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CBC Before Surgery- What Info Does It Show?

I recently had a physical with blood work, it showed slightly low potassium and thyroid levels. The regular family Dr. is not overly concerned. He said eat high potassium foods.. and said nothing about the thyroid levels or what I could do about it at home.. BUT when having a major surgery (scheduled for full TT with Breast Lift Jan 2012) what are the PS and Anastes. looking for in a CBC? Also IS low potassium ( or thyroid) a concern with a Tummy Tuck surgery or Breast lift and augment?

Doctor Answers (9)

Listen to your doctor

+4

He is absolutely correct in making sure these values are normal.  The cbc shows if you are anemic and if the platlet count (clotting), and any sign of infection or other.  These are critical.


San Francisco Plastic Surgeon
4.5 out of 5 stars 35 reviews

Blood tests before surgery

+3

Among other things, CBC tests your blood count to make sure that you are not anemic.  As for your potassium and thyroid levels, your medical doctor, as part of your medical clearance, should also determine whether these levels are acceptable for surgery.  When these levels are only slightly low, it is generally safe to have elective plastic surgery. 

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
4.5 out of 5 stars 56 reviews

Tummy Tuck Pre-op?

+2

Thank you for the question. The CBC  is a blood test that measures numbers of cells ( such as white blood cells, red blood cells, and platelets).  This test will inform your surgeon if you're  anemic,  have a potential for bleeding, or potentially have an infection.   This test is a part of the preoperative workup used by many surgeons.

As you prepare for your surgery a few words of advice may be in order...Although  patients who are about to undergo plastic surgery spend a lot of time thinking about the physical preparation for the procedure (for example weight loss issues) they do not typically spend a lot of time thinking about the emotional aspects of the recovery period.

Although most patients eventually experience a positive emotional “boost” after their procedure, it is not uncommon for patients  to experience severe “mood swings” during the recovery period. These emotions may range from depression ( “why did I do this to myself”) to elation  (which may lead to over activity). I think it is helpful to be aware that these emotional swings do occur frequently during the postoperative period.  The awareness that the emotional swings after surgery are common may help you weather the storm.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 791 reviews

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Get yourself optimized before major surgery

+2

Your surgeon and anesthesiologist are showing good judgment wanting your labs to be as optimal as possible.  You are about to undergo major surgery that may have blood loss and any electrolyte disturbances may put you at higher risk for complications under anesthesia.  Make sure all your doctors are happy with your health before surgery.  Good Luck.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 87 reviews

CBC Before Surgery- What Info Does It Show?

+2

CBC: A commonly used abbreviation in medicine that stands for complete blood count, a set values of the cellular (formed elements) of blood. These measurements are generally determined by specially designed machines that analyze the different components of blood in less than a minute.

The values generally included are the following:

White blood cell count (WBC). The number of white blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4,300 and 10,800 cells per cubic millimeter (cmm). This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 109 cells per liter.
Automated white cell differential. A machine generated percentage of the different types of white blood cells, usually split into granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
Red cell count (RBC). The number of red blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4.2 - 5.9 million cells/cmm. This can also be referred to as the erythrocyte count and can be expressed in international units as 4.2 - 5.9 x 1012 cells per liter. 
Hemoglobin (Hb). The amount of hemoglobin in a volume of blood. Hemoglobin is the protein molecule within red blood cells that carries oxygen and gives blood its red color. Normal range for hemoglobin is different between the sexes and is approximately 13 - 18 grams per deciliter for men and 12 - 16 for women (international units 8.1 - 11.2 millimoles/liter for men, 7.4 - 9.9 for women).
Hematocrit (Hct). The ratio of the volume of red cells to the volume of whole blood. Normal range for hematocrit is different between the sexes and is approximately 45 - 52% for men and 37 - 48% for women.
Mean cell volume (MCV). The average volume of a red cell. This is a calculated value derived from the hematocrit and red cell count. Normal range is 86 - 98 femtoliters.
Mean cell hemoglobin (MCH). The average amount of hemoglobin in the average red cell. This is a calculated value derived from the measurement of hemoglobin and the red cell count. Normal range is 27 - 32 picograms.
Mean cell hemoglobin concentration (MCHC). The average concentration of hemoglobin in a given volume of red cells. This is a calculated volume derived from the hemoglobin measurement and the hematocrit. Normal range is 32 - 36%.
Red cell distribution width (RDW). A measurement of the variability of red cell size. Higher numbers indicate greater variation in size. Normal range is 11 - 15.
Platelet count. The number of platelets in a volume blood. Platelets are not complete cells, but actually fragments of cytoplasm from a cell found in the bone marrow called a megakaryocyte. Platelets play a vital role in blood clotting. Normal range varies slightly between laboratories but is in the range of 150,000 - 400,000/ cmm (150 - 400 x 109/liter).

In a surgery the important issue is anemia and clotting that a recent, less than 3 weeks old, CBC demonstrates. As for the low K+ this could be a sign of cardiac issues and needs to be resolved. The low thyroid test may have an effect on healing. So a pre operative work up is the correct course to follow to be sure you are medically cleared to have a surgery. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

CBC Test Prior to Surgery

+1

The vast majority of patients who are undergoing mommy makeover surgery have preoperative blood testing which includes a CBC. This test has several components which are critical elements of the preoperative evaluation. These include the platelet count, the white blood cell count, and the hematocrit and hemoglobin levels. Each of these measurements is extremely important. The platelet count measures the patient’s ability to clot blood, an elevated white blood cell count is an indicator of infection, while the red blood cell count, hematocrit, and hemoglobin all measure the body’s oxygen carrying capacity.

Occasionally other blood tests are performed in combination with a CBC. In your case, electrolytes and thyroid studies have been drawn as well. When potassium is slightly lower than normal, it may not be unreasonable to proceed with surgery but this depends on the specifics of the individual case. When thyroid studies indicate significant abnormalities, consultation with an endocrinologist is appropriate.

If you’re concerned about your preoperative blood testing, it’s appropriate to consult your plastic surgeon. Your surgeon should be able to discuss these lab values in detail. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 89 reviews

CBC Before Surgery

+1
It is very wise to work with your surgeon and primary care physician to make your surgery as safe as possible.  Each physician will weigh the information slightly different, but the key is that you are working with your team to make your surgery safer.  Excellent work.

For more information, please see my website at:
WirthPlasticSurgery.com

Thank you

Garrett A. Wirth, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 6 reviews

Blood work before surgery

+1

I agree with Dr. Aldea - you should talk with your plastic surgeon about the lab results, since he or she is responsible for making the decision whether or not you are safe for surgery.  I'm glad you are concerned and want to know more, because being involved is the most important thing you can do for yourself!

Michelle Spring, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 25 reviews

CBC Before Surgery- What Info Does It Show?

+1

RE: "recently had a physical with blood work, it showed slightly low potassium and thyroid levels. The regular family Dr. is not overly concerned. He said eat high potassium foods.. and said nothing about the thyroid levels or what I could do about it at home.. BUT when having a major surgery (scheduled for full TT with Breast Lift Jan 2012) what are the PS and Anastes. looking for in a CBC? Also IS low potassium ( or thyroid) a concern with a Tummy Tuck surgery or Breast lift and augment?"

Wow! you did not give your age, medical history, list of medications and supplements you are taking and you would like a cogent explanation on the meaning of multiple blood tests as they may apply to you and your upcoming surgery. Obviously - that cannot be done.

So - in general terms
CBC - a complete blood count gives a specific snap shot of your blood at that moment in time. It will detect anemia and suggest the type of anemia. It may pick a severe infection or inflammation as well as leukemia and a platelet disorder causing either clotting or bleeding. An anemic patient should not be operated on electively if significant blood losses are anticipated unless blood is available for transfusion.

Potassium (K) - our cells are rich in potassium and it is essential for our well being. Low potassium may result in fatal racing of the heart (While a high dose of it will stop the heart - a common way of execution). You should NOT be low on potassium unless you are losing it by taking certain water pills or have long standing loose bowel movements. While supplementing your K may work, personally I would like to know WHY you are low.

Thyroid Levels (?TSH or T4) - We do not want to operate on patients who are either producing too little or too much thyroid hormones. Each condition complicates the safe performance of surgery. The fact that your doctor saw fit to spend your money on this test means you have a history of this disorder and he/she wanted to make sure you are corrected by having a normalized TSH level. If you are on synthroid and your TSH is normal barring other risks, it should be safe to proceed.

Plastic Surgery is similar to taking a plane on a joy flight. It is NOT "I need" surgery - but "I want" surgery. No one really NEEDS a Tummy Tuck, Breast Augmentation, Breast Lift, Face lift, Liposuction etc (while a woman with breast cancer needs a mastectomy, a person with a ruptured appendix needs his/her appendix removed - well, you get the point).

As a result, prior to getting into the cockpit and taking off, checking your general well being with an examination and certain lab tests is our version of the pilots' walk around the plane checking it before taking off. We want to make sure we did not overlook a glaring abnormality which may crash our plane - your well being.

Keep asking questions. Understand your options and you'll do great.

Good Luck.

Peter A Aldea, MD

 

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.