It's a rainy Sunday morning (well, technically- I'd still call it a Saturday night, but whatever). Since it's a Sunday and all, let's talk about something. What, exactly, I don't quite know yet. I need to get this written, though, because falling asleep needs to happen at some point too, and I would be remiss in Novemblogging if I kept putting off these posts until morning, tempting as it may be.

Screw it. Let's get gross tonight. We're going to talk about fluids. Not my fluids specifically (well, not entirely my fluids specifically) but the general grouping of fluids that may arise- this sentence has already fallen apart. Let me start over.

We're going to talk about fluids. More specifically, we're going to talk about giving fluids and the experiences involved therein. At times, we will be talking about my specific experiences regarding the giving of those fluids, because those are the only experiences for which I can vouch, what with cogitoing all the ergo sum and such.

"Gonna cogito some serious ergot, if you know what I'm saying. I'm going to do hallucinogens derived from a fungus in an effort to achieve some sort of euphoria, is what I'm saying. In French and Latin, though. Maybe some Greek if I'm feeling frisky."

I'm talking, of course, about platelets. Yeah, you could give blood, and you probably should. I don't, because I have a pretty common blood type that (apparently) isn't in super high demand (since the Red Cross doesn't hound me about it constantly), and giving blood takes a lot more out of me than giving platelets, what with the slower generation time for red blood cells. Platelets are good to give if you're eligible to do so, what with saving kids with cancer (and it's an easy-ish way to lose some weight in a hurry! Who needs to be able to clot?). Also, it made me feel pretty great afterwards, which makes me wonder if I should buy some therapeutic leeches for the next time I get sick.

Also, as a warning, some of these stories can get a little graphic in terms of description (well, as graphic as I can manage, I suppose), so don't read it if you are easily queased. I mean, I'll absolutely hold it against you for not reading, because you don't care about the artistic passion that burns within my soul, and you just can't handle how real and edgy my blog is.

So. You're going to give platelets. You raging fucking badass, you. God. You're going to save kids. Imagine that. You could totally walk into a bar that night and say, "Hey, ladies [or dudes, or yourself because we here at Novemblog do not judge on the basis of gender or sexual orientation so long as all parties are giving and are capable of giving enthusiastic consent in a safe and sane environment], I just saved some children with cancer. Who wants to buy me a drink?" You may very well drown in alcohol (which you should really be avoiding after giving fluids like that, but everyone knows that it's easier to get drunk with a little bit of volume depletion) that you did not have to purchase. You are a real American hero. Well, you will be if you manage to give platelets successfully.

You wake up, hopefully with plenty of time before your appointment. You'll want to start drinking water now and not stop until, say, an hour before your appointment. I don't care if you're full- you want as much volume in you as possible, or else your veins might start to collapse (more on what that means for you later). You also need to eat a decent meal. I've never been too sure about why this is, but, then, I usually make sure to eat a good meal. I've heard that you're more likely to pass out if you don't eat well beforehand, but, again, anecdotes are something that you need to make sure you anecdon't totally trust at face value (even though they can certainly nod suggestively towards the truth of the situation). Anyway, you've eaten something that you've defined as a good meal, and you're drinking plenty of water (which you should do anyway, because most people are at least a little bit dehydrated and don't realize it). I'd say you're good to go, and maybe you would be if you were giving whole blood, but this is platelets. This is not fucking around time. There are rules.

Your average Red Cross nurse.

And rules you'll read when you get to the donation center and check in. You get to read a whole list of medications that you better not have ever taken and countries that you better not have been in and jobs that you or your parents better not have had, or else you won't be drowning in free booze tonight. Then, you sit in a room while a nurse takes your vitals (which you hope are sufficiently normal to allow you to actually donate) and asks you questions relating to the rules and the materials that you just read. They'll stick your finger and take blood as an offering to the ghost of Clara Barton, who hungers for the vigor of the youthful. Nah, they're just measuring your hematocrit to see if you're anemic. If you are, then get the hell out of here. We don't want your platelets in kids. You're a disgrace to your family and your country. Have you been feeling sick? Leave. Now. We don't take kindly to your type. Had any gay sex (even once, as the questionnaire likes to say) or sex with someone who had any gay sex (EVEN ONCE)? You will be offered as a sacrifice to Clara Barton, so that she may stay fabulous in her afterlife.

But, for the sake of argument, all of this went well. By now, you probably have to pee. I mean, geez, you've been drinking enough water. So, by all means, go pee. And, hey, you're going to be in that chair for a while (oh, I didn't mention that it takes an hour and a half once they get you started? Whoopsie!), go ahead and pick out a movie from their shelf. Of course, you might want it to be a movie that is an hour and a half or less, because otherwise, you're probably not going to finish it (see: The Blues Brothers, In Good Company, Pan's Labyrinth). Also, you may want to see if the portable DVD player by your chair actually works, because otherwise they're going to play it on the big screen in the middle of the room, and all the nurses and other patients are going to be privy to your moviegoing experience (see: In Good Company, Pan's Labyrinth). Also, grab a blanket.

Mr. DNA will explain why, as is his wont. Hopefully it won't involve dino DNA.

See, for platelet donations, they're taking plasma and platelets, but you can't just ask nicely for the plasma and platelets to come separately from the red blood cells. To handle that, they take everything out of one vein, spin the ever loving crap out of it (thereby separating the blood cells from everything else), store the plasma and platelets, and then pump your blood back into you with a little bit of saline to keep your volume up. Unfortunately, the machines and tubing that they're using aren't warmed to body temperature, so you're going to lose some heat. You won't necessarily notice it at first, but after about twenty minutes, you're going to be pretty cold. So grab that blanket. You'll probably want it.

Now that they've got you in the chair, they'll confirm your name and various other relevant information before they start pumping up blood pressure cuffs and asking you to squeeze stress balls (today, I had a pickle stress ball. My nurse was a bit quirky.) to find your veins. They'll mark them with a pen, which might actually be a little uncomfortable. Ha. Oh, you, thinking a pen is uncomfortable.

Next, they'll sterilize the area, because nobody wants to get an infection at the Red Cross. That's just asking for... I dunno, gangrene or some shit. By now, hopefully your movie is playing. Watch that movie. Seriously. Don't take your eyes off of it. Just watch the movie and keep your arms still, because you are about to have a garden hose sticking out of it. They usually start with the inlet vein to get some saline flowing, which I imagine is to get your volume up so a.) you don't pass out, and b.) to keep your veins patent.

Hopefully, they actually hit the vein. How will you know, you ask? Well, if you've had needles in your arm before, you'll know what a good hit feels like. There should be a little bit of discomfort, but it should stay pretty normal. If they didn't hit the vein, you're going to feel some pinching. It'll start right around where they got the vein, but it'll expand before too long. You might look down at your arm, but you might not be able to see anything, because they're nice enough to put some gauze over the needle so you aren't looking at a needle coming out of your arm.

Like I said, a garden hose.

If you're feeling that pinching, before long, you'll notice the skin around the needle starting to bleb up. Bleb is not a word that ever has good connotations. They've missed the vein, so they're just pumping fluid subdermally, like a TB test, but with a lot more fluid. Usually, they'll take a shot at another vein (I say usually- this has only happened to me once, which was more than enough). So, hey, double the chances of bruising!

Once they've got the inlet going, they'll go for the outlet arm. It's the same process, and it usually isn't as bad, because you've already done all of this once, and your movie is probably through the opening credits by now, which is nice. The big difference with the outlet arm is that you have to squeeze a little ball periodically to maintain pressure so that your blood doesn't get a chance to clot off over the needle (more on that later). There's a helpful screen that hangs out next to your chair that'll have your inlet pressure (usually around 60 mm Hg, and usually not something you need to worry about) and the outlet pressure, which you want to keep between 0 and -100 mm Hg.

Hopefully, you remembered to drink a lot of water, because otherwise, your veins might collapse. This isn't a big deal on the inlet vein, since they're pushing fluids in, and veins are floppy enough to open right on up if you're putting something into them. If your veins collapse, your outlet pressure is going to keep rising (well, falling, I guess, since they're negative pressures), and you might get a soothing little alarm. A similar thing happens if your body tries to clot over the needle and occludes it. Now, when this happens, the solution seems to consist of a fairly simple method:

1. Confirm that the donor is squeezing.
2. If 1 is confirmed, confirm that there are no obstructions in the tubing.
3. If 2 is confirmed, grasp the needle.
4. Retract the needle. Watch to see if the absolute value of the pressure drops.
5. If 3 is unsuccessful, reinsert the needle.
6. Repeat steps 3 and 4, preferably in rapid succession, until the pressure drops.

Now, if that doesn't sound painful, I failed you, dear reader. Having a needle jammed in and out of your arm HURTS. Oh, and you can't move your arms, or else the needle might go through something that's actually important (because, dude, nobody likes veins). So I hope nothing important is happening in your movie, because you're going to be distracted by nurses ramming needles in and out of your arms like you stepped into a cross between a Hellraiser movie and Alien. Oh, and the bruises from THAT will really look awful.

But, hey, let's say you drank plenty of water. Good for you, drinking all those fluids. Your veins aren't going to collapse. Say, when was that last glass of water? And when did you last get to use the restroom? You went and picked Waterworld as your movie, huh? Rookie mistake. Yeah, you've still got thirty minutes to go. Are you going to make it? Well, just try not to think about water and waves crashing on the horizon and- Yeah, yeah, you can call a nurse and they'll unhook you. They might not be too happy about it, though. Be warned, unhooking you takes about 5 minutes, so you'd best be able to hold it. Those chairs are not designed with your bladder in mind.

If you managed to make it through the whole hour and a half without and occluded line or an urgently full bladder, congratulations! You just gave a full unit of platelets. They're going to unhook your various lines and put on some bandages and the weird compression tape stuff while they talk about the dos and don'ts of post-platelet donation. Once that's done, go use the restroom and get yourself a snack. You earned it.

And, oh, by the way, they went ahead and increased the flow rate, so you really gave two units of platelets, so you saved, like, three kids! Good work. Don't walk into any corners, though, or you might bleed out. Toodles!