surgery in 2 weeks - blood question

[s&d]

(David's scheduled for posterior fusion surgery on Dec. 12, probably T-4 to T-11 to correct 68* thoracic. Also has 50+* compensatory lumbar curve and a compensatory cervical curve.)

Everything I've read on scoliosis surgery says blood donation, blood banking, etc. But our surgeon at TSRH told us it wouldn't be necessary, they just filter and re-use the patient's blood. I've not encountered that anywhere else. Not that I don't completely trust him, I do, but I'm sort of a "belt and suspenders" person - I like to be prepared and have backup available. David is very thin and now at this point wouldn't be able to donate his own blood, anyway. We all have the same blood type (well, I'm pretty sure...it's been a while since I've had to know that) - but I'm currently on anti-coagulants to treat blood clots and may have some clotting disorder - that might rule me out as a possible donor for David. My husband is more or less healthy and they could get a pint from him if needed...daughter will still be taking finals in college, so she won't join us until after the surgery.

So, what's your experience with blood issues in surgery?

[Mary Lou]

So many things to think about huh? Jamie donated two units of blood (the doctor requested four but she was only able to give two) and they used both of them in the O.R. Her doctor didn't recycle her own blood and I'm not sure why, but I wouldn't worry about it too much, David's surgery should be much shorter than Jamie's so he might not even need any additional blood during the surgery. If they find he needs blood after the surgery, you could always ask about your husband donating at that time.

Mary Lou

[pat]

Hi! My daughter's surgery was a year ago, and she donated two units of her own blood (8 hour surgery), and ended up needing only one unit. But since her surgery, our hospital now does "recycled" blood, which I heard is working out fine! Pat

[s&d]

That's very encouraging to hear! And I'm glad to know another facility is taking this approach ("recycling"). Even if I have all the confidence in the world in our surgeon and TSRH, I thought it odd that I hadn't run across any other mention of recycling blood.

Thanks for the info!
SanD

[SandyC]

S&D,
Even though I'm an adult, I thought I would answer your question about "recycling" blood. The machine is called a "cell saver". As the doc is operating, blood is syphined off and out of the area being operated on. This blood is channeled thru the cell saver and re directed into the patients body, thus "recycled".

I noticed that you said that your husband is "more or less" healthy. He would be able to donate is he is compatible with your child. But if he has heart problems/diabetes/RA or several other chronic dieases he would not be able to donate. If your daughter is over 18 and compatible she would be able to donate. The other reason for family donation is finanical. Blood and blood products are very expensive. If your daughter donated at her local blood bank and specifically requested that her blood be donated towards her brother's account it would be, even though he may not recieve the actual blood.

[s&d]

Thanks, SandyC -

(I'm Sandy, too)
Husband is just on blood pressure medication, otherwise checked out fine (well, weight, but we won't go there!). Daughter away at college is 20 and usually weighs 95 - 102, probably on the low end right now because she loses weight when she's stressed (and I gain what she loses).

I'll ask more questions at TSRH when we go next week for pre-op. I'm not sure if blood is needed during surgery if that's covered under their charity or if that would go to our insurance. Since we were referred to TSRH two years ago there's been no charge for any of their services (what a blessing!). However, we've kept our insurance busy - and unhappy, it seems - with several expensive, non-orthopedic issues, so I'd better write this question down for financial as well as medical reasons.

SanD

[nikyergen]

SanD - Crystal didn't donate any blood of her own because she had pneumonia that winter and in the hospital and we were just trying to keep her healthy for surgery. She has severe asthma and a little cold can set her on a whirl wind. They recycled her blood and she didn't need any from the blood bank. I felt very reassured when they told me how safe the blood was. If your son should need blood, the insurance may get billed for it, but then TSRH should absorb the rest of the cost. They may do the same for pre-op lab work, etc. I about choked when I got a claim notice from the insurance on about $1,500 that they didn't cover on the blood work for Crystal. I called the hospital and they said that they pick up the rest of it. But, do double check on that, you don't want any surprises. I love the Scottish Rite Hospitals and Shrine Hospitals, because there is never any surprises with them.

I do understand the part of expensive and non-orthodic uses of insurance. Crystal was in the hospital last Thanksgiving with pneumonia, and then the beginning of this month she was in for kidney stones. I am glad we are on a group policy, therefore they can't cancel her insurance on us.

SandyC- Thank you for the info on the blood "recycling". It is nice to understand it now.

'til later,
Nikki

[marmyte]

it always strikes me as interesting, the differences between hospitals worldwide. here in the uk the attitude is very much that a patient donating their own blood prior to surgery is futile and could potentially weaken the patient. i would never, ever worry about receiving blood from the uk because i know how rigorously tested it is. about a month before i had surgery i went to give blood (not because i was asked, because i wanted to. my conscience suddenly became aware that i may need blood, and i wanted to try and help out other people) they asked me a million questions and i gave blood then they sent me a letter saying due to a flaw in their machines (not the blood i had given) they couldn't use it

as it happens, i lost hardly any blood during surgery (partly due to only being down there for 2 hours) but i really wouldn't worry about giving blood, especially as you say your son is very thin. like nikki said, you want to have the best possible chance of coming through surgery positively and to do that you have to be as strong as possible

[nicoles mom]

S&d
Our Surgeon Wanted A Pint Of Blood For Nicole Surgery. He Did Filtered And Reused Her Blood During The Surgery. Her Surgery Was 5 1/2 Hour Posterior Shes Fused For T-4 To L-1.

My Nicole Couldn't Donation Blood For Herself. She Was Too Small And Only Weighted 74 Pounds. I Wasn't Able To Donation For Her Either Due To Health Iusses. My Husband Donation A Pint For Nicole. She Was Given This After Surgery In The Picu.
Theresa

[flowerpower]

My son will be donating 2 units of blood for his surgery. We were told that the blood bank does not bill insurance so we will have to pay ($270 per unit) and our insurance (BlueCross) will reimburse us. If we were to have family, etc. donate for Joseph there would be a 1-time fee of $45 and that would cover everyone who donated in his name. You would think they would charge less to donate your own blood, but then again it I guess it helps the blood bank to get more blood (and blood types) then will be needed for the actual surgery.

Renee

[nikyergen]

SanD - I forgot to mention that Shriner's told us that if Crystal did donate blood, it was only good for 30 days and then they have to get rid of it. So, if for any reason that your son's surgery is rescheduled, Crystal's was rescheduled once, he would have to donate again if it was outside that 30 day window. When you work with Shriners and Scottish Rite Hospitals, there is always the possibility of a reschedule because a child in more need, life and death situation, may need a surgery spot immediately. So, be sure to ask about the 30 day window. I'd call the doctor's nurse and ask her today, then you have that answer right away.

Nikki

[sweetiepie3]

Hi all!!! I just saw what you posted about blood transfusions. Having blood on hand is an absolute must. I almost needed a transfusion during surgery even with my refiltered blood. My friend who also had the surgery did need a transfusion. Also don't be fooled just because you don't need a transfusion right during the surgery does not mean that you will not need one at some point during the hospital stay. I would reccomend having blood on hand!

[s&d]

I had a message to call TSRH for some pre-op info when I got home this evening, so when I return the call tomorrow I'll see if I can ask some questions regarding blood. At this point it won't be David's blood - he's too underweight.

David passed out at school today - completely out ("they made a big deal out of it"). His dad was closer to the high school so he got him to the doctor immediately. Looks like it was low blood sugar, but Dr. said there could be a virus along with it. David was very low-energy and mopey all weekend - more so than usual.

I WILL ask about blood - I'm sure they're required to have some on standby since it's major surgery, but I want to be sure and not have doubts.

Nerve-wracking...
SanD

[flowerpower]

Sorry to hear about your son. I hope he will be healthy enough for surgery when the time comes. We got hit pretty hard with strep throat in our family - all three kids one after the other and Joseph (my surgery boy) had a relapse so he was on antibiotics for over two weeks. I'm crossing my fingers that we stay healthy as well as wiping, cleaning & disinfecting everything in site. I think I just read a post today where someone mentioned keeping their child home (and tutored) for 1 to 2 weeks prior to surgery. Maybe your sons school would allow something like this, at least he would have a chance to rest prior to surgery and minimize his exposure to all the viruses going around right now.

Renee

[nikyergen]

SandD, We kept our daughter home for three weeks before surgery. Our school had an incredible virus going around and she has severe asthma and catches any little cold that comes along. Do check on keeping your son home. He will need all the strength he can muster to get through surgery. Explain his current medical condition, and since he passed out at school they already know his problem, and see if they can help out with the problem. Our school was more than cooperative and even sent a tutor at no cost to us. Surgery dates can be hard to come by sometimes, so you don't want to miss this. The internal mental stress of upcoming surgery could of contributed to the problem too.

Let us know how things go.

Nikki

[s&d]

I didn't get to ask TSRH about blood today. It turned out that it was the psychology dept. from there calling to get some info, so they weren't the ones to talk to about blood. That and trying to fit in 5 or 6 other medical and school (David's) calls in between teaching classes pretty much ate up my day. I was chugging a protein drink, making phone calls and working on lesson plans for my absence during my lunch period when a teacher had an emergency and I was called to cover her class until someone else could get there. I know, I'll email the surgeon's nurse! I forgot that I had her email address.

David seemed a bit better today and did go to school. I should get the results of the blood work they did in the morning, if I can squeeze in a call.

Thanks for all the good, practical advice, everybody! I'm pretty wiped out at the moment or I'd go into more detail and maybe have some worthwhile questions to ask. But I did want to acknowledge your time and effort - it is truly, truly appreciated. :)

SanD

[LeaEvelyn]

Hi S&D,
When my son had his surgerys{two}, he donated two units of blood each time. The hospital he had it done at, also recyles the blood. He ended up using his blood for his first surgery. He got it on the fifth day post op. And that was only because his energry level was below average. His doctor told us he was going to give it to him to raise his energy, so he wouldn't be sleeping so much. He made a point of telling us, that he wouldn't have given him blood, if he didn't have his own to use, and he would have been fine without it.
For his second surgery, he used none of the two that he donated. I truely believe in the recycling of blood during surgery. When we were at the blood donation center, they stressed to us how safe the blood is that comes from the blood banks. They said that each unit goes through intense testing, and is very safe to use.
I wish yous the best of luck with the surgery and I hope he has a speedy recovery. Oh, and I almost forgot. My son also passed out in school, just after he found out he needed a second surgery. I chucked it up to nerves. But we still have to watch him, for he has done it another time since. His doctor thinks it could be low blood sugar. But, he now knows the signs. He gets really light headed, hot and sick to his stomach just before he passes out. His doctor told him, if he gets to feeling this way, he should lay down, if that isn't possible, then he is to put his head down on the desk, and let another student alert the teacher.
I hope this has helped you some.
Take Care
LeaEvelyn

[Sheena]

i had to have two pints of blood given to me in a transfusion