Ask Dr. Etingin: Donating platelets; When to stop therapy; Ankle fusion

I donate blood several times a year, and my blood bank recently asked me to donate platelets. Is there any difference between a typical blood donation and platelet donation?

First, thank you for donating blood. Blood transfusions save millions of lives every year. Platelets are the components in blood that causes it to clot. (Other components of blood include red cells, white cells, and plasma.) Cancer patients are often given platelets because low platelet count is a common side effect of some cancer treatments. People who have a blood disorder, or who are undergoing major surgery or have suffered traumatic injuries, are other common recipients of platelets.

Donating whole blood typically takes less than an hour, but donating platelets usually takes about three hours. When you donate platelets, your blood goes into a machine that removes the platelets and then returns the blood to your body. One donation may yield enough platelets for two or three patients.

Here are some more facts about platelet donation: Platelets may be donated more frequently than whole blood—up to 24 times per year. Platelets cannot be donated at a mobile blood drive; an appointment is needed at a blood bank that is equipped with the machinery to extract platelets. Eligibility requirements are the same for platelet donation as for whole blood donation.

I have been seeing a therapist for the past six months to deal with grief and depression that I suffered after losing my husband of 40 years. I have made improvements, but I feel like our sessions have become repetitive. Should I consider switching to a different therapist?

It’s not uncommon for someone in therapy to feel as though the sessions are getting repetitious. You may be at a point where you no longer need therapy, or you may gain more benefit from a different type of therapy.

If you and your therapist set goals for your therapy when you began, this is a good time to review them. It’s also a good time for you to consider how much progress you have made. For example, are the coping skills and strategies you have learned helping you effectively deal with your symptoms of depression? If you feel like you need more help with certain issues, try to identify those issues so you can be specific when asking for what you need.

Discuss your concerns with your therapist. If you both agree that you need to continue with therapy, update your goals so you’re both clear on what you are trying to achieve. If your therapist feels that your issues may be more successfully resolved with a different type of therapy, he or she may refer you to another therapist. Or, you may be ready to discontinue therapy.

I’ve had arthritis in my ankles for years, and my doctor recently mentioned ankle fusion as a possible solution. What’s involved in this procedure?

Ankle fusion is the standard surgical procedure for the later stages of ankle and foot arthritis. During the procedure, the surgeon removes the cartilage between the tibia (shinbone) and talus (one of the ankle bones) and then fuses them together using stainless steel rods, screws, or plates. This eliminates motion, which stops the bones from grinding against each other and causing pain.

You’ll need to wear a splint or cast for several weeks after the surgery and use crutches for six to eight weeks to avoid placing your weight on the ankle while it fuses. During your recovery period, you’ll have physical therapy to help you maintain the strength in your foot and leg.

Most people who undergo ankle fusion experience some loss of motion in the ankle afterward, but most patients report the relief from their arthritis pain far outweighs any negative effects of reduced mobility.

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