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Is it a good idea to donate your own blood before having abdominal myomectomy surgery?

Dr. Parker’s Comment: I recently attended a lecture by a world expert in blood transfusion medicine and it was eye-opening. It turns out that every day that blood, even your own blood, sits in the blood bank refrigerator, it decreases in quality. Studies show that in an ICU with really ill patients, the ones who were transfused did worse than the patients with similar illnesses and similar levels of anemia who did not get transfused. The reason is that the blood cells become more fragile, then fragment and clog up capillaries, blocking blood flow and oxygen delivery to the tissues. Here is the reference for the abstract: http://jama.ama-assn.org/cgi/content/abstract/288/12/1499

Although serious problems are less of a risk for young, healthy women who are having myomectomies (you are all really young and healthy compared to 80 year-olds in an ICU!), the best strategy is getting your blood counts up before surgery and using a cell-saver during surgery.

For women with very low hemoglobin levels (below 9), I usually use Procrit to stimulate red blood cell production for about 3 weeks before surgery. High doses of iron must also be given, so your body has the building blocks to make red blood cells, and vitamin C is also given to help you absorb more iron through the intestines. There is no magic number, but it is nice to have the hemoglobin 10 or higher before surgery, unless heavy menstrual bleeding does not allow us to get the blood counts up even with Procrit and Vitamin C (very rare).

The second strategy is the use of the cell saver, which allows us to replace blood loss, if necessary, immediately during surgery with the patient’s own blood, before it has a chance to deteriorate. Also, there is no risk of HIV, hepatitis or mismatched blood with the cell-saver.

Blood is suctioned from the incision and operative area, stored in the canister, and then filtered and returned to the patient through an IV

Blood is suctioned from the incision and operative area, stored in the canister, and then filtered and returned to the patient through an IV

And lastly, the current recommendation is to not transfuse blood unless the patient is very dizzy when they stand up or very weak, or until the hemoglobin is below 7 (it used to be below 10). Since the blood doesn’t work very well anyway, it is better and safer to allow the patient to build up her own blood slowly during the recovery period.

There is a push to explain all this new information to doctors because it is different from what we were all taught. So, you will find differences of opinion based on a doctor’s knowledge of this new information.

More about myomectomy surgery can be found at this link: http://www.fibroidsecondopinion.com/abdominal-myomectomy/

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Disclaimer: The ideas, procedures and suggestions contained on this web site are not intended as a substitute for consulting with your physician. All matters regarding your health require medical supervision.

2 Comments

  1. Cynthia
    Posted September 23, 2009 at 10:07 am | Permalink

    Is it possible to build up hemoglobin enough to be able to just wait and watch fibroids. My hemoglobin was 6.6 and is now 7.5 from taking iron supplements. My uterus is 6 times normal size with one fibroid the size of a softball, and numerous others. My doctor is strongly recommending a laparoscopic hysterectomy. I just found your website today, and it is the most helpful and informative site I’ve found. Thank you for your help.

  2. Posted September 23, 2009 at 9:25 pm | Permalink

    You did not say, but I assume the anemia is from heavy menstrual bleeding due to the fibroids. If so, it is unlikely that you will be able to correct the anemia because you will be losing blood every month. However, there are many other ways to help you other than hysterectomy. Depending on the size, number and positions of the fibroids, hysteroscopic myomectomy, laparoscopic/robotic myomectomy, endometrial ablation, abdominal myomectomy, or uterine artery embolization are alternatives. Myomectomy is always possible and should work just fine. You should discuss these options with your doctor, or consider getting a second opinion.Also, take a look at these web pages regarding alternatives;
    http://www.fibroidsecondopinion.com/laparoscopic-myomectomy/
    http://www.fibroidsecondopinion.com/abdominal-myomectomy/
    http://www.fibroidsecondopinion.com/hysteroscopic-myomectomy/

    Bill Parker, MD

Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in San Diego, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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