Once you and your health care team have decided on a particular type of procedure that is best suited to your desire for bloodless treatment, you may be given a number of recommendations to follow in advance of your procedure.
Get enough iron and other nutrients
You may be advised to eat a diet high in iron to build up the amount of iron in your blood. Iron is required by your red blood cells for good oxygen-carrying capacity. The best dietary source of iron is lean red meat. You can also get small amounts of iron from chicken, turkey, eggs, iron-fortified cereals, and beans, although the iron in these foods is not utilized by your body as effectively as the iron in red meat.
You may also be given iron supplements, such as ferrous sulfate or ferrous gluconate. Try to take these supplements with some vitamin C (e.g., swallowing the iron pill with a glass of orange juice). The vitamin C helps your intestine absorb the iron more effectively.
Consider consulting a nutrition specialist or registered dietician to get advice on how to eat the most optimally nutritious diet possible. Other vitamin supplements that you might be advised to take in order to maximize your body's production of healthy red blood cells include folic acid and vitamin B-12.
Boost your blood counts
Erythropoietin is the name of a chemical normally produced by your body, primarily by your kidneys. Erythropoietin stimulates the bone marrow to produce red blood cells. Laboratory-made synthetic erythropoietin (e.g., Procrit, Epoetin alfa, Epogen, or Aranesp) may be administered prior to your surgery in order to maximize your bone marrow's production of red blood cells. Similarly, synthetic G-CSF (Neupogen) or GM-CSF (Leukine) may be given in order to bolster your body's production of white blood cells, and interleukin-11 may boost your body's ability to crank out platelets.
Check Hemoglobin levels
If you are having elective (not emergency) surgery, and blood tests just prior to your surgery show that you have a hemoglobin level lower than 10 grams per deciliter, your surgical team may choose to delay your surgery. Rescheduling your surgery for a couple of weeks later will allow you to take some medications and make some diet changes in order to boost your hemoglobin into a more optimal range.
Stop certain medications
Before your surgery, your doctor may ask you to stop taking medications that have adverse effects on blood count and clotting ability. Medications such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs; anticoagulants (such as Coumadin); vitamin E; and herbal preparations containing garlic or ginkgo biloba are known to interfere with blood clotting. With reduced clotting ability, you are more likely to lose blood.
If you aren't told which medications to stop taking before your surgery, be sure to ask. However, don't ever stop taking a prescription medication without the knowledge of your health care team.
If you are a smoker, do everything within your power to stop smoking several weeks before your operation. Smoking interferes with the free flow of blood throughout your body, decreasing oxygen delivery to your organs and tissues. Oxygen delivery is something you will want to optimize before your surgery.
Sign a medical directive
When you check into the hospital or surgical center, sign a medical directive that clearly states your preference not to receive blood products. You'll want this document to explicitly list those products and/or procedures that you absolutely do not wish to receive, as well as those products and/or procedures that you are willing to accept. Many bloodless surgery centers will place a special wristband on you (along with your regular hospital wristband) that identifies your preferences regarding blood products. A sticker should be placed on your hospital chart and a sign should be posted on your hospital room wall or hospital bed to alert the medical care team about your specific requirements concerning blood products.
Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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