What do you mean I need surgery?
Like a lot of folks I fortunately sailed through my childhood and young adult years without serious injury, disease, or surgery. So, I never dreamed I would ever need surgery – until recently. Trust me, the older you get the more likely you will need an operation of some kind. I’ve now had two in as many years. Thank God both were elective. A total knee replacement in 2008 and gall bladder removal in early 2010.
As a medical editor I’ve watched all types of surgeries over the years without so much as a quiver. After all it was to help the patient, right? Ah, but when it was my turn it was a different matter. The very thought left me hollow. My stomach did little flips, my hands turned cold, and tiny beads of sweat rolled down my back. Everything in my head said NO! What was I worried about? Certainly not my surgeon and anesthesiologist, both are excellent at what they do. My concern was blood. I didn’t want any. I’m not alone.
Blood transfusion? No way
When you check into hospital for surgery, one of the things you are asked is whether you will accept a blood transfusion. Without hesitation I said “absolutely not.” It’s not my religion. I’m not a Jehovah Witness whose faith forbids blood transfusions even in the face of death. I just know the risks associated with donated blood: Hepatitis, HIV and other diseases, pulmonary complications, slower healing, longer recovery even death. And since I was having elective surgery, I had the choice to refuse. I and every patient who refuses a transfusion can thank Jehovah’s Witnesses.
Bloodless surgery and conservation
Their religious beliefs forced physicians develop ways to perform surgeries without blood transfusions. That trend began in 1962. Today, the approach to bloodless medicine and surgery is state-of-the-art and in demand by mainstream patients who hear their doctors say ‘the best blood is your own’. What a change in attitudes. Doctors who once thought donated blood was necessary now offer their patients ways to save their own blood and avoid transfusions.
Dr. Jan Seski, a gynecologic oncologist here in Pittsburgh, Pennsylvania, is a pioneer and leader in bloodless medicine. He got involved back in the 1970’s while completing his fellowship at M.D. Anderson Cancer Center in Houston, Texas. In 1981 he brought a bloodless technique to Pittsburgh. Ten years later he opened the Oakland Infusion Center which offers patients facing open heart, orthopaedic and cancer surgery a wide range of blood conservation methods.
Dr. Seski, like most physicians, doesn’t pooh-pooh donated blood. In certain situations it has value. However, he’s quick to add “it’s a good thing to avoid blood transfusions if you can, not just because of the risks involved with transfusions but the expense.” Hospitals pay approximately two-hundred dollars per unit. Tack on disease testing and blood typing and patients will pay roughly one-thousand dollars per unit. Depending on the treatment some patients can go through five or six units of blood. In severe trauma cases and liver transplantation it is not unheard of for patients to receive 70-units or more. You do the math.
Save every drop
So hospitals and doctors alike are doing what they can to recycle a patient’s blood and limit the amount of blood lost after surgery.
* Pre-operation preparation – Patients can plan ahead and collect their own blood for use during surgery.
* Drugs can boost blood levels before surgery.
* Blood Cells can be salvaged and blood can be diverted or looped during operations.
* Doctors can limit post-surgery blood draws – patients can lose a pint of blood a week from drawing blood
*Micro-sampling techniques for lab tests to preserve patients own blood is available in some hospitals.
* Post-operative anemia can be corrected with Intravenous Iron and High doses of the growth hormone, erythropoietin, to make bone marrow produce red blood cells or prevent anemia caused by blood loss
Unfortunately, not all hospitals are alike. It’s up to you, the patient, to refuse blood transfusions before surgery – if that’s what you want. And, to ask your doctor what, if any, bloodless techniques he or she can provide. With the demand for bloodless medicine and surgery on the rise, chances are good that you can get what you need without donated blood.
Dr. Jan Seski, Director, Oakland Infusion Center – 412- 621-2888
Center for Bloodless Medicine and surgery 412-359-8787 www.bloodlessmedicine.org