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Jeff-
When you next see the doctor, ask him/her about planning ahead for transfusions. When my son gets 3 units of prbcs and one of platelets, we are usually at the hospital for about 10 hours maximum if we plan ahead. Approx two hours per bag of red, one for the platelets, allow for flushing and change of tubing between each bag and lasix between the 2nd and 3rd bag of reds. It is a LONG day but can be much longer if we don't plan ahead. We usually go in to the lab the day before to get a cbc and type and cross match. At our hospital (and I assume at others) this has to be done every time. I have also made it known that if the blood products they send aren't fresh, I will send them back so now, the blood bank calls me to tell me the expiration dates for my approval before we even get there.
There is no sense in giving someone who is transfusion dependent, red cells that will soon be expiring. I tell them to save those for someone who needs it for surgery, etc or some other one time deal. Not someone whose life is dependent on it. I refuse to let my son get a product that is ready to expire. Why should he take on all that iron, spend all that time and money, not to mention take on the usual risk of transfusion and not get the absolute maximum benefit from the product. It DOES make a difference. After a year of getting transfusions, believe me I know. I chart every transfusion and I was able to track that the fresh ones lasted longer.
I also make sure that I see every bag and check the info myself to see that it is the correct blood type, that the product is irradiated and that the expiration date is reasonable. You have to be an advocate for your wife.
There's no reason why everyone shouldn't be agreeable to this. The longer your wife can go between transfusions, the fewer bags of blood she will need and that is good for everyone.
I won't let him get prbcs that aren't at least 3 weeks from expiration date. Don't let anyone tell you that isn't possible. Even after irradiation, it is possible. We often are able to get them nearly 4 weeks from expiration.
Wendy/mom to Grant
age 15
dx 12/4/98 AA
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