What Can I Do To Avoid a Blood Transfusion?

Educate yourself
Educate yourself about Bloodless Medicine and its benefits. Be completely convinced of the benefits and be resolved to stick to your decision. If you are not completely convinced of its safety and superiority you will likely cave in to the recommendations of others – including doctors – who are well meaning but lack sufficient education in the benefits of Bloodless Surgery and the risks and dangers of blood transfusions. 

Plan ahead
Locate the Bloodless Hospital nearest you (from our homepage). Investigate its Bloodless Surgery Program. Some hospitals have blood conservation programs which may vary from a true Bloodless Surgery Program; their goal is to reduce or minimize the amount of blood given to a patient - not avoid giving blood. 

The goal of a true Bloodless Surgery Program is Total Blood Avoidance. Their objective is to back your decision to avoid a blood transfusion. They are convinced of the superiority of Bloodless Surgery and their conviction will strengthen you resolve to avoid a blood transfusion. 

Have an advanced medical directive
To inform doctors of your medical wishes legal experts suggest that you have an Advance Medical Directive. Learn more.

Most countries recognize that adults have the inalienable legal right to refuse or accept any medical treatment. An Advance Medical Directive document clearly states your medical wishes.

Also, in a medical emergency, an Advance Medical Directive clearly states your medical wishes in the event that you are in a comma, unconscious, or otherwise unable to communicate your position on certain medical procedures.

A Directive should state your desire to avoid blood: An Advance Medical Directive can legally direct medical personnel not to administer blood. They are bound by this legal right. 

Hospital Directives
Most hospitals now have Advance Medical Directives on hand. In fact they are bound by law in the United States to have them on file. Use the hospital’s copy if it is acceptable. Make adjustments to the directive if necessary – likely it will not have a clause stating your right to refuse blood products or blood transfusions. In fact, it will likely state exactly the opposite. You can cross out any paragraph that you desire – this is your legal right according to the Patient Self Determination Act.

Of course, a Bloodless Hospital will have the proper forms on hand. 

Distribute multiple copies
After you fill out a the Advance Medical Directive - either from the internet, from our website, or from the hospital. Give copies to your doctor, lawyer, clinic, health care surrogate and/or anyone else who can assist you and stand by your decision. Keep a copy in your glove compartment, home, purse etc. as well.

Wallet size Advance Medical Directive
Carry a wallet sized Advanced Medical Directive Card – a 'No Blood Card'.
Emergency medical personnel are trained to look for a victim's ID. A NoBlood card in your wallet should do three things:

First, the face of the card should state clearly in bold letters that you do not want blood products.
Second, the reverse side or contents of the card should state more fully what your wishes are.
Third, it should direct medical personnel to your more complete Advance Medical Directive form, which is even more complete and contains more information.

Medical bracelet
Some people wear a 'No Blood' bracelet as an added measure of protection. At least a few in the medical profession feel that this is a must. Others feel that a ‘No Blood’ card and an Advance Medical Directive form are sufficient.

Correct anemia
Anemia is the most common reason that surgeons administer blood. If you have anemia it will only increase the doctor’s likelihood of giving you a blood transfusion. Correct your anemia immediately. If you are not sure if you are anemic, find out. Over two billion people worldwide are anemic. It is one of the most commonly undiagnosed medical conditions. 

Some would consider carrying a NoBlood card and having a curable anemia at the same time as not being responsible. Although skilled Bloodless Surgeons can operate on an anemic Bloodless Patient it is not the most desirable situation. Anemia slows healing, increases the chances of heart attack or stroke and significantly increases the chance of post-surgical mortality.

Additionally, in a medical emergency, you may end up in a conventional hospital where you may find doctors who may do their best to honor your wishes and not administer blood. But if you are anemic you are not helping your own situation. Hospital administrators and anesthetists, the doctor who has the power to give or withhold blood, may be willing to only go so far. 

Every point your blood count drops puts more pressure on conventional doctors to administer blood. Carry a NoBlood card but take care of the anemia if it is treatable! Most anaemias can either be cured or treated. Learn more about your condition and do something about it.

If a surgeon tells you that he cannot operate without blood because you are anemic then immediately search for a Bloodless Surgeon. Bloodless Surgeries are performed on anemic patients by adequately trained surgeons.

Stop smoking
If you smoke, quit. Smoking inhibits the delivery of oxygen at the cellular level. You need every advantage possible when undergoing surgery. You need every molecule of oxygen possible.

In developing countries
In poorer countries a fresh vegetable fruit juice of apple, beet and carrot juice in a ratio of: 1 part apple juice, 2 parts beet juice and 3 parts carrot juice is recommended as an excellent natural blood builder - it is locally called ABC – 123. It will build up your red blood cell count. This will treat but may not cure the cause of anemia. 
 
"U. S. physicians are well-trained and well-intentioned...yet most lack formal education in blood component therapy and many injure patients through unnecessary transfusions."  -Strategic Blood Management
 
Internet links: 
How to Avoid a Blood Transfusion
SABM PowerPoint presentation
St. Vincent Charity Hospital pdf download
Swedish Medical center FAQ
Southlake Regional Hospital Blood Conservation FAQ

Listen to the experts
"Wake Forest University researchers report… that anemia is… underdiagnosed and undertreated in elderly populations."  -WebMD

"Avoid transfusion regardless of the level of preoperative anemia. Allogeneic blood transfusion should be avoided whenever possible, not only because of associated risks but also because transfusion has not been proven to improve postoperative outcomes."  -National Anemia Action Council

"Doctors also request bloodless surgery for their patients, because they recognize there's still a risk associated with transfusions and they want to be able to offer their patients alternatives."  -Dr. Patricia A. Ford, Medical Director, The Center for Bloodless Medicine and Surgery, Pennsylvania Hospital, Philadelphia

"Immunomodulation [repression of the immune system] may have long-lasting effects, even in a patient who has received a single unit of [transfused] allogenic blood. Data supporting this association are even stronger than data linking cigarette smoking to lung cancer."  -Accessmylibrary - Shander, Ozawa and Teekam

"Blood transfusion is essentially different from medicine administration and is similar to organ transplantation, so that merit and demerit must be sufficiently considered."  -Sciencelinks

"The life of every person who receives blood depends on the honesty of the individual donors who have given their blood."  -South African National Blood Services

"Clearly, recombinant erythropoietin should be on everyone's mind as the first drug of choice to treat anemia in patients who do not need to be transfused."   -Aryeh Shander, MD, Pulmonary Reviews

"Bloodless surgery patients not only didn't have an increased mortality risk, but they actually had shorter stays in the hospital."  -Dr. Patricia A. Ford, Medical Director, The Center for Bloodless Medicine and Surgery, Pennsylvania Hospital, Philadelphia