If You Have Surgery

[plantime]

I just had spinal fusion done, and had an interesting conversation with the anesthesiologist. He said that celiacs do not absorb medications properly. He told me that it makes a tremendous difference in how he preps a person for surgery, since swallowed medicines, even glutenfree, would not work at a properly measurable level. He switched me from swallowed meds for surgery to injections.

I use oral meds for pain and such now, but he said the dosage for surgery had to be exact, and even a healed celiac would not absorb oral meds for something so vital properly. It was interesting to hear about my intestinal issues from the guy that was telling me to breathe deep and count backwards from ten!

I hope my post makes sense. I'm not sure if my spelling is correct or if I worded it correctly.

[Lisa]

I just had spinal fusion done, and had an interesting conversation with the anesthesiologist. He said that celiacs do not absorb medications properly. He told me that it makes a tremendous difference in how he preps a person for surgery, since swallowed medicines, even glutenfree, would not work at a properly measurable level. He switched me from swallowed meds for surgery to injections.

I use oral meds for pain and such now, but he said the dosage for surgery had to be exact, and even a healed celiac would not absorb oral meds for something so vital properly. It was interesting to hear about my intestinal issues from the guy that was telling me to breathe deep and count backwards from ten!

I hope my post makes sense. I'm not sure if my spelling is correct or if I worded it correctly.

Hi Dessa - Good to see you again.

My bolded, of the quote surprised me. I would like to learn more about "healed" people with Celiac,not being able to absorb crucial meds.

I would have thought, that once healed, the Celiac Disease would be in total remission, unless gluten was re-introduced.

In the case of severe damage, extended damage or refractory sprue, it would make sense that healing would be hindered.

Thanks for posting this.

[lovegrov]

This makes little sense. If we start absorbing foods and other things properly, why not meds?

richard

[Lisa]

This makes little sense. If we start absorbing foods and other things properly, why not meds?

richard

richard! Sometimes you're like a bull in a china shop!

But, I do tend to agree.

[plantime]

That's what I thought was interesting. I always thought that, once healed and always glutenfree, I would be just like everyone else. According to him and my PCP, the simple fact of having celiac marks me as having a compromised intestinal tract. They both said that they do not trust a celiac intestine to ever absorb anything properly, since the possibility of gluten contamination always exists. They cannot test to see if I have been contaminated or am lying about being careful of my diet, so they always assume that the absorption ability is compromised.

For things like vitamins and my lexapro, they said it is not an issue. But for surgery, the anesthesiologist has to be absolutely certain that I get enough of the medicine. It sounds to me like they take a better-safe-than-sorry view, since they are able to provide the necessary drugs by iv.

I like being safe, so I am quite willing to go along with them on this issue. I do not want to find myself conscious or feeling pain during surgery!

Thanks for the welcome back! Life has been busy for me, including the addition of a new grandson. I hope to have time again to post!

[jerseyangel]

They cannot test to see if I have been contaminated or am lying about being careful of my diet, so they always assume that the absorbtion ability is compromised.

That makes sense to me--in this case, it's better to be safe than sorry.

Welcome back, Dessa

[Lisa]

In that context, it does make total sense. They cannot document full (voluntary) compliance with the diet, when crucial/life saving measures are warranted. Ah, life is complicated, isn't it???

Yes, I understand.

BTW - As a new grandmother, your babies are beautiful.

[kenlove]

Glad you guys posted this as i'm schedule for surgery on the 12th. I told them all I'm celiac and they said Oh yeah we know -- no problem -- something I've hear way too often at questionable restaurants.

So regardless -- I think i'll bring it up just to pressure them into double checking things...

In that context, it does make total sense. They cannot document full (voluntary) compliance with the diet, when crucial/life saving measures are warranted. Ah, life is complicated, isn't it???

Yes, I understand.

BTW - As a new grandmother, your babies are beautiful.

[Gemini]

This makes little sense. If we start absorbing foods and other things properly, why not meds?

richard

Well....here goes the other bull in a china shop!

I agree, Richard, that it makes no sense. I had minor surgery in November and the meds they gave me knocked me on my butt and did everything they were supposed to do. They were oral meds. I have also taken antibiotics since I have healed and they worked very well.

I think what a doctor has to do is grill a patient on how compliant they are and see if there are other associated issues which haven't calmed down. Anyone following a gluten-free diet should see some improvement if they are following the diet as they should. Plus, most meds given in surgery to put you to sleep are given through an IV and that takes care of the problem. You will not have absorption problems with IV meds.

A physician does need to know if you have Celiac but, unless you cheat or don't follow the diet,

it shouldn't make any more difference than someone without Celiac. If the crappy American diet that most people eat doesn't affect their surgery, it shouldn't be a problem for us.

[ravenwoodglass]

They both said that they do not trust a celiac intestine to ever absorb anything properly, since the possibility of gluten contamination always exists. They cannot test to see if I have been contaminated or am lying about being careful of my diet, so they always assume that the absorption ability is compromised.

I think what it boils down to is that doctors figure we will cheat on our diet like many do on other medically needed dietary regimes. I don't think many of them 'get' the severe repercussions that many have from eating gluten. It just isn't a diet that we can simply drop for a day because a yummy chocolate cake is near like someone who is restricting calories. When 'cheating' makes you deathly ill for days or weeks it is not something one does.

My GI doctor asked me before my last procedures how often I cheat. When I told him never he said 'well most people do'. Personally I don't think so but I didn't contradict him.

[kenlove]

IU see some messages form time to time about cheating and I just cant imagine it.

Purposely putting ourselves into a painful situation like that just doesn't compute.

I think what it boils down to is that doctors figure we will cheat on our diet like many do on other medically needed dietary regimes. I don't think many of them 'get' the severe repercussions that many have from eating gluten. It just isn't a diet that we can simply drop for a day because a yummy chocolate cake is near like someone who is restricting calories. When 'cheating' makes you deathly ill for days or weeks it is not something one does.

My GI doctor asked me before my last procedures how often I cheat. When I told him never he said 'well most people do'. Personally I don't think so but I didn't contradict him.

[plantime]

IU see some messages form time to time about cheating and I just cant imagine it.

Purposely putting ourselves into a painful situation like that just doesn't compute.

I agree. Even a tiny slip causes me extreme pain and emotional disturbance. My sister is non-insulin dependent diabetic, and she always cheats on her diet. It makes her sick, but she doesn't care. I use her behavior as an example of why the doc I had chose the methods he did.

[Googles]

When I first was giving the possible diagnosis I called a friend because I was so upset. She told me that I could cheat and just have a little discomfort, because that is what another friend of her's did. So there are people out there who cheat. After going gluten free I would never intentionally eat gluten. But I think a lot of people (who don't know what it is really like) think that people can cheat with little consequence. So it would make sense that doctors wouldn't trust that people are gluten free since there are people out there who cheat, they can't know for sure.

[Reba32]

I can't imagine cheating. Why the heck would I deliberately send myself writhing in pain on the floor for a few moments pleasure of food? That makes all kinds of No Sense!

That said, I've had so many surgeries prior to my diagnosis, I'm now seriously considering having "Celiac" tattoo'd on the inside of one of my wrists, just in case I'm in a car crash or something and they try to feed me that liquid food stuff down my nose.

[Lisa]

Remember, not all people with Celiac have pain and discomfort when exposed to gluten.

[Lisa]

That said, I've had so many surgeries prior to my diagnosis, I'm now seriously considering having "Celiac" tattoo'd on the inside of one of my wrists, just in case I'm in a car crash or something and they try to feed me that liquid food stuff down my nose.

If that were the case, I would think that having Celiac Disease would be the least of your worries!

[plantime]

Remember, not all people with Celiac has pain and discomfort when exposed to gluten.

This is true, Lisa, very true. My first symptom of being glutened with wheat is sinus congestion. That's all, just sinus congestion. The other symptoms don't hit until a week later. With barley, however, the pain and diarrhea start within an hour. I have also heard that some celiacs can consume small amounts of gluten every now and then without getting sick. My concern is that they still damage their intestines, which is what the doctor and anesthesiologist were concerned about.

I don't cheat on this diet, but I appreciate them taking it seriously.

[Reba32]

well sure, but who wants to have bloated pain in the guts when you've got a breathing tube down your throat and food tube down your nose? ICK!

I thought of that over the holidays when my Mum was in ICU on a ventilator. They put that liquid food in her and I read the label and said "gee, this stuff would kill me, Mum you're lucky you're not Celiac!" Which made me think of getting a tattoo.

my brain is a strange place.