(no subject)

[serene]

For my own safety (yeah, right), I don't qualify to donate bone marrow.

Comments

[dawnd.livejournal.com]

Um. Why would there be a maximum weight for YOUR safety? I can certainly understand a MINIMUM weight for safety.

[hobbitblue.livejournal.com]

I'd have thought there should be a minimum weight too...

[serenejournal.livejournal.com]

There is.

[marci-ny.livejournal.com]

That is so ridiculous!!!

[skywhisperer.livejournal.com]

Wow. They've widened the ranges a lot since I was last listed as a donor. They booted me off the rolls about 10 years ago, when they wouldn't take anyone who was more then 10% overweight.

[kalmn.livejournal.com]

erk. i can see where for your own *comfort*, they'd like you to be under a certain weight. because when i get injections in my knee i now go off to the radiologist because it's hard for my rd to visualize where my bones are, due to the fact that they're so attractively padded. (you know the part where they lose the vein and have to look for it with the needle? less fun if they're looking for a joint.)

but safety? foo.

[serenejournal.livejournal.com]

I'm fat, and I'm told I'm an "easy stick" for blood draws and injections. If they are looking after my comfort and safety, I can see a warning: "Warning: this may be uncomfortable and/or unsafe if you are very fat", but not a prohibition. My marrow is as healthy as anyone else's, and I'm healthier than either of my doctors (one of them said he would trade his bank balance for my cholesterol numbers). But I'm preaching to the choir, I know. Gah.

[cassidyrose.livejournal.com]

I've had only one easily accessible vein in my arm since my teen years regardless of my weight. Draws and getting a line in for an IV was equally difficult when I was ~150 pounds and when I was 250 pounds. The fat was not the issue--my crap veins were.

[serenejournal.livejournal.com]

Yeah. My veins are super-easy -- haven't ever needed a second stick -- whereas my mom's, even when she was thin as a rail, roll and are difficult.

Bleah. I've decided to stop responding to this thread, because it makes me angry and frustrated to see the apologetics. Not saying I couldn't have foreseen it, but it still gets to me.

I'm not saying that I agree with them, but I suspect I know why the limits are there

[dakiwiboid.livejournal.com]

I used to work in a Bone Marrow and Stem Cell Transplantation Department. (By the way, you've got a small typo--it's blood cells and bone marrow, not blood marrow.)

I never saw any of these difficulties kick in with a donor, by the way. We did have patients whom it was extremely difficult to accommodate diagnostically. I had to cross my fingers and hold my breath that one or two of them would fit in the Open MRI across town, and to call physicians back and tell them that they simply could not have CT or PET exams because we could not fit their patients in the devices.

The NMDP is worried, I think, about how difficult it's going to be, in the case of bone marrow extraction, to get the extraction needle through layers of subcutaneous fat as well as through the hip afterwards. In the case of stem cells (I'm not sure what other blood cells they're talking about), they may be worried about how difficult it might be do apheresis with a really large donor. Our pheresis department was set up with special chairs connected to pumps. We could probably have accommodated gurneys, but it would have reduced the room available for the rest of the donors. There's also the difficulty of the donor's cathether placement, which can be tricky, again, if there's a lot of subcutaneous fat.

I suspect, to be honest, that if there is no other match available, the NMDP could possibly be persuaded to allow testing of a family member whose weight went beyond their "desirable parameters".

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[sharpstick.livejournal.com]

Also, I am guessing that the donor is put under general anesthesia during the donation process (if I am having my bone marrow extracted, I want to be unconscious to be sure) General anesthesia comes with risks, the main one being not waking up again. These risks increase when a person is obese. I believe it is generally considered to be poor form to kill the donor during the donation procedure.

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[serenejournal.livejournal.com]

But it's fine to put that same person under the knife for weight-loss surgery? I don't buy it. If I want to take the risk of general anesthesia (I've been fat all my life, and other than making me vomit, it's never harmed me, and I've had lots of surgeries), then I should be allowed to take that risk.

(Not to mention that no one agrees on what the definition of "obese" is, no one agrees on the actual risk, etc.)

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[sharpstick.livejournal.com]

I only know one person who has had weight loss surgery, and the surgeon made her loose 45 pounds *before* he would do the surgery precisely because of the general anesthesia risk. So in fact, no, it's not fine to have the same person go under the knife. Also, whether or not it's agreed that a BMI of 30 or 32 or 35 constitutes being obese is not at issue here. They accept people up to a BMI of 40.

I have no doubt that the reason these guidelines were put into place was because at some point some donor died, and then his/her next of kin showed up with a big ol' law suit. I also have no doubt that if someone needed a transplant and you were the only match and you were willing to sign all sorts of waivers, they would take your marrow.

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[serenejournal.livejournal.com]

The word "obese" became an issue here when *you* brought that word (which I loathe) onto my LJ. I'm through here.

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[sharpstick.livejournal.com]

I'm really sorry that I offended you. Really, really not my intention. I tried to pick the most clinical, non-loaded word that I could come up with. I really wish I could figure out how to have these conversations without causing angst. Is there an approved word list somewhere?

Doctors and public health people make arbitrary rules all the time (like every profession). And while the exact rule is arbitrary, usually, there is some actual reason behind it. I was just trying to shed some light on that.

If there was truth in their website, instead of saying the rule is for the comfort and safety of the donor, what they actually would have said was more along the lines of, "This rule is here because we're afraid if it's not, someone will sue our asses back into the middle ages- at least that's what our homes will look like when th lawyers are done with us." Juries really like to side with the family members of dead people. That's all.

Again, really, really sorry.

Re: I'm not saying that I agree with them, but I suspect I know why the limits are there

[serenejournal.livejournal.com]

If it's about fitting in the devices, that's easy to address: "Note: If you have trouble fitting into a normal MRI device, or cannot have MRI for some other reason, we will be unable to accommodate you for this procedure at this time."

I do remember our having problems with lumbar punctures and bone marrow extractions

[dakiwiboid.livejournal.com]

to do with layers of fat in the back and over the hip. I'm not sure whether these weight limits are new. I do know that subcutaneous fat can be very difficult to penetrate, and that they are very unwilling to do the extractions from the sternum rather than the hip because there's a greater risk of hurting the donor. The marrow extraction is certified as a form of minor surgery, and it's not trivial to do under the best of circumstances. The nurse-practitioners I worked with were highly trained in that procedure and spent some hours each week performing it.

There are other equally unfair disqualifications for donation, you know, Serene. I seem to recall that the donor form ran through the standard Red Cross blood donation questions, including asking if you've ever had sex with a man who had had sex with another man, and whether you've been to a long list of countries, etc.

Re: I do remember our having problems with lumbar punctures and bone marrow extractions

[cassidyrose.livejournal.com]

There are other equally unfair disqualifications for donation, you know, Serene.

And many of these really piss of those of us who would otherwise be able to give blood. Any man who has had sex with a man since 1975 is disqualified for the rest of his life, regardless of disease status. A woman who has had sex with a man in the past two years (I think) who has had sex with a man since 1975 is disqualified. I am pretty much permanently disqualified, at least as long as I have sex with my husband.