Upcoming Major Surgery

Hi everyone I was diganosed with ITP in 2001 and have been on prednisone and then danazol for years until I trusted my Hemo and got off the awful meds and my counts have stayed in low 30's-40's.

Last month my count went to 27 and I had to get a new Hemo (old Hemo retired) and I was in hospital with IV transfusion and prednisone and count came up to 84 and 2 weeks later has dropped to 59. This was my second transfusion first was 2005.

I am having surgery June 20th for diverticulitis (pouches on colon from perforation) and I am worried about the platelet count.

I tried to talk to my surgeon about my ITP concern and he acted as if oh well. He says transfusion will be done.

Has anyone here had major surgery and done alright? This will be my first major surgery and yes I am scared of bleeding risk.

So HOPING someone can tell me if they have had surgery and done alright with it.

Thanks everyone

How about doing IVIG or steriods prior to surgery to get your counts up to a safe level for surgery?

My ITP initially discovered when I was already under anesthetic, with heprin onboard to prevent clots when they actually looked at the pre-surgery bloodwork and discovered my platelets were 79K. Needless to say I had technicolor bruising, but I came through just fine.

Can your do IVIG or Winrho? or a short pred protocol to bump them up for the surgery?

Charlotte, I've had two major surgeries in the past few years. I had my spleen out in /06 and my gall bladder out in /07. For both surgeries, I had 3 days of IVIG to bring my counts up. The same surgeon did both surgeries, as he knew my history and I didn't want anyone else. I was concerned about bleeding too and asked my doc about platelets on hand and he said he didn't keep them in surgery; needless to say, I was a little worried! But I trusted him to do what was best and I've been fine ever since. Do you trust your surgeon? It helps if you do.

Let us know how everything goes for you. And I wish you a speedy recovery.

Thanks Bunnie and Cindyl but yes I am scared because having a resection of the colon is a major surgery and my surgeon says platelets will be available but I know there will be a lot of bleeding cutting the colon to get rid of the disease part and I am so scared.

Gallbladder is a minor surgery,isn't it? I mean you are out in a day but with this it will be 3 to 5 days sometimes 1 week if complications.

This surgery coming up has taken over my life. I find myself depressed,crying and all the emotions you can think of. I am usually a strong person but this has gotten me down.

Hope someone else has had success with major surgery and will post.

Thanks Bunnie and Cindyl.

www.itpsupport.org.uk/american/13.%20Surgery%20in%20the%20Patient%20.pdf

This article discusses the platelet counts necessary for various surgeries, usually 50K is enough. It would be better to do something before surgery such as win rho rather than having a platelet transfusion.

Try not to stress about it but try to work something out. Is there nothing can bring your count up before surgery? You say you had a transfusion that brought your count up. Was that a platelet transfusion or an IVIG infusion or something else?

When I had surgery, the doctor wanted a near normal count so I did steroids just beforehand. She didn't want me on steroids afterwards because it impairs healing so we had to time it right but my count was good for the op and that was good enough for us.

It seems to me that you need to talk to your haematologist and your surgeon and get them to communicate with each other and to decide a way to get your count up for the surgery. If the surgeon is not helpful, try the haematologist.

Charlotte:

That really is the big question - can you do anything to get counts up before surgery? If so, then you really don't have to worry about that.

Thanks everyone for such encouraging words and helping me face this disease with an upcoming surgery. I say so many times "IF ONLY" I didn't have this ITP I wouldn't be such a basket case as I am now because of the fear of bleeding.

I read the article Dina and found it to be very interesting. There is hope now and I want to thank you for sending the site.

CindyL I was wrong gallbladder surgery is considered to be a major surgery so praying my surgery will go well too.

Ann I had the IVIG transfusion with 40mg of prednisone for 2 days so my counts did come up.

Thanks Sandi for your encouragment also.

I hope now I can concentrate on other things rather than the surgery.

I am a bit reluctant to post in this thread, since some of the posts have taken on a "my surgery is worse than your surgery" tone. That's unfortunate. Everyone's ITP is personal to them, and comparing battle wounds doesn't go anywhere constructive.

That said, I have had an open splenectomy, stomach surgery, and brain surgery, all with counts in the single digits. The risks are something to discuss with your surgeon, keeping in mind that no surgery is without risks, both anticipated and unanticipated. Find a trauma surgeon who isn't afraid and who is prepared. As I recall, my count was 4 when my splenectomy started, and 56 when it ended, because my surgeon was smart, went slowly, with lots of cauterization along the way, and did it right.

Best wishes for your surgery.

Thanks Gort I do know I will be having IVIG transfusion before surgery but with ITP it does cause worries. I don't know my surgeon very well because my first meeting with him was June17th so I will just have to put my faith in him.

Thanks everyone for your "so much needed" support and advice. I am schelduled for July 20th and hope all goes well.

Okay as you can tell I am still very concerned about this upcoming surgery on the 20th Sorry everyone I used to be a strong person until I found out I will be having major surgery and I am worried.

My question is if I have the transfusion to increase platelets will they last 3 to 4 hrs. during surgery? I heard my surgeon say they can do surgery at 50,000. My count stays at 20-30 now. I know the platelets come down quickly so what happens in surgery if I start to bleed bad.