Health

Diagnosing PCOS: Symptoms, signs and what to look for

Published

1 month ago

May 23, 2024

When you were young, you might’ve been prepared for some of the hormonal changes your body would experience throughout your life. It all started with puberty and then your first period. Then you can expect even more changes if you get pregnant. And lastly, the changes that often come as you get closer to menopause – goodbye periods, hello hot flashes.

But what if you start noticing changes in between these big milestones? Irregular periods, trouble getting pregnant, suddenly gaining weight without making changes to your diet or activity levels, and hair growing in places you’re not used to are just some symptoms that could be caused by polycystic ovary syndrome, or PCOS.

Keep reading to learn more about the symptoms of PCOS. We’ll also talk about risk factors, how it affects the body, how to get diagnosed and treatment options.

What is polycystic ovary syndrome?

Polycystic ovary syndrome is a medical condition caused by a hormonal imbalance in the ovaries. It happens when ovaries produce an abnormal amount of male sex hormones, or androgens. Typically, women only have a small amount of androgens, and the excess can lead to reproductive issues.

What happens when someone has PCOS

Ovulation – when an ovary releases an egg – happens once during each menstrual cycle. But your body needs to make enough female sex hormones, like progesterone and estrogen, to ovulate. So when your body doesn’t make enough of these hormones, ovulation may not happen at all or only occasionally.

When ovulation doesn’t occur, cysts (air or fluid-filled sacs) can grow on the ovaries. These cysts make androgens and are the reason women with polycystic ovary syndrome often have high androgen levels. And while some women with PCOS do develop cysts, not all women do. There could also be an abundance of abnormal follicles in the ovaries that contribute to PCOS. The hormonal imbalance is tied to several other symptoms of the condition, which we’ll talk more about below.

How common is PCOS?

The condition is more common than many people may realize. According to the Centers for Disease Control and Prevention, it affects around 6-12% of reproductive-age women in the United States – that’s around 5 million people. And while it’s believed that women are born with the condition, the symptoms usually start during puberty and may persist until or after menopause.

Symptoms of PCOS to look for

The earliest signs of polycystic ovary syndrome may seem normal or unrelated to each other. That’s because it may be easy for some people to explain away acne, weight gain or excessive hair growth in unusual areas. Occasional missed or irregular periods might not raise a red flag if it’s happened before or if you’re a little more stressed than usual.

So when looked at separately, symptoms can seem normal. But together, they may be first signs of PCOS.

Irregular menstrual cycle

One of the most common symptoms of PCOS is an irregular menstrual cycle. As we mentioned earlier, women with PCOS often have higher than normal androgen levels. These hormones, like testosterone, can interfere with their cycle and stop their body from ovulating.

The hormone imbalance can stop the egg from either maturing or being released. And without ovulation, the uterus doesn’t get the trigger it needs to shed its lining (have a period). Some people with PCOS can have regular periods and ovulate occasionally, but others may have periods every 4-5 weeks or none at all.

Ovarian problems

PCOS can lead to enlarged ovaries or ovaries that have many cysts. In your ovaries, there are thousands of follicles. In each follicle is an egg, and when the egg matures, the follicle breaks open and the egg is released for fertilization. When the follicle doesn’t release the egg, it can grow and turn into a cyst. Generally, follicular cysts don’t cause pain, but these cysts can cause the ovaries to swell, especially if there are many of them.

Stomach pain

If small cysts in the ovaries develop as part of your PCOS, it’s possible that these cysts could break open, become very large or disrupt blood flow to the ovaries, causing stomach pain.

Hirsutism

Hirsutism is a condition where women experience excessive hair growth in areas that are associated with male-pattern hair growth. For example, hair may grow on the face, back, chest (especially around the nipples), abdomen and thighs. This hair is medically described as terminal and is the type of hair you’d find on your scalp, eyebrows and eyelashes.

After puberty, it’s common for women to experience terminal hair growth in the armpits and pubic area. Although women naturally produce male hormones, the excess that comes with PCOS can cause these coarse, dark hairs to grow in areas where fine hairs are typically found.

Weight gain

Many women who have PCOS tend to put on weight easily and have difficulty getting rid of it. That’s because PCOS affects the way your body uses insulin. Insulin is responsible for controlling blood sugar, and PCOS can cause your body to develop insulin resistance. This stops your body from responding to insulin, sending a signal to your pancreas to produce even more insulin. Your body then takes the extra insulin and blood sugar and stores it in the body as fat, typically in the abdomen. This cycle is what leads to weight gain.

Insulin is also an appetite stimulant. High levels of this hormone can increase hunger and cravings, causing some people with PCOS to overeat or consume more calories than they need. It also can lead to medical problems, like insulin resistance and diabetes.

Skin issues

PCOS can lead to symptoms that affect your skin, such as:

Acne and oily skin. When androgen levels in the body are high, this increases oil (or sebum) production in the skin. Sebum is usually a good thing. It keeps the skin from drying out, but too much can plug your pores and lead to acne flare-ups.
Dark or thick skin patches. The high insulin levels associated with PCOS can lead to a condition called acanthosis nigricans. This happens when the top layers of the skin get darker, thicker and appear velvety. These patches are usually found on the back of the neck and sometimes under the arms, breasts and in the groin.
Skin tags. Skin tags are a less common symptom of PCOS, but they do occur for some. They are small, noncancerous growths that usually grow in the same areas as dark skin patches.

Thinning hair

High levels of androgens, like testosterone, affect hair growth. Androgenic alopecia is a symptom of PCOS that causes women to experience hair loss. It’s often characterized by hair loss around the temples and frontal areas of the scalp. Instead of baldness, female pattern hair loss typically leads to thinner, shorter hair.

Infertility

PCOS is one of the most common causes of female infertility. If you’re under 35 years old, infertility means not being able to get pregnant after one year of trying. If you’re 35 or older, this time is shortened to six months. As we mentioned earlier, when excess androgens interfere with your menstrual cycle, it prevents your body from regular ovulation. If your body doesn’t go through normal ovulation, it becomes harder to get pregnant. But it’s important to know that pregnancy is still possible.

Causes of PCOS aren’t yet known

While we know that PCOS stems from a hormonal imbalance, doctors and researchers have yet to uncover what causes the imbalance. But there are a few factors that might play a role:

PCOS may be linked to genetics. Your chance of having PCOS increases if you have a family history of the condition.
Another factor that may cause it is insulin resistance. High levels of insulin can lead to your body producing excess androgens, creating the hormone imbalance seen in people with PCOS, as well as many of the symptoms listed above.
When your body experiences an injury or infection, it responds to protect itself. Your white blood cells launch a “response” called low-grade inflammation, which produces a steady flow of inflammation throughout your body, a chronic condition in people with PCOS. This can cause polycystic ovaries to produce androgens and the cycle of symptoms continues.
Having an excess of body fat can affect how well your ovaries work, but even losing just 5% of your total weight can improve ovarian function.

How PCOS affects the body

While PCOS has many specific symptoms, it can lead to other chronic health conditions. Women with PCOS are more likely to experience or develop:

Reproductive problems – As we mentioned earlier, PCOS and infertility are connected. However, the condition is also linked to reproductive complications like gestational diabetes during pregnancy, increased blood pressure during pregnancy or delivery, and uterine cancer.
Type 2 diabetes – PCOS can lead to insulin resistance, causing problems with the way your body regulates its blood sugar. Because the body produces too much insulin, this can lead to diabetes.
Heart disease – High insulin and blood sugar levels can damage the heart and blood vessels which over time leads to heart disease, including atherosclerosis (hardening of the arteries), coronary artery disease, high blood pressure, high cholesterol, heart attack and stroke.

How PCOS is diagnosed

A primary care doctor or a women’s health specialist like an OB-GYN – a medical doctor or clinician who specializes in female reproductive health – can diagnose PCOS. The process usually begins with a conversation. Your doctor will start with your symptoms and medical history before moving on to a physical exam, which will likely include a pelvic exam.

Doctors often look for three symptoms for diagnosis: irregular periods, excess androgens and polycystic ovaries. Two out of three of these symptoms are typically needed for a positive diagnosis. And because a physical exam can’t confirm the presence of abnormal androgen levels or polycystic ovaries, doctors may use additional tests, such as ultrasounds and blood tests.

Ultrasound

Your doctor may use an ultrasound to confirm a PCOS diagnosis. This test uses soundwaves and echoes to take pictures of your reproductive organs, or in this case, your ovaries. With an ultrasound, your doctor can look at the size of your ovaries and see if there is a high number of small follicles in your ovaries (polycystic ovaries).

Blood tests

Doctors use blood tests to check for high levels of hormones. This can tell them if your body is producing higher than normal androgens. They can also use a blood test to check your blood glucose levels as well as your cholesterol, both of which can be signs of PCOS. Blood tests also rule out other conditions that can mimic some of the features of PCOS.

Does PCOS go away on its own?

PCOS is a chronic condition that has no cure, and it can show up as any assortment of symptoms. Fortunately, there are many PCOS treatment options available to manage symptoms and help people reach their pregnancy goals.

PCOS affects each person in different ways, but your doctor can help you find a treatment plan that works best for your needs. Similar to other reproductive conditions like endometriosis, treatment of polycystic ovarian syndrome often depends on your pregnancy plans.

Conservative treatment may include birth control pills or ovulation medications, as well as changes in your diet, diabetes medication, and oral or topical medications for symptom management. More advanced treatment options, like ovulation medication and surgery, are also considered if you are having difficulty getting pregnant.

Talk with a doctor about PCOS symptoms

PCOS can come with a wide range of symptoms. If you’re experiencing irregular menstrual cycles, excessive hair growth, acne or inexplicable weight gain, schedule an appointment with your primary care doctor. Whether or not you have the condition, your doctor can help you take steps to feeling better.

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Health

Longevity Cheat Sheet: 15 Ways to Live Longer

Published

12 hours ago

July 6, 2024

Stacker

First off, this guide is not just about lifespan. These tips can improve your energy, happiness, productivity, and much more than just how long you live.This cheat sheet is designed to be short and jam-packed with science-based tips to improve your longevity. Guava Health will focus exclusively on results of modern science. For each tip in the guide, a reasonable longevity improvement is identified that an average person might be able to attain, ranging from 7% to 66%. The percentage benefit is derived from the hazard ratios in the studies, and the corresponding Scientific Rigor score was subjectively determined by Guava Health’s statistician and medical officer.Disclaimer: The studies below are mostly correlations, not guaranteed causations, and are based on averages of many people. This means that your personal health may react differently than in the studies. Before taking action, you should talk to your doctor about your specific situation.

#1: Do not smoke cigarettes

Benefit: +66%
Scientific Rigor: 3/3

The most boring and yet most effective recommendation on the list shouldn’t surprise anyone. Don’t light toxic stuff on fire and then inhale it. Never-smokers vs. lifelong smokers have a whopping 66% reduction in mortality by age 79, and quitting after a long time of smoking can also retain much of this benefit.

#2: Take 8,000 to 12,000 steps per day

Benefit: +51%
Scientific Rigor: 2/3

There’s a reason fitness trackers target 10,000 steps per day: It’s the magic number that gets you most of the possible improvement. Increasing step count from 4,000 to 8,000 per day was associated with a staggering 51% reduction in death from all causes (all-cause mortality). Additionally, the intensity of the steps, like running vs. walking, didn’t matter at all. So 25 minutes on the elliptical might save you time in obtaining your step goal, but each step will benefit your longevity the same as a normal walk.

#3: Get sufficient sunlight

Benefit: +50%
Scientific Rigor: 1/3

This was higher up the list than expected, but it turns out that totally hiding from the sun might really hurt you. A study of 29,518 Swedish women found a 2X decrease in mortality associated with the highest amount of sun exposure. Note that we only gave this study a scientific rigor score of 1/3 because it was only women and took place in a northern climate. The correlation with sunbathing was seen in a country with a very low UV index, which should be interpreted with caution. However, many other studies have found that adequate sunlight is important for longevity, often related to Vitamin D and melatonin.

It’s obvious, but worth stating anyway: Too much sun can kill you. So don’t take this as advice to sit in the sun all day or to get sunburnt.

#4: Consider dry sauna a few times per week

Benefit: +40%
Scientific Rigor: 1/3

The study showcasing sauna benefits is from Finland, as many sauna aficionados might have guessed. The study only includes men and they’re all from Finland, but it’s the best study Guava Health found and it shows a substantial 40% reduction in all-cause mortality for those who used a sauna 4-7 times per week compared with once per week. Normally the study would include comparisons with zero saunas per week, but apparently that is unheard of in the sauna capital of the world. Keep in mind this is for dry saunas at around 175 degrees F, so does not necessarily apply to cooler saunas, infrared saunas, or steam rooms. However, a study linking infrared sauna with coronary improvements was found.

#5: Brush and floss your teeth nightly

Benefit: +37%
Scientific Rigor: 2/3

In addition to not aggravating the people within smelling distance, brushing and flossing each independently help you live longer, according to Guava Health’s chosen study on dental behaviors, conducted on adults 52 and older. Brushing and flossing every day compared to not every day was associated with a mighty 37% reduction in death during the study period. Yep, it wasn’t just something your parents bugged you about; it might actually kill you. A curious discovery in the article was that nightly brushing was most important, and was even better than morning and daytime combined. Flossing every day was best, but don’t worry if you’re lazy sometimes, there was still a noticeable benefit in flossing “sometimes,” just not as much.

#6: Minimize your stress levels

Benefit: +34%
Scientific Rigor: 2/3

Another commonly mentioned factor of faster aging, reduction of perceived stress, landed on the list with thorough scientific evidence. There is an entire industry around stress reduction, but if you’re looking to improve, you should first consider all the other health improvements on this list since many can reduce stress. Then, perhaps consider meditation or massage, which both have scientific evidence of stress reduction.

#7: If you drink alcohol, stay below 7 standard drinks per week

Benefit: +31%
Scientific Rigor: 3/3

A small amount of alcohol appears to give you slight protection from a few causes of death, notably myocardial infarction, but it’s still detrimental to overall longevity. For amounts below 100 grams (~7 drinks) per week, this study of 599,912 people found negligible effects on mortality. But, as you can see in the chart, those negative effects increased steeply above 7 drinks per week. Cutting down from 3 drinks per day to 1 drink could reduce your risk of death by 31%.

Keep in mind that if you don’t currently drink, it’s not recommended you start, since alcohol is known to be addictive and moderating your consumption might be difficult.

#8: Consider intermittent fasting

Benefit: +26%
Scientific Rigor: 1/3

Caloric restriction is one of the most effective and persistent methods of extending life across every species of life ever studied. Humans, however, have not been equally proven to live longer simply by reducing calories. There are some studies showing probable positive effects, such as the people who eat less in the Japanese islands of Okinawa, and across studies of fasting, which is a little different from calorie restriction. The best study Guava Health found wasn’t as thorough as hoped because it studied only 2,714 people and they were all recovering from a surgical procedure. But, it did show a very substantial reduction in mortality for those who routinely fasted for 5+ years compared with those who didn’t fast.

#9: Don’t consume too much sugar

Benefit: +23%
Scientific Rigor: 2/3

This study found that consuming only 10% of your daily calories as sugars compared with 20% or more offered a 23% reduction in mortality. The authors also found that it was more helpful to reduce sugar in beverages than it was in solid foods. Similar to avoiding excess sugar, avoiding high glycemic index foods can also be helpful to your longevity. Basically, eat more of the stuff like nuts and vegetables that don’t give you an instant dump of energy.

#10: Minimize processed meat

Benefit: +19%
Scientific Rigor: 3/3

Of all the meats you can eat, fish is one of the best for longevity, while red meat and processed meat are among the worst. That’s a generalization, of course — some fish are much healthier to eat than others (wild salmon is great), and the quality of red meats can vary significantly. The study Guava Health chose shows the biggest offender to be processed meat by far, but also indicates red meat is slightly harmful on average. So the official recommendation here is to avoid processed meat when you can, and either avoid red meat or be sure it’s high quality.

#11: Avoid bad air quality

Benefit: +17%
Scientific Rigor: 3/3

Bad air can come from many sources, including polluted cities, factories, forest fires, and high-heat cooking. Basically, it’s not healthy to burn stuff and then breathe it in. A massive study on U.S. cities found that each 10 µg/m3 decrease in PM2.5, a common measure of air pollution, reduces your mortality by 17%. This amount of reduction or more could be achieved by moving from a polluted city or factory to the suburbs. You can easily find your neighborhood’s current PM2.5 measurement online. If you’re in one of the world’s most polluted cities, your potential benefit could be much higher than 17%. And if you don’t plan on moving, you can also use an air purifier in your home and office, and use a car with HEPA filters to help minimize your exposure.

#12: Consider drinking coffee — even decaf

Benefit: +15%
Scientific Rigor: 3/3

Before modern science began adjusting for confounding factors, researchers used to think that coffee increased death rates. In reality, coffee drinkers were just more likely to also smoke cigarettes. After adjusting for this, recent studies show a non-trivial reduction in mortality for moderate coffee drinking of 2-4 cups per day. Furthermore, the improvement appears to remain even if you’re a slow metabolizer of caffeine, which is something you can test for with popular genetic test kits. Note that it’s coffee studied here, not caffeine. Decaffeinated coffee has shown similar results.

Remember, caffeine is a drug and is often addictive. It can be beneficial, but can also cause serious effects on your body, particularly at high amounts, so consult your doctor if you’re unsure.

#13: Eat 5 servings of fruits and vegetables per day

Benefit: +13%
Scientific Rigor: 2/3

More servings of fruits and veggies were associated with lower mortality, plateauing around ~5 servings. Notably, this does not include starchy veggies like corn, peas, and potatoes, nor does it include fruit juices. Increasing from 2 to 5 servings per day is what showed the 13% benefit being highlighted.

#14: Sleep 7-9 hours per night

Benefit: +11%
Scientific Rigor: 3/3

Many studies, including this meta-study, show increased mortality if you sleep too little. One difficulty is they had to combine different definitions of “short sleep” ranging from 4 to 7 hours, but the overall result was that staying above ~7 hours reduced mortality. A curious result of their study was that long sleep was even worse than short sleep. Somewhere in the range of 7-9 hours looked optimal for most studies, and although the studies were based on survey answers and couldn’t measure it, it’s common to recommend 7 hours of time actually asleep and not just laying in bed.

#15: Consider metformin

Benefit: +7%
Scientific Rigor: 3/3

Normally a drug targeting a specific disease would not be included in a longevity cheat sheet built for everyone, but metformin is a notable exception. In studies meant to understand its effectiveness at improving diabetes, the researchers were surprised to find that metformin reduced death from all causes for diabetics, even beyond non-diabetics, by 7%. This suggests that non-diabetics could benefit by even more than 7% by taking it. However, metformin is a prescription drug in the U.S., so Guava Health only recommends considering it through talking with your doctor, or other legitimate pathways if you live outside the U.S.

Bonus: Drinking more water doesn’t seem to help

Benefit: +0%
Scientific Rigor: 1/3

Strangely, no correlation was found between the amount of liquids consumed in a day and mortality. We all know that you’ll die within days if you stop drinking water, but perhaps the negative effects only appear with extreme dehydration, whereas all the study participants had full access to water.

This story was produced by Guava Health and reviewed and distributed by Stacker Media.

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Health

Amazon's No. 1 Bestselling Pull-Up Bar Just Dipped Below $25, and Shoppers Say It's 'Worth Every Penny'

Published

24 hours ago

July 6, 2024

Michael Charboneau

Men’s Journal aims to feature only the best products and services. If you buy something via one of our links, we may earn a commission.

If you’re even remotely interested in setting up a home gym, there’s one item that should be at the top of your shopping list: a pull-up bar. These simple, incredibly useful devices allow you to perform not only pull-ups, but all kinds of other exercises (dips, push-ups, and more), and they’re ideal for building upper body strength. That’s what makes the Ally Peaks Pull-Up Bar such a screaming deal: Now less than $25, you can get a great at-home workout that delivers real results.

The Ally Peaks Pull-Up Bar is now on sale for just $24 after an on-page coupon—a total discount of 25% off the normal $32 price. This well-made, highly versatile home workout tool has stacked up nearly 5,400 glowing five-star ratings from all kinds of fitness enthusiasts, and it’s currently the No. 1 bestselling strength training pull-up bar on Amazon.

Ally Peaks Pull-Up Bar in Silver 2, $24 (was $32) at Amazon

There are tons of pull-up bars for doorways on the market, but this is one of the best we’ve seen, especially at this price point. It stands out because of its durable 1.7mm-thick steel frame (including the top crossbar) that’s powder-coated to prevent rust, and it’s rated to hold up to 440 pounds. It’s also easy on your home thanks to durable silicone pads that protect your doorframe, and it even includes a second set of pads that you mount on the doorframe itself for extra protection. Finally (and perhaps most importantly), it’s designed for maximum workout versatility. It features hand grip areas for a variety of exercises, like wide pull-ups (great for working your shoulders), chin-ups, and neutral pull-ups. You can also use it on the floor for incline pushups, dips, and sit-ups, too.

Reviewers love that the Ally Peaks Pull-Up Bar has a solid feel when installed. One shopper called it “really sturdy” and said it “works well” in their home. Another shopper called it “stable and secure” and said they “feel 100% comfortable and confident on it.”

Others marvel at the versatility that comes with having this inexpensive piece of equipment. “Sturdy, versatile, and worth every penny,” one shopper said. “It has exceeded all my expectations. As someone who prioritizes fitness but doesn’t have the space for bulky equipment, this pull-up bar is a game changer for my home gym setup.” Another shopper agreed, saying, “So far I’ve been using it for wide pull-ups, close pull-ups, wide and close push-ups, and tricep dips.”

With its compact design and wide variety of uses, the Ally Peaks Pull-Up Bar is a must-have for any home fitness setup. At just $24, it’s a nearly unbeatable bargain, but act fast, because this killer deal won’t last forever.

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Health

Montana Creates Emergency ‘Drive-Thru’ Blood Pickup Service for Rural Ambulances

Published

1 day ago

July 5, 2024

Kaiser Health News

By Arielle Zionts

Crystal Hiwalker wonders if her heart and lungs would have kept working if the ambulance crew had been able to give her a transfusion as the blood drained from her body during a stormy, 100-mile ride.

Because of the 2019 snowstorm, it took 2.5 hours to drive from her small town of Lame Deer, Montana, to the advanced trauma center in Billings.

Doctors at the Billings Clinic hospital revived Hiwalker and stopped the bleeding from her ruptured ectopic pregnancy. They were shocked that she not only survived after her heart stopped beating and she lost nearly all her blood, but that she recovered without brain damage.

The Montana State Trauma Care Committee, which works to reduce trauma incidents and to improve care, later realized the ambulance that carried Hiwalker had passed near two hospitals that stocked blood. What if Hiwalker had access to that blood on her way to Billings, committee members asked.

That realization, and question, inspired committee members to create the Montana Interfacility Blood Network, which they say is the first program of its kind in the U.S. The network allows ambulance crews to pick up blood from hospitals and transfuse it to patients on the way to the advanced care they need.

“We kind of came up with the idea of having a blood handoff — like driving through a fast-food restaurant drive-thru — and picking up blood on the way,” said Gordon Riha, a trauma surgeon at the Billings Clinic trauma center, where Hiwalker was treated. Riha said timely blood transfusions can prevent death or permanent brain injury.

The network is aimed at rural patients, who face elevated rates of traumatic injuries and death, said Alyssa Johnson, trauma system manager for the state of Montana.

“We have to get more creative. We don’t have a blood bank on every corner, and we don’t have a Level 1 trauma center on every corner,” Johnson said.

Network leaders say the program has helped at least three patients since it launched in 2022. They hope it will be used more in the future.

Hiwalker is excited about the program.

“I’m so glad that something like this got started, because it would save a lot of lives from where I live,” she said.

Hiwalker said she has heard about people bleeding to death after car crashes, gunshot wounds, and stabbings in her rural community. Johnson said work injuries, cancer, gastrointestinal problems, and childbirth can also cause serious bleeding.

The Montana trauma committee began discussing the blood network a few months after Hiwalker’s brush with death. First, it created a map of 48 facilities with blood banks. Then, it created guidelines for how hospitals, blood banks, ambulances, and labs must communicate about, package, transport, document, and bill for the blood.

The network is used only during emergencies, which means there’s no time to test patients’ blood types. So it uses only type O red blood cells, which can be transfused safely into most patients.

The receiving hospital — not the one that provided the blood — is responsible for billing patients’ insurance for the blood. The cost depends on how much blood patients need but typically ranges from several hundred dollars to more than a thousand, said Sadie Arnold, who manages the blood bank at Billings Clinic.

Arnold said blood must be stored in a lab and managed by professionals with specific degrees, clinical experience, and board certifications.

Some rural hospitals lack space for a lab or money to recruit these specialists, Arnold said. Or they may not need blood often enough to justify storing a product that can expire and — especially during the current national blood shortage — is needed elsewhere. The network uses blood that has a maximum shelf life of 42 days.

Rural hospitals that do store blood may have only small amounts on hand. A rural Montanan with severe bleeding experienced that firsthand when he went to the nearest hospital, which had only one unit of type O blood, according to a report on the blood network. But thanks to the new program, ambulance medics picked up more blood from a hospital halfway through an 80-mile drive to the trauma hospital.

Ideally, rural patients with serious bleeding would be transported by medical helicopters or airplanes outfitted for transfusions. But, as in Hiwalker’s case, flying can be impossible during bad weather. That can mean hours-long ambulance rides. Some towns in northeastern Montana, for example, are more than 250 miles away from the nearest advanced trauma center.

“This was truly designed for kind of that last-ditch effort,” Johnson said. When “we’re out of options, we’ve got to get the patient moving towards a larger center, and we can’t fly.”

The blood handoff may involve the ambulance stopping at the second hospital, Johnson said. But during one incident, a police officer picked up the blood and delivered it to the ambulance at a highway exit, she said.

Ambulances may also pick up a paramedic or nurse to provide the transfusion along the way, since many rural ambulance crews are staffed by emergency medical technicians, who in Montana aren’t authorized to do so.

Medics in other cities and states, including ones with rural areas, have started performing blood transfusions in ambulances and helicopters, said Claudia Cohn, chief medical officer of the national Association for the Advancement of Blood & Biotherapies.

She said researchers are also interested in the potential of using frozen and freeze-dried blood products, which could be helpful in rural areas since they’re easier to store and have longer shelf lives.

Johnson said the Montana Interfacility Blood Network is the only program she knows of specifically aimed at rural patients and involving ambulances picking up blood from hospitals along their routes. She said the network is gaining interest from other states with large rural regions, including Oregon.

Hiwalker said receiving a blood transfusion in the ambulance could have prevented her near-death experience and the trauma her husband faced from seeing her suffer as he rode in the ambulance with her. She’s glad her ordeal led to an innovation that is helping others.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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