A Conversation for Haemolytic Disease of the Newborn

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Post 1

Haylle (Nyssabird) ? mg to recovery

Odd coincidence you wrote this one smiley - smiley. I was lurking on your page and down there in your entries is one about Rh Disease. Sorry, I had to deal with it with my two pregnancies (both of which survived, thankfully) and very little tends to be written about it. What prompted you to do so?


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Post 2

Danny B

A friend of my girlfriend has a young son and went through the whole process when he was born. My girlfriend asked me to explain why it happened (she thinks that, because I have a PhD in genetics I should know these things... smiley - erm) , and I thought I'd turn my explanation into a guide Entry. Of course, first I had to explain blood groups, 'cos there was nothing about that in the Guide either...

Anyway, I hope you and your children came through it all unscathed smiley - smiley


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Post 3

Haylle (Nyssabird) ? mg to recovery

After many unpleasant in utero blood transfusions, yes, they ended up fine smiley - smiley. I'm just worried about the baby my husband and I would like to have in a few years time. smiley - erm


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Post 4

Witty Moniker

Thanks from me, too. Like Nyssa said, very little is written for the general public on this subject. In my case, my daughter was attacked by Kell antibodies, which is extremely rare. I was told (13 years ago) that less than 8% of Caucasian American men are Kell positive and my husband is one of them. No immunisation exists as yet for that one and the poor kid was transfused 4 times before birth. Keeping perfectly still for the duration of the transfustion is extremely nerve-wracking. She turned out just fine and didn't even need photo-therapy.

Nyssa, is njan RH positive?


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Post 5

Danny B

I'm glad you both (and your children) came through relatively unscathed smiley - smiley

Nyssa - writing it, I got the impression that, with preventative treatment, the need for transfusions etc. has greatly decreased. Is that not the case..?


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Post 6

Witty Moniker

You are right, but there are cases where preventative treatment are missed. Once the antibodies develop in a woman the condition is irreversible and immunisation is no longer an option. For example, this can happen if a woman miscarries early on and doesn't receive immunisation within the proper window of opportunity. Then all subsequent RH Negative fetuses are at risk.


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Post 7

Danny B

Thanks for clarifying that! smiley - ok


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Post 8

Haylle (Nyssabird) ? mg to recovery

Yeah - in my case it was an undiagnosed ruptured placenta that caused internal bleeding.

On a up note, apparently if I lived in a town big enough to have a plasma bank, I could make a fair bit of money donating blood (which I guess they make the rhogam shot out of).


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Post 9

Danny B

Don't think Didcot or Abingdon fit into that category smiley - winkeye

The John Radcliffe hospital in Oxford may have something along those lines though!


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Post 10

AEndr, The Mad Hatter

The JR does indeed do apheresis collection - taking just blood plasma. However, you couldn't make money out of it - in the UK blood donation is voluntary and not renumerated.


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Post 11

Haylle (Nyssabird) ? mg to recovery

How do they keep a sufficient stock of the Rhogam shot then?


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Post 12

Z

Because a lot of people like to do things for the good of the country - that and a cup of tea.

Yes they're always short of donors but every time stocks get low then they put a public appeal out and lots come forward. In fact the last time an appeal went out I rang up and couldn't get through. The blood bank is nationalised (of course) so they can plan in a lot of detail
what's needed.

I read that in the states a barrel of blood is worth more than a barrel of oil - here my gay friends are disgusted becasue they can't give it away. (gay men are bared from donating at present - and an awful lot would give blood if they could).

Which reminds me I must ring up and get an appointment though I haven't given blood for a while.


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Post 13

Haylle (Nyssabird) ? mg to recovery

Yeah, but plasma donation for the Rhogam takes a lot of time and a huge commitment - it's not just like going in once in a while to drop off some blood. That being the case, I don't see why a person shouldn't expect compensation of some kind, even if it's just for transportation and whatnot. Also, there is enough of a shortage of Rh sensitized women that women who are 'done' having kids will often become sensitized such that they can donate, which is a sacrifice in and of itself.


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Post 14

AEndr, The Mad Hatter

That's very nice of them - or are they in it for the money. To me it just seems monetaristic to want compensation. It's probably a culture thing. Blood donation here is just that - donation. We also don't allow money to change hands for organs and surrogate mothers may not be paid, they are only renumerated for their expenses.


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Post 15

Haylle (Nyssabird) ? mg to recovery

Well that's just it - if expenses are renumerated for other kinds of donation, then a person committing several hours out of their week, each and every week, should be offered something similar. It can always be turned down by the the ultra-altruistic. On the other hand, if you all can get enough rhogam without having to resort to compensation, then more power to you.


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Post 16

Z

The only kind of donation that they're renumerated for is for surrogacy - the sort of donation that involves something living inside you for nine months! Which is a bit more of a scarafic than donating plasma..


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Post 17

Haylle (Nyssabird) ? mg to recovery

Well, that depends. 1. if the woman who was sensitized in order to do it decides she does want another child, she is guaranteed a really difficult time of it, and 2. Depends on how long the plasma donation is continued, i.e. I think a decade of doing it for the majority of the year is definitely on par with a pregnancy.


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Post 18

Z

I think that over here it would considered seriously unethical for some one to be sensitised in order to be able to donate.

I've never heard of there being a shortage over here, - I would expect that most women who donate are grateful for the heath care that they've recieved in the past (remember it's on the NHS, so they didn't pay for it- well they did indirectly) and do it to give something back to other women.


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Post 19

Haylle (Nyssabird) ? mg to recovery

Over here they have to sensitize and pay women, otherwise they wouldn't get enough, since every woman with a negative blood type needs at least 2 shots per pregnancy. But that's interesting what you say about the NHS. Here, since we pay up the a** for it, we have a sort of sense of entitlement. We're also quite aware that the people making the Rhogam shot from are blood are making a huge profit on it. It will be interesting, and probably nice, to experience a more give and take health care system, though I have to admit I'm a little scared of it.


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Post 20

Z

Well people's bodies aren't different over heresmiley - laugh and every woman who is negative needs two shots here as well!

But I wouldn't donate blood if it was going to a company who was making money out of it, I wouldn't donate if it was going to someone who was paying to recieve it. I only do it because it's a 'good thing to do'.

The NHS is something that people donate money to as well as blood, hospitals will often have fund raising events and it's quite common to have public appeals for the childrens ward or something. There's also a force of volenteers who run the shops in hospitals as well, (The WRVS) they're working for free and the money is donated back to the hospital.

It'll be intresting how you find it, but then again so much of that is how you get on with individual doctors really.. I don't know much about the USian system. But American patients tend to be a lot more demanding with a simalar sense of entitlement.

I supposed that's just how it is, after all you've grown up with a culture of being able to choose your doctor haven't you?

Anoother difference may be that here doctors have no incentive to indulge the 'not ill' I was talking to an American I met interailing who astounded when she went to a doctor in the Uk and was told 'there's nothing wrong with you'.. she thought that in the US they would have done some tests and asked her to come back a couple of times for the results.

I guess the only thing to say is don't judge an NHS hospital by it's builings! Some of the best and most famous teaching hospitals, that get excellent results in league tables have old run down builidings.

Oooh and waiting is part of the hospital experience of course. Even if you have an urgent, rapid access out patients appointment - all suspected cancer should get one within two weeks... it goes something like this..

Go to GP - perhaps wait a couple of days for an appointment
see GP - who refers you to a hospital. Get a letter a week later asking you to go on a particular day.

Out patient clinics are *always* running late even the first appointments in morning clinics - the doctors have to see there inpatients in bettween their clinics. So usually there's a couple of hours wait to see the doctor. Then if he asks for an X ray it's an other hour for the X Ray, and perhaps another hour to see the doctor again. The doctor might not be the one that you had the appointment with, he'll be the one that's running the clinic, but it will be someone on his team that you see.

It's really unusual for patients to complain about this, to the extent that when they do it really stands out. After all, we're English we don't like to make a fuss.. and complaining won't get your seen any quicker anyway. And besides we love queuing. If you've got a hospital appointment your employer will expect you to be go for nearly the whole day anyway.

That's not to say that you won't get seen quickly if it's an emergency, but if it's something routine it's a lot of waiting.

(You know I agree with Bill Bryson, this country would have done a fantasitic job of communisim, we love queuing, never complain, and donate blood and loose change to a government department (well the NHS))


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