Q. I really want to donate blood, but I'm absolutely terrified of needles. What should I do?

A. Donating blood does involve a needle, and probably always will involve a needle. But I would still encourage you to try. Fear can be too easy an excuse. Just keep in mind the patient at the other end of the donation who probably also doesn't like needles, but who is now sick, vulnerable and dependent on transfusion being available. This person doesn't have an option when it comes to needles.

After your first donation, you will know how easy and relatively painless it is. But for that first time, try to bring along a friend who has previously donated blood for support. Once you're there, you will see that other donors are not having a terrible time. In fact, chances are that you, like the other donors, will enjoy participating and feel proud of yourself when it's over.

If you're nervous, tell the staff. We deal with people all the time who are uncomfortable and we know how to make them more comfortable by explaining what to expect before, during and after donating blood. For example, some people feel lightheaded after donating. Our staff also knows how to handle these situations and how to get you through them. Then, we celebrate your success with you when you're finished.

After your first donation, of course, we hope you'll come back as soon as you can!X

-Linda A. Chambers, MD
Senior Medical Officer,
Biomedical Headquarters
American Red Cross
Washington, DC

Q. Should I donate my own blood prior to having surgery?

A. This is called an autologous blood donation, and it was quite popular in the early 1980s when the risk of HIV infection was very real. But today, it's not worth doing if your community has a robust blood supply.

Although autologous donations can spare you some of the very low infectious risks of using the available blood supply, from a cost/benefit standpoint it's a very expensive option to prevent a very few bad outcomes. Cost-benefit estimates tell us that the use of autologous donation to prevent virus transmission can cost hundreds of thousands of dollars, if not millions, per infection avoided.

Half of all autologous donor blood doesn't get used, however, and must be discarded. Plus, it's possible for you to donate your own blood and have a reaction to the donation, or your donation can be mixed up with someone else's and used for the wrong patient.

The point is that these risks, though small, are greater than the risks autologous donation is used to prevent. My personal opinion is that, under most circumstances, the best transfusion option for medically needed transfusion is the community blood supply. Having said that, I should also add that, to my knowledge, all blood centers today offer the option of autologous donation for the peace of mind of those patients who are concerned.X

-Louis M. Katz, MD
President, America's Blood Centers
Washington, DC
Medical Director, Mississippi Valley
Regional Blood Center
Davenport, IA