Let’s stop blood donations drying up
‘It only takes about an hour and could be literally a matter of life or death for somebody else’
The Battle of Passchendaele, which had a centenary this year, also marked the first use of blood transfusions on the battlefield. “It restored hope where previously there was none,” wrote Lt Geoffrey Keynes, recording how, on the “moribund wards” of the field hospital where he was stationed, “I had the satisfaction of pulling many men back from the jaws of death”.
That life-saving potential is, however, threatened by a marked fall in the number of potential donors – down by almost a third over the past 10 years – attributable variously to people being busier, taking more exotic holidays abroad and the current vogue for tattoos (both of which may preclude potential donors), and, one might presume, a cultural decline in altruistic behaviour.
The shortfall could be made up by “regulars” donating more frequently where, according to a recent study, reducing the interval from 10 to eight weeks allows for an additional two units to be collected over a period of two years. Apparently, this does not have a major adverse effect on the donor’s quality of life or physical activity, but may predispose to donationrelated symptoms from the transient fall in haemoglobin level, notably fatigue, breathlessness and dizziness. The general message would seem to be that those with a rare blood type (such as AB) should probably donate more frequently, if possible, but others should stick to the current schedules. Meanwhile, those who do not donate regularly should consider doing so. “It is simple and only takes about an hour of your time,” notes Jon Latham, the associate director of NHS Blood and Transplant. “It could be literally a matter of life or death for somebody else.”
Still a sore point
Surgeons’ enthusiasm for removing children’s tonsils – including my own, in Aberdeen Royal Infirmary, still vividly recalled 60 years later – has long since waned. Now designated as a “procedure of low clinical effectiveness”, the number of operations fell by a further half in the decade up to 2011. But the situation with adults is very different.
Recurrent episodes of tonsillitis scar the tonsils, which then become a focus of infection, requiring repeat courses of antibiotics and predisposing to complications such as quinsy and peritonsillar abscesses. Here, the benefits of tonsillectomy are substantial, with a marked reduction in GP consultations, days off work and a general improvement in the quality of life.
“A return to the operation rates of the Fifties is not justifiable,” says Andrew Swift, ENT specialist, but the controversial indications of the past should not obscure the fact that it remains “a highly effective procedure for both chronic and recurrent acute tonsillitis”.
Leg pain explained
The excruciating pains starting in the feet then moving up around the ankles to below the knees, as recently featured in this column, are, by general consensus, most likely to be a virulent variant of cramp – or, as a reader describes it, mega-cramp. “It lasts for about 15 minutes, during which my legs feel like crushed rolling pins. I have to stand in a cold sweat, hanging on to the wardrobe.” The antidotes suggested include magnesium supplements, lots of water and dipping a wet finger in salt (or Marmite). Two further suggestions attribute these ascending pains to problems in the lower spine (“neural tethering of the nerves”) or one of the “protean manifestations” of restless legs syndrome.
Bowel problem over
Finally, for those afflicted by troublesome bowels, an 85-year-old reader beset by constipation and headaches for his entire adult life reports their miraculous resolution. Four months ago – overnight, on the third day of the Lord’s Test Match – they started functioning normally again, since then he has not required a single dose of his plentiful supply of laxatives. “I don’t like mysteries,” he writes, “and would clearly love an explanation,