FARGO — Fargo native Alexa Puppo never thought much about blood until her body stopped producing it. Soon after enrolling at Columbia College of Chicago in 2013, she became extremely lethargic and noticed she was bruising easily.

“I would pinch myself and a bruise would show up right away,” she said. “I woke up and all along the inside of my mouth it was covered in black. I was hemorrhaging, I guess.”

With her general health declining rapidly at age 18, a school nurse informed her she was bleeding internally and needed to go to the emergency room.

“A normal person has 150,000 platelets. I think I had like 3,000, 5,000 in my body,” she said. “When you get in that situation, you just don't trust anything anymore. They didn’t know if I was gonna live or die.”

It’s been five years since she was diagnosed with severe aplastic anemia, an uncommon blood disorder where the bone marrow doesn’t produce enough new blood cells. She describes the time of her diagnosis as “the most hellish six months of my life.”

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“When you don’t have hemoglobin, you age by 50 years. I was 20 but I felt like I had been on this planet for hundreds of years,” Puppo said.

She became exhausted to the point of struggling to walk up stairs. Every three days or so, she’d need to go in for more blood.

“Any time you get diagnosed with anything long term like that, it’s just a horrible waiting game,” she said. “Everything is an immediate emergency and then you’re sitting in limbo for hours or days or months.”

Alexa Puppo, left, in the fall of 2013 with a nurse at the University of Minnesota Medical Center in Minneapolis, Minn. shortly after undergoing immunosuppressive treatment. Special to the Forum
Alexa Puppo, left, in the fall of 2013 with a nurse at the University of Minnesota Medical Center in Minneapolis, Minn. shortly after undergoing immunosuppressive treatment. Special to the Forum

Thanks to a successful round of treatments and roughly six months of blood transfusions, Puppo made a complete recovery. Today, she lives in New York and works for digital media and broadcasting company VICE as a video editor.

“My life is back to normal; I can do whatever I want,” she said.

She hopes that healthy donors will consider donating blood in light of her experience.

“I don’t know how to encourage people to do it, other than (saying) people need it to survive,” Puppo said, adding that, prior to her diagnosis, she hadn’t known such an illness even existed.

Blood donations reached a critical low

The Fargo blood center lost 480 donors due to inclement weather by Feb. 20, and on that particular blustery day, there was only one donor sitting in a room full of empty chairs.

Winter-related viruses, as well as travel alerts, forced donors to cancel appointments at Vitalant, the center previously known as United Blood Services.

So what happens when blood drives and appointments are cancelled?

“We add blood drives, ask existing blood drives to add more donors, communicate the need through social media,” said Katie Bartelson, Vitalant’s senior donor recruitment representative. “We plan so far in advance that our hospitals are already depending on those units, so when we cancel, we have to make up the difference.”

After reaching a critical low in February, the blood supply is stable now, but with heavy snowfall predicted for this weekend, Bartelson predicts more cancellations.

“During the winter months, there is an increased chance of accidents, and on the flip side, it prevents our donors from getting to blood drives,” Bartelson said.

The need for blood also increases because patients opt to schedule elective surgeries such as knee and hip replacements in the winter.

Blood lasts for 42 days and then it expires, so donors are needed on a constant basis. Blood donors are eligible to donate once every 56 days. Platelet and plasma donors can donate more frequently.

“With preemies being born every day, surgeries and trauma situations occurring constantly and so many going through cancer treatment, the vital part of all of those situations is blood,” Bartelson said.

Kristi Wirrenga, of Adrian, N.D., was the lone donor at the center that blustery day in February. Her father-in-law recently underwent open heart surgery in Fargo, which required two units of donated blood.

Kristi Wirrenga from Adrian, N.D., donates platelets on Wednesday, Feb. 20, 2019, at Vitalant in south Fargo.
David Samson / The Forum
Kristi Wirrenga from Adrian, N.D., donates platelets on Wednesday, Feb. 20, 2019, at Vitalant in south Fargo. David Samson / The Forum

Wirrenga’s husband was struck by a train 17 years ago and while being treated, he received 18 units of blood. He has since recovered.

“He was a pedestrian trying to save our dog on the train tracks. We had just had twins and he was in the hospital for a long time, about three months,” Wirrenga said.

According to American Red Cross, less than 38 percent of Americans are eligible to donate blood, and approximately 3 percent of eligible people donate annually.

In addition, Bartelson said baby boomers are donating more than millennials, but the most reliable age bracket is 36 to 55, according to a study published in Transfusion Medicine and Hemotherapy journal in August 2010.

At a Weible Hall blood drive at North Dakota State University on Thursday, Feb. 28, most students walked by shaking their heads, objecting when they were asked to donate.

Student Kailyn Reed was among them.

“I have a really big phobia of needles. I can’t even get flu shots, I can’t even see needles or I’ll start crying,” she said.

Tyler Perkins Clark, who works for Residence Life and helps facilitate blood drives, said students who rely on income from donating plasma choose to get paid for giving plasma before donating, despite the urgent need for blood.

Paid plasma donors can give as often as twice a week, compared to an eight-week waiting period after donating whole blood. That means a student who donated blood would have to wait eight weeks to get paid for donating plasma.

Bartelson said that hospitals transfuse plasma from volunteer donors, whereas paid donor plasma is used to manufacture pharmaceutical products for specialized patient needs, but not for patient transfusions.

“Anything that we collect from a volunteer donor here is given to a patient in the hospital,” Bartelson said. “It has to come from someone who volunteered their time; they can not get paid for a transfusable product.”

Eligibility misconceptions

But does giving blood hurt? According to NDSU student Chloe Schaehrer, you can hardly feel it after the needle poke.

“It’s like getting a shot and then kind of nothing. Sometimes you get cold, sometimes you get tired. Depends on the day,” Schaehrer said.

Also, for those previously told they couldn’t donate blood, they might be able to now. The yearlong deferral period for surgeries, piercings and tattoos has been eliminated and other regulations have loosened, as well.

“The basic guidelines are, as long as people are feeling well and healthy, most of them are eligible to donate,” Bartelson said.

She said the most common misconception people have is that taking medication is an automatic disqualifier. To ask about certain medications, call 877-258-4825.

Other qualified donors include those with regulated diabetes, have been cancer-free for one year, or who are 16- and 17-year-olds. Minors must bring a consent form, which is available at https://www.vitalant.org/Resources/Donor-Forms.aspx.

Bartelson compared the donation process to an oil change: getting rid of old blood and challenging your body to make new blood can be a good thing.

“We are hearing more and more from the medical world that doctors are encouraging people to donate blood, as it is a healthy thing to do,” she said.

The actual blood draw is the shortest part of donating blood, taking about five to eight minutes. Adults have about 10 to 12 pints of blood in their body and give one when they donate.

“With that little bit of blood they can impact up to three patients,” Bartelson said.

Vitalant also offers incentives for frequent donors, such as points that can lead to gift cards, movie tickets and other rewards for those who donate enough.

“People can be on their phones, they can bring their laptops in. We make it as comfortable as possible,” Bartelson said.

Interested donors can also fast track their upcoming appointment by taking the health history questionnaire prior to arrival which can be found at http://www.bloodsystems.org/health.aspx.

Anyone interested in volunteer work at the blood center can contact Bartelson at 701-365-8928.

To locate a blood drive, go to bloodhero.com and then click on “Locate a Blood Drive.”

To schedule an appointment to donate at Vitalant, a blood donation center in Fargo, visit https://bloodhero.com. Anyone with eligibility questions can call 800-289-4923.