Thalassemia and blood transfusions

[pem]

My surgery will be in less than 36 hours.

I have a form of Mediterranean anemia called Thalassemia Minor. Because it is the minor form, there are no symptoms. However, in a blood test, my hematocrit shows up as below normal (the normal range is 40-50 and mine shows up as low 30s).

I just learned that decisions about transfusion depend on hematocrit. So I'm concerned that because of my Thalassemia, my low hematocrit would result in me receiving an unneeded transfusion. I plan to discuss this with the surgeon on the morning of my surgery, but I was wondering if anyone on the forum might have an insight into this?

Thanks!
pem

 

[Luana]

I have beta thalassemia, minor. My hematocrit is usually at the low end of normal, and my RBC count is almost always just a tad high, usually just outside the normal range.

First, do confirm you will be able to talk to your surgeon the morning of surgery. I was told I would not see him before surgery. There's an awful lot done to you before the surgeon begins; it can take an hour or more to get all in order for the surgeon.

When I met with surgeon, he said he did not see any need for blood transfusion, unless something unlikely happened, he said not much blood is lost during the surgery. I did have a blood transfusion the day after surgery; my lung collapsed, and ICU nurse advised a transfusion for more RBCs, or as the respiratory therapist said, "more trucks." Before I knew it there was a consent form in front of me which I signed. When you're on oxygen and gasping to take in a breath, there's not too much to argue about.

 

[Natina13]

pem
My surgeon ordered a red blood cell transfusion; when my hemoglobin dropped below 8 ( Normals: Men 13-18 rams per deciliter, 12-16 for women) They did a CBC daily, during my 7 day hospital stay. I required 4 units of blood, during my 3 days in ICU. I was also given platelets while in surgery, to help my blood to clot.
Although I have had 2 previous major surgeries....this was the first time I required a blood transfusion.
Best of luck on your trip to the other side of the mountain and may you have a bump-free recovery !
Renee
Go Team 2011

BAV with severe stenosis and 3 proximal arteries 75% + occluded dx 11/2011 4/14/2011 AVR Edwards "Magna" Bovine Tissue Valve and a triple bypass

 

[pem]

I have beta thalassemia, minor. My hematocrit is usually at the low end of normal, and my RBC count is almost always just a tad high, usually just outside the normal range.

First, do confirm you will be able to talk to your surgeon the morning of surgery. I was told I would not see him before surgery. There's an awful lot done to you before the surgeon begins; it can take an hour or more to get all in order for the surgeon.

When I met with surgeon, he said he did not see any need for blood transfusion, unless something unlikely happened, he said not much blood is lost during the surgery. I did have a blood transfusion the day after surgery; my lung collapsed, and ICU nurse advised a transfusion for more RBCs, or as the respiratory therapist said, "more trucks." Before I knew it there was a consent form in front of me which I signed. When you're on oxygen and gasping to take in a breath, there's not too much to argue about.

Thanks for responding. Sounds rough - glad it's behind you! Do you happen to know whether or not they took your Thalassemia into consideration for the purposes of making the transfusion decision or determining how much to give you?

Best,
pem

 

[pem]

pem
My surgeon ordered a red blood cell transfusion; when my hemoglobin dropped below 8 ( Normals: Men 13-18 rams per deciliter, 12-16 for women) They did a CBC daily, during my 7 day hospital stay. I required 4 units of blood, during my 3 days in ICU. I was also given platelets while in surgery, to help my blood to clot.
Although I have had 2 previous major surgeries....this was the first time I required a blood transfusion.
Best of luck on your trip to the other side of the mountain and may you have a bump-free recovery !
Renee
Go Team 2011

Hi Renee,

Thanks for your well-wishes and for sharing your experience.

Do you have Thalassemia Minor?

Best,
pem

 

[Luana]

Thanks for responding. Sounds rough - glad it's behind you! Do you happen to know whether or not they took your Thalassemia into consideration for the purposes of making the transfusion decision or determining how much to give you?

Best,
pem

No, I don't know. It all happened very quickly. I was sitting up in a chair in the room. I happened to notice that my O2 sat numbers were dropping rather quickly on the monitor, which I thought was odd and not very good. My nurse came to my room very quickly, ordered me back in bed and said more red blood cells would help me get more oxygen. I only got one unit of blood. I'm guessing she didn't know what my hematocrit was or that it mattered. She upped the LPM on the oxygen, called in respiratory therapist, and a pulmonologist saw me later.

 

[Lynlw]

My surgery will be in less than 36 hours.

I have a form of Mediterranean anemia called Thalassemia Minor. Because it is the minor form, there are no symptoms. However, in a blood test, my hematocrit shows up as below normal (the normal range is 40-50 and mine shows up as low 30s).

I just learned that decisions about transfusion depend on hematocrit. So I'm concerned that because of my Thalassemia, my low hematocrit would result in me receiving an unneeded transfusion. I plan to discuss this with the surgeon on the morning of my surgery, but I was wondering if anyone on the forum might have an insight into this?

Thanks!
pem

As others said I would NOT wait until the morning of surgery to hope to discuss this with your surgeon. I would call now just to make sure. Also idon't know if your cardiologist is on staff at the hospital were you're having your surgery, IF so I would also call their office. IF You haven't had your "pre op" testing day yet, i would also talk to anesthesia and whoever else you meet with about your concerns

 

[pem]

As others said I would NOT wait until the morning of surgery to hope to discuss this with your surgeon. I would call now just to make sure. Also idon't know if your cardiologist is on staff at the hospital were you're having your surgery, IF so I would also call their office. IF You haven't had your "pre op" testing day yet, i would also talk to anesthesia and whoever else you meet with about your concerns

Lyn,

You are the voice of experience. I spoke with the Surgeon's office today and the nurse told me that they look at a variety of things, including hematocrit to make that determination and, furthermore, that my recent hematocrit was subnormal, but only by a little. So it sounds like this won't be an issue. But, on your recommendation, I will mention it again when I speak with the anesthesiologist.

Thanks!
pem