Iron supplement prior to surgery and other rambling

[debbei]

Hi All,

I had my last appointment with Dr. Neuwirth yesterday, and I think he definitely thinks I am prepared, from the questions I asked. I also donated blood yesterday. They were able to get out 410 cc's before the tap just STOPPED. The minimum is 300, and it took me 45 minutes to get out the 410. My husband and son also donated, and apparently they have BIG veins, and it took them only 10 minutes to pump out 450 cc's. Hurumph they were making fun of me. Anyway, the blood center paperwork said to take Ferrous Sulfate 300 mg 3x a day until surgery. At the drugstore this morning, I came home with 'Slow FE', slow release iron, which has only 47.5mg, and says to take 1-2 per day at bedtime. Will this be enough?

In the meantime, I had a burger after donation yesterday, I had steak for lunch today, and a friend of ours shot 2 deer and is giving them to us (yummy) and I plan to have Stir Fried Bambi every day until surgery. Along with spinich, beets, and all the other good stuff you're supposed to eat.

So I guess my question is, are these iron pills good enough? I don't want to end up constipated either. SHEESH I guess I'll have that after surgery anyway. I figured I'll also eat beans every day and that should help, besides the other medications they recommend.

One other thing--we took the train into the city, and on our way back, luckily for us, it was the HIGHT of rush hour, and I (ummm don't yell at me) almost fainted in Penn Station. I leaned against a wall and just plopped down on my butt. If I hadn't I would have just fallen over because the sides of my vision were starting to close in. I'm drinking lots of fluids and trying to rest today.

Did I tell you that I had to cancel out of my girls weekend this weekend? Sigh...my son is in crisis and needs me. Turns out his problems are related to my upcoming surgery. Turns out that I am the glue that holds the family together. He will be ok, he is in a much better space right now.

One other interesting piece of info. Remember that article I found about vision problems after surgery? It can happen, although it has never happened to him. He says there are lots of unknowns in this area, but they know that they shouldn't lower the blood pressure too much. Also they used to put the patient's head in a face-cradle kind of thing, which put too much pressure on the eyes. Instead, now they put the patient's head in traction so there isn't pressure on the face. I had to ask ( because you know me by now, right?) how they put your head in traction? PINS in the sides of your head. I was ok with it when I heard they don't have to shave off any of your hair to get the pins in. LOL I really worry about the important things, huh?

[Carmell]

Lots of deep breaths, Debbe. You'll do great. Your menu for the next many days sounds, um, tasty. I just wanted to emphasize HYDRATION! DRINK, drink, drink water, milk, etc. Nothing carbonated or caffeinated (hard, I know!). These things dehydrate you quickly. Drink as much as you can, and IV placement will go better, your recovery will go smoother, your constipation will not be as bad, etc.

About constipation, have you talked with the pain services people at the hospital? If so, great. Hope you talked about SCHEDULED meds for preventing constipation, no just as-needed meds. If not, please have them give you the "plan" for pain management. Write it down so whoever is with you after surgery/for recovery knows what the nurses should and shouldn't be doing. Then, have them keep track of meds and doses. You can't be too careful about this.

Best wishes!

[debbei]

Thanks Carmell, I am drinking like crazy, but that's because I'm so thirsty.

I just looked up this iron rich foods list, and it's cracking me up:

http://www.weightlossforall.com/iron-rich-food.htm

It has many strange sounding items, like 'cockles' and 'Pilchards' and Lord knows what else. LOL I did notice though, that venison has a much MUCH higher content than beef. Stir Fried Bambi for me!! My kids even love it.

[Carmell]

Um, are some of those items really food? I guess I live fairly sheltered... ewww... I do know what haggis is - wouldn't touch it with a ten-foot pole! I don't have THAT much Scottish heritage.

Do you know why you're so thirsty? Do you have a salt deficiency? Something? Hope it gets better. Usually when you are plenty hydrated, the blood donations go much quicker - not 45 mins to get it all out. You must have rapid clotting capabilities. Most the time that's good. Or just naturally thick blood. Good luck with all the preparation and anxiety before surgery. I'm not a scoli patient, but having scoliosis surgery every 6-8 months (for 7+ years now) means we have to plan ahead too. Planning... you'd think I'd be more organized at home. I think my very DISorganized home is my coping mechanism... or something (ok, it's an excuse, does it work?).

More deep breaths.

[debbei]

I think I just have small veins. So does my oldest son, who's almost 200 lbs and has to have a butterfly baby needle used on him for blood tests. The other son has big fat veins like my husband.

Makes me wonder how they'll get the IV and everything else in me. SHEESH. I'll not worry about that, too much other stuff going on.

It turns out that cockles are some very small sort of clam. Who knew? LOL

[sccrm08]

Debbi,

You can ask the pharmacy to special order you the higher dose of iron. My Dr. said that was a must since theres a chance of so much blood lose during surgery. I hate iron as I had low blood iron most of my life and took iron on and off for many years. I was not anemic for the 2 years prior to surgery but they still had me take high doses prior.

Good Luck!!!

[Susie*Bee]

Debbe- I was told to take 325 mg OTC iron tabs-- ferrous sulfate, 3 x day. I found it at Wal-Mart. And yes, it can cause constipation and flatulence, etc. But you can get through it. There's a few threads you can do a search for that talk about foods, etc. As far as being ready for the donations, I was told (by the blood people) to always eat something "substantial" about an hour before-- like a sandwich. Since my donation site was about an hour away, I ate on the way... This should help with that weak feeling afterward. Sorry you had some trouble. And sorry to hear about your girls' weekend. Not much longer, and then you'll be through this part! Keep the positive attitude (as much as possible!) -- you're doing great! Hugs, Susie

Here are some links that may help:

http://www.scoliosis.org/forum/showt...lood+donations

http://www.scoliosis.org/forum/showt...lood+donations

[loves to skate]

Hi Debbe,

I don't think the Slow Fe 47.5mg 2 times a day will be enough for you. I would suggest you go back to the drug store and get the 300mg ferrous sulfate the blood center recommended to you. You can get it with colase so you won't get constipated. I copied and pasted a post by texasmarinemom that she posted several months ago for your information. I don't know how to reference posts so this is what I did. Hope it helps. Sally

__________________________________________________ _______________

Boosting Hemoglobin Before Autologous Blood Donation
Keywords: blood iron diet nutrition supplement pre-op self autologous donation low hemoglobin difficulty absorb heme non-heme meat fish chicken pork molasses spinach liver kidney caffeine tea pekoe inhibitor

As stated in another thread on pre-op autologous donation (and the inability to consume supplements to boost low hemoglobin after multiple donations), this is simply a repost.

Hopefully the keywords will help return it higher in the search results - and be of use to those in the future.

The original thread is located at http://www.scoliosis.org/forum/showt...?t=7290&page=2





Quote:
Originally Posted by loves to skate
About that spinach, make sure you cook it because the iron isn't as absorbable in the raw form even though it probably tastes better raw for most people.
Yeah ... I was thinking lightly sauteed in a splash of olive oil with fresh garlic ... mmmm ;-). It's also easy to chop and work into meatballs, meatloaf, soups, casseroles and pasta - but wait until you see what I read earlier about spinach ...

And, man ... blackstrap molasses. Ugh! I think I must have deliberately erased all memory of that foul stuff until it was mentioned here. Even just the *odor* (it's just like sulphur) makes me sick: I haven't even smelled it in years, yet can vividly recall it. My Dad LOVED it (especially on biscuits with ham), and it was all I could do to stay at the table when he opened the can. I can barely even handle the smell of regular molasses when it's called for in a recipe ...

I did a quick Google because I knew there were tons of iron-rich foods I didn't remember from when I was pregnant (AGES ago ... the pre-natal vitamins with iron made me nauseated so I compensated as best as possible via diet).

Shell, at your age, normal RDA (I'd assume even more when you're already deprived) of iron is 18 mg.

It is NOT recommended to consume > 100 mg of iron per day, and actually, this is difficult (almost impossible) to do without supplements.

The website beefinfo.org contains some helpful data like an RDA chart for all ages - male and female, and it also claims vegetarians should multiply their intake by a factor of 1.8.

It goes into detail about the 2 types of iron (heme and non-heme):

HEME IRON:

* is more readily absorbed by the body (approximately 23% of the iron consumed is absorbed)
* absorption is not changed by other foods
* found only in meat, fish and poultry
* important sources of heme iron: beef, organ meats (liver, kidney, heart) lamb, pork, veal, turkey, chicken, fish and seafood


NON-HEME IRON:

* is not absorbed as well as heme iron (only 3-8% of the iron consumed is absorbed)
* absorption can be increased or decreased by other foods
* found in vegetables, fruit, grains and eggs
* important sources of non-heme iron: dried fruits (raisins, apricots), whole grain cereals, enriched cereals and pasta, dark green, leafy vegetables (spinach, chard, kale), legumes (lentils, dried peas or beans)


... and here's what it has to say about compared absorption rates:

"Only some iron in food is absorbed well by the body. Heme iron, found in meat, poultry, and fish is much better absorbed than the non-heme iron found in plants foods and eggs.

For example, your body absorbs four times as much iron from a 90 gram serving of beef sirloin steak (cooked) than from a 175 mL (3/4 cup) serving of bran flakes."

While most charts list overall iron content per serving of foods, what *really* matters is how much is absorbable. The linked chart, gives an example of iron content vs. iron absorption: For instance, on various sites, a baked potato (with skin) might be listed with an iron content of anywhere from 2.8 - 4.0 mg, but only =>0.3 mg of that is actually absorbed! BIG difference.

They have tips and a bit of information on "iron inhibitors", as well. I found it interesting that while spinach is considered a good source of iron, this information was also on the page:

"Some components in tea and coffee can limit the amount of iron your body can absorb from foods with non-heme iron. To a lesser extent, oxolates in spinach or phytates in whole grains can also limit the amount of iron your body can absorb."

The New Zealand Beef and Lamb Marketing Bureau website provides some good information on iron intake, and more on ways to increase absorption:

What to do to avoid iron deficiency and have a healthy diet.

* Eat lean beef and lamb at least 3 to 4 times per week as an excellent source of iron. As a guide, a portion of meat should be about the size of the palm of your hand (not including fingers!).
* Eat meat, poultry or fish (haem iron foods) with vegetables, breads, pasta or grains (non-haem iron foods), as haem iron helps you absorb up to 4 times more iron from non-haem iron foods.
* Eat foods rich in vitamin C, eg oranges, kiwifruit and tomato, to help boost iron absorption from non-meat foods.
* Alternatively, drink fruit juice with your meal, which is also high in vitamin C.
* Avoid drinking tea or coffee with meals as they reduce iron absorption.

Interestingly enough, several sites suggest it's possible to increase the iron content of food by cooking with iron cookware (i.e., cast iron).

Also of note is what the Colorado State University Extension - Nutrition Services has to say about iron absorption in people with low levels:

"Iron absorption is affected by the iron status of the individual, the type of food eaten, vitamin C intake ad other factors in the diet. People with a low reserve of iron will absorb more iron than those with sufficient stores. This is the body's way of trying to maintain adequate levels of iron."

Bloodindex.org has a large list of overall iron content in foods, but remember most lists don't contain accurate absorbable counts.

Be sure to avoid iron inhibitors and do what you can to maximize the dietary iron you consume.

Before you know it, all this pre-op stress will be over and you'll be on the other side of surgery ... recovery!

Regards,
Pam
__________________
Fusion is NOT the end of the world.
Finished the AIDS Walk Houston 2008 5K @ 33 days post op!


39 yr old female, dx'd JIS & Boston braced @ age 10
Non-progressing ±53° right thoracic curve (surgery performed to address pain) ... Post-op curve ±20°
Posterior fusion Feb. 5th, 2008, T4-L1 ... Darrell S. Hanson, BCM - Houston

[bsprings]

Hi Debbe,
I've been thinking of you-I know you are glad it's almost here! I took Slow FE too, any other iron pill made me feel kind of sick. Just wanted you to know I will be praying- you'll do great! You are having posterior only, right? I bet your surgery will be a breeze- keep us posted!
Cathie

[leahdragonfly]

don't forget the Vitamin C Debbe

Hi Debbe,

I've been thinking of you as your surgery approaches. I know you are going to do great!

Vitamin C is very helpful with iron absorption (as mentioned in Pam's post). I had some transient anemia during pregnancy, and my OB told me this. So make sure and drink plenty of OJ with those Bambi stir-frys! Or other vitamin C rich foods. A daily dose of Colace, or a fiber supplement like Citrucel, will also help keep things moving. Don't wait until you are severely constipated to take action-prevention is much more pleasant!

Hang in there, your great sense of humor will go a long way in helping you get through this!

Take care,

[amae28]

Sounds like your appointment went well! I just wanted to comment on the iron... personally, it made me really constipated so I cut back and only took it like once a day instead of the 2-3 times that was suggested and I also took a stool softener with it. If your iron levels were OK when you went and gave blood too that should help.

Dr. Lenke used traction to hold my head up during surgery also, except they didn't tell me about it until the morning of surgery... which I was OK with not knowing. It wasn't a big deal though in the end, I just had little scabs behind my ears and it was bruised but I don't think that I would have noticed it had no one told me. Good luck with everything!

[laurieg6]

I know of a totally non-constipating liquid iron supplement called Floradix. My midwives recommended it during my pregnancies. I also gave it to my son in between his blood donation and his surgery. It's a food-based syrup made out of all kinds of high iron vegetables and fruits. It has other vitamins such as Vit. C, some B's and other supportive nutrients. It tastes relatively okay and it does not up upset your stomach. You can get it at health food stores.

Good luck with your surgery. You sound very well prepared and I'm sure it will go really well.