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Transfusions and Iron Overload Blood and platelet transfusions, iron testing and treatments

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Old Thu Jul 8, 2010, 09:23 PM
SkipM SkipM is offline
Join Date: Nov 2007
Location: Philadelphia, PA
Posts: 19
1st Transfusion Questions

This week my hbg fell below 8 for the first time and is now 7.2. I'm still functioning alright and even went on a 10 mile bike ride last Sunday. The Dr. wants me to come in and get a transfusion but I'm on vacation so will wait until next Tuesday to do it.

My big question is do I need someone to be there with me to take me home? My wife works and won't be able to take off that day.

How long does this process take? Can I go right to work afterwards?
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Old Thu Jul 8, 2010, 11:26 PM
Neil Cuadra Neil Cuadra is offline
Join Date: Jul 2006
Location: Los Angeles, California
Posts: 2,493
Transfusions typically take a couple of hours, depending on how much paperwork, cross-checking, etc. they do. You shouldn't need anyone to pick you up afterwards and you should be fine going to work. In fact, you'll probably feel better than when you went in.

After a transfusion you should notice if any symptoms of a problem occur, like shortness of breath, pain, tingling, chills, fever, swelling at the transfusion site, bleeding, and so on. If there's anything out of the ordinary, call the transfusion center or your doctor to report it and ask what to do.
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Old Fri Jul 9, 2010, 08:42 AM
Marlene Marlene is offline
Join Date: Oct 2006
Location: Springfield, VA
Posts: 1,344
Before John's treatment, he was able to get his red cells on his own. Like Neil said, he felt better after getting them. After his treatment, he needed me to drive him for a whole host of reasons but mostly because they had to pre-med him before red cells because he started getting hives with his red cell transfusion. He couldn't drive because of the Atarax...made him way too sleepy. In addition, he was pretty wiped out in general.
Marlene, wife to John DX w/SAA April 2002, Stable partial remission; Treated with High Dose Cytoxan, Johns Hopkins, June 2002. Final phlebotomy 11/2016. As of January 2017, FE is 233, HGB 11.7, WBC 5.1/ANC 4.0, Plts 146K.
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Old Fri Jul 9, 2010, 10:45 AM
squirrellypoo squirrellypoo is offline
Join Date: Nov 2008
Location: London, UK
Posts: 458
As long as you're not getting piriton/benadryl before your transfusions (I only got these with platelet transfusions after a bad reaction) then you should be fine to drive. Before my transplant, I would regularly get transfusions and go to work directly after. But remember that red blood bags take around 2-2.5 hours to drip through, plus an hour padding on either side (if your outpatients is anything like mine), so even if I got there right as they opened at 9, I would still only get to work around lunchtime and work a half-day.

(I know you didn't ask about platelets, but they're much quicker - 15min and you're done!)
36/F - 1984 SAA treated with ATG [complete remission until] Oct 08 - burst blood vessels in eyes and low platelets; Jan 09 - AA & hypo-MDS; July 09 - BMT (RIC MUD PSCT) July 10 - 10k for Anthony Nolan (1yr post BMT! 53:48) Sep 10 - Wedding! I've run 5 marathons now!! (PB 3:30!)
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Old Fri Jul 9, 2010, 10:56 AM
Gloria J Gloria J is offline
Join Date: Sep 2009
Location: New Jersey
Posts: 53
I always felt a little blah the evening after a transfusion (usually two units) and sometimes even the next day. A nurse once told me it was because of the new blood trying to assimilate with mine. Whether that's true or not, I always tried to make sure the next day held nothing too taxing for me.

I always drove myself in, but it was a long day - in by 8AM, home by 6 PM. A day out of your life, but the boost in energy and well-being always made up for it.
Gloria, early 50s, dx SAA Summer 2007, Pred July 07, Rituxan Aug 07, dx PNH Feb 2008, ATG Apr 08, began Soliris 5/31/11
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Old Fri Jul 9, 2010, 05:04 PM
launch launch is offline
Join Date: Mar 2009
Posts: 193
Also, if you have any cardiac conditions, they may drip the transfusion even slower. So, may be longer than 2.5 hrs. Hopefully not though. My husband has a stint from 10 yrs ago and the Regional Hosp would require a longer transfusion time than they did at the Cancer Center? Different rules/protocol.
Cindy, wife of Ron 66 dx w/MDS(RARS)Feb'09,Vidaza 13mons. BMB 2/10 -5q/increased blasts. Watch/wait May-Jul10. Revlimid Jul-Aug10:A-Fib. BMB Aug18, 12%blasts. MDS to AML. Induction completed 9/21/10. BMB Oct10:CR. Consolidaton:10/25/10. Dacogen Dec27-29. SCT on Hold. Fevers/Nt sweats Jan11.
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Old Sat Jul 10, 2010, 04:56 PM
Laura Laura is offline
Join Date: Aug 2006
Location: Minnesota
Posts: 433
I would always get premedicated with Tylenol and Benadryl prior to transfusions. Sometimes the Benadryl made me tired. Each transfusion would last between 3-4 hours. Maybe see how you feel after the first time you go to get transfusions? Then based on how you feel see if you are up to working or not. I usually drove myself there. You again might want to see how the first one goes and have your wife there. Then based on how you feel decide for the next time if you need someone or not.

Laura; dx SAA; MUD transplant June 18, 09; ITP June, 2011; fighting multiple complications/GVHD and now low counts again...
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Old Sat Jul 10, 2010, 05:48 PM
mausmish mausmish is offline
Join Date: Mar 2010
Location: Maryland
Posts: 450
At one location was not premedicated; at the other, I had benadryl. I recommend having someone go with you the first time since you don't know how you might react. I felt fine with mine but everyone is different. The quickest I had was 2 hours, the longest 5. Hope this helps.
Karen, age 62, dx MDS RAEB-2 1/8/10: pancytopenia WBC 2.7k/Hgb 7.4/Hct 22.1/Plt 19k; complex cytogenetics -3,del(5)(q14q33),-6,+8,+mar,17% blasts. MUD BMT Johns Hopkins 11/30/10. Dx tongue cancer 8/31/12. ok now. blog mausmarrow.com
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Old Sun Jul 11, 2010, 12:02 AM
Chirley Chirley is offline
Join Date: Oct 2007
Location: Logan City Australia
Posts: 1,100

It sounds like we all have different experiences. I always have a premed of IV Hydrocortisone and although I also have IV Phenergan ordered I always refuse to have it. I drive myself and it would be too dangerous (and illegal) to drive. After being given the premed the nurses wait half an hour before starting the transfusion.

My blood units are run in using a pump and are given at one and a half hours per unit. Add in the time at the beginning to establish IV access, check orders, check your identity etc and time at the end to flush the lines and remove them and take a final blood pressure and temperature.

Depending on how busy the day is you can sometimes have to wait a considerable length of time just to start the process.

All in all.......how long is a piece of string?

Good luck.
Copper deficiency bone marrow failure (MDS RAEB 1), neuromyelopathy.
FISH reported normal cytogenetics but gene testing showed
Xq 8.21 mutation
Xq19.36 mutation
Xq21.40. mutation
1p36. Mutation
15q11.2 deletion
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Old Tue Jul 13, 2010, 05:42 PM
SkipM SkipM is offline
Join Date: Nov 2007
Location: Philadelphia, PA
Posts: 19
Thanks everyone for your input. It was helpful. Long story short. False alarm. I went in today to get the transfusion and my hbg was 8.2. So I did not need a transfusion right now. Dr. is putting me back on Revlimid and will be checking cbc's weekly for now.
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Old Wed Jul 14, 2010, 10:03 PM
Lisa Z Lisa Z is offline
Join Date: Nov 2008
Location: Ft. Washington, PA (Philadelphia area)
Posts: 111

skip - Depending on where you go and if you are premedicated, this will determine if you can drive. I always went to Abington for my transfussions. If you get 2 bags, plan on spending the day. One time I did not get premedicated and I ended up with hives all over my body. So, you should get the tylenol/benadryl pre-meds. I think with the benadryl, they want you to have someone drive you home, even though it is really worn off by then. But, hospital liability......... those are likely the rules.

Glad you didn't need it in any case.
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Old Fri Jul 16, 2010, 06:13 PM
Hawaii Bill Hawaii Bill is offline
Join Date: Jun 2008
Location: Waikele Hawaii
Posts: 100
Not sure if this helps, but

A lot depends on the rules of the transfusion site. At the place where I received most of my transfusions, I learned that the overall time was reduced if I went in the day before for the "type and cross" if I was receiving red blood (not required for platelets). Otherwise, they would do it when I arrived for the transfusion, and that added a lot of wait time.

Another center I went to a couple of times wanted a type and cross for platelets, too.

I think having someone there with you the first time is a good idea. They'll probably be bored, but that's what you want!
Male, 56, dx Nov2006 VSAA (BMA:0%). Responded to ATG/CsA/Prednisone/Neupogen Dec 2006, but relapsed in June 2007. Counts are responding to using CsA 200mg bid alone since Jun 2008. Last PRBC tx: Jul 2008.
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Old Thu Jul 22, 2010, 12:15 PM
Join Date: Jul 2010
Location: USA
Posts: 5
Generally not. Although transfusions can result in adverse reactions, it is not typical.
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