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#1
Old 12-28-2006, 12:40 PM
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Naturally raising hematocrit level (for platelet/plasma donor)

All of my Googling ends up at sport doping sites or "enhancing performance" for sports.

For regular donors in apheresis programs, a hematocrit level below 38% will result in a 56 day deferral. For a healthy active woman (my sister), a normal hematocrit level is 35-46%. For the past several months in a row, she's been at 37% and getting turfed from the apheresis program. We go together monthly and this is no fun for either of us, it's when we sit and chat and catch up. We figure why use our planned social time to do good.

Her iron levels are awesome, (she's an athlete, eats organic health food stuff and takes her vitamins), but since the summer she's been stuck at 37%. It used to be 38.5%.

Is there anything she can do to... get a better score?

She also wanted me to ask... :: plugs ears with fingers la la la la la ::

Does her menstrual cycle influence anything? She started getting the 37% HCT score when our schedules worked out that we go for apherisis the day before her period starts.
#2
Old 12-28-2006, 12:55 PM
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I always stopped for supper and ate liver and onions, spinach and macaroni and cheese after apherisis donations. But then, my hemocrit levels were way high anyway. But, I liked the meal, so what the heck.

Tris
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#3
Old 12-28-2006, 01:42 PM
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Quote:
Originally Posted by Triskadecamus
I always stopped for supper and ate liver and onions, spinach and macaroni and cheese after apherisis donations.
But my sister needs to raise her levels before apherisis. That way she won't get deferred for 56 days and we can continue with our sibling social ritual. Oh, and saving lives too.
#4
Old 12-28-2006, 01:47 PM
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Quote:
Originally Posted by Swallowed My Cellphone
But my sister needs to raise her levels before apherisis. That way she won't get deferred for 56 days and we can continue with our sibling social ritual. Oh, and saving lives too.
You might try having the ritual meal the day before.
#5
Old 12-28-2006, 02:11 PM
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I asked this question once, and I didn't get jack-beans for a response. However, I eat an iron-rich diet, and take iron supplements for several days before donations. Results: Nada. I'm at the low end of the bell curve whether I do something or nothing.

Same with platelet counts. I'm at the low end there, too, and have been deferred because my platelet count was below Red Cross standards. In this case as well as with the iron, not pathologically low--just below their minimums.

But 56 days? Really? They told me just come back in a week or so.
#6
Old 12-28-2006, 02:39 PM
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I'd look at fluid intake before the test. Tell her to not drink any fluids the morning before you go in and see if that helps. This is tied to the menstruation deal as well in that women tend to retain fluids during this time of the month and increased blood fluids will lower hematocrit values.

Understanding Hematocrit
#7
Old 12-28-2006, 07:05 PM
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This is only anecdotal, but I've at times been deferred from apheresis donation for low hematocrit. I associate this with not enough meat or other iron-rich foods in my diet. I also tend to be fairly athletic, so your sister may try upping her iron intake either with a multi-vitamin or other iron-rich foods. I guess she could also ask her doctor about this during a check-up. (I'm not a doctor, so I don't know whether this is a serious concern.)

Quote:
Originally Posted by daffyduck
I'd look at fluid intake before the test. Tell her to not drink any fluids the morning before you go in and see if that helps.
The apheresis donation takes fluid from you, and the nurses always ask whether I've had a good meal and plenty to drink before my donations. Are you sure that restricting fluids before the donation is a good idea?
#8
Old 12-28-2006, 07:18 PM
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Quote:
Originally Posted by Triskadecamus
You might try having the ritual meal the day before.
Unfortunately, hematocrit doesn't work that way. While your hemoglobin count and hematocrit are related, they aren't the same thing. Her iron levels are fine. Actually they are more than fine, the nurse told her "You're obviously taking iron supplements. You should stop."

This is how my sister explained it to me, while I nodded and shook my head pretending to understand:

Imagine that a vial of her blood is a bowl of frosted flakes.

When you look at the flakes, wow, they are just covered in frosting, great gobs of frosted goodness. That would be her high hemoglobin count.

BUT there is too much milk in her bowl, she doesn't have a whole lot of flakes. The fraction of whole blood volume that consists of red blood cells is lower than what they'd like to see for a donor.

Or maybe I got that whole analogy backwards. I kind of got comfuzzled when she said hemoglobin was expressed in g/L, and hematocrit is the fraction of stuff per whole blood. It sort of sounded like it was the same thing to me.
#9
Old 12-28-2006, 07:18 PM
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Trips to Shangrila, or at least Tibet, or Peru. Denver, maybe.

You have to stay there a while, though.

Tris
#10
Old 12-28-2006, 07:59 PM
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I got deferred from donationg the last time I went to give blood, even though I take a multi-vitamin and an iron tablet each day. My doctor then prescribed a triple dose of the iron, and I've only managed to take a double dose each day. My hematacrit hasn't budged a bit. This is very frustrating, as I want to donate occasionally (not on a regular basis, I know that gastric bypass patients are discouraged from donating regularly due to anemia concerns, but I wanted to be able to at least donate back what I received while in the hospital, since they can now find my veins).
#11
Old 12-28-2006, 08:01 PM
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Quote:
Originally Posted by Schuyler
The apheresis donation takes fluid from you, and the nurses always ask whether I've had a good meal and plenty to drink before my donations. Are you sure that restricting fluids before the donation is a good idea?
Unlike a blood donation, you get your volume back, so as long as you're not dehydrated enough to mess with your blood pressure, restricting fluids a bit is fine.

In fact, the head nurse here told my sister to avoid hydrating as much as she normally does. (She plays a lot of sports and always drinks copious amounts of water).
#12
Old 12-29-2006, 02:13 AM
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Quote:
Originally Posted by Swallowed My Cellphone
Unlike a blood donation, you get your volume back, so as long as you're not dehydrated enough to mess with your blood pressure, restricting fluids a bit is fine.

In fact, the head nurse here told my sister to avoid hydrating as much as she normally does. (She plays a lot of sports and always drinks copious amounts of water).
Thanks. I know the bag(s) have some fluid in them, along with the other stuff they take, and I tend to feel a bit lightheaded when I excersize afterwards - which I don't do anymore, since I feel lightheaded. Maybe I'm more sensitive to fluid balance.
#13
Old 12-29-2006, 02:34 AM
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Wait, I'm confused.

Hematocrit is a measure of the amount of hemoglobin in your blood, a value roughly approximated by the number of Red Blood Cells. A quick measure of the ratio of red blood cells in your system is a Packed Cell Volume. Basically, they take a small sample of your blood and centerfuge it so all the red blood cells settel out from the plasma.

So I can understand why they would turn down your sister at whole blood donation, but what should it matter for plasma donation? You get your red blood cells back. If anything, her hematocrit should temporarily improve after the donation because the plasma would be selectively removed. Is there a fear that she will be temporarily anemic until they give her RBC's back to her? If so, what does that matter?
#14
Old 12-29-2006, 01:44 PM
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Altitude or EPO.

And the EPO isn't natural, legal, or healthy.
#15
Old 12-29-2006, 06:41 PM
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Quote:
Originally Posted by Pullet
So I can understand why they would turn down your sister at whole blood donation, but what should it matter for plasma donation? You get your red blood cells back.
You are exactly correct and even the nurses roll their eyes at the fact that they have to turn away donors. It's a blanket cutoff policy for ALL donors here, whether they are donating whole blood or platelets. Pretty much everyone thinks it's pointless for healthy apheresis donors. My sister is right, plum in the middle of the healthy range for adult women. It's a shame the system turns away a perfectly healthy donor unnecessarily when platelets and plasma are in such demand.

That's one of the reasons that it's so annoying. You get all your red cells back AND her hematocrit is usualy only 1- 0.5% off target. That's why she's wondering if there's anything she can actively do, that is natural and healthy, to boost her hematocrit.

daffyduck, you might be right about the fluid retention if she's going just before her period. We pre-book our apointmetns well in advance. Her hematocrit level never used to be a problem before, it's only since we ended up with a bunch of donations that coincided with the start of her menses. I'll pass that link along. We'll find out soon enough because we pre-booked our appoinments a few months ahead and the next batch will be a week or so off, maybe we'll see a difference. In the thirty-so-odd years she's had her cycle I have never asked my sister any details about her period and I honestly don't think I ever will, 'cause that would just be icky, I think.

:: puts fingers in ears lalalalala TMI TMI lalalalalalala ::

threemae, I was aware of EPO from the sport doping websites, and for obvious reasons that would not at all be appropriate for someone who is simply striving to meet the standards for apheresis. I wish there was a simple solution like eating brussel sprouts or walnuts or something.

Schuyler, wow, I don't know any other donors who feel whoozy after apheresis. They take so little fluid. Maybe the anti-coagulant doesn't get along well with you. I know my sister is a bit shakey right afterwards, but by the time we walk over to the pub for our post-donation beer, she's fine. I've worked out afterwards with no ill-effects (although it made my arm ooze a little).
#16
Old 01-02-2007, 01:09 PM
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Quote:
Originally Posted by Swallowed My Cellphone
Schuyler, wow, I don't know any other donors who feel whoozy after apheresis. They take so little fluid. Maybe the anti-coagulant doesn't get along well with you. I know my sister is a bit shakey right afterwards, but by the time we walk over to the pub for our post-donation beer, she's fine. I've worked out afterwards with no ill-effects (although it made my arm ooze a little).
Don't get too worried about me. I tend to be sensitive to fluid intake - if I'm a bit low, I'll get lightheaded occasionally when rising from the floor (I have read about this in athletes with low blood pressure [I'm not an athlete now, but I'm in generally good shape], but I am not a doctor and it's not a big deal in my daily life). After apheresis donations, for me it's not wooziness (if you mean nausea), but a bit of blink-eyes/focus-on-standing/gather-my-wits, and then I'm fine. If I try to work out later that day (running or weights), then I'll feel a bit 'off'. Good luck with your sister.
#17
Old 01-02-2007, 04:34 PM
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Quote:
Originally Posted by Swallowed My Cellphone
Unlike a blood donation, you get your volume back, so as long as you're not dehydrated enough to mess with your blood pressure, restricting fluids a bit is fine.
In my case they want me to drink more ahead of time because I'm a hard stick and there's a chance the veins will be easier to stick with more fluid on board.

I've always had trouble meeting the hemo level too. When I would think of it I would take iron pills in the days leading up to pheresis and that sometimes helped.

I don't feel woozy after but I get very sleepy and yawny during. They don't let me close my eyes though.
#18
Old 01-02-2007, 11:26 PM
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Quote:
Originally Posted by threemae
Altitude or EPO.

And the EPO isn't natural, legal, or healthy.
Assuming that your sister does not have anything medically wrong with her, threemae gave some good advice but allow me to elaborate.

The body produces its own natural EPO that controls red blood cell production in your body. It is only when you inject artificial EPO into your body that it "in't natural, legal, or healthy." The more EPO you have in your body, the higher your hematocrit will be. This is why artificial EPO is so popular with unethical endurance athletes because it can greatly increase the amount of red blood cells in your body and thus your ability to use oxygen. However, I don't recommend this.

With that out of the way, I recommend that you tell your sister to try out altitude training since you say she is an athlete. Altitude training will also increase the hematocrit level of your blood because stressing the body at high elevations will cause it to create more red blood cells to keep up with demand. See http://en.wikipedia.org/wiki/Altitude_training for more information.

To perform altitude training, you can either go live near the mountains or you can buy an altitude tent that simulates the low oxygen levels at high altitude. See http://en.wikipedia.org/wiki/Altitude_tent for more information. However, an altitude tent will likely set you back a couple of grand. The least intrusive way to use it would be to tell your sister to sleep in it. BTW, altitude tents are perfectly legal.

Since you say your sister is an athlete, one more thing you can try is to ask your sister if she has been over training in her sport. Doing more than her body can handle can reduce her fitness and likely her hematocrit level. If she is, ask her to try tapering off her training for a couple of weeks and see what happens. Symptoms of over training include long-lasting fatigue, higher than normal resting heart rate, lack of motivation to train, and a noticeable drop in peak performance.

Hope this helps.
#19
Old 01-03-2007, 03:12 AM
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[QUOTE=Chasing Dreams]Since you say your sister is an athlete, one more thing you can try is to ask your sister if she has been over training in her sport. Doing more than her body can handle can reduce her fitness and likely her hematocrit level./QUOTE]

That's a good point. I'm not clear on exactly how active your sister is, but extreme endurance athletes will often suffer from large losses in hematocrit after long events. Basically, as your cardiac output (volume pumped over time) increases over a 12 hour ultra-marathon or whatever, that exercise can put tremendous stress on your red blood cells. Any given red blood cell might be making two to three times the number of trips around your sisters body than it would if she were sedentary, and this can stress red blood cells. Your body excretes old red blood cells after they loose elasticity, oxygen carrying capacity, and generally become worn out. Consequently, vigorous exercise over long periods of time can actually lower her hematocrit, even if only in the short term.
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#20
Old 01-03-2007, 10:41 AM
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Quote:
Originally Posted by threemae
That's a good point. I'm not clear on exactly how active your sister is, but extreme endurance athletes will often suffer from large losses in hematocrit after long events.
Interesting. I'll pass that along too. As she is aging, she has become more of the "weekend warrior" hobbiest athlete and probably doesn't over-train. She's never been much of an endurance athlete. Nonetheless, I'll float that past her too.

Thanks!
#21
Old 03-07-2007, 04:04 PM
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FOLLOW-UP: Hey, so my sister made her donation last month (I didn't go last month and she forgot to update me). Her hematocrit levels were great last time around and she was not deferred. It was almost at 39%.

daffyduck it looks like fluid retention was indeed the key. She hydrated normally, but this time made sure her platelet donation did not in anyway coincide the the time of the month during which she was most likely to be retaining water. She made no other efforts to modify her eating or drink habits (although I'm pretty sure she still takes a multi-vitamin daily).

All her appointments are scheudled in advance, so we'll see next time if she continues to meet the hematocrit cut-off when she's... um... at low tide.
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