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rohrer01
04-25-2010, 11:10 PM
I've read on here that a couple of people have suffered some significant blood loss a couple to a few days AFTER surgery. Why is that, and how can that be prevented? I would think the greatest risk would be during surgery. Thanks for any answers.

rohrer01
04-26-2010, 07:21 AM
No one has an explanation for this? I will be asking my doctor about it today, if I remember. I will post what I find out. I was just hoping that someone with experience in this would chime in. Thanks anyway. :confused:

jrnyc
04-26-2010, 09:50 AM
if you read AdMoul's post (Anne) you will see that even when specialists tried to figure it out, they couldnt tell why she had excessive blood loss...very often completely unexpected and reason unknown!

i dont know if such blood loss can happen even with minimal invasive...but i will take the minimal invasive route...i suspect with unexpected and unknown origin it could even happen with any kind of surgery...

jess

loves to skate
04-26-2010, 10:00 AM
I just had minor revision surgery to remove bone that was still pressing on nerve roots and lost quite a bit of blood. My Hct went from probably 40% to 27%. When bone is cut, it bleeds and will continue to bleed for a couple of days. I had a drain in my back and the bulb continued to fill up with blood and fluid for two days. My original surgery, I needed four transfusions during and after both surgeries, a total of eight, two of which were from the cell saver during surgery.
Sally

rohrer01
04-26-2010, 10:03 AM
Wow! Well I intend to use the cell saver. I know they also have a mini cell saver that they can connect to your incision and clean and reroute any lost blood back in. My friend had double knee replacement and that's what they did for her.
Thanks for the replies!!! It helps alot!;)

LynetteG
04-26-2010, 10:26 AM
I had minimal blood loss during surgery, but then lost quite a bit afterward through my drain and was given a transfusion afterward of 2 units a few days later - no idea why!!!

ADMoul
04-26-2010, 11:44 AM
Yes, I'm the blood loss queen in Dr. Lonner's practice. And Jess was right, no testing before or after indicated why it happened. I lost 8 units, all of which were replaced during surgery. (I had donated one of my own.) I didn't have to have any afterwards. Because of this large amount of fluid and the resulting swelling, I was on a vent overnight and woke up intubated which was not fun. I still have a little bit of edema from this in my abdomen and hips and tomorrow will be 3 months post op. I have talked with folks who work in hematology and said they have seen this kind of thing happen occasionally with basically healthy people. It's like the body is so traumatized, it "forgets" how to coagulate. Sounds like an over-simplification, but we really don't have any other answers at this point. However, once I got out of that OR, my body has done what it's supposed to and I've been fortunate to have a good recovery.

rohrer01
04-26-2010, 05:09 PM
Thanks again for the input. My surgeon did an about face on me today and basically told me that NONE of my pain symptoms are scoliosis related and would not do surgery...????:confused: I am not understanding this at all, as the first time I saw him, he said my pain pattern was perfectly consistent with scoliosis, last month he said he was surprised that I wasn't hurting worse, and to come back if my symptoms worsened (which they did - I'm on heavy narcotics), now this. At least I won't be having to worry about blood loss. I'm so at a loss and confused.... Best wishes to those of you on the other side. I wish you all speedy recoveries and a pain free life.

loves to skate
04-26-2010, 07:09 PM
Yes, I'm the blood loss queen in Dr. Lonner's practice. And Jess was right, no testing before or after indicated why it happened. I lost 8 units, all of which were replaced during surgery. (I had donated one of my own.) I didn't have to have any afterwards. Because of this large amount of fluid and the resulting swelling, I was on a vent overnight and woke up intubated which was not fun. I still have a little bit of edema from this in my abdomen and hips and tomorrow will be 3 months post op. I have talked with folks who work in hematology and said they have seen this kind of thing happen occasionally with basically healthy people. It's like the body is so traumatized, it "forgets" how to coagulate. Sounds like an over-simplification, but we really don't have any other answers at this point. However, once I got out of that OR, my body has done what it's supposed to and I've been fortunate to have a good recovery.
Anne, do you know if your Doctor gave you any fresh frozen plasma (FFP)? Once you lose 6 units of blood, your clotting factors become depleted, so a transfusion of FFP is in order to replace the clotting factors. Bank blood or even your own blood lose clotting factors after 48 hours of collection. Sally

ADMoul
04-26-2010, 07:33 PM
Hi Sally--that's interesting. That's the first I have ever heard of FFP. I don't know whether it was given. Met with the hematologist twice afterwards and that was not mentioned. Hmm--it will be a question I ask when I have follow-up in June. At that point, we'll get results of cat scan and find out how things are fusing. The last thing I want to do is any more surgery, but the possibility exists because of hardware that wasn't finished. Thanks for the info!

RitaR
04-26-2010, 09:25 PM
My dr said I had some blood loss, but not too much to have transfusions. Other than when he yanked out the drain one morning in the hosp - YIKES!!!! Had I been able to run I would have chased after him for that.....OMG!!!!

Back-out
04-27-2010, 01:26 AM
ADMoul :eek::eek::eek:
Sally, you're a whiz. You must be at least a nurse.

Sometimes knowing so much must be frightening, as you may find yourself ahead of your doctor sometimes, and that might put a dent in the ol' confidence and all. I know I worry when I think of something ahead of my doctor - or even when s/he hasn't even thought of it at all.

I'm used to that in my backwoodsy area but I sure hope it doesn't happen with my scoli surgeon. I figure if I'm going to be unconscious for that long, I HAVE to have absolute confidence in him/her. Or for that matter, THEM! (One consultant will only operate in tandem with another surgeon)

For anyone interested in names, that surgeon is Dr. Thomas Errico and his partner is Dr. Frank Schwab.

Any comments would be much appreciated.

jrnyc
04-27-2010, 07:05 AM
Dr Errico was listed in NY Magazine a few years ago as one of the best orthopedic surgeons in NYC.....i know his waiting room was always packed!

jess

doodie
04-27-2010, 09:37 AM
Hi Joy -
As Sally said, when bone is cut it bleeds and it continues to bleed for several days afterwards so that's why when you are closed up after surgery, drains are inserted - I had two, one on the upper left side and one on the lower right side where they harvested more bone for grafting material.

I suppose how much blood is lost would depend on how big (how many levels) a surgery you are having, what's being done 'in there' and individual clotting factors. During my surgery a cell saver was used. I also received 6 units of packed red blood cells and 7 units of fresh frozen plasma. On Day 2 I received 2 units of packed red blood cells for postoperative anemia.

Cell Saver - I think this is pretty much standard procedure - my Dr. uses it During a surgery but is not in favor of any cell saver type apperatus After surgery due to increased risk of infection.

I did not donate blood to myself before surgery - used strictly banked blood. In fact Dr. Kebaish was against patients donating to themselves - the window for use is just too small to donate enough and get your own hematocrit level build back up to a healthy level in time for surgery.

JenniferG
04-27-2010, 04:38 PM
Am I the only one here who didn't have a drain? I wonder where all that post-surgery blood-loss went?

Like Janet's doctor, mine also doesn't believe in donating for your own surgery, at least not with adults.

rich1752
04-28-2010, 12:01 AM
I had t-10 to L5 and had both anterior and posterior. My surgery took 12 hours and had lost 6 units of blood. My blood pressure dropped two days after surgery, where they gave me two more units in a hurry. They used blood pressure cuffs to squeeze the blood quicker into me. I donated 3 units myself and family donated five.

rich