liquid life michelle chan
liquid life by michelle chan
liquid life written, designed, and photographed by michelle chan
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for the stanford blood center, paige, and my mom and dad
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acknowledgements First off, I would like to acknowledge and thank the students
and teachers of Freestyle Academy for all the advice and assistance towards the creation of this book. I don’t know what I would do without you all! Also my aunt, Dorothy Vriend, who helped edit this. Thank you for taking time out of your schedule to help me out. Secondly, I would like to thank Julie Ruel, Paige Topole, and the Stanford Blood Center for all their cooperation and insight about blood banks. I have learned so much and I appreciate all that they have done to make this possible. Overall this project was an unforgettable and incredible learning experience. Thanks from the bottom of my heart!
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julie ruel, social media manager
paige topole, blood donor and volunteer 5
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table of con tents acknowledgements foreword introduction chapter one: the history of blood donation chapter two: the need for blood in our community chapter three: the donation process conclusion works cited
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foreword For as long as I can remember, my dad
page book was intimidating at first, but I found would come home every couple of months with it to be so full of fascinating information that I was able to use for this book. a pint of ice cream and a bright red bandage I ultimately decided I would document around his arm. I was always happy to see the the Stanford Blood Center because I think that ice cream, as well as my dad, of course. But it its value to the community is often overlooked wasn’t until I was older that I found out why unless you’re a patient receiving blood. Even he got the ice cream. As both he and BaskinRobbins like to call it, it was “A Pint for A Pint”. though my dad is a regular blood donor, I didn’t know just how much his donation impacted For every pint of blood that my dad donated, the community until after I researched it. After Baskin-Robbins would give him a pint of ice a couple of trips to the Mountain View blood cream in return. center I got the opportunity to shadow Paige as When we were first asked to choose a she went through the donation process and I topic for the Documentary Unit, I wasn’t sure learned much about how the center functions. at all what I was going to do. But I finally deIn a few words to describe my experience there cided to research the Stanford Blood Center. are that the nurses are very nice and it has very This topic was introduced by my friend, Paige Topole, who is a volunteer there. After doing a delicious cookies. Through interviews with little research about it I found that it was actu- both donors and staff members at the blood center, I was able to find out and appreciate all ally very interesting. During this time I read a that it offers to the community. book titled Blood by Douglas Starr. The 496
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introduction Imagine that you were just in a head on
collision and you need surgery right away or you will die. That was the case for seven-year-old Brennah Payne who was left with massive internal abdominal damage, a bowel severed in five places, and a broken spine. Brennah was rushed to Lucile Packard Children’s Hospital in Palo Alto for immediate treatment. Over the course of six months, she endured surgery after surgery - 22 procedures - and many transfusions of plasma and red blood cells to repair the damage done by the crash. Without the many, many units of blood, her survival would have been slim. Brennah, now fourteen-years-old, is doing just fine and encourages people everywhere to donate blood. Her mother, Heather, knows just how important blood donors are. “I’ve been on the other side,” she says. “Sometimes you think you’re only one person and that one unit of blood won’t make a difference, but drop by drop, it all makes a difference. We’re so grateful” (Van De Hey). Blood donation isn’t anything new. In fact, it started back in the 1600’s when one of the first recorded donations of blood took place. Soon, 10
platelets
hospitals everywhere started utilizing the human resource of blood. A few centuries later, medical scientist Bernard Fantus found that blood was able to be stored. He called it a “blood bank” and that name stuck. The creation of blood banks came just in time as months later World War II occurred. During the war many make-shift blood donation centers were put into operation to support the number of people giving blood. The Red Cross hired a publicity staff to encourage people to donate blood for the war effort. One poster showed a wounded soldier with the caption. “He gave his blood. Will you give yours?” It rallied the
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“The value of a man resides in what he gives and not in what he is capable of receiving.� - Albert Einstein
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people on the home front to do what they could to help the war effort. Douglas Starr, author of Blood, states “…it became clear that they (blood that was transferred to the soldiers) gave soldiers a psychological boost – not only because they increased the men’s chances of survival, but because those fighting knew the enemy had virtually none. Even the cosmetic effects of blood proved uplifting: Soldiers who were used to seeing their wounded comrades look death-white, even with plasma, now beheld a rosier glow” (Starr 142). Because people had donated blood, the soldiers felt more compelled to fight on. They knew that blood was a powerful weapon that they could use in their advantage. Blood had such a powerful effect on the soldiers and was so very precious. Albert Einstein said: “The value of a man resides in what he gives and not in what he is capable of receiving.” He is right. Giving to others is a good thing to do. During World War II, people from all across America gave their blood to do their part. Even today,
blood is still needed. Roughly five million people need blood each year for surgeries or due to illnesses. Unfortunately, only five percent of people who can donate blood actually do. Approximately every two seconds, someone needs blood. That means dozens of people have needed a transfusion since you started to read this book. Blood banks are always in danger of not having enough. Two contributing factors are that donated blood has an expiration date and patients have to receive their own specific blood type. Donating blood is so important and many do it because they want to help others. So, why should you donate blood? Of course, the most conventional answer is because it saves lives. But if you dig deeper you will see that donating blood isn’t just about saving lives. It’s about taking part in your community and giving back. It’s about the joy you receive from giving. Donating blood has been a big part of the United States’ history and there’s no reason to stop now.
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chapter one : the history of blood donation One of the first documented transfusions
was performed in France during the 15th century by Jean-Baptiste Denis, a physician to Louis XIV, when he transfused blood from a lamb to an extremely weak young man (Starr 11). Of course, this isn’t your normal type of transfusion and now doctors know not to mix human and animal blood. But it did save the boy’s life. During this time, the way most doctors cured illnesses was to bleed the patient no matter what the ailment. Bleeding, or bloodletting, was enthusiastically practiced for more than twentyfive hundred years all around the world. Whether it was pneumonia, a fever, back pain, a headache, or to stop other wounds from bleeding, the cure was to bleed. And yet, there was no evidence that bloodletting improved the patients’ health. Thus, Denis decided to try an alternate approach to cure his patient, as all of the other doctors had bled him at least twenty times with no signs of improvement. This was the first time he had attempted to transfuse blood from an animal to a human, but to his amazement, it worked and the patient awoke free of pain (Starr 11). Much later on it was discovered that bloodletting only 14
weakened the patient and therefore it became a retired practice. This was, of course, long before the time when blood was able to be stored in a fashion that allowed for the doctors to get the blood and go. Before then, they had to call up a person on the phone who was of the same blood type as their patient and ask them to come in to the clinic. This was what they called “direct transfusion”, and it remained the procedure of choice for a number of years. That is why Bernard Fantus’ discovery of the blood banks was so important. For many years, doctors had been relying on “donors-onthe-hoof ” (Starr 53) or people they called up to come in to donate, which meant that they weren’t always dependable. What he found was that when you mix the blood with a small amount of sodium citrate, the blood is able to be kept in a fluid state, and is able to be used later on. Fantus was able to establish a facility that was able to bleed the donors into a flask containing the sodium citrate. Then they were able to test it, seal it, and then store it in refrigerators. He called this the “Blood Preservation Laboratory”. But soon came up with a shorter name: Blood Bank (Starr 71).
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Since then, many blood banks have opened around the world. In 1978, the Stanford Blood Center opened in hopes to meet the needs of the Stanford Hospital and the Lucile Packard Children’s hospital in Palo Alto. Since then, they have provided over 100,000 pints of blood and blood components to local hospitals each year. A unique feature of this blood center is its integration with research programs in finding the “causes, prevention, and treatment of blood diseases and blood borne disorders” (About Blood Center). They are currently partnered with medical researchers at Stanford University in providing blood and blood components that allow for the development of potentially lifesaving therapies and treatments. Besides the three fixed sites (Mountain View, and two in Palo Alto), the Stanford Blood Center hosts blood drives all around the Bay Area. This method of collection has come a long way since the first blood mobiles were trailers attached to trucks. Now, the mobiles are much more modern and are specially constructed to attend to the needs of the nurses. The blood mobiles account for approximately half its annual blood supply, while the other half is collected at the donation
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centers. From churches, to companies, to schools, the Stanford Blood Center travels everywhere to reach out into the community. Leon Chan, a frequent blood mobile donor, told me what he likes about giving blood at the blood mobiles. “It’s very convenient. They stop by at my work. So on my way into work it’s there and I just do it before I go into the office on those days. It’s an easy way for me to give back to the community” (Chan). He said there is always a good turnout at the drives.
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chapter two : the need for blood in our community More then 23 million units of blood com-
ponents are given each year in the United States by approximately 11 million volunteer blood donors, which are transfused to more than 5 million patients per year. The need for blood is great; each day about 32,000 units of red blood cells are needed. Accident victims, people undergoing surgery, and patients receiving treatment for leukemia, cancer, or other diseases, all utilize blood. However, only some of us are eligible to donate. Less than 38 percent of the U.S. population is able to, and only 5 percent actually do. Much of the population is deferred because of a low iron count, because of HIV exposure, because of travel to a malarial region, or because of medications. Studies show that the average donor is a collegeeducated white male, between the ages of 30 and 50, who is married and has a good job. Recently, the Stanford Blood Center helped support the successful surgery that separated conjoined twins, Angelica and Angelina Sabuco, at Lucile Packard Children’s Hospital on November 1, 2011. The surgery took almost 10 hours and required approximately 10 units of blood. Their mother, Ginady Sabuco, expressed her thanks to
all who made it possible: “We are so grateful to the medical team and selfless blood donors who made Angelica and Angelina’s separation possible. Please give blood so that other patients have it available when they need it too” (Conjoined Twins Angelina and Angelica Sabuco). Of the people that don’t give, the two main reasons for that are because they are afraid of needles, or they have never thought about it. I, for one, am very afraid of needles. I have never liked them, and I strongly dislike getting my annual shots. But if you think about it, the brief pain you might encounter doesn’t even begin to compare to the benefit to patients who receive your donation. Julie Ruel, the social media manager at the Stanford Blood centers expresses this so well. “We provide blood to the Stanford Hospital, where they have the cancer center there, and you think about those people and what they’re going through, I mean they have to get blood and platelets sometimes daily, weekly...it’s just a small price to pay... Think of all the lives that it saves, and all the good you’re doing for the community, and thinking of the people who need these blood products, and the suffering that they’re going 19
through, I mean they have to get blood and platelets sometimes daily, weekly...it’s just a small price to pay... Think of all the lives that it saves, and all the good you’re doing for the community, and thinking of the people who need these blood products, and the suffering that they’re going through, I mean a small needle prick is nothing...” (Ruel). Although it may take some time to get over that first prick, knowing that what you are doing is for a good cause can make all the difference. In fact, just one donation can save up to three people. Furthermore, people are afraid to give because they think that they could contract a disease from giving. That is not true at all. Donating is a very safe process. A sterile needle is used only once for each donor and then is discarded. When the nurse inserts the needle, he or she wears a special mask to make sure that they don’t pass any germs into your body. No potential donor should be scared off because it is such a safe process. One of the main challenges the blood center faces is keeping the donors coming back. Ruel knows the importance of that: “A lot of our regular donors that come into the blood center, they 20
are starting to retire and are no longer able to give blood. I mean high school students are precious to us. High schools are so great, the blood drives that we do at high schools; they draw a fantastic number of students that come out. But it’s a challenge to keep them once they go to college. How do we get them to come back in?” (Ruel). As a high school student, I’ve often seen many of my classmates leaving class to give blood on campus. And, they enjoy doing it. I don’t know if it’s for the free cookies or if it’s because they get to miss a little bit of class, but either way, they are doing good in their community. Paige Topole, a high school donor, told me why she donates blood, “I believe donating blood is a very easy thing, and you can save a life. I mean, I don’t see a reason why you shouldn’t donate blood… Giving blood is the easiest thing you can do to help people. Giving blood doesn’t cost anything. It’s something that your body regenerates on its own. Frankly, I think it’s kind of selfish to not give blood. That’s a little extreme, but if you have the ability to give blood there’s nothing that should be stopping you” (Topole).
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chapter three : the donation process Giving blood is such an easy thing to do.
It doesn’t take very long and knowing that you’ve helped someone is worth it. Paige explained to me what she does in preparation for giving this great gift: “For me, if I’m going to give blood I start preparing a week in advance, and I start eating a lot of cream of wheat, because I sometimes struggle passing my iron...And now that I’m giving platelets, I have to take calcium supplements; so I would start taking double my dosage” (Topole). The most common donation is a whole blood donation which takes approximately 30 minutes, and allows the person to donate every 56 days. It’s the fastest and probably one of the easiest ones to give. Paige, on the other hand, has started to give platelets which allow blood to clot. For cancer patients, platelets save their lives because most chemotherapy drugs affect their cells in the bone marrow. This commonly leads to low levels of white blood cells and platelets, which can cause a person to be at risk for internal bleeding. However, the additional platelets help control bleeding and induce clotting. The only downside to donating platelets is that it takes a little over 22
two hours to donate, but the clinics have a variety of movies that you can watch, or you could invite a friend to hang out with you. In order to donate blood, a person must generally be between the ages of 17 and 74, be in good health, and weigh at least 110 pounds. All potential donors must pass the physical and health history examinations given prior to donation. From start to finish, here are the following steps: First, when you arrive at the blood center, a receptionist will ask for your information. Then, you will be asked to read a donor education material and fill out a medical history form to determine your eligibility. After that, a nurse will take your blood pressure, temperature, pulse, and a drop of blood to test your hemoglobin level to ensure your eligibility to give blood. Your hemoglobin level is your iron level, and the hemoglobin molecule is what is responsible for carrying oxygen throughout your body. When you give blood, you temporarily give up a part of this resource until your body replaces it. That is why Paige consumes a large amount cream of wheat to ensure that she will be able to donate because this
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1. Registration.
2. Waiting for the medical history examination.
3. The nurse checks Paige’s information.
food source has a lot of iron in it. Next, you will be asked confidential questions about your medical history to make sure your donation is safe for you, and the person that uses it. Then, you will be guided to one of the chairs where the nurses will sanitize your arm with iodine, and then insert the needle. Approximately one pint of blood is drawn through the needle into a plastic bag, and takes only 5 to 10 minutes. Finally, it is all done and you will be asked to rest in the canteen for 15 minutes and enjoy some light refreshments before you carry on with the rest of your day. It is so simple to do, and who doesn’t like complimentary cookies and juice? In fact, sometimes you can even receive movie tickets or a t-shirt. After your blood is drawn, it goes into testing and processing at one of their centers. Then, the blood is driven to one of the local hospitals and is quickly used up by one of their patients. For the donors, their body replenishes the fluid lost in just 24 hours. 7. The nurse gets some samples for the lab.
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8. Paige watches a movie as she donates.
9. Paige looks at the screen to see her progress.
4. The nurse gets ready to put the needle in.
5. The needle.
6. Donating!
One of the main reasons people might get deferred are because they have traveled to a malarial country or because they have low hemoglobin (iron level). But even if you can’t give blood, there are still other things you can do to help out. First, you can volunteer at one of the blood centers. Volunteers do a variety of things. Paige Topole told me that she works at the canteen and is “the person that gives cookies and juice to the people who donate” (Topole). She told me that the nurses know you by name and you get to know the people there. She said it’s a great way to give back. Another way to help is to host a blood drive. These drives are one of the biggest ways the center receives blood. Finally, you can make a donation. Because the Stanford Blood Center is a non-profit, it needs financial donations in order to keep running. For example, it is currently raising money to purchase a new bloodmobile that will allow it to collect 3,500 more units of blood each year. 10. After taking out the needle, the nurse wraps a bandage around her arm.
11. Paiges’ donation of platelets.
12. Paige in the canteen.
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Conclusion Although many people do give
blood regularly, blood centers still need new donors. As each year passes the need increases, yet the number eligible stays the same. Awareness is the first step toward the solution. Now that you’ve read this book, you know just how important giving is. You can reach out to those who are afraid of the donation process and tell them that there is nothing to be scared of. If you’ve never given blood before, you can take the first step by scheduling an appointment with your local blood center. The main difference between the Stanford Blood Center versus the Red Cross is that the Red Cross is more of a global organization whereas the Stanford Blood Center is more of a community blood
center that gives to local hospitals. For patients who receive your blood, it could be a matter of life or death. It’s such a small, yet big way to give back to the community. Even though it has been a number of years since the accident, Brennah Payne is still an advocate for blood banks. She’s held many blood drives in her hometown and is able to communicate the necessity of blood donations, as she received them herself all those years ago. Many people are afraid to try something knew, but knowing the good that you are doing for your community is so much better than that fear. It’s really not as scary as you think, and blood that you are donating to help local patients could go to you or me someday.
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Works Cited “About Blood Center.” Stanford Blood Center. Stanford School of Medicine, 9 Mar. 2012. Web. 10 Mar. 2012. “Blood Facts and Statistics.” American Red Cross. American National Red Cross. Web. 10 Mar. 2012. Chan, Leon. Personal interview. 11 Mar. 2012. “Conjoined Twins Angelina and Angelica Sabuco.” Packard Children’s Hospital at Stanford LPCH: Northern California Children’s Hospital. Lucile Packard Children’s Hospital at Stanford, 7 Nov. 2011. Web. 10 Mar. 2012. “Learn About Blood.” American Red Cross. American National Red Cross. Web. 3 Mar. 2012. “Other Ways to Help.” Blood Center. Stanford School of Medicine. Web. 10 Mar. 2012. Ruel, Julie. Personal interview. 14 Feb. 2012. “Stanford Blood Center Facts.” Press Kit. Stanford School of Medicine. Web. 10 Mar. 2012. Starr, Douglas P. Blood: An Epic History of Medicine and Commerce. New York: Alfred A. Knopf, 1998. Print. Stinger, Matt. “Matt Stinger’s Story.” Hemophilia. Donatingplasma.org. Web. 10 Mar. 2012. Topole, Paige. Personal interview. 2 Mar. 2012. Van De Hey, Lisa. “Brennah Payne’s Story Is Published.” The Gridley Harald, 10 Mar. 2012. Web. 15 Mar. 2012. “What Are Transfusions?” Why Cancer Patients Might Need Blood Product Transfusions. American Cancer Society. Web. 11 Mar. 2012. 28
“Give the gift of life!” - paige topole
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“ At Stanford Blood Center, we provide hope for the future: teaching tomorrow’s leaders in transfusion medicine, researching to unlock mysteries inherent in blood, and connecting donors to patients every day. ”
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Michelle Chan C 2012. All rights reserved.