Understanding Therapeutic Phlebotomy

Phlebotomy is when blood is drawn from the body. Therapeutic phlebotomy is when blood is drawn to treat a disease. It's also called bloodletting.

Therapeutic phlebotomy is safe and easy. It's like donating blood. During the procedure, you will have about a pint or more of blood drawn. A pint of blood is sometimes called a unit.

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Therapeutic phlebotomy is done to treat certain diseases. It's often used to treat blood disorders that raise iron levels in the body. The procedure removes red blood cells, causing iron levels to drop. Iron is a mineral your body needs. But too much of it can lead to problems such as liver failure, an irregular heartbeat, and diabetes.

Your doctor may advise this procedure if you have:

• Hemochromatosis, a disease that causes high iron levels.
• Sickle cell disease.
• Non-alcoholic fatty liver disease.
• Porphyria cutanea tarda, a rare blood disorder that causes blisters to form when the skin is exposed to sunlight.
• A higher concentration of red blood cells after a kidney transplant that's not controlled in other ways.

Therapeutic phlebotomy can also help treat polycythemia vera. This is a rare type of blood cancer. It causes the bone marrow to make too many red blood cells. The blood then becomes too thick. This thickening of the blood can lead to heart disease, blood clots, and other problems.

Therapeutic phlebotomy may be done weekly, monthly, or less often. It depends on your condition. Your doctor will decide how often you need it done and how much blood will be taken each time. You will also need regular blood tests to check your iron and red blood cell levels.

It's best to drink lots of fluids and eat a good meal a few hours before therapeutic phlebotomy. Don't drink alcohol for 24 hours beforehand.

The procedure takes about 1 hour. During it:

• You sit or lie down.
• Your pulse, blood pressure, and overall health is checked.
• A needle is put in a vein in your arm. Blood goes from the needle through a tube into a bag.
• A unit of blood (500 mL) or more is collected, as advised by your treatment plan. Each pint of blood is replaced with fluids, either through your vein or by mouth, during the procedure.
• Once enough blood is collected, the needle is taken out.
• The blood is usually discarded.

After the procedure, you will be asked to stay for at least 15 minutes. You may be given something to eat and drink. Over the next 4 hours, drink more fluids than usual. If there is bleeding from the site of the blood draw, raise your arm and apply pressure to the area.

Your doctor may also advise that you:

• Don't smoke for at least 1 hour.
• Don't drink alcohol after the procedure until you have eaten.
• Don't use heavy machinery or stand on a high surface, such as a ladder, right after the procedure.
• Don't do any strenuous activity for 24 hours.

This procedure has the same possible risks as donating blood. These are:

• Nausea.
• Vomiting.
• Dizziness.
• Fainting.
• Bruising at the site.
• Seizures.
• Infection.

Contact your doctor now or seek immediate medical care if:

• You have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.
• You have bleeding that doesn't stop from the site of the blood draw.
• You have symptoms that don't get better, or get worse.
• You have new symptoms.