“I definitely wasn’t eating regular meals, and I think the pressure of keeping up my two donations a week was making me sick,” he says.
Kevin Crosby, 48, began plassing 10 years ago to provide for his six-year-old daughter.
“Every time I’ve had this weird hollowed out feeling. And a lot of times the next day I will have serious fatigue," he says. "Then, about five years ago when I was working night shift at a security job, I had that weird fatigue. I don’t know what hit me but I woke up on the floor. They accused me of falling asleep; I know I blacked out.”
Crosby has had several blackouts, including one that hit when he was driving.
"I had to pull over," he says. "I had to sit there several minutes in a daze. It really freaked me."
The fact that other Western nations adopt a “better safe than sorry” attitude (when they sanction commercial collection centers at all) by insisting on two-week intervals between donations should raise eyebrows about U.S. practices. Many people I interviewed left me questioning whether, when poverty is the primary motivation, the advisability of twice-weekly plassing should be reconsidered. Not to mention the other likely health complications donators may suffer from, including stress, poor nutrition, and inadequately or untreated medical conditions.
All told, I interviewed almost three-dozen regulars at CSL and Yale Plasma. More than half of them confessed to frequent, bizarre tingling sensations, pains, rubbery legs, and severe dehydration, as well as to having been homeless, having lied to pass medical exams, and having used "tricks" that allowed them to pass protein-level tests. They lived in circumstances that made plassing a hardship, but said, "I can't eat if I don't plass."
I described the experiences above to medical historian Harriet A. Washington, author of Deadly Monopolies and Medical Apartheid: The Dark History of Medical Experimentation on Black Americans. Washington said, “Our blood supply is now very safe, although not perfectly so.” Hepatitis C and HIV infection are as rare as 1 in every 1 million blood recipients.
Washington is not opposed to payment centers that observe safety standards and adhere to regulations. Neediness and economic hardship don't necessarily make a donor unsafe, which is a historic prejudice. The crux, Washington says, "is how we screen donors."
"If these companies are winking at donors' deception, then they're putting us all in serious danger. In an ideal world, I'd want more government oversight to closely monitor these collection sites."
Why do donors, including myself, suffer fatigue akin to blackouts? During plasmapheresis, centers often use a chemical, sodium citrate, to keep blood from clotting, Washington explains.
"Sodium citrate and other citric-acid derivatives bond with the calcium in your blood, and afterwards the calcium is no longer available to your body. We know that some people respond badly to sodium citrate. The worst case is rare: extreme hypocalcaemia, which can be fatal. But more often, people will suffer fainting, tingling and numbness, muscle contractions, or even seizures. Walking around with depleted calcium can be extremely dangerous. It can lead to serious healthcare issues."