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Anemia After Spinal Fusion

MarkRMMarkR Posts: 172
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
Last week I had an appointment with a primary care physician due to a forced insurance change to an HMO (it was forced, unless we wanted to pay over $600/month for PPO coverage). The exam included blood work.

I just got the results and they indicate anemia. This is interesting because I had my lumbar fusion in mid-August. I took iron supplements as required for 3 weeks prior to the surgery, but was told I did not need them after the procedure. I assume my levels were fine at the time of surgery (and even the week prior at my pre-op), otherwise the procedure would have been postponed.

Anyway, my red blood cell count, hemoglobin and hematocrit levels are all slightly below the low point of the reference range. However, my platelet levels are really low. It should be between 140-450 K/UL and mine is 60. I would not be as concerned if it was only a few points below the reference range, but this is pretty low.

The PCP asked me to take iron supplements and repeat the test in several weeks. I don't mind taking the iron supplement if I have to, but I am a bit concerned that the platelet levels are so low 3 months after my surgery.

My surgeon told me I had lost approximately 25cc of blood during the surgery - the lowest amount he has ever seen. I have another appointment with my surgeon next week and will bring these lab results with me and discuss the situation with him. I'm starting to wonder if I have an extremely small blood leak somewhere.

In the meantime, has anyone experienced anything like this, where they were diagnosed as anemic after their fusion surgery?

Thanks in advance for your input.
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Comments

  • My step son had thrombocytopenia, low blood platelets, when his platelet level would get below 10(10000) then he would need a immunoglobulin transfusion. His lowest was a 2 (2000), that was bad, and required hospialization. The other times he was treated as an outpatient. Once he had his spleen removed he went back to normal. He would get symptoms like, horrible nose bleeds, bruises or small red spots in his mouth. If you get any of those symptoms I would call your doctor for a blood test sooner than the 3 months! I do remember we were to avoid asprin and alcohol use as well.

    Hopefully you will boost back up naturally and not need any future treatments.

    Take Care,
    Shell
  • Mark, this is confusing to me as anemia doesn't typically include thrombocytopenia. Your platelets seem disproportionately low. That is less than half of low normal. I have anemic patients all the time whose platelets are completely normal. How low is your H/H? I am wondering if any of the meds you are taking can have thrombocytopenia as a side effect?

    Shell, what your step son had is called ITP (idiopathic thrombocytopenia purpura). I have taken care of many pediatric patients with this. Most respond to IVIG infusion and get to keep there spleen, but I recall 2 who had to have spleenectomy in their teens to get rid of it. They try not to remove the spleens of really small children cause they are at risk of overwhelming sepsis and death. I had a 2 year old patient who had her spleen removed after an injury and she was on antibiotics daily until she turned 7 to prevent infection. Crazy stuff!

    Good-luck Mark, I know they never even tested my blood post-op even though I had 250 ml blood loss and tons out of my drain. No wonder we are so tired after surgery. >:D< Sue
  • Cali-Sue said:
    Shell, what your step son had is called ITP (idiopathic thrombocytopenia purpura). I have taken care of many pediatric patients with this. Most respond to IVIG infusion and get to keep there spleen, but I recall 2 who had to have spleenectomy in their teens to get rid of it. They try not to remove the spleens of really small children cause they are at risk of overwhelming sepsis and death. I had a 2 year old patient who had her spleen removed after an injury and she was on antibiotics daily until she turned 7 to prevent infection. Crazy stuff!
    >:D< Sue
    Yep, would respond to the IVIG for a week or 2 (I think it took a few days to go up after it was given). He was 17 when he had the spleen removed. The spleen was enlarged as well, they were able to do it laproscopically, looks just like a gallbladder scar.

    I do remember reading about the meds though, but I dont remember which ones could cause it.
  • I had a very low HB after surgery - It is usually about 132.0 but had gone down to 5.5 after surgery and I was given 2 units of blood which brought it up a bit to 8.5 .
    After 3 months it was at 10.5 and I had been taking Iron and folate every day.
    Last week I had blood test and was suprised to find it is still marginally low (after 6 months) and is at 114.0
    NR (119-160)

    I did discover that you shouldn't take Iron and calcium together as the body can only obsorb one of them and I had been taking both, also that you need to take vitamin C with iron (which I was). SO I now take Iron and C for breaky and calcium and D for lunch and dinner :))( and hopefully it will pick up.
    I am just suprised at how long it has taken for the HB to come up. The haematocrit is also marginally low but the platlets are fine.

    I hope you find the cause of it soon but if you are not feeling bad dont stress yourself over it.
    Do you bruise badly? as I know this is a sign of ITP.

    Blessings Sara O:)
  • Cali-Sue said:
    Mark, this is confusing to me as anemia doesn't typically include thrombocytopenia. Your platelets seem disproportionately low. That is less than half of low normal. I have anemic patients all the time whose platelets are completely normal. How low is your H/H? I am wondering if any of the meds you are taking can have thrombocytopenia as a side effect?

    Good-luck Mark, I know they never even tested my blood post-op even though I had 250 ml blood loss and tons out of my drain. No wonder we are so tired after surgery. >:D< Sue
    Cali-Sue -

    Thanks for your input. The following are the levels from my Hematology report:

    WBC: 4.3
    RBC: 4.21
    HGB: 12.9
    HCT: 37.3
    MCV: 89
    MDHC: 34.5
    RDW: 13.4
    PLAT: 60

    The medications I am currently on are: Darvocet-N 100, Soma 350, Protonix 40mg (for reflux). I also take a men's one-a-day vitamin and magnesium supplements several times a week. That is it. The only change in this routine is that I was on Percocet after my surgery and changed to Darvocet several weeks ago. I also just started on the Soma several days prior to giving blood for this test.

    Thanks again for your insights.

    -- Mark
  • Mark, your hemaglobin and hematocrit are barely low. Normal for a male is 14-16 (female 12-14). Do you know what your preop hemaglobin was? Anyway, perhaps it is just a fluke. My pre-op potassium was 2.7 (very low) so had to have it redrawn immediately before surgery, and it was 3.6 (normal). I think mine was a lab error personally, cause I was not sick or anything. You might want to look up the side effects to your drugs just to see if any list thrombocytopenia. I'll try to look later too and see what I find, but gotta go pick up my son now. Most likely it will all be normal when you get it redrawn. Just follow your doctors instructions and let me know how you do.
    >:D< Cali-Sue
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