait for years and I feltwe were going ahead of otherchildren who’d been waitinglonger, but we were assured thatit was all about who was the bestpossible tissue match.”

Shohanna had a split livertransplant, where she receivedthe smaller lobe of a liver and thelarger lobe was transplanted intoan adult patient. “The operationwent well, and we certainly owe Shohanna’s life to a 12-year-old girl whose familyagreed to donate her organs,”says father Simon.

“I’m very proud of how she’scoped,” says Deloris. “Sheunderstands what’s happened toher, knows about healthy eatingand is happy to try any new food.She also understands she has totake it easy sometimes when her friends are racing about.

ALI

SON

MC

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UG

ALL

blood pressure, heartbeat,kidney and other functions.

QHow would you decide if apatient needed blood?

AI’d take that decision togetherwith the surgeon. By

measuring haemoglobin levelsthroughout each procedure, I cananticipate when these levels maydrop and blood be needed. Or thesurgeon might ask for blood if thepatient is losing too much duringthe operation. We’ll usually givepatients different blood productsdepending on the circumstances.If a patient was losing bloodbecause their own blood wasclotting abnormally then they maybe given plasma or platelets. Wecan receive the right blood for atransfusion in a matter of minutes.

QWhat measures are taken to reduce the need

for blood?

AWe try to use alternatives toblood and blood products

where possible. Not only is blood aprecious resource, for manypatients it is also safer and just aseffective to use other fluids. We are able to improve manypatient situations withouttransfusing blood.

QSo, what are thealternatives to giving

donated blood?

AWhen blood volume is lostduring an operation we can

often replace it with fluids calledcrystalloids and colloids. Bloodvolume is important as it maintainsa patient’s blood pressure andother functions.

Using fluids in this way means thatalthough the patient may still bleed,he or she is actually losing fewer redcells, for example, because theblood has been diluted.

Also, we can sometimes workwith the National Blood Serviceto take a unit of blood from apatient before their operation.This is then ready to use duringsurgery or afterwards to aid theirrecovery.

If necessary, I can also takeblood from a patient duringsurgery, replace the lost volumewith fluids, and return theirblood after the operation to raisetheir blood levels and help theirrecovery.

QDo you see the patientafter an operation?

AYes. I can advise them on pain control and their

recovery process.

QYour job is obviously veryintense, how do you relax?

AI have three young boys athome and they keep me

incredibly busy when I’m notworking. I also play the Frenchhorn and I do enjoy taking a littletime for myself to practicewhenever I have a rare moment ofpeace and quiet! l


Dr Helen Smith is a consultant anaesthetist

at Addenbrooke’s Hospital. She works

alongside surgeons to monitor patients’

progress before, duringand after surgery,

ensuring they receive thebest possible treatment

MEET THE EXPERT

A safe pair of hands A safe pair of hands

QHow did you become ananaesthetist?

AI practised anaesthetics as amedical student and found I

enjoyed the practical and dynamicnature of the specialism. Afterqualifying, I worked all over theworld before joining Addenbrooke’sHospital as a consultant in 1992.

QAnd what is your role as an anaesthetist?

AI look after a patient’s healthbefore, during and after an

operation. Before surgery I look atthe patient’s health history todecide how to ensure the best levelof care. I discuss the operationwith the patient, including theirexpectations of the surgery, andpain prevention options. Decidingif the patient is fit for surgery is alsopart of my job, and I performvarious tests to check, for example,that their haemoglobin levels are high enough to cope with thestress of the operation.

QWhat is your role during anoperation?

AI work alongside the surgeonto ensure the patient’s well-

being. My role is not simply to keep

Dr Helen Smith enjoysworking alongside surgeonsand looking after every aspectof the patient’s well-being

the patient asleep and pain-free. In theatre there’s a blood-gasmachine that checks haemoglobinlevels, and I also keep an eye onhow much blood the patient’slosing. Swabs are weighed, and a


“In theatre there’s a blood-gas

machine thatchecks

haemoglobin levels,and I also keep an eye on how much blood the patient’s losing”

suction bottle collects the bloodsucked from the surgeon’s workarea. I also have to make anestimate of any blood loss on thefloor or the theatre staff’s clothing.

Also, I monitor the patient’s

THE DONOR WINTER 200630

Bugs in blood l Since 1997 there have

been only 27 cases ofpatients receivingcontaminated bloodcomponents in thiscountry.

l Seven of these patientsdied from the infectionthey acquired.

l Virtually every case could be traced to germs from the skin in the crookof the arm. l

ASK THE DOCTOR

QWhy is arm cleaning soimportant?

Skin is a fertile breeding groundfor bacteria, viruses, fungi andprotozoa. Some are harmless,but others can cause diseases ifthey get inside the body. So wehave to reduce the chance ofthese bugs getting into theblood you donate or, indeed,getting into your own body.

QSo what do you do toreduce the risk?

Before you give blood, your armis cleaned thoroughly. Also thefirst 30mls of each donation arediverted into a small pouch. Aswell as providing the samples fortesting, the procedure alsoreduces the risk of any bacteriaor the tiny skin plug getting into

the donation. We also regularlymonitor the presence of bacteriaat blood donation sessions.

QWhy are you changingthe way you clean?

Until now cleaning your armwith an antiseptic wipe has beenthe way we removed harmfulbugs, and it is pretty effective.

But now there’s a better way, the‘Chloraprep wand’, which weare introducing to sessionsaround the country; so if youhaven’t already, you will beseeing them soon.

QWhat is the wand andwhy is it better?

The wand consists of a handleattached to a sponge. Thehandle contains a powerfulantiseptic which is released intothe sponge when needed. Thewand has clear benefits overwipes because our staff touchonly the handle when they arecleaning the skin and are far lesslikely to accidentally touch thedonor’s arm. Obviously thisreduces the risk of our staffpicking up germs from donors(and vice versa) and transferring

them to others.

QWhat difference has itmade?

A study showed that acombination of cleaning donors’arms with the wand anddiverting the first 30mls couldreduce the risk of bacterialcontamination of plateletdonations by up to 70 per cent.

QHow will patients benefit?

The wand is another steptowards safer blood for patients.If bacteria contaminate blooddonations, particularly platelets,then there can be deadlyconsequences. Red cells arestored at 4 ̊ C, and most bacteriacannot survive this lowtemperature. Platelets, on theother hand, are stored at 22˚ C,so any bacteria that get into thedonation will grow and multiply.

QHow big a problem is contamination of

donated blood?Luckily it is a very rareoccurrence. Each year, we issuearound 2 million units of bloodfor patients, and yet during thesame period the occurrence of serious problems due tobacterial contamination is only in single figures.

QHow will the new wandaffect me?

We will simply wipe your arm for30 seconds with the spongeapplicator and then let thedisinfectant dry. If you notice anysort of skin reaction, please makesure you let us know. l

Our doctor,

Moji Gesinde,

answers your

questions about

arm cleaning

Arm cleaningArm cleaning

ACROSS6 Type of design (ana-

gram of clients) (7)7 Earnest request (4)8 Garment with

particular type ofsleeve (6)

9 Free from ostentation (6)

10 Distinctive of agroup of people (6)

12 Arab of particularrepublic (6)

13 Instruments mentioned in OldTestament (6)

16 Having a fancifulartistic style (6)

18 In a sullen manner (6)19 The ability to see (6)21 Slow trickle (4)22 An edible mollusc (7)

DOWN1 Meat in 16 down (4)2 Serving as a graphical

representation (6)3 Cold and sticky (6)4 Widespread out-

break of disease (8)5 Famous admiral

Horatio (6)6 Barely sufficient (5)

Complete the crossword. The perimeter letters, beginning at 5 and proceedingclockwise, spell out a three-word phrase. Send the phrase on a postcard togetherwith your name, address and daytime phone number to Crossword Competition,The Donor, NBS, Colindale Avenue, London NW9 5BG. You could win an ‘Amazing’NBS sports umbrella. Answers and the winner will be in the next issue of TheDonor. All entries must be received by 28th February 2007.

11 Current events film (8)14 Witchcraft (6)15 Former space station (6)16 Uncover (6)17 Near… the cathedral area (5)20 Philosophers' porch in

Athens (4)

CROSSWORD

LAST ISSUE’S SOLUTION

WE HAVE A WINNER!Congratulations to Nina Raqeeb from London, whocorrectly answered last issue’s crossword.The correctanswer was RHESUS NEGATIVE.


32 THE DONOR SPRING 2004

NBS INFORMATIONIf you have a general enquiry or need any information about giving blood, just call the 24 hour Donor Helpline on

0845 7 711 711 and staff willanswer your queries on:

• Whether you are able to give blood• Where you can give blood locally• Your donor session details• Becoming a bone marrow donor• How to become a platelet donor• Medical aspects of giving blood• How travelling abroad might affect your

giving blood• Any other general donor mattersRemember, you can call the Helpline to tell us ifyou have moved house or changed employers –we don't want to lose you!

DON’T FORGET information is also available onour website www.blood.co.ukBBC2 Ceefax page 465 will give you details ofblood donor sessions in your TV region over thenext two days.

We always need new donors. So please, if you arenot a donor, fill out the coupon below, place it inan envelope and send it to National Blood Service,FREEPOST, 75 Cranmer Terrace, London SW17 7YB,or call 0845 7 711 711 now to enrol as a donor.

SURNAME

Mr/Mrs/Ms/Miss

FIRST NAME

DATE OF BIRTH / /

ADDRESS

POSTCODE

DAYTIME PHONE No

To give blood you need to be in good health,aged 17 to 59 and weigh over 7st 12lbs/50kg.Please send this coupon to the address above. MO6I would like to join the NHS Blood Donor Register as someone whomay be contacted and would be prepared to donate blood.I understand that the National Blood Service (NBS) or its partnersmay phone, write or otherwise contact me with details of localdonor sessions. I agree to the NBS holding my personal details on their donor database and processing this information as necessary for the proper administration of the NBS.3 THE DONOR WINTER 2006

Blood stocks are lower at ChristmasPlease give blood this festive season

GIVE THE GIFTOF LIFE

the donor - winter 2006

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