Subject: White Blood Cells Date: Mon, 15 Jan 96 12:27:00 PST If you ever want a free, legal high, volunteer to donate white blood cells. They give you cool drugs for the day before. I dunno. Sometimes I think I'm just a sucker with no clue what it is that I'm really doing with my life, so whenever the pherisis center calls to ask me to give a chunk of time and a pint of specialize fluids, I can't seem to say no. I guess I'm kinda a strange kinda girl that way. I can easily say no to kisses and propositions and blandishments of all kinds, but I can't say no to having a nurse worry her heart out by trying to stick a needle in my veins. Actually, I usually find that I really enjoy the situation, the people that I do get to meet, and actually find that the rewards are nice. I always wonder, though, before I do it if I'm doing it 'cause I really want to do it or if it's 'cause I know that someone in the world is going to have a worse chance of recovery if I don't. The blood is the life. Mark once commented, long ago, that giving roses is easy. That giving time and love to someone you enjoy being with is easy. He once commented that it would mean so much more if you actually could give blood, life, to someone that you loved. Perhaps a macabre image to most, but for me it made a lotta sense. It turns out, too, that it's *difficult* for me to do these donations, and that the difficulties are recorded, in full detail, on my chart with the center. The nurses at the pherisis center both like seeing me and hate seeing me, 'cause they really love my attitude and know that I'll work with them as best I'm able to get it all to work, but with the record of all the problems I've had in the pherisis unit, they know that it's going to be a struggle getting The Machine to treat me gently. I was called Friday morning by the recruiter, asked if I could donate white blood cells, warned that it was much like platelet pherisis, but would take three hours instead of an hour and a half, and then told that I would have to take medication. As usual, before really thinking about it, I just said, "Sure." I was healthy, I didn't have anything planned for Saturday, and I'd done most of this before. Sometimes I should remember that the blood center is just made up of human beings instead of Folks Who Always Know What They're Doing. I told the lady that I would be at the Bellevue center for my blood tests and my medication and she said that that would be fine. So I went into Bellevue, and waited until the lady receptionist got off the phone and helped the guy in front of me (which took her a good long time). A business man in a suit lined up behind me and was kinda amused by the fact that I was pacing. I wanted to be done with stuff and gone, and I thought that the blood test they were talking of was just a pin stick to see if my iron count was high enough. When I got to the front of the line I said, "Hi, I'm here 'cause I'm gonna be giving white blood cells tomorrow and they told me to come here for a blood test and my medication." The receptionist looked completely blank. I tried different wording, "Uhm... they said that there would be a nurse here that would take care of the blood test, should I just go back?" The pherisis unit is in the back of the Bellevue center. She looked even blanker and got in front of her computer and asked me, "Are you here to donate?" I blinked at her and said, "Uhm... yeah, but not until tomorrow and it's gonna be white blood cells..." She cut me off with a brisk, "OK, then. What's your Social Security Number?" I think she panicked and tried to get into her 'normal routine' to deal with this obviously weird donator. I heard the business man behind me giggle, which was such a very cool sound coming from a suit. I tried a gentler, more authority based approach. "The downtown pherisis center said that I should come here to get a blood test from the..." At the phrase 'downtown pherisis center' her face lightened and I honestly think she got her world back. "Oh! Just go on back! They'll know what to do back there." I bounced back to the pherisis center, and the two nurses were deep in conference, and a tall, thin, grey haired man came into the area and spoke with them in a very British accent. I introduced myself to one of the nurses that looked up; and they recognized the name immediately and found my folder and a small envelope with my name on it. There were three big times written on it 11pm, 8pm, and 6:15am. The nurse kinda stared blankly at the times and frowned, obviously not sure it was right. She took it to the other nurse and they conferenced over it anxiously. I heard "What are the hours it's supposed to be taken? Is it 2...?" Then they started searching their closets for 'a white card that's supposed to go with the white cell donator's medication.' They never found the cards and it sounded, a little, like someone had taken them away from the Bellevue center, after they'd downsized the eastside pherisis, but the lady updated the 11pm time to 10pm and then emphatically renumbered the times and said, "This is right. Take one at 8pm, one at 10pm, or just before you go to bed, and then one at 6:15, as you're donating at 8:15am, right?" I nodded, "Right." While she'd been doing all that, I'd taken my Mad Bomber hat off my head and set it on the counter. The doctor noticed and looked at it and said, "That looks like a very warm hat." I nodded, "Yes, it's mine." At hearing that accent I daringly added, "I wear it when the soft top is down on my Land Rover." His interest was snared, "How old is your Land Rover?" "We have three," I said, "One is a 1956 station wagon, one is a 1966 long wheel base..." He smiled in delight, "Wonderful!" He went on about how Land Rovers always got him home when he was in Africa, and that he'd had a long wheel base when he was there, and how much personality it had had. He was also astonished at the damage the beast had been able to take and still run. He told about a dent in the side of the car which had been put there by a charging water buffalo, and how they'd never fixed it because it was so much more fun to talk about the story about the water buffalo than it would have been to have a pristine truck. He was happy and nostalgic and glad that there were Real Land Rover owners still out there. He asked, "Have you seen the new Land Rover dealer over there in Bellevue?" I nodded and kinda frowned, "They're all so new, though, no personalities, yet." He nodded as the nurse led me off to get my blood test, "Yes. I never quite saw the point to buying a car you couldn't eat in." I laughed, "Exactly." That was fun. I'm always amazed at what kinda people I get to meet at volunteer blood centers. Hanyway. The nurse did the Usual Questions, and then did the Usual Paperwork, and then did the Usual Physical, and then we did the slightly unusual blood test draw. She said that they were doing it in order to have the results before tomorrow, so that they could just take the white cells directly to the patient instead of having to wait until the evening. She asked me what was an easy vein to draw, and so she put on gloves, pulled out a small needle, a couple of vacuum tubes and then just had me place myself comfortably and in went the needle. The problem, though, was also that I was still dehydrated from my game Thursday night with the Red Door Cafe team (the game wasn't much to talk about, just cold, the women had no subs, and since John had a red card from the week before, he couldn't play, so he went home, had dinner, and came back with warm clothes to watch the end of the game), so the nurse had a hell of a time finding the vein. Poke, poke, poke, poke, wander here and there, and I was kinda bored by it. Tells you something about me and needles, I guess. But she just kept trying, kept asking me if I was okay, and the vein just kinda melted away from the needle point. I kept reassuring her and sighed internally at it all. She finally went just a touch deeper, directly at it, and hit it. Sloop, sloop, sloop and three test vials were filled quick and easy as can be. We closed up the vein and I was out the door, into the sunshine, with my medication in my pocket and me happy to be OUTTA there. I was a tiny bit worried about my right arm and vein. It was actually kinda sore from the small draw, but not all that badly. So I just meandered back to work and stayed until 7:50pm, as John and I had a whole lotta stuff to do before the freeze of build material at the end of Friday. We had it all done and ready to go with the new week when I took my first pill and we walked out the door. The blood folks had also asked me to eat full meals, and lunch had been a Chinese restaurant lunch special. Dinner we had at Boston Market, which is a place that actually does rotisserie chicken *right* and has stuffing and all the fixings for that kinda stuff. I felt like meatloaf, stuffing with gravy, and creamed spinach (of all things), and was happily full when we got back in time to watch X Files. After the TV show, I got my little envelope out and ate my second pill. John took the envelop and looked at it kinda hard and said, "What's this mean?" He pointed at little tiny numbers to the left of the times and the BIG circled numbers that said 2, 12, and *18*. Hyup. They'd screwed up the math on the times for my dosage. I should have taken one at 2pm, 8pm, and then the 6:15... There were three different, rather big problems, at this time. The first was that the drug was hitting my system, and, quite honestly, I didn't know what the hell the stuff *was*. They'd told me that it was to stimulate my white cell production, and that it might have the side affect of making it a little hard to sleep; but that was it. It didn't help, at all, for them to have screwed up the test draw *and* the timing on the drug. Secondly, I was blaming myself for not suspecting that they'd done the timing wrong, as all the clues were there. Both the chaos that was happening, plus the information was Right There, written on the envelope. THAT really hit me in my perfectionist's crack, as I really did believe that I SHOULD HAVE KNOWN. That is not a productive attitude. Third problem was that I wasn't sure why I was doing all this. As I said, I wondered if I was being a sucker, putting other people's good before my own, and if I, as usual, was sacrificing myself and my desires for other people's needs. I mean, who, in their right mind, would *WANT* to go somewhere, be completely unable to move their arms for three to four hours, get needles stuck in them, and get all their blood pulled from their bodies and put back in? John's never done it, and he's already pretty notorious, to me, for doing things for other people. MOST people I know say that they'd *never* do something like that. There are only two people that I know who do do it, and those are Flynn and Sue Paules, a gay lady from church, both of whom I really, really like a lot. They're both really cool people; but I wasn't doing it to 'be like them.' So... why was *I* doing it? John took care of the drug problem by saying, quite matter of factly, that we'd just go there in the morning, and tell them about the screwup, and if it was a problem, we'd go home and I wouldn't be any worse for it. The fact that the drug itself was making me jittery and nervous, didn't help things, plus a cumulative exhaustion of the last week kinda caught up to me all at once, and I pretty much fell apart and cried myself into a heap. Not productive. I finally just got tired of being so messed up and stopped and started just concentrating both on getting some sleep and making sure that I had enough liquids through the night to make my veins a little easier to find the next day. I also figured out, in my head, that a big chunk of why I do do this is because I'm able. The only thing that ever really worries me about the whole procedure is whether my bladder will last that long, how bored I'm going to get, and whether or not there will be someone there to scratch my nose. I am not scared of needles, I know I can outlast the procedure, and it's no real big, if the nurses are competent. If. Nice thing is that the downtown nurses have never failed me. I guess, basically, a chunk of it was simply pride in being able to do something so many people thought was impossible for them. It was just barely enough. I knew, though, that to do it next time I'd have to have more reason; but I'd promised, and I wasn't going to back down from a promise. I was also going to do the best at the promise I had made. I have an internal alarm clock. Every hour, on the hour, without any external alarm, I woke up, drank a glass of water, used the bathroom if I had to, and went back to sleep. At 4am, John started to snore so loudly, I couldn't go back to sleep, so I went downstairs, drank my water, curled up in the guest bed and went to sleep. I did my 5am stint and then slept until 6:13am, which was when I woke up, went up the stairs, took my pill, and then set the alarm, before it rang at 6:15 for 6:45, and went back to sleep until the alarm work both John and I. I showered while John was a sweety and made me a breakfast of sausage, hash browns, and hot cider. We had a cheerful drive to the center and he stayed long enough to find out that odd timing on the medication was just fine; and discussed with the nurse when I'd probably be off The Machine. He decided to come back about 12:30. It was only 8:30.The nurse there was very appalled at the drug problem, and told me that it was definitely NOT my fault or problem, that it was the problem of the nurses at the Eastside clinic and their support. And that I should talk to the pherisis program managers to tell them what had happened, or else it wouldn't get changed. The Usual Questions were skipped through the nurse simply asking if the AIDS question answers were the same as the day before. They spun the blood for iron count while I went to the bathroom, and I never heard the results. They then set me into the chair, put pillows under my arms, and rolled my sleeves up and then the nurses were really outraged to find bruising all around the only good vein I had. They muttered that the nurses at the Eastside should have had better sense about the whole thing. There were two nurses, one was a very nice Caucasian Lady in a neckbrace and the other was a younger Eastern European. The Lady asked me where I thought the other nurse was from, and teased the other, asking her if she'd worked Halloween night. The Eastern European lady explained that she was Romanian, NOT Russian; and then admitted, in hushed tones, that she was from the Northern part of Romania, basically Transilvania. The lady kept teasing the Transilvanian nurse about having an inherited gift for finding veins, and the Easter European lady cheerfully answered to the nomer of Vampire Nurse. THAT was fun. The Vampire nurse told me that the recruiter was crazy pulling me for a white cell procedure because they couldn't do the white cell set with a single needle setup. They had to do it two needle; and with my veins, it was a crime to have them pull me when there were so many other donors. But we went ahead with it, as I had done two needle frequently enough that I knew it was possible. THEN she flipped through my chart, got a worried look on her face and went to the main desk and called someone. Turns out that the last time I gave platelets, I'd only had a 142 count on platelets and if it's below 150, they have to check with a research nurse about the next draw. Turns out that white cell draws aren't dependent on platelet counts. So we went with it. They pulled out all the apparatus, and let the Vampire nurse have her turn, first, with the left vein. She hit it and hit it hard on the first try; but went right *through* the vein. So that when she tried to draw it hurt, she pulled the needle out a little and the draw was purrrrfect. The return worked as well, without a problem. The lady nurse hit my right vein, first time, and it drew beautifully into the apparatus. The problem was that that when The Machine tried to return saline it *HURT*. Turned out that the left needle had settled back in a little, and they had to pull it out a little more, again, to get the return to work. The Machine went through the initialization just fine, and then when it started the *real* return my left arm started to ache. The lady nurse took one feel and said that it was wrong. I forget the exact word she used, but it felt like 'infiltrate'... and they seemed to use it for whenever the fluid was being forced into the flesh around the vein instead of back into the vein. More than likely, when the needle went all the way through the vein, it had weakened the opposite wall, so it was leaking, under pressure, into the flesh around the vein. So we stopped, pulled the needle from the left arm, and the Vampire nurse checked my left hand as I said that it had been used before. She approved. Said that the vein there was much better than the one in my arm. She also apologized, profusely, for having to stick me twice. I reassured her, saying that it certainly wasn't her fault, if anything, it was just from the fact that my veins are just too darned small. We put a lot of heat at the point of the vein in my wrist and it showed beautifully. She iodined it, cleaned it, cleared it, got the needle, and with the heat off it, it disappeared. Whee. She banged on it, asked me to pump it up, and with a small prayer, she sunk the needle three quarters of an inch into my wrist. Woo. She hit it. Perfectly. We both said a soft, "Thank God." and started on the three hour procedure. She had to go save another setup, while the lady nurse got me _Remains of the Day_, and a pair of headphones so that I could catch all the subtle dialog, and left me to The Machine, as she caught up on all the paperwork they had to do for me because their computers were down. Yes. I call it The Machine 'cause it reminds me of The Machine of _The Princess Bride_, the one that sucked a man's life from him in complete agony. It worked on a suction principle, and this particular machine of reality really was sucking my life away. It also put most of it back, but I like the poetry of it. It turned out that there was a consent form that I should have signed before any of this happened, including my taking the medication. They put it on my lap to make sure that I signed it when they were done; and I read it while I listened to the movie. It was a sheet with a full explanation of the steroid that was the drug along with the fact that it might make my sleep a little difficult, would increase my appetite and might make me more active. I also found out that they were dripping a starch laden saline into me, in order to make the white blood cells a touch heavier so that they would separate more easily from the red blood cells, that the saline might give me a headache the next day. I giggled softly at reading that the anticoagulant might make me buzz and that I should ask the nurse to slow the procedure if that happened, that there might be some brief discomfort in putting the needles for the procedure into place, and that there was nearly no chance that the procedure would introduce significant air bubbles into my circulatory system. Whee... Nice to know for next time, I guess, is the catch word of the day. And that I should be more careful when I think of going into a medical procedure. And, in reality, when The Machine makes me buzz, I ask for TUMs. Turns out that the anti-coagulate binds with calcium, which is the main ion that inhibits neuro activity. So, when the calcium in my body gets depleted, all my neurons start firing randomly, which makes me buzz. TUMs floods my system with calcium and damps the buzzing. It's funny, but I actually do like it when the procedure is in process. It's one of those times when I can, without guilt, ask for things. I can ask for a warmer blanket, for a drink of juice, for TUMS, for them to make adjustments for my comfort, for someone to scratch my nose, for the volume to be turned up or down on my movie. I think it's the first place where I found that I *should* ask for things because the folks asking really, really wanted to make me more comfortable and if I was in any discomfort it usually meant something wasn't going correctly. So they wanted to know; and that has actually helped me ask for things in real life, too, when I know that someone really is interested in my well-being. The movie was nearly perfect for the exact three hours of extraction. That was nice. We also finished about a quarter 'til noon. Needles came out without a problem. But the right vein wouldn't close. We worked on it for a good ten minutes before it even slowed. The Vampire nurse indignant about the mess the other nurses had made of my right arm and told me that they simply should NOT have done it on the only vein that was worth drawing from. That they could have messed everything up by doing that. The Lady nurse was nice and did me up in purple bandages, 'cause I was wearing a purple sweater and asked for purple instead of the flesh colored bandages. She also, very kindly, informed me that I wouldn't bleed to death even if the vein didn't close, as it was nearly impossible to bleed to death from an open vein, it was only arteries I had to worry about. I have to admit I giggled at that. I then tottered over to the canteen with my laptop, had a hot chocolate and a tomato juice and then another tomato juice and another hot chocolate and started this account when the warmth from the hot chocolate finally hit my system. While I was on my second chocolate, the Vampire nurse wandered by, and I asked her what I should do the next time, if they needed to draw a sample the day before. She sat down and very kindly told me that, if the recruiter called again, that I should just say no. My veins were tiny, and there just wasn't any way to do a single needle job on me, and I only had one good draw vein. If there was any way that they could find another donor, they should. She understood that this time I was a perfect match and that it had been for a small child. She frowned a bit at that and then patted my hand and told me that, if they had to do it again, that the nurses should leave the draw vein alone, any test vials should be taken from the trickier left vein, and that I should point out the wrist vein for the return. It was actually quite a good vein, and would show up beautifully if heat were applied beforehand. She patted my hand and said that it was very kind of me; but it was tricky enough that God had to have been looking out for that child and for those of us trying to help. I kinda blinked after her. The information about both the perfect match and the child was completely new to me. On hearing that I felt a whole lot better about all the pain I'd just gone through and felt like it had all been worth it. Also, after hearing her say, with no equivocation, that I just shouldn't volunteer for this without a reason and knowing about my lowering platelet count, I knew that I'd be *able* to tell the recruiter No. If there was any way they could find another donor, I would have no problem at all refusing anymore. That was really neat to find out. That by having the medical reasons, I was going to be able to be good to myself and just say No even to a cold call. John found me about then, hugged me, helped me haul myself down to the car and hugged me some more and then took me to the House of Hong. A car pulled out from the tiny parking lot, and for the first time in the ten years I've lived in Seattle, John and I were actually able to park in the parking lot of the House of Hong while we went into have dim sum. I was tired and still muzzy and very glad of the miracle of the short walk. We had our lunch and we had fortune cookies at the end. John's said, "You have a keen sense of humor and love a good time." which was something that's extraordinarily fitting for him. I ate my two egg custards, first, and had a sip of tea just before I opened mine. I nearly choked on the tea. Real life is *always* weirder than fiction. The slip of paper read, "Our first and last love is self-love." I guess I'm finding mine, again.