|Bloodless medicine: A personal story|
Suzanne K. is a 46 year-old woman with three children who had to undergo surgery to have her gallbladder removed. Because she is a Jehovah's Witness, she opted for using bloodless surgical methods. She answered questions about what was involved in taking that approach.
Suzanne, what was the reason you had gallbladder surgery?
Well, I'd had ultrasounds and tests that showed that my gallbladder was full of stones. I was having these periods of pain, and my doctor was pressuring me to get the gallbladder taken out so that I wouldn't risk other problems. I put it off because I really didn't want to have surgery. As a Jehovah's Witness, I wouldn't allow it to be done with any blood being given. And it was hard to find a good time to do it -- a time when I wouldn't be needed by my family during my recovery!
Anyway, I finally realized that I needed to get on with it. So my husband and I started reading up on the kind of surgery I'd need.
What information did you find?
I thought it was exciting that they can take out your gallbladder through such a tiny opening now, using scopes and special tools. This obviously seemed less likely to cause bleeding. We're lucky because we live in a big city, so we could look around at all the hospitals in the area and find out which ones have done a lot of operations without giving blood, and which ones have doctors, nurses, and anesthetists committed to bloodless medicine. We also talked to friends in our church to find out who they had gone to.
It used to be that some doctors would refuse to take care of Witnesses because they thought they'd get sued if something went wrong and the doctor couldn't use blood. My husband did a lot of the reading, and he was pretty convinced that we had to go somewhere with more experience operating on patients without using blood, so they would know what to do if I did have any complications.
So, you chose your surgeon by virtue of his experience with bloodless techniques?
Yes, but not just the surgeon, the whole program. I went to him with all the information about how I wanted to have the gallbladder taken out though the scope. And he was fine with that, because he'd already done so many and didn't feel at all nervous about whether it would be too dangerous for me or risky for him malpractice-wise. He said if I hadn't brought it up, he would have, because he pretty much prefers to do the scope surgeries for gallbladders, unless you have some other problem. That made me trust him more.
What kinds of things did you do to prepare for your surgery?
I had iron-poor blood -- I always have, on and off. So right away he had me start to take iron tablets, and I paid more attention to my diet to eat more foods with lots of iron in them. He gave me pamphlets about nutritious eating, and that was really helpful. And I took some other vitamins -- folic acid, I think, and some B vitamins and E. I think to make my blood better and help me heal faster. We set up the surgery date a couple of months in advance, so I had time to make a difference with my diet and the vitamins, and so I could get everything organized at home.
How did you make your need for bloodless medicine clear to the surgical team?
My husband and I had taken care of that a long time ago. We had written down and notarized our medical directives, and we have key chains and medical alert bracelets that we and the kids wear. These are sort of like what a diabetic patient would wear, to make sure that if we are in an accident, we wouldn't be given blood. You can even get forms on the internet that are very professionally written to fill in with your preferences about not receiving blood products or whatever. So we already had all that, and we just made sure that my doctor and the admissions office at the hospital had copies. Also, my husband had them in his wallet when he brought me to the hospital for my operation, so if there was any kind of confusion he could pull out the papers.
But the place we went was very professional, and they had a special bracelet for me, along with the regular hospital ID bracelet. The special bracelet said "No Major Blood Products Under Any Circumstances," which was also written real big on the front of my chart. And just like they always ask you about your allergies, the nurses kept checking with me that the bloodless request was right.
What kinds of things were done for you during the procedure?
Well, of course I was asleep for most of it, but I know that my doctor told me in the office beforehand that they would be using special tools to immediately stop any bleeding. And the openings they made were as small as possible, just enough to be able to put the scope and tools inside. I had an IV to keep my fluids up, and the anesthetist did a lot of work with my doctor, so he knew what to watch for. I know they used a lot of monitors to see how I was doing and watch for any complications.
What happened after the procedure?
I was lucky because I'm pretty good at healing. I think all the vitamins I took must have helped too, because the wounds stayed clean with no complications. I have to say, the wounds were tiny but they hurt more than I thought they would. And I really felt sick for the first couple of days -- maybe the medicines that put you to sleep made my stomach upset.
One good thing is that my iron didn't drop back down, so when I left the hospital, they said my blood was still good.
What would be helpful for other people to know when they are about to have a bloodless procedure?
I'm glad my husband found the names of people who were good at these kinds of operations. That's probably the main thing. The nurses and everyone knew what we were talking about when we said we wanted bloodless methods. They didn't act all surprised or disapproving or anything, which used to happen a lot. They understood our position, and they knew what to do to make sure that's what happened. So read about the people you're going to see, and read about the kinds of operations so you can ask for the best options.
Reviewed By: 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.