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What's in Your Blood

A finger stick is all Mary Church of Houchin Blood Bank needs to get your red blood cell count.

You might not have a desire to take a peek at that red liquid coursing through your body, there are some people in town who seem to work exclusively with blood.

Think about it. How often has your doctor ordered a blood test? (Maybe you’re feeling sick. Maybe it’s just for a routine physical.) But the blood has to go somewhere once it’s been drawn. And someone has to examine it. What happens to it? And what exactly are doctors looking for?

It turns out, there are a lot of things physicians are looking for when they have your blood tested—because blood is an amazing indicator of health. Most types of illnesses and infections show up in the blood, which makes it the best resource for physicians looking to diagnose a patient.

So what is blood? No shame in admitting you’re not sure. Obviously, there’s a very scientific explanation, but let’s stick with the short answer. Blood is made up of plasma (the liquid), red blood cells (they carry oxygen to your body’s tissues), white blood cells (which fight infection), and platelets (that help the blood clot). Blood’s mission is to provide your body with nutrition, oxygen, and to remove waste. And you’ve got roughly five liters (more than one gallon) in your body right now.

But more to the point, what exactly can a technician tell by looking at your blood?

Why not start at the tip (of the finger, that is).

“With a finger stick, we’re checking to see that you have enough red blood cells,” explained Mary Chruch, a Donor Services Specialist at Houchin Community Blood Bank. “We want to make sure that we won’t make a person anemic by drawing blood.”

Though Houchin is not in the business of testing blood for doctors, the procedures they follow are much the same. When a potential donor comes in, their blood is tested with the finger stick. They’re also asked various questions about their health status. But once they’ve been approved, their whole blood is drawn, type-tested, and sent out for further testing (for infection or viruses)—before it will make its way to a blood bank.

Ken Cleek, Laboratory Manager, and Kelley Gonzales run blood tests at PAL.

Type-testing is important, Church added, because it determines who the blood can be donated to. There are antigens present on the outside of our red blood cells, and that’s how technicians deduce what our blood type is. You can be A, B, O, or AB. They also look for our Rh factor, which is an antigen that is either present on our red blood cells or not. If the antigen is there, we’re positive, if not, we’re negative. That further helps Houchin determine who can be given our blood.

Now, when it comes to testing the blood for analysis, there are numerous things physicians are looking for. A doctor might want your cholesterol levels. They might want to find out what your white cell count is at. Or maybe your hormone levels. And a little vial of blood can give them all those answers and more.

At Physician’s Automated Laboratory (PAL), Clinical Laboratory Scientists work hand in hand with phlebotomists, pathologists, cytologists, and even microbiologists to look at what your blood is spelling out.

“A physician may have us run a CBC, which is a complete blood count; and a ‘chem panel,’ which is a breakdown of the chemistry of the blood,” said Ken Cleek, PAL’s Laboratory Manager. That’s a typical order from a doctor’s office.

The CBC will break down the levels of red blood cells, white blood cells, and platelets.

A chem panel will identify how hormones are functioning, and how proteins are effecting such organs as your heart, liver, kidneys, pancreas (which produces insulin), and your lungs. Together, they give someone a good look at how well your body is doing.

Just how do the technicians at PAL do all this?

According to Cleek, when our blood is tested, it’s tested against a standard.

Clinical laboratory scientists running blood cultures at PAL.

“For example,” he explained, “to get a patient’s glucose reading, we’ll create a standard to test blood results against. We’ll mix glucose with water to make a 100 milligram, 500 milligram, and 1,000 milligram standard.” Then, your plasma is tested against those standards to show the level of glucose in your blood.

PAL uses markers to alert them when there is a difference. Cleek said they use color changes, fluorescence, and look for changes in light absorbance as it passes through a sample cuvette to look for those discrepancies in levels.

“We always have a quality control, as well,” he added. “To ensure that our standards are still functioning as they should be as we continue to test blood samples against them.”

The nice thing is that all of these tests are automated. High-tech machines now enable laboratories like PAL to process thousands of blood samples a day. And they do it in a timely manner—they have to.

Not only are some results urgently needed, to determine if a patient has enough clotting factor in his or her blood to undergo surgery, but some results can change the longer the blood is in the vial.

“If we were wanting to test a sample for blood sugar, we have to add a preservative anticoagulant to the blood because red blood cells continue to metabolize sugars after blood has been drawn,” Cleek added.

The automation also allows them to perform specialized tests ordered by physicians, too. In addition to the CBC and chem panel, PAL can look for infections and other communicable diseases. This allows them to supply critical information to the Kern County of Public Health—where data is used to help track disease trends in our community.

Blood can also indicate, on a molecular level, the potential a person has to develop a disease, like cancer.

We have the ability to select which drugs will be best to treat that form of cancer by the way the blood reacts to certain tests. We won’t have to waste time on a medication that won’t work. —Dr. Ravi Patel

“We can glean a large amount of medical information about a person by looking at their blood,” said Dr. Ravi Patel, founder of Comprehensive Blood and Cancer Center (CBCC). “A large amount of information is stored there—indicators of conditions that are both benign and malignant.”

With medical technology and information growing, physicians can even use the blood to determine how well treatments for cancer will do.

There are various ways to look at cancer in the body, but the most practical way is to do a blood test.

The presence of certain antigens gives doctors the ability to determine how a treatment is working.

“We can isolate actual cancer cells from the blood,” Patel explained. “We can get a picture of the type of cancer in a patient and analyze it to determine the best course of treatment.”

CBCC can even monitor the effectiveness of a drug based on a blood test.

“We have the ability to select which drugs will be best to treat that form of cancer by the way the blood reacts to certain tests,” Patel added. “We can perform a particular gene test on the blood and identify whether a patient would have a reaction to that particular chemotherapy drug. We won’t have to waste time on a medication that won’t work.”

And blood tests have the potential for future research.

“If we store blood, we’ve captured a fingerprint of that blood at a particular time,” Dr. Patel continued. Doctors can go back to look at original blood work and determine how the blood has changed—the number of red blood cells, white blood cells, antigens—after certain cancer treatments and how the blood will react to a new type of drug. Blood can tell our doctors some amazing things about our health.

With all the power that blood holds and all that it does for our bodies, it doesn’t make sense for us to feel squeamish in its presence, now does it?

Article appeared in our 27-2 Issue - June 2010