Daily life and work did a number on Charlie Rios' knees.
"I worked 44 years in the construction business," he said. "I got to the point where I couldn't climb the stairs. I couldn't live. I couldn't do ladders, so the pain was really terrible."
Rios had a double knee replacement last January, and despite it being major surgery, he wasn't given an ounce of blood.
Dr. Gary Bachowski, clinical pathologist for the American Red Cross said, "We're trying to use blood effectively so it's used in the best way to treat the patients and it also preserves blood supply for patients who need it most."
The American Red Cross and Regions Hospital in Saint Paul are working together to prevent unnecessary blood transfusions, turning around traditional thought that more blood is good.
"Studies have shown that patients who receive blood products, more than is really necessary, they have a longer stay in the hospital, they are prone to infections and they are prone to multiple complications," said Dr. Zena Khalil, a pathologist.
So how effective has the project been?
Since 2011, Regions said it has decreased blood use by 14 percent and more than 1,100 patient transfusions were avoided.
Rios' orthopedic surgeon used to give 20 percent of his patients blood transfusions. Now it's down to five percent.
"They have dropped usage of blood, yet their patient population is still doing well and even doing better," said Khalil.
Rios recovered so quickly from knee surgery, he fit in a shoulder surgery this year too. His knees no longer slow him down.