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the value of supplements [split]


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  • Re: the value of supplements [split]

    Re supplements in my "previous" career, I'll tell a story of one of my scariest cases. I was a shoulder specialist and did a lot of total shoulder replacements (TSR) - about 200/year. I was doing one one day on a guy who had been on aspirin and Plavix, both blood thinners. But we knew that and had stopped them both at the appropriate intervals - we thought. I made the incision and he bled from everywhere. Even just the skin and superficial tissues bled like crazy and took me a long time with a cautery to get it controlled. When I got down to the shoulder joint I realized I had lost 300 cc of blood - my normal for a usual entire TSR was about 150-200 cc. So I aborted the procedure - wisely it turned out. You may not realize this but bone bleeds and most of the blood loss from joint replacements is from the bone bleeding after we cut it (at least hips and shoulders). I was afraid he would bleed to death if I cut the bone, based on what I had seen. I had to go tell his wife about the problem and why we stopped.

    Turns out this guy was on some supplement and after we investigated it, this supplement potentiated the effects of the Plavix and aspirin, making their effect last much longer. We had stopped them at the standard time period but it was not enough. A hematology consult turned this up.

    About 6 weeks later we went back in, now having stopped the supplement, and the asprin and Plavix at the same time interval. Procedure went great - he lost about 100 cc for the entire surgery and did very well with his TSR. Good decision by me on that one, but it was very scary watching that bleeding from no known cause.

    So supplements can be dangerous. Sorry, but I do not remember what he was on.