Bloodless Surgery: A Brief Insight

Unsurprisingly, I never thought I'd actually learn anything from watching "Grey's Anatomy" apart from the odd tiny fact. Like most TV shows I watch it is purely for entertainment purposes and, at this stage, mostly because I want to know how the story ends. But whilst watching episode 13 of Season 9 I actually learnt something: Jehovah's Witnesses don't believe in blood transfusions.

Typically I avoid any discussion of religion or politics because it tends to lead to awkward situations or arguments, but I thought I would write about this revelation because it genuinely intrigues me, as did the thought of bloodless surgery that was mentioned in the episode. Enough so that I went and looked it up to see whether it was true, which it is.

So, to start with, I just want to say that not accepting blood transfusions seems rather strange to me, but each to their own. Apparently the Jehovah's Witness interpretation of Bible verses which prohibit ingestion of blood encompasses such acts as blood transfusions. They believe this to include whole blood and its major components (red cells, white cells, platelets and plasma), however will allow certain procedures which use their own blood (e.g. dialysis), blood substitutes and blood fractions (e.g. albumin, haemoglobin, clotting factors).

As I mentioned above, the episode of Grey's Anatomy I watched mentioned bloodless surgery and this is mostly what I wanted to read about. It's rather a strange concept when you first think about it, but after doing a little bit of reading it doesn't actually seem that much of a stretch. Especially when you realise that the term "bloodless surgery" doesn't actually mean there's absolutely no blood involved. What the term actually means is that it is surgery performed without the use of allogeneic blood donation, i.e. no whole blood transfusions of blood from someone other than the patient. There are a myriad of procedures and techniques that the term bloodless surgery encompasses, one of the main ones being autologous blood donation - use of the patient's own blood collected pre-surgery or cycled through a machine and then back into the patient during surgery.

Turns out that "bloodless surgery" as term started appearing around the 1880s, supposedly when orthopaedic surgeon Adolf Lorenz started using non-invasive techniques to treat patients due to his own allergy to materials used in operating theatres at the time.

In modern times bloodless surgery has been developed for a number of reasons, beginning in the 1960s and 1970s at the impetus of patients who rejected blood products for religious reasons or for fear of blood contamination and blood borne diseases. Denton Cooley was a surgeon who is now known as the modern father of bloodless surgery. He performed the first bloodless open-heart surgery in 1962, and in 1977 published his study of/report on 542 open-heart surgeries that he had performed without allogeneic blood transfusions. It's a little bit incredible when you think about it.

Recently bloodless surgery has garnered more interest due to the fact that it can be less costly and there is a reduced risk of post-operative infection or disease without an allogeneic blood transfusion. Also, without transfusions there are apparently fewer complications and faster recoveries according to the research. Not only that, but it is also thought if we can reduce the dependency on blood donation and blood banks then even better because it is never guaranteed. Nor are blood transfusions always the best course of treatment, and thus bloodless surgery should be available as an option if it is better for the patient.

Recent hallmarks for bloodless surgery:

• 2008: The WA Government was the first in the world to implement Patient Blood Management (PBM) as a policy
• 2010: The World Health Organization officially recognised and adopted the principles of PBM
• 2010: US Department of Defence granted approximately US$4.7 million towards training military and civilian physicians and health care providers

Further information / where I went to read (I know there's not many 'sources' here, but this is not uni, I didn't read extensively, just enough to gain an understanding, and they're not all listed here. I did also venture to Wikipedia and even the Jehovah's Witness website, but the below are very interesting/informative):

• Nathaniel I. Usoro (2012). Bloodless Medicine and Surgery, Blood Transfusion in Clinical Practice, Dr. Puneet Kochar (Ed) - chapter 11: http://cdn.intechopen.com/pdfs/32731/InTech-Bloodless_medicine_and_surgery.pdf
• The Wall Street Journal article "Bloodless Pressure: More Surgery Without Transfusions": http://online.wsj.com/article/SB10001424127887323494504578340962879110432.html
• WA Government's PBM: http://www.health.wa.gov.au/bloodmanagement/home/about.cfm

So, there you go, you learn something new every day!

Peanut Butter Chocolates, of all things...

This might seem like a crazy topic to start with after letting my blog lapse for 2 years, but it's not such a bad thing. I love chocolate and I love peanut butter, but for some reason have never really tried peanut butter chocolates much.

What typically springs to mind when thinking about peanut butter chocolates is Reece's Pieces or Reece's Peanut Butter Cups. I don't really remember when I first tried the Pieces, but I know the Peanut Butter Cups made a definite impression when I first tried them whilst spending the weekend at a friend's place in 2012. They're seriously addictive is the best way to describe what I remember about them (and my response to them).

Head to head - which wins?!

I was recently talking to a friend at work about some random stuff and was surprised to hear that there is such a thing as Peanut Butter M&M's. Said friend then gifted me 2 things, a packet of Reece's Pieces and a packet of Peanut Butter M&M's. Having never tried the M&M's variety before I was given this awesome gift with the intention of being able to try both and compare them. This then challenged me to pick a favourite of course.

I semi-seriously taste tested, if you're going to make a running joke of something you might as well finish it properly, right? Initially the jury was still out on my preference. I think that may have had something to do with the Indian I ate for dinner before trying each of them, so I saved some and tried them again on two different nights a few days later.

Turns out I prefer the M&M's. Factors considered included size, coating, filling and overall taste. At first I thought their overall flavour was letting them down, but I reserved final judgement until a total of three taste tests were completed. The second two tests swung the vote in the M&M's favour.

As my friend also points out, the colour variety in an M&M's packets lets you be selectively OCD about what colours you eat first and save for last. Like all good children do of course!

Although, when you think about it, technically the Reece's Pieces are Peanut Butter Candy... no matter!

It's been a while...

So, I was traipsing my way through all my online accounts to check what I still had when I came across my blog. Poor, discarded, bereft thing that it is I seriously considered just deleting it entirely. But then I thought perhaps it could give me something to do when I'm bored.

Let's face it, it's very easy to watch way too much TV, read a lot, and do not much else with my time other than go to work. So I figure maybe I can branch out a bit and give some new life to this blog by chronicling the occasional adventure or reviewing books, TV shows and the like. Probably a bit too late to finish blogging my Europe trip (from 2 years ago!!) so I won't be doing that!
We'll see how it goes. No definite plans as of yet, just an intention to try :-)