So I donated plasma for the first time yesterday? I’d love it if I could say I’m in a place in my life where I’ve got the time, energy, and financial stability that this is just out of a sense of altruism, but admittedly I also need the money. That said, it occurred to me that it might not be a terrible idea to talk about the process and what all was involved in case that’s something that anyone else was considering. I donated at a CSL plasma center; I imagine some details are a little different with other companies, but probably most of it still applies. Anyhow, rest is under the cut, long post ahoy~
For the curious, plasma donation is different from whole blood donation in multiple ways. For starters, yes, you can get paid for it. Also, you can donate plasma much more frequently than whole blood— plasma is the liquid part of your blood, which your body can replenish within a few days. In contrast, red blood cells take a couple of months. In plasmapharesis, the machine does draw blood, but it then centrifuges/filters out the cellular components, and returns the blood cells to you. The other nice thing is that it only ever draws off about 8 oz (1 cup) of blood at a time before it returns the whole components to you— which means, if you’re like me, and prone to passing out when donating blood (which is the reason I don’t donate whole blood anymore), plasma donation was a lot easier and didn’t make me feel woozy.
So, first thing I did was check out the company’s website and download their app. From what I gather, regardless of what company you’re looking at, they’re only going to accept donors within their ‘collection area’ (I believe to keep people from attempting to register with more than one program/center), so first thing to check is where the closest donation center is for you. I live in a city, so that was fairly easy for me; if you live further away from a center, you may need to call/email to double check that your address falls within their area.
I will say that the websites/CSL app were actually pretty helpful with information on qualifications, or more specifically, what would disqualify a donor. The major standout ones are age, weight, recent tattoos/piercings, and for anyone AMAB who has sex with other AMAB people. Unfortunately that last one I think is a holdover from the AIDS pandemic, and plain old institutionalized homophobia. :\ Tattoos and piercings have to be older than 4 months, and you have to be 18 years old. (Minors weren’t actually allowed in the building at the center I was at.)
As for weight, you have to be minimum 110 pounds; this one is a legal requirement, so it’s going to be the same no matter what company you’re looking at. What’s not as clearly laid out is that if you’re lower-weight, they can’t take quite as much plasma from you, which also means your compensation is lower. For my center (and, it does vary by region, even within the same company), people from 110-149 lbs receive $90 for the first three donations, $40 for the 4th-6th donations, and $90 for the 7th and 8th. So, up to $570 for the first month. By contrast, anyone 150+ lbs receives $100, $50, and $100 (or $650 total) on the same schedule. (This is the payment structure for the first 45 days only, if you donate 8 times within that timeframe; I suspect the payment amount is reduced after that.)
Which brings me to donation schedule— it’s totally voluntary, and there is no minimum schedule or commitment. Obviously they want people to donate as frequently as they’re safely able to, and to become regular donors instead of donating just once or twice, but there’s absolutely no reason you can’t do exactly that. You can only donate 2 times within any 7 day period, and you can’t donate on successive days. (So, my first donation was on a Thursday; I can’t donate again until Saturday, and if I do, I won’t be able to donate a third time until next Thursday.) Again, this is a legal requirement, and why you're not allowed to double dip by donating to multiple programs— this one is a safety thing, for the donor.
Another safety thing is making sure you 1) are very hydrated and 2) ate a solid meal beforehand. You’ll also want to have gotten a good night’s sleep, and not had anything caffeinated within the last few hours. And, when I say hydrated, they want you to drink an extra 4-8 cups of water within the 2-3 hours before you donate. I managed 4 before I started to feel like I would make myself sick if I drank more, but took a water bottle with me. Side note, don’t chug water, you need to space it out so your body can actually absorb as much of it as possible, but you do really want to have that extra water on board, because they are going to be removing a decent amount of fluid from you.
Okay! About the process of becoming a new donor and the actual plasmapharesis:
Show up at the center (no appointment required at CSL).
Bring your driver’s license and social security card. Or, do like me and make it to the center, realize you forgot your SSC, and drive all the way back home to get it. :’)
Get into the new donor line; tell the person at the counter you'd like to donate, provide IDs. Get instructed to go to a private booth for purposes of verbally confirming that you are literate, and what spoken, written or sign language(s) you communicate in.
Get given a packet to read/video to watch that contains a boat load of info about the process, qualifications, etc. (I had the option to watch the video on my phone by scanning a QR code.) Sign forms indicating that I’ve been provided this info and understand it, and consent forms.
Move to new donor waiting area. Sit and wait.
Continue waiting.
Wish you had realized how long the wait would be, because those 4-8 cups of water are catching up with you and now you really need to pee. (Keep an eye on the people who arrived before you; if there are still people who were there earlier, you’ve probably got plenty of time to run use the bathroom. But that’s part of the reason why it’s good to bring a water bottle, so you can stay hydrated while you wait.)
Finally get called back to a private booth to start being processed.
Go over a lot of the same information that you reviewed at the beginning. This will not be the last time. They are very insistent that you know and understand all of this.
Fill out a 64 point questionnaire confirming your eligibility. (A couple of these are literally quiz questions, where basically you are confirming that you know and understand the info.) Get your picture and digital fingerprint taken.
Once overall eligibility is confirmed, receive a donor number and donor Visa card; this is where compensation will be directly deposited after each completed donation.
Move on to “day-of” screening— things that will not disqualify you from donating, but can cause you to be deferred to come back another day (or week, or month, depending on what it is). This includes weight check, temperature, blood pressure, and a finger-stick (using a spring-loaded autolancet and a pipette, the tech will get a few drops of blood from your finger; it pinches/stings, but it’s not terrible) to check hematocrit and protein levels. If you’re underhydrated, this is where it will show and you can get deferred for the day. Also like... if you have a fever or are visibly sick, which... yeah, please don’t try to donate body fluids if you’re sick.
Also get checked for cuts/scrapes, plus needle injection sites, new tattoos and piercings. (I was asked to remove my jacket and show the tops and undersides of my arms, including lifting my arms up. Might have shaved if I’d realized that but oh well. :’D ) Cuts or scrapes won’t disqualify you, so long as they’re scabbed over and not inflamed. New tattoos, touch ups, or piercings will get you deferred (4 months from the date that you got them).
Get asked how many previous tattoos and piercings you have and where. See the tech’s palpable relief when you don’t have sleeves. Relief becomes understandable when you realize that she has to record and describe every tattoo and piercing you have.
Once day-of eligibility is confirmed, get sent to Medical waiting area.
Start getting hungry, because you’ve been here for a couple of hours by now. Open up a pack of fruit snacks, because if this is anything like waiting for the initial screening—
Get called back to an exam room almost immediately.
Debate stuffing entire handful of fruit snacks into your mouth at once or searching for a ziploc baggy in your bag to put them into.
Begrudgingly decide to be an adult.
Physical exam with the medical staff. Very routine— things like listening to your breathing and heart with a stethoscope, checking whether or not being struck in the tendon below your knee will make you accidentally kick the doctor, shining a light in your eyes to make sure your pupils dilate, and checking inside mouth with a tongue depressor.
Sheepishly explain that you were eating fruit snacks right before you came in here when the doctor wonders why your tongue is unusually red.
Also get asked to lay down on the exam table so they can palpate your liver and spleen. Also also get arms checked for cuts and injection sites again— and this time, ankles as well.
Really, really wish you had shaved recently. But like, it’s long pants weather, c’mon.
(The doctor was not phased in the slightest, to her credit.)
Get sat down to review and verbally confirm same information that you’ve gone over twice already. You will know all of this. Resistance is futile.
Review any and all medications you take with the medical staff, both over-the-counter and prescription. There are only a handful of meds that can cause you to be disqualified/deferred, but you still want them to know any meds you are on, as part of signing up is consenting to potential random or spot-drug tests. (I was not drug tested, just had to agree that they had the right to potentially request a drug test in the future, and that if I were to decline I would be disqualified/deferred.) For any of my fellow ADHD kids, you definitely need to let them know in advance if you take Adderall, as that will give a false positive on a drug test for meth.
(I discussed this with the doctor, including whether or not they needed a letter from my psychiatrist or a copy of the prescription; at least for CSL, I was told that they didn’t need any of that, that it’s basically on the honor system. So long as they know about it in advance, then I’m good to go. They did ask what conditions my various medications were being prescribed for; I don’t generally mind telling people that I’ve got ADHD and anxiety, but just as a heads up. Also, if you take birth control pills, don’t forget to mention those— I don’t, and the doc double checked that with me, but she didn’t ask me to explain.)
Finish with the physical, and finally (finally!) get cleared to go over to the donation floor. (Personally, I’d been at the center for about 3 hours at this point. I was told that new donors do usually end up having to spend a couple of hours in-processing on their first visit, though it seemed like this was a little longer than usual, but there was a decent amount of people there that day. Just, be aware, first time is like, a half-day commitment.)
Realize that there is also a line to wait in here, for returning donors. Die a little inside.
Be shown mercy by the medical staff, and be placed at the front of the donor line. (This is for first-time donors, since it’s such a long process to get to that point, they let you jump the line.)
Get called over to one of the donation beds— oh my god we’re actually getting to describing the actual process of having the plasma drawn, it’s happening—
Confirm your name and birth date, if you’re allergic to latex, iodine, bandaids, or nickel, and what arm you’d like to donate from. (I went with my non-dominant arm, since it was my first time and I wasn’t sure how sore/fatigued that arm might be later; I also was asked to remove that arm from my jacket.) Go over donation floor rules— no eating or drinking (including water) on the donation floor, no talking on a phone. Watching videos, texting, playing games, listening to music, reading, etc, is all perfectly fine and encouraged. (They did have complimentary wifi.)
You are kindly requested to not nap during the donation.
If you fall asleep, they are forced to assume that you have passed out and respond appropriately. Please don’t.
A pressure cuff is used on donation arm, along with you being asked to clench your fist multiple times then hold it clenched, so the tech can identify where exactly your vein is on the inside of your elbow. (My tech used some kind of tool to make a shallow circular indent in the skin on the spot he identified as the best injection site, which was a new one to me.) The pressure cuff stays on for the whole procedure, FYI, though it’s not engaged the whole time.
Iodine scrub for 30 seconds on the injection site, then 30 seconds to dry.
Needle is inserted at injection site, into the vein.
...into the vein.
Third time’s the charm??
Get asked if you mind the tech trying your other arm. Sigh internally but agree.
Before the tech pulls the needle, a supervisor happens to walk by and they ask if they want to give it a try. Supervisor manages to find the vein after another two attempts.
Look I’m sorry I don’t control how big my veins are.
Joking aside, very important note: the needle is large, and it is rigid. If you’ve had an IV before, this needle is larger than that, and many IV needles (or at least the part that gets left in after the initial injection) are plastic and flexible these days— this one is not. I was implored to please, please not bend that elbow, because 1) it would feel incredibly unpleasant and 2) it would push the needle through/blow the vein, and the procedure would have to be stopped immediately. Plus, there would be a very high likelihood I would have to then get stuck in the other arm anyways, so they could return whatever blood cells were still in the machine at that time.
Warnings aside, I do want to note— being very honest and up front, the needle was not particularly comfortable to have put in. Having it inserted was a little painful. (It also took multiple attempts for them to find the vein, which was definitely a contributing factor.) That said, the tech was very gentle, constantly checking with my to see if I was okay, and told me to let him know if it was hurting at all. My answer was, truthfully, no more than I would expect from having a needle in my arm. Despite the trouble in finding my vein (which, that’s not the first time that’s happened), I could tell that he wasn’t digging around with the needle, and seemed very skilled and professional. There was no point where I was concerned that he wasn’t experienced or didn’t know what he was doing. And, once the needle was successfully in, it only took a minute or so to get used to; I was always aware that it was in, but like, only in the “very mildly uncomfortable” sense. It was not painful at that point, or during the blood draw or return. It was definitely more uncomfortable to not be able to move or flex my arm for an extended period of time.
And now more waiting! Except at least this time, it’s at least while the plasmapharesis is actually happening. You’re hooked up to a machine that does all the drawing, filtering, collecting, and returning, but there are techs circulating on the donation floor and checking on you every few minutes. (There was always a tech within eye/ear shot.)
The machine also controls the pressure cuff; when the machine is actively drawing blood, the pressure cuff will be engaged, and you will clench and unclench your fist to help keep blood pumping to that vein, and help avoid the vein collapsing. (For me, the tech also lowered the maximum collection speed on the machine to 85%, because my vein was, in his words “tiny”, although once we started he noted that I was getting a very good flow rate.)
When the machine is filtering/returning blood cells to you, the pressure cuff will relax, and you can relax your hand/arm. The way it was told to me was, “when the cuff’s working, you’re working— when the cuff relaxes, you relax”.
I’d been told the process can take 30-60 minutes, depending on how much plasma they’re collecting from you and the rate of flow. Since I’m in the lower weight group, they were collecting a slightly smaller amount from me (you can see the collection bottle hooked to the machine, mine only got filled about 75-80%), but as noted above, they turned down the machine’s speed for the same reason. In total, my donation time was 57 minutes.
One thing that momentarily caught me off guard, and was probably the most uncomfortable part of the actual donation itself— before you totally finish up, the machine will give you some saline to help replenish some of the fluids/electrolytes it’s drawn off. The saline is cold as fuck. The only reason I realized I was getting saline at all was because my arm was suddenly really frickin’ cold, and I was getting concerned, until I happened to glance over at the machine and saw the “administering saline” text. This was only a couple of minutes at the end, fortunately, but it still would have been nice to know, especially since that arm was out of my jacket.
Finishing up: once the machine totally finishes, another tech comes over, double checks that you haven’t developed an allergy to latex in the last hour, puts a piece of gauze over the injection site, has you hold pressure on it while they remove the needle, then wraps your elbow with a stretchy bandage to hold the gauze in place. This bandage is supposed to stay on for 2+ hours.
Sit up, carefully. I didn’t feel woozy, which I take as a good sign, but I’d say better safe than sorry. Verbally confirm that you feel alright, whether or not you have any last questions, and get informed what the soonest day you’re able to donate again is.
And that’s it, you’re done!
Well more or less.
Aftercare instructions: drink a few bottles of water throughout the remainder of the day to help rehydrate, go have a good meal, no heavy lifting for at least a few hours. (The bandage prevented me from bending my arm completely while it was on anyhow.)
When you do go to remove the bandage, if your needle site is still oozing a little (which is possible, there is a small amount of anticoagulant added to the blood that is returned to you), you should put the bandage back on for another hour or two. Mine was not still oozing, but the clot that formed was stuck to the bandage, and they do very specifically tell you not to pull off any scab or clot on the injection site; I ran warm water in the kitchen sink and held my arm under the water for about 30 seconds to soak the bandage off. Just to be safe, and just in case I had accidentally removed too much of the scab, I went ahead and put some antibiotic ointment and a regular bandaid over the site (since the original bandage was soaking wet at that point).
But, that’s $90-100 dollars that just got added to your prepaid donor card, once the donation’s completed! So that’s nice!
Anyhow, there you go! Sorry that was a novel, but— I like to know what to expect when I’m doing new things, especially by myself, and I figured on the off chance that this could give someone an idea of whether or not they want to try donating, I felt like it was worth taking the time to type up.
As for whether or not I’m going to continue donating? Yep! Honestly, the excessive amount of time it took this go round was just because it was the first time. Now that that’s out of the way, I think the process will be: check in, answer questionnaire, do fingerstick/temp/weight/cuts-scrapes-and-new-tattoos check, go get in donor line, donate. So, way faster, maybe like an hour and a half. I was also told that Wednesdays, Sundays, and rainy days are particularly good days to come donate (at least at our center), because those tend to be slow days with little to no wait. For my second donation, I will also get a front-of-line express pass (I assume to incentivize people to actually come back for more than just the initial donation), so that’s nice too!
For future visits, I probably won’t take a water bottle or snacks inside with me, because the returning donor queue is on the donation floor, and I imagine the time between checking in and getting to go to that line (and the no food/no drinks area) will only be a few minutes, so, not much of a point. I’ll probably still have those things with me for afterwards, though, just stashed in my car.
But do make sure your phone is charged! And, that you know where the bathroom is. :D
Happy donating!
