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]

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]

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

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.

__

[Guest guest]

Hi Mike,

I hope that your proceduse goes well. I also have lowish cortisol- not that

bad, just a bit lower than it should be. I was told by my dentist that before I

had a very tricky extraction under sedation that I should double my dose of

pred the day of the procedure. There were no complications, and since then I

have had two operations under local anaesthetic with no problems using this

method. I hope this goes in some way to reassure you

Stenning

FW:

Re: Upcoming surgery - comments?

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

[Guest guest]

Well, I've heard back from the docs. My PCP does not think

the ferritin is enough of an issue to prevent me from having

the surgery. I'm supposed to go back for more testing towards

the end of the year.

The functional medicine doc that ordered the cortisol test said

that it was inconclusive and nothing to be concerned about, and

that we should include DHEA the next time, or better yet, do a

24 hour urine test. If this test has no real diagnostic value, why

did I blow an hundered odd dollars on it? Anyway, she seems

to think that it would not be of interest to the anesthesiologist.

Now I feel like a jerk for leaving a message with the surgeon's

office.

>

> 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]

Anyway, she seems

to think that it would not be of interest to the anesthesiologist

But would't you feel better if you spoke to them? I certainly would

given your history. Tell her its all about making you feel more

relaxed about the procedure. Don't feel like a jerk, you have the

right to ask questions.

lotsa luv

Dawnx

[Guest guest]

Hi Dawnx,

I did leave a message with the surgeon's office. I'll take the test

results in with me and ask the anesthesiologist about it. Also,

my doctor is going to ask the lab to test the saliva already collected

for DHEA. If the numbers look bad, she will contact the surgeon

and anesthesiologist directly. In an email from my doc, she sort

of suggested that I over reacted about the test results, and that

the anesthesiologist wouldn't really take me, or the test results

very seriously. They kind of poo poo saliva tests and would

rather use serum or 24 hour urine. Now they probably think

I'm a hypochondriac. I've been putting this surgery off for a year

thinking that it would be better to have it done after I lost a lot

of weight. I'm a little over half way done with my weight loss

goal, but I've had to wear what amounts to a weight lifter's shirt

as an undergarment to keep my innards from coming out my

belly button. That and people were kind of grossed out about it.

The thing does hurt most of the time now. I really can't put it

off any longer. I just hope that it doesn't have anything to do

with my ferritin level of 7.

Thanks!

-Mike

>

> Anyway, she seems

> to think that it would not be of interest to the anesthesiologist

>

>

> But would't you feel better if you spoke to them? I certainly would

> given your history. Tell her its all about making you feel more

> relaxed about the procedure. Don't feel like a jerk, you have the

> right to ask questions.

>

> lotsa luv

> Dawnx

>

[Guest guest]

Hi Mike,

suggest that you take appropriate iron ( with vit C)suplements- that resuly it very poor.

> thyroid treatment > From: mlawson66@...> Date: Mon, 17 Nov 2008 05:40:11 +0000> Subject: Re: Upcoming surgery - comments?> > Hi Dawnx,> > I did leave a message with the surgeon's office. I'll take the test> results in with me and ask the anesthesiologist about it. Also,> my doctor is going to ask the lab to test the saliva already collected> for DHEA. If the numbers look bad, she will contact the surgeon> and anesthesiologist directly. In an email from my doc, she sort > of suggested that I over reacted about the test results, and that> the anesthesiologist wouldn't really take me, or the test results> very seriously. They kind of poo poo saliva tests and would> rather use serum or 24 hour urine. Now they probably think> I'm a hypochondriac. I've been putting this surgery off for a year> thinking that it would be better to have it done after I lost a lot> of weight. I'm a little over half way done with my weight loss > goal, but I've had to wear what amounts to a weight lifter's shirt> as an undergarment to keep my innards from coming out my> belly button. That and people were kind of grossed out about it.> The thing does hurt most of the time now. I really can't put it> off any longer. I just hope that it doesn't have anything to do> with my ferritin level of 7.> > Thanks!> > -Mike> > > >> > Anyway, she seems> > to think that it would not be of interest to the anesthesiologist> > > > > > But would't you feel better if you spoke to them? I certainly would> > given your history. Tell her its all about making you feel more> > relaxed about the procedure. Don't feel like a jerk, you have the> > right to ask questions.> > > > lotsa luv> > Dawnx> >> > > > > ------------------------------------> > TPA is not medically qualified. Consult with a qualified medical practitioner before changing medication.> >