Upcoming surgery - comments?

[Guest guest]

I'm going in for a hernia repair surgery on Dec 4. Is there something

I should do considering these levels? The surgery will be about an

hour, under general anesthesia, with a 2 1/2 hour stay in the

recovery room.

4 x Saliva Cortisol

0.8 (3.7 - 9.5)

0.8 (1.2 - 3.0)

0.5 (.6 - 1.9)

0.9 (.4 - 1.0)

Cortisol Burden 3 (5.9-15.4)

My most recent ferritin level was 7.

Is it safe to have surgery with those levels? I did have high cortisol

5 months ago. It was just shy of the diagnostic criteria for

Cushing's. Some folks are telling me that I should go on HC

and stress dose for the surgery. Others are concerned about

the low ferritin. The only reason that I'm a little concerned is

that the last time I went under general anesthesia, my BP dropped

to 40/10 and they had to pump me full of pressors. I had to

ride it out without any pain meds until we got home and my wife

could get back out to the pharmacy.

Here are some select lab results:

10/22 - Serum

T4 free 1.0 (.8 - 1.8)

T3 free 370 (230-420)

TSH 1.09

Glucose 85 (70-99)

Globulin 2.1 L (2.2 - 4.2)

A/G ratio 2.4 H (1 - 1.9)

Exceptions:

B12 1426 H (200-1100)

Folate > 24.0 (> 5.4)

Ferritin 7 L (20-380)

Iron Binding Capacity 680 H (250-425)

Iron Saturation 14 L (20-50)

RBC 5.96 H (4.4-5.7)

MCV 74.5 L (81-100)

MCH 22.7 L (27-35)

MCHC 30.5 L (32-37)

RDW 17.6 H (11.8 - 15.1)

Eosinphils Absolute .3 H (0-.2)

9/17 Serum

Triglycerides 134 (<150)

Chol. Total 112 L (125-200)

HDL 24 L ( > 40)

LDL 61 (< 130)

DHT 61 (25-75)

IGF-1 100 (86-220)

Estrone <10 ( <68)

Insulin 7 (<17)

Estradiol 50 (13-54) * this fluctuates between 13 and 50. I feel best at 20.

SHBG 14 (9-45)

8/25 - Serum

Testosterone 992 (250-1100)

Free T% 2.45 H (1.5-2.2)

Free T 243.5 H (35-155)

T4 Free 0.9 (.8-1.8)

T3 Free 332 (230-420)

TSH 1.65

Vitamin D 25-OH 38 (30-100)

Vitamin D3 32

Vitamin D2 6

Estradiol 13 ( 13-54)

TPO and TG antibody tests were negative.

Parietal cell antibody test also negative.

By mouth, my temp is usually 97.9 - 98.3.

My blood pressure is 118/74 - 130/84.

It is treated with Micardis 40 mg.

Pulse is usually 60 at rest and mid 70's during the day.

I'm at 2 grains of Armour, and have been there since

Aug 25. I don't remember the increases before that.

I feel so much better than I did before I started Armour

that I don't think I have any symptoms. I feel great!

It is possible that I'm not getting quite as much out

of the Armour as I did a few months ago, but I'm

still caffeine free and very active.

-Mike

[Guest guest]

Sorry. I've posted the question on a couple different groups

to get a wide range of opinions.

The reason that I'm posting the question on the groups is that

none of my doctors want to talk about it. Even the one that

ordered the test is not answering.

So far, it looks like the smart thing to do is to call ahead and

let the surgeon's office know that I've come up with very low

cortisol results, and that info should be passed on to the gas

passer so they will have some solumedrol on hand. I will also

take the results with me on the morning of the surgery.

The surgeon has all of my labs except for the cortisol one.

Thanks Sheila,

-Mike

>

> Hi Mike

>

>

>

> You need to be asking somebody this question who is medically qualified and

> who knows about the problems associated with surgery on a person who is very

> low cortisol as I mentioned in my previous posts. Is your ferritin still

> very low? What iron supplementation are you taking? With many surgical

> procedure, they will do a blood test. Unless you are anaemic, they are

> likely to do the surgery, but let them know in plenty of time about your low

> Ferritin level. Even with low ferritin, they might still do your surgery but

> they would need to know about this in case you needed a transfusion. To be

> honest Mike, with your previous history of your BP dropping so frighteningly

> low when undergoing anaesthesia, I would ask your doctor to speak as a

> matter of urgency with a specialist regarding these matters before you

> undergo any surgery. You may need to build up both your cortisol and

> ferritin levels well before the 4th December.

>

>

>

> Sorry not to be more helpful - but this is specialised information you need.

>

>

>

> Luv - Sheila

>

[Guest guest]

Thanks Dawnx. I really appreciate it.

>

> Hiya

>

> I would be quite concerned and contact the anaesthatist (spelling?)

> prior to admittance, tell him about your BP experience, your cortisol

> tests are pretty bad as is your ferritin.

>

> I was reading a paper about the risks to hypo patients undergoing

> surgery and with those cortisol levels your thyroid hormones may be

> having problems working properly.

>

> I definately agree with peoples concerns.

>

> Good luck and God bless whatever you decide to do.

> Dawnx

>

[Guest guest]

An excellent idea Mike. Let us know what your surgeon suggests

and I sincerely hope that everything works out well for you, as I'm sure it

will.

Luv - Sheila

So far, it looks like the smart thing to do is

to call ahead and

let the surgeon's office know that I've come up with very low

cortisol results, and that info should be passed on to the gas

passer so they will have some solumedrol on hand. I will also

take the results with me on the morning of the surgery.

The surgeon has all of my labs except for the cortisol one.

Thanks Sheila,

-Mike