My doctor didn't request labs/blood work... Hm!

Question

I know this isn't generally normal because I see all the girls and surgeons talking about lab work to clear for surgery... However, my surgeon says at my age and weight (25, 5'8", 140lbs) I'm a healthy candidate. But how does he know for sure that I'm healthy and don't have anemia or high blood pressure for example? Is blood work done the day of surgery? Or should I just proceed and get lab work done myself? Thanks much!

Ramiro Morales, Jr., MD · Answer

Why aren't you asking your PS these questions.  His or her office will know if labs are drawn on the morning of surgery which is the usual case in young healthy patients.  Also, your blood pressure will be measured before surgery as well.  If however you do decide to go to your primary MD for a pre-op clearance, then please inform your PS office ahead of time.  This can at times complicate matters with the primary MDs wanting info about the surgery spedifics etc before they do a clearance.

Richard H. Tholen, MD, FACS · Answer

Aha! You've found a reckless surgeon! Cancel the BBL! But wait . . .You said you are young and normal weight, and a healthy candidate by your surgeon's examination (you did see him, didn't you?). BTW, blood pressure is neither a lab nor blood work, but you knew that, didn't you? (It's taken continuously during surgery.)Let's postulate that you were anemic. Somehow, though your nailbeds were pink and your skin color normal, you must have lost lots of blood yet failed to mention that to your surgeon. Probably menstrual losses, perhaps?But let's assume your surgeon can perform surgery with minimal blood loss. At what low hemoglobin level would you expect your surgeon to refuse surgery or require blood transfusion?The reality is that with excellent surgery, there is minimal blood loss and knowing is different from treating. To give you a true example--my 89 year-old mother underwent aortic valve replacement last week with a hemoglobin below 7.0 (normal is 14). She did not receive any blood transfusions prior to her surgery, which required a vascular stick with a pretty huge needle/catheter. Her cardiologist only prescribed several iron treatments. She did great, by the way. And of course, her surgery was done via the cardiology lab rather than in the cardiac surgery suite with a sternal split. Labs were done, but there was no change in the therapy (transfusion or not), so was the actual blood count (test for anemia) really necessary?You are young, healthy , and undergoing elective cosmetic surgery. Your pre-operative physician evaluation should uncover (via history and physical examination) any abnormalities for which laboratory work or blood tests might be necessary or advisable. But in your setting, labs/blood work are commonly NOT needed, nor automatic.No plots, conspiracy theories, or poor medical judgement. Not that getting labs is wrong, unless it is "routine" when it should be "when appropriate." I also assume you would tell your surgeon and pre-op physician if you already "knew" you were dangerously anemic or had a history of chronic or recent major blood loss. Best wishes! Dr. Tholen

Matthew Schulman, MD · Answer

Every surgeon is different in terms of the required pre-operative medical clearance. While it is true that labs are not "required" for a 25 year old, I always get basic labs anyway. I think you are absolutely correct.....how do know you are "healthy"?  Just because you are 25 and don't have medical problems that you know of? It is not that uncommon to find some minor abnormalities on routine labs, such as anemia. In some situations, the anemia is great enough to not be cleared for surgery. For elective cosmetic surgery, my preference is to be absolutely sure that everything is perfect before.  If you are concerned, speak with your surgeon.

Luis E. Redondo, MD · Answer

If he didnt requested is because he dont think safety is important. Just change the surgeon and do it fast, before he convince you otherwise. Best of luck,

Steven Wallach, MD · Answer

Every surgeon is different. The minimum would be a pregnancy test. I often get blood work on patients going for surgery and many times a medical clearance.

Samir Shureih, MD · Answer

Medical clearance prior to surgery is a requirement.In a hospital setting and where anesthesia is given, general or sedation then the accrediting entity will require a medical clearance with history and full blood work, if all is well that is enough, if there is any abnormality then that needs further workup.In an office based surgery also the accrediting body will require preoperative clearance except local anesthesia. That includes full history and physical examination and full blood work.This is required by the accrediting organizations like AAAASF, and AAAHC. Further work up is needed if there is any abnormality or need .This is for patient safety.The office based centers must follow all the requirement and standards of the accrediting organization and local and federal regulationsFor you as a patient considering surgery in an office based facility then you need to make sure the surgeon is a board certified in the specialty and approved by the American Board of Medical Specialties.The facility must be accredited and you must make sure of that. If they are not, then find another surgeon.

Erika Sato, MD, FACS · Answer

Every doctor has different guidelines that they use to decide if a patient needs any workup before surgery. In my practice if a patient is young with no medical problems, not taking any medications and had normal vital signs (heart rate, blood pressure and oxygen saturation) when I see them for consultation then I do not get any labs etc.

George Lefkovits, MD - Account Suspended · Answer

While some surgeons do not routinely perform blood work on young patients with no medical problems I believe that it preferable to have bloods drawn. I come across abnormal values from time to time which require correction and/ or postponement of surgery.

My doctor didn't request labs/blood work... Hm!

Answers (8)

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