Having an operation: What does the surgeon need to know about MPN?

Posted by lynnebgraham @lynnebgraham, 3 days ago

What does my surgeon need to know about my having MPN ET.

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From Google AI:

Preparing for surgery with Essential Thrombocythemia (ET) taking Hydroxyurea (HU) requires strict collaboration between a hematologist and surgeon to manage bleeding and thrombosis risks. Key steps involve optimizing platelet counts (often via continued or adjusted HU), temporary cessation of blood thinners like aspirin, managing skin hygiene to prevent infection, and utilizing prophylactic measures to prevent post-surgical clots.

Key Pre-Surgery Preparations
Multidisciplinary Consultation: Ensure your surgeon is in close contact with your hematologist to review your CBC (Complete Blood Count) and manage the surgical plan.
Platelet Management: HU is often continued, but dosage may be adjusted, or in some cases, treatments like plateletpheresis may be used to quickly reduce high platelet counts before surgery.
Medication Adjustments: Typically, you will be instructed to stop anti-platelet agents (e.g., aspirin) for about one week prior. Your doctor may modify or switch other medications like Warfarin or similar drugs to heparin, say MPN Voice.
Infection Control: Use chlorhexidine soap/wipes to clean your skin for 3 days before surgery, particularly in areas like underarms and the groin, to reduce bacteria.
Blood Clot Prevention: Because ET increases the risk of clotting, you may receive Heparin post-surgery to prevent blood clots.
Diet and Lifestyle: Stop smoking/alcohol at least 2 weeks prior. Adhere to the "nothing by mouth" (NPO) guidelines provided by the hospital, usually avoiding solid foods after midnight.

Actionable Checklist
Inform all doctors about all medications (including herbs and supplements).
Arrange for someone to pick you up.
Prep a care package for recovery (protein-heavy food, comfortable clothes).
Review with your care team if a platelet-lowering procedure is necessary immediately before surgery.

When is your procedure, lynnebgraham?

REPLY
Profile picture for janemc @janemc

From Google AI:

Preparing for surgery with Essential Thrombocythemia (ET) taking Hydroxyurea (HU) requires strict collaboration between a hematologist and surgeon to manage bleeding and thrombosis risks. Key steps involve optimizing platelet counts (often via continued or adjusted HU), temporary cessation of blood thinners like aspirin, managing skin hygiene to prevent infection, and utilizing prophylactic measures to prevent post-surgical clots.

Key Pre-Surgery Preparations
Multidisciplinary Consultation: Ensure your surgeon is in close contact with your hematologist to review your CBC (Complete Blood Count) and manage the surgical plan.
Platelet Management: HU is often continued, but dosage may be adjusted, or in some cases, treatments like plateletpheresis may be used to quickly reduce high platelet counts before surgery.
Medication Adjustments: Typically, you will be instructed to stop anti-platelet agents (e.g., aspirin) for about one week prior. Your doctor may modify or switch other medications like Warfarin or similar drugs to heparin, say MPN Voice.
Infection Control: Use chlorhexidine soap/wipes to clean your skin for 3 days before surgery, particularly in areas like underarms and the groin, to reduce bacteria.
Blood Clot Prevention: Because ET increases the risk of clotting, you may receive Heparin post-surgery to prevent blood clots.
Diet and Lifestyle: Stop smoking/alcohol at least 2 weeks prior. Adhere to the "nothing by mouth" (NPO) guidelines provided by the hospital, usually avoiding solid foods after midnight.

Actionable Checklist
Inform all doctors about all medications (including herbs and supplements).
Arrange for someone to pick you up.
Prep a care package for recovery (protein-heavy food, comfortable clothes).
Review with your care team if a platelet-lowering procedure is necessary immediately before surgery.

When is your procedure, lynnebgraham?

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@janemc Thank you and AI for that comprehensive recap. I have AML and am in remission.
Meeting with the surgeon on Tuesday to schedule gall bladder removal and will present your post. Will also send to my HEM/Onc.

REPLY
Profile picture for sonieaml @sonieaml

@janemc Thank you and AI for that comprehensive recap. I have AML and am in remission.
Meeting with the surgeon on Tuesday to schedule gall bladder removal and will present your post. Will also send to my HEM/Onc.

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@sonieaml

All good wishes to you, sonieaml!

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The type of surgery may determine prep, but I've been told by my cardiologist that clot risks are the major concern. I think it's important that the surgeon and oncologist work out a surgical plan together. Would be great if some folks who have had successful surgeries with ET could weigh in!

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Profile picture for nohrt4me (Jean) @nohrt4me

The type of surgery may determine prep, but I've been told by my cardiologist that clot risks are the major concern. I think it's important that the surgeon and oncologist work out a surgical plan together. Would be great if some folks who have had successful surgeries with ET could weigh in!

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@nohrt4me
That is a great idea…and any of us having surgery while still in treatment for cancer may want to share their experience through the process!
So I Googled search terms applicable to me; not certain why I didn’t think of that to begin with???
THOSE are the findings I will share with my Surgeon and Hem/Onc.
Prayers for/to all.

REPLY
Profile picture for janemc @janemc

From Google AI:

Preparing for surgery with Essential Thrombocythemia (ET) taking Hydroxyurea (HU) requires strict collaboration between a hematologist and surgeon to manage bleeding and thrombosis risks. Key steps involve optimizing platelet counts (often via continued or adjusted HU), temporary cessation of blood thinners like aspirin, managing skin hygiene to prevent infection, and utilizing prophylactic measures to prevent post-surgical clots.

Key Pre-Surgery Preparations
Multidisciplinary Consultation: Ensure your surgeon is in close contact with your hematologist to review your CBC (Complete Blood Count) and manage the surgical plan.
Platelet Management: HU is often continued, but dosage may be adjusted, or in some cases, treatments like plateletpheresis may be used to quickly reduce high platelet counts before surgery.
Medication Adjustments: Typically, you will be instructed to stop anti-platelet agents (e.g., aspirin) for about one week prior. Your doctor may modify or switch other medications like Warfarin or similar drugs to heparin, say MPN Voice.
Infection Control: Use chlorhexidine soap/wipes to clean your skin for 3 days before surgery, particularly in areas like underarms and the groin, to reduce bacteria.
Blood Clot Prevention: Because ET increases the risk of clotting, you may receive Heparin post-surgery to prevent blood clots.
Diet and Lifestyle: Stop smoking/alcohol at least 2 weeks prior. Adhere to the "nothing by mouth" (NPO) guidelines provided by the hospital, usually avoiding solid foods after midnight.

Actionable Checklist
Inform all doctors about all medications (including herbs and supplements).
Arrange for someone to pick you up.
Prep a care package for recovery (protein-heavy food, comfortable clothes).
Review with your care team if a platelet-lowering procedure is necessary immediately before surgery.

When is your procedure, lynnebgraham?

Jump to this post

@janemc on the 7th May. 11 days time. My surgeon has said not to take one of my diabetic medications which contains
dapagliflozin. Said okay to have cartia (asprin). Only clear fluids and water from Wednesday till 11.00am Thursday. Hopefully they give me a big dinner as I will be starving by then lol. I was going to change my medication from HU to Anagrelide prior, might just stay on it till after op. Thank you for the information will talk to Dr. ❤️

REPLY

You're well ahead of the game, lynnebgraham!

Also essential: Please treat yourself to all your favorite things.

We're rooting for you!

REPLY
Profile picture for lynnebgraham @lynnebgraham

@janemc on the 7th May. 11 days time. My surgeon has said not to take one of my diabetic medications which contains
dapagliflozin. Said okay to have cartia (asprin). Only clear fluids and water from Wednesday till 11.00am Thursday. Hopefully they give me a big dinner as I will be starving by then lol. I was going to change my medication from HU to Anagrelide prior, might just stay on it till after op. Thank you for the information will talk to Dr. ❤️

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@lynnebgraham Will be thinking if you on the 7th!

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Hi all. ET with CALR and a 66yo female. I've been on hydrea 500 daily dose since September 2025 with asprin 5 days. My platelets stay in the mid 300s. January 2026 I had to have a Jones Fracture ORIF surgery with plate and screws placed on the right foot. My pcp, hemo-onco & ortho all communicated. They had me discontue both hydrea and aspirin for 5 days prior then resume the day after surgery, hyrldrea at normal dose however did aspirin 2x daily for a period of 2 weeks. All went well and I have recovered nicely and back to my normal active fitness routines and running about. I felt they did a good job coordinating, sharing reports etc before and after.

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I would suggest you provide your medical team with Dr. Natasha Szuber’s research article on Perioperative Outcomes and Management in Patients with MPN’s.

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