All CAD’s will need to be kept warm, to some degree, during surgery and recovery. Unless you are certain you are not impacted by cold temperatures.
Your cold re-activeness will dictate just how much warming is required. You need to know your individual level of Cold Re-activeness. Are you mostly un-affected, mild, or acute? Conditions that trigger your own Hemolysis must be communicated to your surgeon. That means making them aware and sharing in your concerns.
You need to have a very serious conversation with any surgeon. Have a two way conversation about your CAD, between you and the surgeon. Follow that up to insure it was documented.
Take care of this prior to your surgery, not during the “day of” while in pre-op. You need to establish some commitments by your surgeon. You need to do this in writing too.
You will be asked to sign all kinds of surgery documents. All, too apparently release any doctor responsibility as much as possible.
When you are signing waivers and documents prior to, or during pre-op. You need to have your own, signed by the surgeon, or “written in by hand” on their documents you are signing. Make sure you give copies to your loved ones or advocate.
If you have to add it to their waivers. State something to the affect they are aware of your Cold Agglutinin Disease, the impacts of cold on you, and they are responsible to keep you warm at all times you are unconscious and under their care…..or none of your waivers or release of responsibility apply.
This all needs to take place before the day you show up for surgery.
My wife is a highly Cold reactive CAD. She has had multiple surgeries while dealing with CAD. Since 2016 she has been so Cold Reactive that her CBC/RBC cannot be run even using “Keep It Warm” techniques many CADs/Blood testing facilities use to test CADs.
Her cold sensitivity is such that she has to have her CBC/RBC run at a special facility using a “Plasma Saline Replacement” Protocol. Most CADs never deal with this high level of sensitivity. It is just FYI information to pass on and indicate surgeries can take place while limiting risks of Hemolysis or adverse reactions from your CAD issues.
During one surgery in the past. The surgeon raised the operation room up to the 80°F range. They also kept pre-warmed blankets on her while in surgery and recovery.
Her latest (Jan 2021) while having a complete double mastectomy, the facility used another method. She was in surgery 4 hours and recovery about 2 additional hours.
In the latest surgery the facility used a 3M device called a “Bair” Blanket. This was put on her in pre-op while she was fully conscious and un-medicated. After finding out about this device and doing more research. I think my wife would inquire of any facility beforehand, then, insist this be used. I don’t believe she would use a facility that wouldn’t commit to use one. She is the type that would then not allow any medication until the facility had a working unit on her in pre-op.
We weren’t aware of this device until 2021. But they have been around for years.
This is not a paid endorsement for the product. We are simply providing a link for your own knowledge and decision making.
