Pre-Surgery - How serious were you all about no asprin, alcohol?

[Neptune]

Pre-op instructions say to stay away from anything that could thin the blood for two weeks prior to surgery. No asprin, alcohol etc. So, here's the question: How serious did you guys that had your HTs adhere to this pre-op instruction? If any of you popped an asprin or had a glass of wine/beer in the days preceeding your surgery, did you feel it made a difference in either the healing of the recipient or donor sites? Not to fear - I'm not thinking of bucking the trend. Just curious as to how people really follow instructions when all is said and done.

[Neptune]

Pre-op instructions say to stay away from anything that could thin the blood for two weeks prior to surgery. No asprin, alcohol etc. So, here's the question: How serious did you guys that had your HTs adhere to this pre-op instruction? If any of you popped an asprin or had a glass of wine/beer in the days preceeding your surgery, did you feel it made a difference in either the healing of the recipient or donor sites? Not to fear - I'm not thinking of bucking the trend. Just curious as to how people really follow instructions when all is said and done.

[HK500]

I just had my second HT two days ago and I will be reporting in detail here as soon as the Doc gives me all the pics he took. I followed the preop instructions to the letter. I did not do it so well on my first HT and I think this second time I can already see faster healing, more than 50% of the scabs have already disappeared, no pain, no swelling and I did the scalp strectching exercises they really help, I have no tightness whatsoever. It's kind of a chore to do all this preparation but so far it seems to have halved my post op symptoms.

[Bill - Seemiller]

Neptune,

 

I don't know from personal experience...but I hope you take my word for it...follow the pre-op instructions. Why chance it? You are spending a LOT of money on this surgery...you don't want to add complications by not following the pre-op instructions. Cheers!

 

Bill

[Neptune]

Well Bill, if anyone would know it would be you! Don't worry, I don't intend to not follow the directions. I was curious to see what everyone's experiences had been. I had surgery on my shoulder last year and went though the same drill. A little different than this though.

[Hair2day]

ASA's anti-platelet effects are permanent for the life of the platelet, typically 10 days, so you should refrain from ASA for 10-14 days pre-op.

[studentjay]

Why would you want to make the surgeons job more difficult. By thinning your blood with these products you will be causing excessive bleeding requiring additional work to clear the area of transplantation. This ultimately may effect the appearance you obtain, if the surgeon cannot see the area properly he cannot place grafts properly. Steer clear of them.

[Jotronic]

Neptune,

 

It's pretty obvious to the surgeon when the pre-op instructions are not followed, especially with regards to aspirin. In our clinic we ask for no aspirin for two full weeks then no alcohol for one week as well as a few other minor products to abstain from. The time requests are made for a specific reason. If these are not followed then the patient may wind up being sent home. If the blood is too thin, you'll have a hard time forming clots therefore you'll just keep on bleeding.

[MrJobi]

Hi

 

I know they say no pills 7-10 days out but i don't remember the alcohol thing.. Maybe the day or 2 before but a week???

[Neptune]

I know. For my shoulder surgery, I was told no asprin for two weeks and no alcohol for a couple of days prior. For hair it's two weeks/one week. I guess the alcohol has more of an affect on the scalp than other body parts. Maybe it makes the recipient area bleed more with as many small incisions as are being made.

[YoungGuy]

Personal experience: I screwed up and had 3 beers a week prior to surgery (honest mistake, really... for some reason, I got it into my head that it was 1 week prior you can't have it, not two and thought I was safe).

 

Don't do it.

 

Even as little as 3 beers makes a noticeable difference in the bleeding of the recipient area. The practical ramifications are, the technicians will get ticked off at you (as they have at me somewhat) because it makes their job harder, and it makes staple removal more painful since when you bleed more, more blood will dry & stick to your hair.

 

None of the staples hurt enough to make me jump out of my chair or anything, but a few there had me catching my breath. I'm only 10 days post right now so I can't speak as to long-term ramifications and I honestly don't expect any, but the surgery itself is traumatic enough as it is. Don't make it harder on yourself than it has to be.

[Neptune]

I think YoungGuy's experience confirms something that could use some talking up to those about to have this surgery. Maybe everyone already lives pre-op surgical instructions to the letter, but for as important as the impact of as little as a few beers (or Asprin) a week to two weeks ahead of time may be, seems we should be sure to really warn those about to have this surgery of the potential impact. Don't take me wrong. I"m not beign critical at all. I've had some outstanding advice gained from being on this forum. Just haven't really heard this talked up as much. Maybe we should hype it up a bit more since the potential impact is so great. Many people around their 40's have already had a surgery or two, and speaking from personal experience, while Asprin was heavily warned against, alcohol was not (at least not for as much as a few days ahead of surgery). HT surgery is a different beast in many respects.

 

Thanks to all for chiming in on this one. Good stuff to use and share.

[nobuzz4me]

Yes, Neptune, good thread and good info pre-op.

 

We here a lot about pre-op scalp exercises ten times more than we hear about this issue. Thanks for bringing this to the forefront, very important as YoungGuy can attest.

[Spursman]

I made the mistake of taking MSM right up to the HT day. I knew you couldnt take asprin and stuff but not msm. It did thin my blood and when the techs were placeing my grafts in they had to spray it with water every now and then so they could see. it just makes the procedure longer. When Dr Feller was punching the holes he didnt say anything so it wasnt to bad.

[Gorpy]

My pre-op instructions said no alcohol 7 days prior.

[Neptune]

My instructions say no asprin 10 days prior and no alcohol 3 days prior. I hear several here say their docs said no alcohol a week prior. Is there not some way to define a "standard" practice here? Asprin seems straightforward. Alcohol not so much. A week seems safe by everyone's standards. But Dr. Epstein says three days. I imagine (based on photos of many patients) he has enough experience to warrant his protocol. Again, I'm not advocating less than a week. Just sharing info. I'll stop good wine a week prior just to avoid any risk. It might be useful for others who have experienced other surgeons to chime in and maybe we can come up with some "alcohol" majority accepted "safe zone" for those who will follow us. If only a few docs are three days, and the rest are a week, that should say something. Then I hear there is a whole different issue when it comes to MSM.

[YoungGuy]

If you want to avoid any risk, stop it for 2 weeks before. 1 week obviously wasn't enough for me

[Neptune]

After hearing what happened to you YoungGuy, I for sure will. Thanks for the heads up!

 

Does anyone know what the impact (if any) of MSM is on thinning of blood?

[Eman]

I was also told no minoxidil 3-months prior to surgery. I initially thought it was 3-weeks, but I was mistaken

[Neptune]

Found this on MSM and blood thinning.

 

http://www.arthritis-msm-supplements.com/faq.htm

 

 

 

The key paragraph says this:

 

 

 

Is safe to mix MSM with other prescribed medications?

 

 

 

MSM has been observed in clinical settings some indications that it may have a blood-thinning, aspirin like effect on platelet aggregation. Therefore, you should consult your doctor if you are taking high doses of aspirin, or blood-thinning medication such as heparin or dicumarol.

 

 

Would indicate that MSM should be discontinued like asprin prior to transplants.

[Gorpy]

Hey guys, I just wanted to add something here since I just had another procedure. My doctor noticed my blood was a bit "slippery", meaning thin. I followed pre-op directions to a tee. The only thing I could think of was I used some "Smart Balance" buttery spread. I noticed it has Omega 3 Fatty Acids (Fish Oil) in it. Maybe that thinned my blood a bit. You have to be careful.

[Neptune]

Prepare for information overload:

 

I'm not sure this doesn't deserve a thread of its own, but I'll throw this information I found out there and you can decide. Interesting stuff related to things that "thin" the blood. Take a look at this article.

 

http://www.ctds.info/natthinners.html

 

Foods that Naturally Thin the Blood

 

 

 

There are a number of foods and supplements that are known to thin the blood. These include foods with high amounts of aspirin like substances called salicylates, omega-3 fatty acids, foods with natural antibiotic properties and vitamin E supplements.

 

It is important to note that while many Americans have problems with blood clots, it is not true that blood thinning foods are desirable for everyone in the population. I have been an easy bleeder all of my life, so I have compiled much of the information on this list so I know which foods to limit in order to keep my blood from being too thin. People taking prescription anticoagulant drugs also need to be careful not to consume too many foods with natural blood thinning compounds in addition to their regular medication. One of my relatives is on a prescription anticoagulant drug for blood clots and has gotten eye hemorrhages from ingesting too many blood thinning foods in conjunction with his prescription medication.

 

Interestingly, my relative was given a list of foods high in vitamin K so he would know what foods to limit so as not to reduce the effectiveness of his medication. However he was not given a list of foods that have their own anticoagulant properties, which is taken in conjunction with his medication could cause bleeding problems. He found some information on his own about blood thinning foods after he had a couple of eye hemorrhages.

 

Blood coagulation should fall within a desirable range. If blood coagulates too easily, clots can form which in turn can lead to adverse health conditions such as heart attacks. However, if blood doesn't clot enough, conditions such as hematuria (blood in the urine), hemorrhages, heavy periods in women, nosebleeds and bleeding strokes may occur. If a person's blood isn't clotting enough and he has surgery or a traumatic event like a car accident, he could have a serious problem by losing too much blood if any wounds or surgical incisions failed to clot properly.

 

Some of the foods that are generally thought to have natural blood thinning compounds are listed below. Please note that this is a hodge podge list based on information I've collected over the years based on my own experiences and my assortment of alternative health books, so it's possible it may contain some errors. See your doctor before you implement any diet, supplement or exercise changes, especially if you are taking any prescription medications or have any health concerns related to coagulation.

Salicylates

 

One type of natural blood thinners are substances that block vitamin K. These include salicylates. The most well known of these is aspirin, but many foods, such as preservatives and flavorings, also contain salicylates or aspirin like substances. Some individuals are known to be aspirin or salicylate sensitive. I'm one of those salicylate sensitive types, but I have found that I can eat more salicylates as long as I eat a balanced amount of vitamin K foods, too. (Vitamin K plays an important role in the body's in blood clotting processes.)

 

Foods that are generally high in salicylates include many spices, most fruit, especially dried fruits, nuts, and also some flavorings and preservatives.

 

Herbs and spices high in salicylates include:

 

* Curry powder

* Cayenne pepper

* Ginger

* Paprika

* Thyme

* Cinnamon

* Dill

* Oregano

* Turmeric

* Licorice

* Peppermint

 

In Ayurvedic (traditional Indian medicine) many of the above spices are known as "warming spices". I think this is because by thinning the blood they increase a person's blood circulation, which in turn speeds up the metabolism and makes a person feel warmer.

 

My family was really cold one late evening at Disneyland, but as soon as we ate some churros we all warmed up. We did not know why at the time, but later realized it was because the churros were dipped in sugar with cinnamon, a spice high in blood thinning compounds and known as a warming spice in Ayurvedic medicine.

 

One of my children has had trouble with night sweats, so we put him on a diet that among other changes limited the amount of salicylates he consumed. That seemed to help him stay much cooler at night.

 

Fruits high in salicylates include

 

* Raisins

* Prunes

* Cherries

* Cranberries

* Blueberries

* Grapes

* Strawberries

* Tangerines

* Oranges

 

Other substance high in salicylates:

 

* Almonds

* Chewing gum

* Honey

* Peppermints

* Vinegar

* Wine

* Almonds

* Vinegar

* Cider

 

Though there are some exceptions, in general most meat, fish, dairy, grains and vegetable foods are not high in salicylates. Many types of fish do however have blood thinning properties due to their omega-3 fatty acid content, as noted below.

 

Vitamin E

 

Vitamin E is an antagonist to vitamin K. Some foods and topical substances these days are preserved with vitamin E, so it pays to read labels carefully. One of my sons, who also seems to be an easy bleeder like me, developed severe nose bleeds from a hand lotion that had vitamin E used as a preservative.

 

Foods high in vitamin E may not necessarily thin the blood, as many foods high in vitamin E, such as spinach and broccoli also contain significant amounts of vitamin K, which tend to clot the blood.

 

I was prescribed vitamin E supplements at one time by a doctor for fibrocystic breasts. Afterwards, I developed an increased number of bleeding and bruising problems. Then I did some research on my own and realized vitamin E could thin the blood. Most medical articles states that people have to take relatively large doses of vitamin E in order for it to have an effect on coagulation. However, I don't think that is true for everyone. For people like me who are easy bleeders even small amounts of vitamin E can cause bleeding issues.

 

Vitamin B6?

 

This is just an anecdotal report based on my own experience, but I took a vitamin B6 supplement at one time and developed a really bad nose bleed shortly afterwards. The nose bleed stopped when I had a vitamin K rich salad, so I do think that the bleeding was from a lack of vitamin K and not other causes, such as trauma or high blood pressure. The vitamin B6 tablet was the only change I made in my usual diet and routine that day.

 

Interestingly, one of my health books noted that vitamin B6 lowers estrogen levels, and it is well established through medical studies that increased estrogen levels are linked to blood clots. As such, if vitamin B6 does lower estrogen levels, then it may make sense that it may also thin the blood. However, I have never found any studies noting this association, so at this time the link between vitamin B6 and thinner blood is just a hypothesis in my part based on information from my health books, my own experience and logical deduction.

 

Omega- 3 Fatty Acids

 

Omega-3 fatty acids have received a lot of press lately because of their ability to lower cholesterol levels and make the blood less prone to clotting. Fish oil is usually high in omega-3s and can be ingested either through purchasing capsules or by eating fatty fish. Fish with high amounts of omega-3s include:

 

* Mackerel

* Anchovies

* Salmon

* Albacore tuna

* Mackerel

* Lake Trout

* Herring

 

When eating fish, one danger is that many fish have high mercury levels, so experts often have mixed recommendations on exactly just how healthy eating a lot of seafood is for most people.

 

The chart in this link to the U.S. Environmental Protection Agency web site contains a table of mercury levels in commercial fish and shellfish. Fish may be a great food for people who are at risk for blood clots, but for easy bleeders like me it is a food I need to limit, regardless of mercury levels.

 

Additional Selected Foods With Compounds That Thin the Blood

 

* Tree Ear

* Jicama

* Garlic

* Onions

* Olive Oil

 

Garlic and onions are natural antibiotics that can kill the intestinal bacteria that manufacture vitamin K. Many studies have found that long term prescription antibiotic use can cause bleeding problems due to a vitamin K deficiency. However, for people like me who seem to always be short on vitamin K, even small amounts of foods with natural antibiotics properties, like garlic and onions, are problematic. I often avoid eating at Italian restaurants because of their liberal use of garlic. When I do eat Italian food, I also try to have have a salad with lots of leafy green vegetables high in vitamin K as a part of my meal.

 

James A. Duke, author of several books on herbal medicine, notes that garlic has nine different compounds that are antiaggregants (compounds that prevent the blood platelets from sticking together).

 

Exercise

 

Based on studies of female athletes, vigorous exercise seems to lower vitamin K levels. Women who are elite athletes, i.e. those who over exercise, instead of being healthy actually are at risk for hypoestrogenism, osteoporosis and vitamin K deficiency. Vitamin K is necessary to clot the blood, so by logical deduction then it may be prudent to consider the possibility that over exercising may thin the blood since it is known to lower levels of vitamin K.

 

At the other end of the spectrum, we know that people who remain stationary for long periods, such as people on bed rest, in car trips or travelers on long plane flights, are at risk for blood clots. One of my relatives developed a blood clot in his leg on a flight from Europe to the U.S. and had to have emergency surgery shortly after landing in the U.S.

 

By logical deduction then, the table below may illustrate the links between the conditions associated with remaining stationary and the conditions with over exercising, two conditions at the opposite end of the spectrum.

Remaining stationary

 

<=>

 

Vigorous Exercising

 

Blood Clots

 

<=>

 

 

Vitamin K deficiency

 

Thinner blood

 

Higher estrogen levels

 

<=>

 

Low estrogen levels

 

Increased cancer risk

 

<=>

 

Decreased cancer risk

 

Table showing known links between exercise, estrogen levels, vitamin K, cancer and blood clotting.

 

Sunshine / Vitamin D?

 

In Ayurvedic medicine, sunshine is supposed to be good for a person's circulation, which I've found usually means it also thins the blood. As noted above, other Ayurvedic remedies for improving circulation, such as cinnamon and ginger, have actually been proven in modern medical studies to be natural blood thinners. As such, it would be logical to consider the possibility that if Ayurvedic medicine was correct about the spices thinning the blood, they may have been right about sunshine, too.

 

Interestingly, a recent medical study found that a "clinical trial of a biologically active metabolite of Vitamin D3 demonstrated an unanticipated reduction of thrombosis in cancer patients." Vitamin D is a fat soluble vitamin that we can obtain in two ways: 1) through food; or 2) it can be synthesized by the body after exposure to sunshine.

 

I don't know if these means that sunshine would have the same impact on blood as the vitamin D from the study, but it is interesting food for thought. If sunshine is found to be a blood thinner, it would confirm what Ayurvedic practitioners have thought to be true for thousands of years.

 

Summary

 

It is well known that foods that elevate vitamin K levels, such as lettuce and broccoli, may clot the blood. People who are taking anticoagulants are often warned to limit these types of foods so they don't counteract the effectiveness of their medicine.

 

However, it is often overlooked that many foods and environmental factors, especially those that lower vitamin K levels, may thin the blood. This information may be important for people on anticoagulants to be aware of in order to prevent their blood from becoming too thin.

 

 

Sources:

 

1. Murray, M. and Pizzorno, J. (1998). Encyclopedia of Natural Medicine. Rocklin, California: Prima Publishing.

 

2. Carper, J. (1988). The Food Pharmacy. New York: Banam Books

 

3. Hausman, P. & Benn Hurley, J. (1989). The Healing Foods. Emmaus, Pennsylvania: Rodale Press

 

4. Duke, J.A. (1997). The Green Pharmacy. Emmaus, Pennsylvania: Rodale Press

[Neptune]

Sorry, the table showing cause and affect did not format correctly. To see it, check out the link on the site I provided above.