#Middlebury #Platelets
DEAR DR. ROACH: I am writing about platelet donations. As a way of giving back, I donate platelets. I was wondering if there is a time that a person should stop donating, based on age or difficulty. I am 61 years old, and the past three times I’ve donated, I felt uncomfortable in some way. Either my arm or wrist hurt, or I had a feeling of malaise during the donating process. One time, I was told that my platelet count was on the low side, but it was not any danger to my well-being. I feel well immediately afterward and do not have health issues, so my concern is whether this is somehow detrimental to my own health as I age. – S.B.
ANSWER: Platelet donation generally is a very well-tolerated procedure. The platelets are removed from the donor’s blood via a process called apheresis; a centrifuge separates the blood into four components: plasma (containing proteins), platelets, white blood cells and red blood cells. For platelet donors, just the platelets are removed, and the rest of the blood components are returned to the donor.
In order to keep the blood from clotting inside the machine, sodium citrate is added to the apheresis machine. This reduces the calcium, which is needed for blood clotting. However, some people can develop symptoms of low calcium during the apheresis. This can be treated by slowing the rate of donation, or by taking some oral calcium before donating. More severe cases might require giving intravenous calcium to the patient via another IV catheter.
The Food and Drug Administration recommends people make no more than 24 donations per year, but there is good evidence that platelet donation is safe. I congratulate you on being a community-minded citizen, and I can reassure you that you have very little short-term risk and essentially zero long-term risk from donating platelets, whatever your age. Donate as often as is comfortable, and try taking a calcium supplement before donating.
DEAR DR. ROACH: have taken 5 mg zolpidem (Ambien) nightly for about three years. My doctor seems to think this is acceptable. I sleep five to six hours with this aid and function normally in the morning. Recently I was told that this drug has a cumulative effect on the body. Would you verify this? Over-the-counter sleep aids have no effect, and this drug seems to be the only way I can sleep. – D.M.
ANSWER: Zolpidem and its cousins, eszopiclone (Lunesta) and zaleplon (Sonata), work for a relatively short time in the body before they are metabolized, so they do not build up in the body. They are mostly gone in the morning, and grogginess is not a problem for most people. However, people often develop a dependence on these medications; it becomes difficult to sleep without them. More importantly, they do increase the risk of falls and auto accidents, especially when used every day and in people over 65. I don’t recommend them for the long term, and I have referred my patients who can’t sleep without them to a sleep specialist, who sometimes (but not always) is able to find a better solution than daily Ambien.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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