07 February 2008

Interesting Day

It was an interesting day, yesterday.

I had signed up to donate plasma at Walter Reed Army Medical Center (WRAMC), which is supposed to be about an hour and a half long procedure. For those who don’t know how this works, they put a needle in one arm and draw the blood out of it. The blood runs through a machine that separates the plasma from the rest of the blood. They put a catheter into the other arm, and once it’s through the machine, return the unused portion of your blood to you through the cath site. This process is called apheresis. (If you’re interested in more info about giving blood in support of military hospitals, click here.) Most people know about whole blood donation. That’s when one donor provides whole blood that helps usually only one or two patients. Fewer know about apheresis, which allows one donor to help up to 3 patients. Whole blood donation can only be done every 56+ days because of how long it takes the body to manufacture the blood to replace the deficit. Apheresis can be done every 2 weeks, because the body isn’t running on less blood, so it can work more efficiently to replace one type of cells in the blood.

For those of you who don’t know, I started giving blood in an effort to squelch my irrational fear of needles. (It works. When they want to give you a shot with that tiny little teensy barely-there prick of a needle, it’s NOTHING compared to the 14 gauge, or whatever it is, that they use to draw blood.) For this reason, it’s not entirely logical to jump to the conclusion that I’d be all about the whole apheresis process, since it requires 2 equally large needles going into two arms respectively.

I got there and checked in, and they took me into the room where they do the procedure. I got all comfortable in the really stinking kewl chair they sent me to, and the young gentleman came over to prepare me to insert the needles. First he had to decide which veins he was going to use. He looked at my left arm and identified 2 likely candidates. The first was the fire-hose vein through the center of my elbow, but it’s a bit deep, and the second was the vein that runs across the top of the inside of my elbow. He looked at my right arm and settled irrevocably on the center vein in my elbow. He did all of the sterilizing stuff, then proceeded to stick the needle in my arm. He poked and prodded, and he tried to get into that big vein with no luck, so he called over another person to try. He poked and prodded, and he tried to get into that big vein with no luck, so he pulled the needle out. He sterilized the other site, stabbed the needle straight into it with no problems, and I proceeded to gush blood all over everything. He cleaned me up and got the catheter all ready to go and drew a half dozen vials of blood from that site, then the first guy went to my right arm. He stabbed right into that big vein in the middle, but couldn’t get it seated properly, so he poked and prodded until he was happy with where it was. He hooked me all up to the machine and got my blood flowing.

A side note—since this procedure usually takes about 1.5 hours, I had brought reading material. When you have needles in both elbows, you cannot bend your arms. This makes reading a less desirable past time. I did manage to finish one book (which only had a few pages left, anyway), but then I took the movie option. They have a huge library of movies to watch.

All was flowing well, and I was very comfortable, and the machine started to beep. The young man came over and readjusted the needle; the machine stopped beeping. A few minutes later, the same thing happened. A few minutes later, the same thing happened. A few minutes later, the same thing happened… you get the picture. He decided my hands were cold, so he got me some warm IV bags to squeeze instead of the foam ball. (I’m a very warm-natured person. I overheat at the very thought of “room temperature”. I was entirely OK with the concept that removing blood and putting it back in cools you down. I was perfectly comfortable with this process. Cooling off is no problem. I didn’t want to get warmed back up, but they made me. Sigh.) Several more shifts of minutes going by and needle adjustments happened. Finally a THIRD guy came over and grabbed the needle to rummage around in my vein a bit, untaped everything, re-seated it, re-taped it. A few minutes later, the machine was beeping again. The second guy came back and stripped the line. He said, “oh, it’s just clotting. No big deal” and we went on. After a half dozen more times of readjusting the needle and stripping the line, they finally decided that it wasn’t flowing well enough to continue. They removed the line to my right arm to try to get some vials out of it. Nothing. Nada. No flow coming through that needle. Apparently I had managed to clot up the whole works from inside the needle. They let the blood continue to flow back in through the cath site, then they had to remove the catheter and reattach the other thingie so they could take more vials out of my left arm, which was also beginning to be sluggish. Eventually, they unattached everything and bandaged me all up. They let me finish the movie (and even brought me snacks), gave me a t-shirt, and sent me off on my own. Apparently, I have very good platelets. haha

I’ve had a friend in the hospital there for more than a week, and I had been trying to reach him to let him know I’d take him to lunch while I was there, but to no avail. So, since I’d visited previously, I just went up to the ward where he had been. I was told that he’d been moved. They checked the computer, and he had been moved to ICU! I was shocked. He’d been on the mend when I’d seen him last, and he had been told he was going to be released. What in the world?!? So I hauled my cookies down to the ICU, where I was immediately presumed to be his wife and escorted into his room. I spent a few minutes there, holding his hand as he slept, and then I asked if it’d be alright if I came back. I was told that I could come anytime I wanted to, and I left to go to an orientation class that I was required to attend at 1.

I went to the auditorium, found a seat, got comfortable, and was prepared to be there for a few hours when I began looking around. I thought, “What’s with all the vestments?” I asked another lady, “Is this the Command Orientation?” She said, “No, this is Catholic Mass.” It was Ash Wednesday, so that made sense, but I had a schedule that said that I was supposed to be there, so I went to check. Surely enough, Command Orientation was cancelled for the day, and it was not communicated. At all. No signs. No emails. No notes. Nothing. A friend of mine told me that there was a Protestant service up in the chapel, and she thought it was at the same time as the Mass, so I headed up there. I figured it would be good for me. It turns out that the Protestant service was at 11, and all was long over and done.

So I ran a few errands in the building, made some necessary visits to a couple of offices, and I went out to my car and got another book and went back up to the ICU. No one had asked me how I knew him. I was allowed to bring in a chair and sit by him and read. He slept most of the time. He was a very sick boy. He only awakened enough to talk and make sense twice, for a few seconds. When he was slightly more conscious, he would squeeze my hand. I was very concerned. Everyone who came in, though, (doctors, nurses, techs, etc.) assumed that I was “family” and told me basically everything they would have told him if he was awake. It was really interesting. I was even given instructions to tell him things when he woke up, which he didn’t do again while I was there.

Eventually, I got my things together and left. By the time I headed home for the evening, I could do nothing but laugh at all the misadventures of the day. I successfully gave plasma, albeit a shorter batch than what they usually take in essentially twice the time it usually takes to give it. I didn’t get the orientation completed, and don’t even know how to go about finding out when it’s to be re-scheduled, which was the main reason I was at WRAMC in the first place. I got to spend time with a friend, who, admittedly, wasn’t entirely conscious of the fact that I was there, and I made some new friends in the hospital. All in all, I have to say, it was a very interesting day.

Much love,

Post Script: I did speak to my friend's nurse, today, and was told that he is doing considerably better. He’s awake, alert, and functioning almost normally. They were preparing to move him back to a regular patient ward, pending the results of some tests. I will see him tomorrow in his new room, when I’m back there, but his condition is much improved. Please keep him, and all our recovering warriors in your prayers.