Rising Blood Pressure
50% of us will need a blood transfusion at some point in our lives. Still, Norwegians are among those who donate blood least
Tekst: Kaia Holen Lovas, Benedicte Midthaug Torsvik
“We’ve found you a new pair of lungs.”
On a warm day in June, Aleksander Lother receives a call from the transplant doctor at the state hospital in Oslo. A few hours later, he’s lying on the operating table. His life is about to get a new start. Aleksander was born with the rare disease, cystic fibrosis, and has lived his entire life with bad lungs. He always knew that the day would come when he would have to get new ones. That day came four months ago.
“They wheeled me down a long corridor with a lot operating rooms, then we came to the end of the hall and I had to say good-bye to my family. It was very strange to see them standing there while I was wheeled further in. I didn’t know if I would ever see them again,” explains Aleksander.
After the operation, Aleksander mysteriously lost a significant amount of blood, and he received between four and five liters from a transfusion. Besides the donated organs, the blood transfusion is the reason he is alive today.
Blood Crisis. If Aleksander had been living ten years into the future, he may not necessarily have received the life-saving blood. According to professor emeritus Hans Erik Heier at the Oslo University Hospital, we are approaching an upcoming blood crisis.
“We’re already buying plasma products from the commercial market in Europe. In ten years, will we also depend on imports of other blood products, such as blood platelets and red blood cells,” says Heier.
The math is simple. The consumption of blood is increasing, while fewer and fewer people give blood. The aging population, more cancer patients and chronically sick patients are the reasons that blood use is escalating. If nothing is done, there can be serious consequences.
“The worst case scenario is that we will have to introducing rationing of blood, in which case we would need to prioritize who gets blood and who doesn’t,” says Heier.
Struggled Long and Hard. Aleksander had previously received a blood transfusion before the lunge operation. He was born two months premature and had to stay in a neonatal intensive care unit. He had too little blood in his body, and received transfusions in order to survive. In other words, Aleksander has had to struggle his entire life.
“I have a steel will. I was working full-time right up until the operation, which is uncommon for people suffering from cystic fibrosis,” he says.
With a lung capacity of only about one liter, a fourth of the normal lung capacity for a healthy person, he was put at the top of the waiting list for a lung transplant. Because of this, he had to give up his job as a truck driver.
NORWEGIANS AT THE BOTTOM. Norwegians are among the nationalities who give the least blood. Departmental manager, Kjell Rune Logan-Halvorsrud at the Blood Bank of St. Olav’s Hospital tells how the idea of donating blood started as a movement of solidarity after the second world war. The spirit of giving is no longer as ubiquitous.
”Currently, we are line with the Eastern Bloc countries, in regards to how much we donate per capita.”
Logan-Halvorsrud believes this can be due to selfishness.
“Maybe we’re too focused on getting something in return. When we’re stressing about our jobs and worrying about earning money, it’s easy to forget about others.”
NEW LIFE. Aleksander describes his life before and after the operations as two different realities.
”Before the operation, I got tired very easily. If I had been at the store to buy groceries, and I was going from the garage up to the house, I would get really out of breath. I would break out into a cold sweat, and it was so shitty, if I can use that expression. Truly, as out of breath as possible, as if I had run the 100 meters,” he explains.
Aleksander is not sure of what would make a person decide to give blood.
“Maybe something would have to happen to a close friend or family member for a person to really understand the reality of giving blood.
This concept became apparent this summer. In the hours and days after the terror on July 22nd, about 1,500 people registered themselves as potential blood donors. In the meantime, Nrk.no has revealed that the Blood Bank was able to make contact with 500 of these people after the fact.
RIGID RULES. Another factor which contributes to the lack of blood is that the rules dictating who can give blood in Norway are considered by many to be very strict. Men who have had sex with another man once or twice in their life are automatically prohibited. Living abroad, changing sexual partners, piercings and tattoos are other factors that can contribute to a longer quarantine period. These rules, which are determined by the Norwegian Directorate for Health and Social Affairs exclude many young people.
Hans Erik Heier is one of the people have officially spoken for a softening of the rules.
”These rules have developed as they have because we are much too afraid. The rules are both too strict and too fixated on sex,” says Heier, who has worked in the field for over 30 years.
He believes that the rules should be analyzed again, and that there should be fewer restrictions for aspects which cause no out-and-out risk of infection.
DOES NOT UNDERSTAND THE ARGUMENTS. Medical student, Sverre Myren is a homosexual, and would gladly give blood if he were allowed.
“I understand that the rules have to be strict, but not as strict as they are today. It’s difficult to understand the argument that a man who has at some point had sex with another man will be excluded for the rest of his life. It would be better if there was a system where the criteria are based on exposure to risk of infection.”
In Sweden and England, among other places, the laws have changed in the past few years. In these countries, the time of quarantine lasts only 12 months for men who have had sex with other men.
”In that way, you don’t exclude a whole group of people in the same way that you do here in Norway. It’s a more rational approach,” says Myren.
LEGIMITZES DISCRIMINATION. Marie-Anne Ramuz Evensen has 35 years of experience in sexual education, has written a textbook on the subject and has worked with sexual rights. She is concerned about the signals the authorities are giving to the young through the current rules regarding donation.
“It should be safe to give and receive blood, but we still need to consider what message we are spreading. Clinging to an old-fashioned way of thinking about the problems surrounding sexuality and the spread of HIV, where you ask about the identity, and not about the actual conduct of the individual, legitimizes discrimination against homosexuals in other situations,” she says.
In today’s sexual education, there is an active movement for escaping that kind of group-think, and Evensen believes it is inappropriate for the Norwegian government to maintain it.
“There’s a question of ethics surrounding the case that we need to take into consideration without compromising security. We may be scaring away people who would otherwise have joined our cause in the noble fight to get more people donate blood,” she speculates.
RECIPIENT IN FOCUS. Departmental manager Logan-Halvorsrud at the Blood Bank in Trondheim thinks there is good reason for the rules to be so strict.
“The patient is always the focus. It should be safe to receive blood in Norway. For patients who are very sick, a transfusion of infected blood can have serious consequences.
Even a cold can be a serious problem for a person with a compromised immune system.
“I believe there are many potential donors among the population. I would rather start at that end,” says. Logan-Halvorsrud.
He emphasizes the importance of young people registering themselves, even if they are unsure if they can give or not.
NEW PRACTICES. Even though there are disagreements regarding how strict the rules should be, both Logan-Halvorsrud and Heier agree over certain practices to lift the storage of blood above the poverty line.
“The current system for mapping donors is very lacking. The Norwegian Data Inspectorate has decidedly put a stop to that kind of registery,” says Logan-Halvorsen.
As a result of this, donors must register themselves every time they move. If you have given blood in Oslo and move to Trondheim, you must undergo a new first-time physical and interview.
“It is particularly inconvenient, expensive and impractical,” says Logan-Halvorsrud.
The most important thing is of course to recruit more donors.
“It doesn’t exactly made us look good when articles are written about this issue, but we are struggling with the marketing aspect,” says Logan-Halvorsrud.
They have yet to find an effective solution to increase the low rate of donation.
STRONG EMOTIONS. Aleksander tells of his feelings of what it is to go through such a serious operation.
“There was no going back. It’s like winning the lottery, you only get one chance. I just had to follow a red line which I couldn’t part with by going backwards or sideways, just as if I was carried along by a conveyor belt,” he says, attempting to describe the feeling.
To give his lungs an easy start, he lay in a respirator the first few hours after the surgery, but it was removed before he awoke.
”I was so tired that I couldn’t be bothered to care, but when the removed [the respirator] I started coughing. My mom said it was as if I had been born again, because I did the exact same thing 34 years ago,” he explains, his voice breaking.
POSITIVE EXPERIENCE. At the Blood Bank in Trondheim, Mona Reitan from Frøya lies in a pleasant room while she is tapped for blood for the second time.
”I’d considered donating for a long time, I just never got around to actually doing it,” says Reitan.
The employees at the Blodd Bank want giving blood to be a positive experience and the donor to feel well cared for. Their duty is also to reject people who should not be donors because of risks to their own, or the patients’ health. This is why a donor has to go through a short interview and fill out a questionnaire every time he donates.
“Essentially, the point is that people forget about what they have done or they don’t think that what they’ve done can have any significance. It can be that you picked off a scab or took aspirin the night before,” says Logan-Holvorsrud.
LIQUID INTAKE. A glass of orange juice sits on the table beside Reitan. When a person gives blood, it is important to consume enough liquid and nutrients, so that the body uses as little time as possible to recover. It is therefore important to have plenty to eat and drink.
”The people who work here are very pleasant, and I feel they take good care of me,” tells Raitan.
She knows several people who are received blood transfusions. For her, it was an easy choice.
”It’s not dangerous at all, and it doesn’t hurt. I would absolutely recommend that others do the same,” she says.
WANTS TO SAVE OTHERS. Aleksander has recently been for a follow-up at the State Hospital, and received generally good results. His lung capacity is normal and the oxygen uptake isnear that of a top athlete.
”Yes, everything’s wonderfu now. I am incredibly grateful to the donors of the lungs and the blood who have saved my life,” he says.
Aleksander is working hard in order to begin working again, and he has big plans for the future.
“If I can’t continue as a truck driver, I would like to be an emergency worker of some kind. In that way, I could give something back.”
