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Fusion...Blood donation and back brace

AnonymousUserAAnonymousUser Posts: 49,900
edited 06/11/2012 - 8:22 AM in Back Surgery and Neck Surgery
I'm now scheduled to have my fusion L4/5 L5/S1 on September 25th. They are asking me for a blood donation. Anyone have to do that?? How many of you needed your blood for a transfusion??
Also, my doc never mentioned a back brace of any sort for after the surgery. I'm reading that a lot of you have had to wear one. Is there a reason for not having it versus having it??? I think I might want one, should I ask for it?? Does it make a real difference?



  • I considered giving my own blood pre-op, but the nurses I asked were so wishy-washy about it and not helpful so I did not push the issue and ended up not doing it.

    I ended up needing 2 units in my second surgery - it would have been really nice if I had followed through on the pre-op end of things.
  • kim- I would ask the drs office how often they have had to transfuse during fusion surgery. It may depend on the surgeon.

    An autologous unit of blood is the safest blood that you can receive. You may want to call your local blood center as they usually have rules and will most likely need a prescription from the dr allowing the autologous donation.

    The blood bank may also set up appointments for autologous donations to ensure they are staffed properly and are ready for any health challenged person..... :))) jade
  • My blood donation is going to be at the hospital where I am having my surgery. It's part of the pre-op stuff that I have to do before my surgery. I am assuming that this is part of the procedure and is covered by my insurance, but then again...we should never "ass"ume!!!! LOL! :))(
    I guess I am glad that they are having me donate blood, it could be worse!!
  • My husband had 4 level fusion in July L1 down and had to give 2 pints. It made us feel better, just in case. And yes he got a back brace 2 weeks later. The Dr had not said anything about it but the day they took his staples out the Dr sent us straight over to get my husband measured for it.
  • Wow, you have been though a lot, I am so sorry you have to go through fusion too.

    I was fitted 2 weeks before surgery for my custom brace. I'm 6 weeks 4 days out and still in it. I hate it and love it at the same time. It is a lot of work but it helps me with my posture and helps me feel safe when I am up and about.

    As for the auto blood, I had to start donating 3 weeks before my surgery. I did mine through the Red Cross, they were fantastic. I went again about a week before my surgery for a total of 2 units. I really didn't expect to need the blood but got both units back. I knew at the second appointment that my hematocrit was falling and I might need *some*. The phlebotomists told me to eat cream of wheat, it has like 45% of the iron you need a day per serving. I did but still ended up needing it. My husband said they had it going in the recovery room, but I don't remember...

    I hope things go well for you. We all know just how you are feeling.
  • Hi Kim, I am 11 weeks post-op and I did not give any blood, it was never brought up and thankfully I did not need it. It sounds like maybe a good idea though. As far as the back brace I asked my doctor before surgery and he said don't worry about it you will be fitted in the hospital. Sure enough the physical therapist at the hospital came in a couple days after surgery and made sure it fit. Mine was only about 10 inches in front and 2 feet across back and had velcro closures, very easy to take off and on and only weighed 2 lbs. At my 6 week check up which was more like 7 weeks doctor told me to start weaning off brace and when I felt comfortable without it I could drive. A week later it was retired. You are having the same levels as I had, and just want you to know I am feeling really good. It is a slow recovery but I have not had pain since the obvious first couple weeks(and that was relieved by medication). I know everyone is different, but listen to your doctor and more important listen to your body. Ask as many questions as you can write down at your pre-op so you go in feeling like you are prepared for everything even if it seems stupid. I wish you great success!
  • I have spent several months meeting with surgeons (3 orthos, 2 neuros) about my condition and lumbar fusion surgery. I am now scheduled for surgery in October.

    I've asked every surgeon I've met about donating my own blood prior to surgery, because I think it's a good idea. All have said I could, but the surgeon I'm going with actually said they insist that I donate my own (I liked that). I will donate 2 units 2-3 weeks prior to surgery. I will use the Bonfils Blood Center, which is a blood bank for the Rocky Mountain region. When I was speaking with Bonfils about the donation, the rep said I should check with my insurance about coverage. Apparently some insurance plans cover it and some don't. She mentioned that some will only cover the donation charges if your blood actually gets used on you in surgery or post-op. Bonfils bills through the hospital, which then submits charges to insurance, and I don't know if that makes a difference. But, my surgeon's scheduler/assistant said she'd never heard of insurance not covering it.

    I've also asked all the surgeons about a back brace. One said no, I wouldn't need one; one said he'd definitely want me in a hard brace & I'd be fitted for it before surgery. Others said maybe. The surgeon I've picked said I'd probably be in a corset for a while, not a hard brace, but he wouldn't decide what brace, if any, to prescribe until after surgery, based on what actually got done and how it went (e.g., how much slip reduction was achieved, how much fusion surface area was attained, what my bones seem like, what kind of instrumentation had to be used...). If I need a hard brace, I'd get fitted for it before leaving the hospital. I would certainly ask about a brace, especially if you think you might overdo things without one (which I'm probably prone to do).
  • Good luck on your upcoming surgery. I did not donate blood ahead as was never mentioned by my NS. Luckily I didn't require any, although they never even drew my blood to check my H/H after surgery. My drain was putting out lots of red fluid for 2 days post-op, but I was told it was normal. I am a nurse and I have never seen as much fluid coming out of my patients, but I haven't taken care of spine patients before either. I asked about checking my blood and the nurses said we'll leave the doctor a note, and that is the last I heard of it. I took iron prophylactically before surgery but stopped after when the constipation set in. As for the brace, my surgeon sent me a prescripton for a TLSO pre-op and I had to go to Hanger Orthotics to get it fitted. It was quite interesting as the technician made me a "mermaid dress" out of stockinette that I had to put on over my underclothes. He then took like a thousand measurements and asked my bra size. I now am the proud owner of a TLSO, ie "Zena Warrior Princess" brace. It even came with extra cleavage to boot =)) =))
  • SWEET. I want a cleavage brace.
  • lo first ur to funny i want one to! :))( :))(

    They wanted me to do my own blood I said no. Insurance wouldnt' cover it, and it was hard enough finding a vein in me anyway. I never ended up needing any in surgery. I forget the price per unit.

    My ortho does not like braces afterwards. His thought is your not using any core strength. Also your fused with hardware so that pretty much is your brace.
    So goes to show you that all Drs. think different.

    Like I said in a previous post about upcoming surgery I had one here before surgery just a waist one w/ strings. Waist level. I used it once inawhile when we walked outside or on a car trip.

    GOOD LUCK HUN >:D< >:D< >:D< >:D<
  • I had a hip replacement 2 years ago and was told to donate my own blood- 3 units. As I have worked in pathology for 10+ years I understood that and was very happy to agree.
    I dontated the first, then when I did the second a week later I was told to have a HB count done before donating the third. Sure enough my HB was too low to donate the 3rd unit.
    So I'm madly taking Iron, eating meat, spinich and having guinness every night. I went into hospital the night before surgery and my Hb was still too low to operate on me, so they had to give me my blood back before I had the surgery.
    I then required another 4 units during and after surgery.

    So needless to say I wasn't going to donate for this surgery. My O/S did say he will probably require blood but they have now found that the patients health often suffers too much from Autologus donation that they no longer recommend it and do it only if the patient insists.

    And to top it off it cost me over $1,000 to donate my blood!

    With my fusion - 3 levels I needed 2 units the day after surgery and 3 months later my Hb is still not back to normal, my body is obvioulsy putting its efforts into repairing my back not my blood!!

    Anyway that is my story - just to give you some perspective.

    Blessings Sara

  • I gave my own blood for 2 units there was no time for a third, I did loose alot so the used both units and let me loose two with no worries. I would give blood for a back up you never know.

    But my most recent surgery they said no need, I also used a back brace, actually I have 5 of them 2 are fitted from an ortho place and the others are soft from my surgeries. if your Dr. wants you to have a back brace they should have the company bring one out to you, or give one at the pro op apt at hospital, or maybe the day of surgery, but they will supply the one they want you to use.
    it does make a difference for me atleast its not so much to support the fusion

    Good luck with your fusion, is it anterior and posterior or just one? If you have any questions threw this process just ask, I have had alot of spine surgeries and know what it is like to go threw fusions. When I had my 1st fusion I didn't even know what it really was, and NO body including Dr. expressed the pain and healing process.

    Hope all goes well.

  • Didn't finish typing bout the reason for the brace. Its not to support the fusion but mostly for restriction of movemtent, and muscle support. Would be very interested if your dr. don't have you wear one on to as why, Like said before all Dr.s think different
  • Thanks to all of you who have commented! I appreciate it!

    ToYoung, I am having an ALIF which the dr said I don't need hardware??? I'm guessing a lot of the people who have had the ALIF did need the hardware. I'm not too sure how this all goes.

    Now for the blood donation, I'm glad that they have ordered it. After hearing all these stories of people who actually need it, it makes me feel better. I really never thought about needing blood during this procedure. I guess all my other surgeries were minor compared to this, even though I've had a lot of them!

    As for the backbrace!! I too would love more cleavage! :))( After having 2 kids I feel like I need some!! LOL! Plus to look skinny too with a flat stomach! YAY! Not that I'm overweight or anything!

    My surgeon even mentioned that he might give me a tummy tuck too!! :))( That I know I could use for next summer!!
  • I did not need any blood-I lost 900 ml. My doc never mentioned giving blood or getting a back brace-but I he is making me wear a hard shell one for 3 months! I had L4-S1 fused too.
  • Wish I had that option of no hardware. The more surgeries I get the More bling, bling, I get. lol maybe someday I can get it removed

    Please keep us informed of how the surgery goes.

  • Do most people get the hardware?? I'm kinda nervous that he isn't giving me any. I just keep hearing about the people who do have the hardware and wonder.....
    I'm sure there are advantages and disadvantages, just not too sure why he isn't talking about it. I wonder if he needs to see the damage first??
  • I'd be nervous too! I have more metal in me that a small car! I do not uunderstand how your spine will be supported without it-but then again...I am no doc! Even hearing that people have plastic cages instead of metal makes me worry.
  • My Neuro uses plastic cages. There is no need to have metal cages... The cages are only temporary support until you fuse. This way, you can still get MRI's if you need them. My doctor is also putting something in my back, but not sure what it is.... Anyway, I think it depends on the person, too... Not just the doctor. My Neuro is going to have me wear a brace for 6 weeks. She has awesome patient satisfaction ratings.. Much higher than the national average. She is very good. I trust her... And I'm actually glad she's using plastic cages. They are actually pretty strong. She showed me actual models of them.
  • My brace frames my breasts, there is a bar that runs right between them. Then a large pad across the top. That is the part that gets me. If I go out in public I wear a button down shirt over it. Mine sounds different.

    As for not having hardware, not everyone does apparently. Maybe ask your doc if/why not use any. It is a good idea to keep a running list for your next visit.

  • I would think without hardware, you will definitely need a brace. Make sure to ask. I do believe the anterior hardware is quite a bit different than posterior. It is more like a plate, not any rods or pedical screws like posterior. Yep, make that list of questions. Regarding blood, you usually donate at a blood bank, I guess some hospitals might have this capacity, but I know mine doesn't. Make sure you are finished donating a couple weeks before surgery so your body has time to replenish what it lost before you go in. My pre-op visit would have been too late. Hey, your lucky if your doc throws in a tummy tuck, no fair :))(
  • I got a "plastic" cage too. It is made of Peek and it is as strong as the metal and helps with xrays. It is radiolucent(sp?) so it doesn't interfere with xrays.
    My implants and hardware cost like $19,000. Isn't that crazy!
  • Hi Kim:

    I did not donate my own blood. One week after my TLIF fusion I needed to go in for an emergency colon repair surgery. After that surgery I needed two units of blood. My insurance covered it because at that time everything was covered 100% for me.

    I did have a back brace. My doctor had me wear it from day one. I was to wear it when I was up walking, through the first six weeks (that is when I was fully fused) and when I was in the car, through the first six months. I found that it was useful when I was on my feet for an extended period of time. I had my surgery late September, 2007. IE...I did some baking at Christmas time and was one my feet more so I would put on my brace.

    I wish you the best on your upcoming surgery.

  • kim- I'll have to keep the tummy tuck in mind when considering surgery. Hope your surgery goes well... :) jade
  • Hey! I want a tummy tuck! Not fair!! I lost 92 lbs 10 years ago(& kept it off!)-plus I have 3 kids-I need one in a bad way! My surgery was through the back though-wish I'd know about having it done through the front!
  • I did not donate blood, and ended up having 6 units after surgery. It has been 15 weeks since my 5 level fusion L2-S1 and I have been in a brace 24/7. I have a new pain over the R side of my scar. It started 4 weeks ago and it has made my walking more difficult. I am praying it is nothing serious.
  • hi keecho,

    i had a two level alif. no rods, screws or plates and no brace. and i did not donate any blood either. my surgery went well, did not need transfusions as lost minimal blood. surgeon said if he wanted to he could grab the peek cage and lift my bodyweight off the operating table, that is how stable the spine is. i did however have NO problems with instability preop.

    i was off meds at 6wks, started PT at 6wks, working 30hrs/wk at 12, introduced bending back in at 12wks (limited and in a controlled environment), now at 14wks and doing pretty well (still no drugs, better work tolerance, progression of exercises at PT). touch wood, things are progressing very well at present.

    i have never been concerned about not having a brace or hardware as i never had a problem with instability and i understand what neutral spine is / can apply it - in saying this if my surgeon had requested a brace i would have followed his instructions to the tee, as i have throughout. if you have difficulty maintaining a neutral lumbar lordosis through movements (sitting; walking, climbing stairs) then a brace could assist with this as it does not allow those movements. on the other hand though, a brace means you dont have to use your core muscles to stabilise so when you do wean off the brace you may have problems with lack of core strength and the instability from deconditioning - this needs to be weighed against your individual case.

    just thought i would chime in as im one of those people that did it ala naturale...
  • I was told with my ALIF that my surgeon could not remember the last time he needed to give someone blood so there was not a need to donate. They did recapture my blood loss during surgery and give me that back in recovery. I did have low blood counts post op but they came back up.

    I also had a brace for 3 months. At first all the time when out of bed then just when out walking and riding in car. The hardware really is not going to go anywhere the brace was to provide stability and prevent me from twisting etc.
  • The Dr. said because it was a 5 level fusion he wanted the brace. I think my past surgery made him nervous. My previous neck fusions did not heal years ago and I ended up with 4 extra surgerys, 2 plates then finally they added a songer cable. Plus 3 1/2 years in a Somi brace Then 2 1/2 years to finally totally fuse after the last neck surgery. That is the reason I put off back surgery for 10 years. I just read that Motrin was not good for Fusion and I have been on it since 1992. Other then the 10 days before surgery no Dr. has ever told me not to use it. I have not taken any strong pain medication since 3 1/2 weeks after surgery. I do take Nurontin also. I have lots of nerve damage in my neck and arm, now add the nerve problems in my leg. But it is all good. I now have a question about Motrin and fusion when I see my Dr. next week.
  • Hi Young,

    My OS does not use braces for his fusion patients. I had a three-level fusion with instrumentation. The OS said that is enough support plus he prefers his patients learn to use their muscles properly rather than rely on external support.

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