Surgery

 

SurgeryBefore you have an operation, ask your surgeon to talk to your bleeding disorder doctor.  They will need to plan what to do before, during, and after the surgery.  For example, they have to be sure you have everything you'll need to prevent bleeding.  You and your family should be part of the planning.  You will need to know what to do after you go home from the hospital.  Before your surgery, order the factor or other medicine you will need when you return home.

Blood tests are done before surgery.  If you have hemophilia, your factor level will be measured and checked for inhibitors.  People with other bleeding disorders may have their platelets and clotting times checked.  Tell your surgeon all the drugs you are taking.  Some of these may slow down your blood clotting.  You may have to go into the hospital a day or so before the surgery for more tests.  The doctor may want to check how high a person with hemophilia's factor level goes after he takes a dose of factor.  Then she or he can plan exactly how much factor will be needed during the operation.

Not all hospitals are set up to do surgery on people with bleeding disorders.  It may be better to choose a big hospital over a small one.  A big hospital is more likely to have the people and machines needed.  Your HTC can tell you the best hospital for your type of surgery.

Some surgery does not have to be done right away.  It may be cheaper to wait until you need two operations done.  Then you can do them together and save money on lab tests and factor.  Talk this over with your surgeon and your bleeding disorder doctor to see if this is an option.

Surgery in the mouth (oral surgery)

If you and your dentist take care of your teeth, you aren't likely to need surgery in your mouth.  Fillings, root canals, and having a tooth pulled can hurt and cost a lot of money.  You can prevent these things by brushing and flossing your teeth every day.  By seeing your dentist every six months, she or he will be able to take care of any problems before they get bad enough to cause bleeding.  Your HTC can help you find a dentist who works with people with bleeding disorders.

Sometimes dental work has to be done in a hospital.  Most of the time it can be done in the dentist's office.  If the dentist or mouth surgeon needs to do a big job on your teeth, she or he should talk to your bleeding disorder doctor first.  They should plan the dental work together.  The dentist will need to have everything a person with your bleeding disorder might need.

A person with hemophilia will always need to take factor before having surgery in his mouth.  Sometimes factor will be needed after the surgery, too.  The medicine Amicar® may be taken before or after the surgery.  It keeps the blood clots that form in the mouth from breaking down.  Then there will be less bleeding and less need for factor.

Sometimes a tooth has to be pulled because it is decayed or infected.  There may be too many teeth crowded together.  Having a tooth pulled sounds simple, but people with hemophilia have to be extra careful.  The dentist and hemophilia doctor should plan it together.  The hemophilia doctor should also be called before having gum surgery, getting a tooth replaced, or getting braces.

A person with hemophilia needs to take factor before the dentist gives him a numbing shot.  He may not have feeling in his mouth or cheek for two or three hours.  He has to be careful not to bite his lip, cheek, or tongue.  Until the feeling comes back, it's safer not to eat solid foods.  Eat soft foods for a day or so until the mouth heals.