Click a word on the left and the definition will appear here:

Albumin: This major protein constituent of blood is often given to individuals who need to retain more fluid in their bloodstream, such as burn victims or patients with liver failure or extremely heavy bleeding (hemorrhage). Albumin (along with clotting factors, growth factors, and immunoglobulins) is sometimes referred to as a minor blood fraction. If you are a Jehovah's Witness, whether or not you can accept treatment with a minor blood fraction may be considered an individual "matter of conscience."

Click a word on the left and the definition will appear here:

Allogeneic blood: Blood donated from another individual, which is typically stored and then provided through a transfusion. Jehovah's Witnesses do not accept allogenic blood.

Click a word on the left and the definition will appear here:

Anemia: A condition in which an individual's blood can't supply an appropriate amount of oxygen to their organs and tissues, either due to a low volume of blood, too few red blood cells in the blood, or too little hemoglobin or iron in the red blood cells. Patients who are suffering from severe anemia are sometimes more difficult to manage, unless they are treated by a team that is very experienced in transfusion-free medicine.

Click a word on the left and the definition will appear here:

Apheresis: A process used to obtain blood components (such as platelets) from a donor. The blood is removed from the donor, the necessary cells are harvested and retained, and the donor's plasma is returned to the donor. Donated platelets are considered a major blood fraction and are not acceptable to Jehovah's Witnesses. However, "therapeutic apheresis" may be acceptable to some Jehovah's Witnesses because it is a treatment performed on the patient's own blood.

Click a word on the left and the definition will appear here:

Blood banking: This is when blood is donated by a person for their own use or a specific individual's use at a later time. It is usually done because of fear that donor blood will not be available or might have contaminants, or because the person has a rare blood type. This procedure is not "bloodless medicine" because it involves blood storage and blood transfusions.

Click a word on the left and the definition will appear here:

Blood salvage: Blood salvage procedures collect blood lost during or after surgery. A variety of methods may be used to collect blood, including suction and drainage devices. The devices that are used are sometimes called "cell savers." Those who object to blood transfusions may feel comfortable with "closed loop" blood salvage, where the blood is never stored and retains a semblance of connection to the patient at all times.

Click a word on the left and the definition will appear here:

Cautery: Deliberate surgical destruction of tissue, either because the tissue is abnormal or to seal off a bleeding area. Cautery is a method of reducing bleeding during transfusion-free surgery. It may be achieved through heat, freezing, chemical scarring, electricity, light, and ultrasonic or microwave energy.

Click a word on the left and the definition will appear here:

Cell savers: Devices that capture and hold blood during or after surgery, so that the blood can be returned to the patient.

Click a word on the left and the definition will appear here:

Clotting: The complex chain of chemical events that produces a plug (clot) at the site of bleeding. It is important for a patient undergoing transfusion-free surgery to have good clotting ability, in order to reduce bleeding/blood loss. Certain medications may interfere with clotting, such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs; anticoagulants (such as Coumadin); vitamin E; and herbal preparations containing garlic or ginkgo biloba.

Click a word on the left and the definition will appear here:

Clotting factors: Chemicals that circulate in the blood and interact together to help cause blood clotting at the site of an injury.

Click a word on the left and the definition will appear here:

Coagulation: The conversion of liquid (blood) into a somewhat solid plug that can prevent further bleeding from a particular site.

Click a word on the left and the definition will appear here:

Colloidal solutions: Intravenous fluid solutions that contain water, salts, sugars, and protein. They may be given to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery. Some colloidal solutions contain albumin -- a protein whose use is a matter of personal conscience for Jehovah's Witnesses.

Click a word on the left and the definition will appear here:

Cryosurgery: A surgical technique that uses extreme cold to destroy abnormal tissues in the body. It is sometimes used as a bloodless medicine technique -- by freezing tissue, bleeding is minimized.

Click a word on the left and the definition will appear here:

Crystalloid solutions: Intravenous fluid solutions that contain water, salts, and sugars. They may be given to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery. Jehovah's Witnesses find cystalloid solutions such as Ringer's lactate and normal and hypertonic saline acceptable therapy.

Click a word on the left and the definition will appear here:

Donor: A person who gives blood. The donated blood may be stored and distributed to hospitals and medical centers to be given to a patient when needed (as a transfusion). When a patient receives whole blood in this way, this is considered traditional medicine -- NOT "bloodless medicine." However, donated blood may be used to harvest blood components that may be used during some bloodless procedures.

Click a word on the left and the definition will appear here:

Embolotherapy: Refers to various methods of blocking a bleeding blood vessel, preventing further blood loss. These include chemical agents that scar the inside of the blood vessel; mechanical agents that block a bleeding vessel, including metal coils and latex or silicone balloons; particles or microspheres, including gelatin foam; and injected liquid that quickly turns into a thicker gel-like or spongy mass to prevent bleeding from a vessel.

Click a word on the left and the definition will appear here:

Endoscopy: A scope that can be used to visualize the inside of the body, either through insertion into a tiny incision or by passing the scope through a body opening (such as the mouth or anus). Endoscopy is used to examine, biopsy, or surgically treat a variety of conditions. Types of endoscopy include arthroscopy (joints); bronchoscopy (bronchial tubes, lungs); colonoscopy/sigmoidoscopy (large intestine); colposcopy (vagina, cervix); gastroscopy (stomach, small intestine); laparoscopy (abdomen); and others. Endoscopy is considered a "minimally invasive" procedure, which results in reduced bleeding. It is therefore a valuable bloodless medicine technique.

Click a word on the left and the definition will appear here:

Erythropoietin: Erythropoietin is the name of a chemical normally produced by your body, primarily by your kidneys. Erythropoietin stimulates the bone marrow to produce red blood cells. Laboratory-made synthetic erythropoietin (e.g., Procrit, Epoetin alfa, Epogen, or Aranesp) may be administered prior to a bloodless surgery procedure in order to maximize your bone marrow's production of red blood cells. Other synthetic chemicals that mimic the activity of erythropoietin are in development.

Click a word on the left and the definition will appear here:

Fibrin glue: A substance made from human clotting factors. These clotting factors can be harvested from donor blood plasma or from a patient's own blood plasma. Fibrin glue can be applied to a bleeding vessel. It both blocks the vessel from bleeding and activates normal clotting/coagulation activity. Because fibrin glue is made from blood products, each individual will need to examine their own conscience to decide if its use is personally acceptable.

Click a word on the left and the definition will appear here:

Fluid expanders: Intravenous fluid solutions that are used to increase the volume of fluid in the circulating blood. The result is that when you bleed during surgery, your diluted blood contains a lower concentration of red blood cells.

Click a word on the left and the definition will appear here:

Gamma knife: A high-tech surgical tool that can be used for brain surgery. This technique utilizes a powerful and precise form of radiation to destroy tumors or abnormal blood vessels with less blood loss than a traditional scalpel.

Click a word on the left and the definition will appear here:

Harmonic scalpel: A surgical tool that uses ultrasound waves to cut tissue and seal bleeding vessels at the same time -- a helpful characteristic in transfusion-free surgery, because it helps keep blood loss to a minimum.

Click a word on the left and the definition will appear here:

Hemodilution: The process of making blood more dilute than normal. The result is that when you bleed during surgery, your diluted blood contains a lower concentration of red blood cells.

Click a word on the left and the definition will appear here:

Hemoglobin: A chemical within red blood cells that allows oxygen to be carried throughout the body.

Click a word on the left and the definition will appear here:

Hemophilia: A disease in which the blood clotting system is defective, resulting in an increased likelihood of serious bleeding after even minor injury.

Click a word on the left and the definition will appear here:

Hemorrhage: Heavy bleeding.

Click a word on the left and the definition will appear here:

Hemostasis: To stop bleeding.

Click a word on the left and the definition will appear here:

Hyperbaric: To be at higher-than-normal atmospheric pressure. Hyperbaric oxygen therapy is used in some facilities to assist bloodless medicine in certain situations. You enter a chamber and breathe pressurized oxygen, which concentrates oxygen in your blood.

Click a word on the left and the definition will appear here:

Hyperoxic: Having higher-than-normal oxygen saturation.

Click a word on the left and the definition will appear here:

Hypotensive: Having low blood pressure. Hypotensive anesthesia is a technique that lowers a patient's blood pressure below normal during surgery. Blood loss tends to be slower when your blood pressure is low. However, blood pressure must be maintained at a particular threshold to ensure that all of your body's organs and tissues are receiving blood, so the practice of hypotensive anesthesia requires great skill and extraordinarily careful monitoring.

Click a word on the left and the definition will appear here:

Intraoperative: During the course of an operation.

Click a word on the left and the definition will appear here:

Iron: A nutrient that is required by your red blood cells for good oxygen-carrying capacity. Iron is important for bloodless surgery and can be obtained from dietary sources like red meat or through supplements, such as ferrous sulfate or ferrous gluconate.

Click a word on the left and the definition will appear here:

Kidney dialysis: A procedure in which the blood is cleansed of toxins through an outside machine, replacing work that the kidneys normally do.

Click a word on the left and the definition will appear here:

Laparoscopy: A surgical technique in which a lighted scope is inserted into a tiny incision in the abdomen. Laparoscopy can be used to visualize the inside of the abdomen for diagnosis, to retrieve tissue samples for biopsy, and to perform surgery using tiny instruments that are also passed into the abdomen through tiny "keyhole" incisions. Laparoscopy is considered a "minimally invasive" procedure, which results in reduced bleeding and may therefore be valuable for bloodless treatment of some conditions.

Click a word on the left and the definition will appear here:

Laser surgery: A surgical technique that uses the energy from light to cut through tissues. It can reduce bleeding compared to traditional scalpels and may therefore be valuable for bloodless treatment of some conditions.

Click a word on the left and the definition will appear here:

Major fractions: Blood products containing plasma, red blood cells, white blood cells, and platelets. Jehovah's Witnesses do not accept major blood fractions as part of any treatment.

Click a word on the left and the definition will appear here:

Mediastinal autotransfusion: A procedure performed most commonly after heart surgery, in which the fluids (including blood) that collect in the chest during and after surgery are collected and then given back to the patient through an IV.

Click a word on the left and the definition will appear here:

Minimally invasive surgery: Procedures that use small surgical cuts and holes, or no cuts at all. These methods can greatly reduce the amount of bleeding and are therefore of great importance to bloodless medicine. An example is endoscopy, which uses scopes inserted into small cuts or body openings. Another example is lithotripsy, which uses sound waves to break up a kidney or other stone into smaller bits, allowing it to pass out of the urinary system without having created any incision at all.

Click a word on the left and the definition will appear here:

Minor fractions: Blood products containing clotting factors, albumin, growth factors, and immunoglobulins. Some Jehovah's Witnesses accept minor blood fractions as an individual "matter of conscience."

Click a word on the left and the definition will appear here:

Normothermia: Normal body temperature.

Click a word on the left and the definition will appear here:

Normovolemia: All people maintain a particular volume of fluid circulating throughout their bodies; this is referred to as "normovolemia." During surgery, you will be given balanced intravenous solutions (volume expanders) to replace the fluids, salts, and sugars that you will invariably lose during the course of surgery.

Click a word on the left and the definition will appear here:

Oximeter: A device that monitors the amount of oxygen carried by the hemoglobin in red blood cells. In bloodless medicine, any blood a patient loses is not replaced by transfusion, so it is extremely important to monitor how much oxygen the patient's body is receiving from the remaining blood.

Click a word on the left and the definition will appear here:

Plasma: The fluid component of blood, in which the various types of blood cells are suspended. Jehovah's Witnesses consider plasma to be a major blood fraction and do not consider it to be an acceptable part of treatment.

Click a word on the left and the definition will appear here:

Plasmapheresis: A type of apheresis that is used to separate plasma from blood. Blood is removed from a donor, the plasma is harvested and retained, and the donor's blood cells are returned to him or her. Plasmapheresis may also be performed on a patient's own blood as a treatment for certain conditions.

Click a word on the left and the definition will appear here:

Platelet: A component of blood responsible for blood clotting at the point of an injury to a blood vessel. Without platelets, our blood would not be able to clot and hemorrhaging or uncontrolled bleeding would result. Platelets are considered a major blood fraction and are not acceptable to Jehovah's Witnesses as part of any treatment.

Click a word on the left and the definition will appear here:

Platelet gel: A concentrate made from a patient's own blood plasma, mixed with calcium and clotting compounds produced in cows. Platelet gel concentrates can be applied during the course of surgery to control bleeding. As with fibrin glue, platelet gel concentrates are produced from plasma, so their use by some individuals is a matter of conscience.

Click a word on the left and the definition will appear here:

Primary blood components: Red cells, white cells, plasma, and platelets (also called major fractions). Jehovah's Witnesses do not accept primary blood components (major fractions) as part of any treatment.

Click a word on the left and the definition will appear here:

Procuren solution: A solution made from an individual's own blood. The growth factors in the patient's own platelets are harvested, and reproduced in a laboratory to create the procuren solution. This solution is then applied to a wound to improve healing capacity and shorten duration of healing.

Click a word on the left and the definition will appear here:

RBC nuclear scan: A test in which the individual's own red blood cells are harvested, tagged with radioactive material, and then returned to the individual. Imaging scans are then performed that will highlight areas of bleeding, because the tagged red blood cells will be seen leaking from these areas.

Click a word on the left and the definition will appear here:

Scalpel: Originally, a scalpel was a very sharp, small knife used to perform surgery. Now a scalpel can use a variety of energy sources to cut through tissue, including light (laser scalpel), microwaves (microwave-coagulating scalpel), ultrasonic energy (ultrasonic and harmonic scalpels), and radiation (gamma knife).

Click a word on the left and the definition will appear here:

Stereotactic/Stereotaxic: A technique for locating the exact area needing treatment by using advanced imaging techniques that verify the three-dimensional coordinates of the abnormal area. By pinpointing the exact area, the surgeon can minimize the amount of cutting (and hence bleeding) that occurs during surgery.

Click a word on the left and the definition will appear here:

Transfusion: The delivery of blood products to an individual to replace blood that is lost during surgery or from injury. The blood or blood products are usually donated anonymously or through blood banking, then stored until the time they are needed. At that point, the blood products are administered through an intravenous (IV) line into a patient's vein. A blood transfusion is what bloodless medicine seeks to avoid.

Click a word on the left and the definition will appear here:

Ventilation: To provide a patient with oxygen.

Click a word on the left and the definition will appear here:

WBC nuclear scan: A test in which an individual's own white blood cells are harvested, tagged with radioactive material, and then returned to the individual. Imaging scans are then performed that will highlight areas of infection, because the tagged white blood cells will migrate to these areas.

Anne B. is a 38-year old mother of two, a boy aged 6 and a daughter aged 5. She lives in Roanoke, Virginia, and works part-time as a pharmacy technician.

What made you decide to lose weight?

I think the main reason, to be honest, is that I didn't like the way I looked. I have always had trouble keeping extra weight off, but after having two children I was about 30 pounds more than before I had kids. I wanted to see if I could get back to where I had been. I wasn't trying to be skinny, because I felt that wasn't really realistic for me. I would have been very happy losing just that 30 pounds. I was up to 180 and that just made me feel unhealthy.

The other reason is that I didn't have as much energy, or as much ability to keep up with my kids. I got tired easy.

Had you tried to lose weight before?

Before having kids, I occasionally went on various diets. My weight would go down to 120 or 130 but then slowly creep back up to around 150. If I really tried hard, I could keep it down, but I wasn't that motivated until my weight went up to 180. That is when I really got serious!

In the past when you tried to lose weight, what went wrong? Did anything you tried seem to work at all in those past attempts?

Really, I was doing the same things I do now, which is to walk in the morning and avoid high-calorie foods. The difference is that in the past I wasn't as committed. Now, I have built these practices into daily habits and have been keeping it up for over a year.

Did you learn firsthand any "myths" about losing weight?

I think the main myth is that it is easy to shed a lot of pounds through some kind of miracle diet and keep it off. I think most people figure out that it doesn't work like that. You can shed weight fairly fast, but then you gain it all back. Keeping it off means being dedicated to an exercise program, even something as simple as walking, as long as you do it almost every day, and for enough time.

Are you currently at a weight you are happy with? How long have you been successfully maintaining it?

Yes, it took awhile for my weight to come down, but it did go down at a fairly regular rate, so I could see I was making progress. I reached my goal of about 150-155. It took awhile to figure out how much walking I needed to do, and even more importantly, what foods to eat.

Describe the program you used to successfully lose weight. How did you get started?

I walk every morning through our neighborhood. There are a couple of steep hills, so it gives me a pretty good workout. I walk for about 45 minutes to an hour. I walk with a friend, and we talk most of the time, so it really is a fun thing to do. We decided to lose weight together and have been a great support for each other. You can't just stroll leisurely, you have to really get you heart beating and keep that pace up.

It took awhile to work up to that. We didn't just start walking fast for an hour. We started walking slower, walking shorter times, and walking an easier route. After about 4 months we had worked up to our current route, which has steeper hills, and our current pace.

The other key is, obviously, watching what I eat. I avoid fattening foods. I figured out that there are a lot of foods that have less calories that I enjoy eating. For example, I eat salads with fresh vegetables but I don't put much dressing on them. I snack on grapes, carrots, whole wheat bread, low-calorie yogurt and crackers, that type of thing. I drink less soda, and more water and juice.

Did you give up any favorite foods?

I enjoy chocolate -- such as ice cream, cookies, cake -- and I have given up a lot of that. I still eat a little of it, because I don't think there is a point in total abstinence, but it is easy to get too many calories if you are not real careful. Very easy! So I don't buy very much of that because it is just too tempting. If I don't buy it, then I can't eat it. A lot of mistakes are made at the supermarket. Don't go shopping when you are hungry, you'll buy everything in sight that looks good.

What major challenges do you encounter, and how do you get past them?

The biggest challenge is finding time to walk. I don't mind walking, so it isn't hard to get motivated to do it, but you have to walk for an hour or so, and that can be hard to fit into the schedule. The single most important advice I have, personally, is that you need to find an exercise plan you will really do, and find a way it can really fit into your schedule. Once you do that and commit to it, you are most of the way there! I believe most people can lose weight, and keep it off, if they make realistic goals and then stick to a plan.

The other thing is finding food substitutes. When you are in the habit of snacking on cookies, it is real hard to give them up. But I was surprised to find foods with less calories that I really enjoyed eating. You should find foods that have bulk to them so that they fill you up. It takes time to adjust to that, but as your weight starts to drop, that is very exciting and for me that was the reward and made it worthwhile. Getting on the scale -- that is my reward! It is really worth it, and to top it off, the time I spend with my friend has been very rewarding.

 

Main Menu


Review Date: 4/17/2007

Reviewed By: Patrika Tsai, M.D., M.P.H., Assistant Clinical Professor, Pediatric Gastroenterology, Hepatology and Nutrition, University of California, San Francisco, San Francisco, CA. Review provided by VeriMed Healthcare Network.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Related Links
Find a Doctor
Request an Appointment Online or call
800-789-PENN (7366)
Medical Services
Visitor Information
Encyclopedia Articles

 

   
   

 

About Penn Medicine   Contact Us   Site Map   Privacy Statement   Legal Disclaimer   Terms of Use

Penn Medicine, Philadelphia, PA 800-789-PENN © 2014, The Trustees of the University of Pennsylvania space