Eziachi: People should not make bold statement over issue they don't have all the facts. As an orthopaedic surgeon of close to 40 years I have lots of experience on this issue than most do. I know for a fact that there is no policy among Jehovah Witnesses's not to receive transfusion as a blanket law. Its down to individual and am hundred percent sure that the lady in question has taken that decision in the event like this through her verbal instruction or what we call medical life will and not by her family.

Jehovah's Witnesses based on their faith, as they perceived it from their understanding of the bible, do not take any sort of blood and in England that is respected by the law and respected by the medical profession and you do all you can for your patient, while respecting their choice of treatment, so I don't know about Nigeria.
Its the right of a patient to choose how he/she wanted to be treated and not only on transfusion by other therapies like Chemo or radiotherapy in cancer treatment. In extreme cases involving children, a judge may decide what happens over the choice made by parents, but like I said, its only in extreme cases.

EDUCATING AND EXPOSITORY.
As a surgeon, I will be the last person to recommend blood transfusion for anybody at will, because what most people do not realise is that transfusion kill people than it saves. I usually tell people that blood is the sewage of the body and every single event in your body goes through the blood stream. Thousands die each year through blood poisoning, hypertisis B, HIV, all through transfusion and this is in advanced countries where blood is specially treated to the highest standard. Can imagine in developing nations?

Over the last 30 years, thanks to this JW people, science had develop advance method of all sorts of non blood surgeries and this includes many hours surgeries like cardiac, brain and most complicated procedures in orthopaedic like Quadraplaty. I can tell you that Jehovah Witnesses started and developed a machine we used today called jpyt, which is a blood salvaging machine, preferred by the rich and famous today in surgeries instead transfusion. I can also tell you that the recovery period of non blood surgeries as against blood surgeries is 5-1.

I don't know what is obtained in Nigeria, but medical science has moved on so much to use non refusal of transfusion as the reason for a patient lose of life, there are many thing you can do, even in the event of severe lose of blood, e.g multiple dilution process. In 2009, the U.S army invested close to a billion dollar to perfect their field medical personal on bloodless surgeries and treatment. Because not only its safer but its very cost effective. In my opinion and when I had seen in the last few decade, we are very close to a time when no single blood will ever to use in medical science.
Jehovah Witnesses may reject transfusion based on their faith, which should be respected but I will personally refuse one based on personal safety and the science of what I knew about blood, but as a surgeon, I do give people blood, but it has never been the first resort.
One more thing, when blood is given to you, it takes at least 48 hours before it become a full part of your body mechanism, i.e if your body didn't reject it.

Eziachi:

As a doctor of many years of experience and orthopaedic surgeon, your statements above is not only false but has no basic medical fact. As I mentioned in my first post, there are many things a good and well skilled doctor can do even when there is even a severe loss of blood. As an orthopaedic surgeon, I treats hundreds of auto accident victims each year that had lost 70 percent of their blood. A male blood count is counted to a measure of 15 and female 14. A male can still live when it down to 2 and female 3.
Last year I operated on a Sierra Leon guy that was severely hurt during their war but now living in England as a refugee. The procedure lasted almost 8 hours, he is a member of this religion and refused transfusion. We did our best for him as his blood count went down up to 1.9 but he survived.

There are things you can do before and after the surgery, like the use of certain drug that boost the red blood cell increase up to 60%, like EPO. There certain food that can boost your blood count more than you realise, a simple fruit like Apricot, fig etc are wonderful. I had this experience once, as a visiting doctor in Owerri in 1989, were a doctor half hearted in treating a patient because she refused transfusion. In fact, his attitude was like, he wanted the lady to die , just to prove a point and I was mad with rage and I made my feeling not only known to him but to those he works for.
I will not be surprise if its not common in Nigeria, where religion is the opium of everything people do. A doctor based on his own religious conviction, may find fault with the JW people and will not do his job properly, just to prove the patient and family wrong. I can easily see that happening.

Eziachi: As an orthopaedic surgeon of close to 40 years I have lots of experience on this issue than most do. I know for a fact that there is no policy among Jehovah Witnesses's not to receive transfusion as a blanket law. Its down to individual and am hundred percent sure that the lady in question has taken that decision in the event like this through her verbal instruction or what we call medical life will and not by her family.

Jehovah's Witnesses based on their faith, as they perceived it from their understanding of the bible, do not take any sort of blood and in England that is respected by the law and respected by the medical profession and you do all you can for your patient, while respecting their choice of treatment, so I don't know about Nigeria.


As a surgeon, I will be the last person to recommend blood transfusion for anybody at will, because what most people do not realise is that transfusion kill people than it saves. I usually tell people that blood is the sewage of the body and every single event in your body goes through the blood stream. Thousands die each year through blood poisoning, hypertisis B, HIV, all through transfusion and this is in advanced countries where blood is specially treated to the highest standard. Can imagine in developing nations?

Over the last 30 years, thanks to this JW people, science had develop advance method of all sorts of non blood surgeries and this includes many hours surgeries like cardiac, brain and most complicated procedures in orthopaedic like Quadraplaty. I can tell you that Jehovah Witnesses started and developed a machine we used today called jpyt, which is a blood salvaging machine, preferred by the rich and famous today in surgeries instead transfusion. I can also tell you that the recovery period of non blood surgeries as against blood surgeries is 5-1.

I don't know what is obtained in Nigeria, but medical science has moved on so much to use non refusal of transfusion as the reason for a patient lose of life, there are many thing you can do, even in the event of severe lose of blood, e.g multiple dilution process. In 2009, the U.S army invested close to a billion dollar to perfect their field medical personal on bloodless surgeries and treatment. Because not only its safer but its very cost effective. In my opinion and when I had seen in the last few decade, we are very close to a time when no single blood will ever to use in medical science.
Jehovah Witnesses may reject transfusion based on their faith, which should be respected but I will personally refuse one based on personal safety and the science of what I knew about blood, but as a surgeon, I do give people blood, but it has never been the first resort.
One more thing, when blood is given to you, it takes at least 48 hours before it become a full part of your body mechanism, i.e if your body didn't reject it.

Eziachi: People should not make bold statement over issue they don't have all the facts. As an orthopaedic surgeon of close to 40 years I have lots of experience on this issue than most do. I know for a fact that there is no policy among Jehovah Witnesses's not to receive transfusion as a blanket law. Its down to individual and am hundred percent sure that the lady in question has taken that decision in the event like this through her verbal instruction or what we call medical life will and not by her family.

Jehovah's Witnesses based on their faith, as they perceived it from their understanding of the bible, do not take any sort of blood and in England that is respected by the law and respected by the medical profession and you do all you can for your patient, while respecting their choice of treatment, so I don't know about Nigeria.
Its the right of a patient to choose how he/she wanted to be treated and not only on transfusion by other therapies like Chemo or radiotherapy in cancer treatment. In extreme cases involving children, a judge may decide what happens over the choice made by parents, but like I said, its only in extreme cases.


As a surgeon, I will be the last person to recommend blood transfusion for anybody at will, because what most people do not realise is that transfusion kill people than it saves. I usually tell people that blood is the sewage of the body and every single event in your body goes through the blood stream. Thousands die each year through blood poisoning, hypertisis B, HIV, all through transfusion and this is in advanced countries where blood is specially treated to the highest standard. Can imagine in developing nations?

Over the last 30 years, thanks to this JW people, science had develop advance method of all sorts of non blood surgeries and this includes many hours surgeries like cardiac, brain and most complicated procedures in orthopaedic like Quadraplaty. I can tell you that Jehovah Witnesses started and developed a machine we used today called jpyt, which is a blood salvaging machine, preferred by the rich and famous today in surgeries instead transfusion. I can also tell you that the recovery period of non blood surgeries as against blood surgeries is 5-1.

I don't know what is obtained in Nigeria, but medical science has moved on so much to use non refusal of transfusion as the reason for a patient lose of life, there are many thing you can do, even in the event of severe lose of blood, e.g multiple dilution process. In 2009, the U.S army invested close to a billion dollar to perfect their field medical personal on bloodless surgeries and treatment. Because not only its safer but its very cost effective. In my opinion and when I had seen in the last few decade, we are very close to a time when no single blood will ever to use in medical science.
Jehovah Witnesses may reject transfusion based on their faith, which should be respected but I will personally refuse one based on personal safety and the science of what I knew about blood, but as a surgeon, I do give people blood, but it has never been the first resort.
One more thing, when blood is given to you, it takes at least 48 hours before it become a full part of your body mechanism, i.e if your body didn't reject it.

toluene12:
I understand your stand on blood transfusion, but some of ur claims are bogus and coming from a surgeon is quite disturbing.
1. Not all cases of blood loss requires blood transfusion, most chronic anaemia are managed with blood substitute except in few cases. Even in acute blood loss mild cases are treated with plasma expanders and oxygen, so STOP making it seem like nigerian doctors dont know what they are doing and are only interested in forcing blood down the throat of all their patients.
2. Provide studies/evidence (not opinion) that shows clearly that blood transfusion kills more lifes than it saves otherwise retract the statement.
3. That the commonest route of contacting hepatitis and HIV in the u.k is via blood transfusion says a lot about the nhs labs in that country and that to me is a very serious mystery.
4. Just like every other medical procedure, blood transfusion has its own risk and complication, the blood substitutes also have side effects and complications, so stop painting one like a saint and the other a demon.
5. Acute blood loss is not an indication for EPO therapy, and blood transfusion in cases of severe blood loss produces immediate response and not 48hrs as u alighted
5. I agree efforts are being made to provide alternatives to blood transfusion, trials are ongoing and initial result is encouraging e.g synthetic hemoglobin concentrates but will the jw people embrace this new technologies? At least they rejected autologous blood transfusion
6. Stem cell transplantation is good but there are moral and ethical factors to consider, these cells produce the blood cells in contention, and if the jw can refuse the offsprings will they accept the precursors. Moreover, they dont come cheap, and are not useful in the mgt of acute blood loss.
We may not like it but blood products replacements remains a viable option in saving patients life in our hospitals, at least for now.

star*:


Really? research is close? How close are you talking? Please! Organ and blood donation is still at critical levels in the uk! People are dying everyday waiting for organs. Do you work for the nhs? Are you aware what financial crisis they're in? What levels of extra money will it take for funding all these 'artificial' organs and platelets?

Also more serious moral questions are being raised with stem cell research., growing human fertilised eggs in petri dishes to get the DNA used for growing organs.

toluene12:
I understand your stand on blood transfusion, but some of ur claims are bogus and coming from a surgeon is quite disturbing.
1. Not all cases of blood loss requires blood transfusion, most chronic anaemia are managed with blood substitute except in few cases. Even in acute blood loss mild cases are treated with plasma expanders and oxygen, so STOP making it seem like nigerian doctors dont know what they are doing and are only interested in forcing blood down the throat of all their patients.
2. Provide studies/evidence (not opinion) that shows clearly that blood transfusion kills more lifes than it saves otherwise retract the statement.
3. That the commonest route of contacting hepatitis and HIV in the u.k is via blood transfusion says a lot about the nhs labs in that country and that to me is a very serious mystery.
4. Just like every other medical procedure, blood transfusion has its own risk and complication, the blood substitutes also have side effects and complications, so stop painting one like a saint and the other a demon.
5. Acute blood loss is not an indication for EPO therapy, and blood transfusion in cases of severe blood loss produces immediate response and not 48hrs as u alighted
5. I agree efforts are being made to provide alternatives to blood transfusion, trials are ongoing and initial result is encouraging e.g synthetic hemoglobin concentrates but will the jw people embrace this new technologies? At least they rejected autologous blood transfusion
6. Stem cell transplantation is good but there are moral and ethical factors to consider, these cells produce the blood cells in contention, and if the jw can refuse the offsprings will they accept the precursors. Moreover, they dont come cheap, and are not useful in the mgt of acute blood loss.
We may not like it but blood products replacements remains a viable option in saving patients life in our hospitals, at least for now.

toluene12:
I understand your stand on blood transfusion, but some of ur claims are bogus and coming from a surgeon is quite disturbing.
1. Not all cases of blood loss requires blood transfusion, most chronic anaemia are managed with blood substitute except in few cases. Even in acute blood loss mild cases are treated with plasma expanders and oxygen, so STOP making it seem like nigerian doctors dont know what they are doing and are only interested in forcing blood down the throat of all their patients.
2. Provide studies/evidence (not opinion) that shows clearly that blood transfusion kills more lifes than it saves otherwise retract the statement.
3. That the commonest route of contacting hepatitis and HIV in the u.k is via blood transfusion says a lot about the nhs labs in that country and that to me is a very serious mystery.
4. Just like every other medical procedure, blood transfusion has its own risk and complication, the blood substitutes also have side effects and complications, so stop painting one like a saint and the other a demon.
5. Acute blood loss is not an indication for EPO therapy, and blood transfusion in cases of severe blood loss produces immediate response and not 48hrs as u alighted
5. I agree efforts are being made to provide alternatives to blood transfusion, trials are ongoing and initial result is encouraging e.g synthetic hemoglobin concentrates but will the jw people embrace this new technologies? At least they rejected autologous blood transfusion
6. Stem cell transplantation is good but there are moral and ethical factors to consider, these cells produce the blood cells in contention, and if the jw can refuse the offsprings will they accept the precursors. Moreover, they dont come cheap, and are not useful in the mgt of acute blood loss.
We may not like it but blood products replacements remains a viable option in saving patients life in our hospitals, at least for now.

miredia: . Do the Jehovah witnesses reject autologous transfusion as you pointed out or allogeneic transfusion? Because I do not see any logic in refusing a reinsertion of your own blood. I can reckon with the homologous transfusion. Knowing someone who suffered a severe anaphylactic reaction and hemolysis after consecutive series of allogeneic transfusion,probable cause could have being an igA deficiency in her blood creating her own antibodies reacting with anti IgA of the donor platelets or RBC. @dr. Eziache you sound detached from conventional medicine and more inclined to homeopathy.

Eziachi:
What is conventional and what is homeopathy? I have forgotten, please educate me, I may have forgotten and detached unknown.

cho25bc: I bliv dat health n religion are 2 diff elements which should be seperated.does religion also prohibits d use of drugs when ill?av we forgotten dat even a medical doctor was part of Jesus' disciples?I'm also a christian n my churcH also have its own doctrines but not d type to jeopardize human lives.i also read bible but I've never come across any part which forbids us from saving our lives when d need arises.please my pple,let us avoid ignorance like plague and stop commiting suicide indirectly in d name of religion.if anyone wants to question dis,then I will illustrate with this comparison.d bible admonishes us to stay away from d company of evil men,yet here we are today mingling among them.we work with them,befriend them,eat with them,sleep with them n even beg them for favours which most of them usually oblige.they are our neighbours,classmates,colleagues in d office,business partners,even our spouses.we are forced not only to live among them but also to mingle with them because they are neccesary evil.so is this issue of medical application to saving one's n religious doctrinal which we most times misinterprete.we should apply wisdom in everything we do.we should be careful in translating d bible meanings.d use of medicine to save our lives is God's gift to man,not a gift from. D devil.may God help us.

cho25bc: I bliv dat health n religion are 2 diff elements which should be seperated.does religion also prohibits d use of drugs when ill?av we forgotten dat even a medical doctor was part of Jesus' disciples?I'm also a christian n my churcH also have its own doctrines but not d type to jeopardize human lives.i also read bible but I've never come across any part which forbids us from saving our lives when d need arises.please my pple,let us avoid ignorance like plague and stop commiting suicide indirectly in d name of religion.if anyone wants to question dis,then I will illustrate with this comparison.d bible admonishes us to stay away from d company of evil men,yet here we are today mingling among them.we work with them,befriend them,eat with them,sleep with them n even beg them for favours which most of them usually oblige.they are our neighbours,classmates,colleagues in d office,business partners,even our spouses.we are forced not only to live among them but also to mingle with them because they are neccesary evil.so is this issue of medical application to saving one's n religious doctrinal which we most times misinterprete.we should apply wisdom in everything we do.we should be careful in translating d bible meanings.d use of medicine to save our lives is God's gift to man,not a gift from. D devil.may God help us.

Atheist:-D:
I aint gonna lie, this story seems fishy. Firstly the husband has all rights to carry out any such action on the wife if she was "out of her mind" rather than her family. This means that he had a solution. Of she refused he should have lied that she was out of her mind due to stress and shock and that he is giving them the consent to do the transfusion. He can face her and the family later after she has been successfully transfused.

Hell if they talk too much nonsense he should pack her bags and send her back to them . Better that she be divorced than dead.

miredia: hey I was being silly, I am not questioning the authenticity of your MD status, but your suggestion of an EPO as a RBC booster and expecting a spontaneous erythropoiesis in the event of an acute blood loss is not totally applicable except offcourse if administered as an ESA which is offtopic. The apricot and fig you spoke about is a long term therapeutic approach.

Eziachi:
This is not a silly issue. If you read my first post I stated clearly that we use the process of called dillusion in the event of great blood lost as the first procedure. I had treated a JW Blood count of two after a lengthy quadraplaty surgery. And he regained enough blood yo push the count to 12 within 13 days, enough to do three more plastic surgeries few days later.

crystalloid of choice is normal saline or lactated Ringer’s solution because it’s osmolality is similar to that of the intravascular volume. In large-volume resuscitation, however, excessive normal saline infusion may produce hyperchloremic metabolic acidosis. Colloid solutions (5% albumin and hetastarch) offer the most efficient intravascular volume expansion, but are expensive and no outcome benefit has been shown. Dextrose 5% in water does not offer significant expansion of intravascular volume because it is quickly distributed throughout body fluid compartments.

*endpoints of therapy are to re-establish normal blood pressure, pulse, and organ perfusion.

Gambrosia:

Please, can the process of dillusion replace Packed RBCs or whole blood components in the event of massive blood loss?
If so, how does this work?
Considering that most patients with HYPOVOLEMIC/cardiogenic/septic shock may already be in DIC and third-spacing.

For example, it is the basic resuscitative principle that: blood should replace blood and crystalloid should be used for vomiting and dehydration.

What substitutes can BLOOD have vis-a-vis dillution?

http://www.aic.cuhk.edu.hk/web8/shock.htm

Crystalloids?

Eziachi:
Telling you how dillusion is more technical for Nairaland forum and haven't go the appetite going deep into that. This is information age, why not look it up. The first time I saw it used in a surgery was in Ohio in 191 and I personally used it in London in 1995 an dit had got better as time progresses. Blood has no subtitute. But the term lose of blood doesn't mean that blood completely dry up in your system.
In a lay term, what I can say now is that the process of dillusion increases the volume of what blood that remain in the system with aid of a synthetic substance, I cant mention. So you have a high volume of blood, what lack the the normal quality of blood on the interim.
Again in a lay terms, Its like topping up your half bottle of sweet wine to get a full bottle, but lost some of it original taste and alcohol volume.

Eziachi:
Telling you how dillusion is more technical for Nairaland forum and haven't go the appetite going deep into that. This is information age, why not look it up. The first time I saw it used in a surgery was in Ohio in 191 and I personally used it in London in 1995 an dit had got better as time progresses. Blood has no subtitute. But the term lose of blood doesn't mean that blood completely dry up in your system.
In a lay term, what I can say now is that the process of dillusion increases the volume of what blood that remain in the system with aid of a synthetic substance, I cant mention. So you have a high volume of blood, what lack the the normal quality of blood on the interim.
Again in a lay terms, Its like topping up your half bottle of sweet wine to get a full bottle, but lost some of it original taste and alcohol volume.