Orchiectomy for diabetic girls on blood thinners, Complications?

[coral]

Had a consultation with surgeon for an orchiectomy yesterday.  He was a bit concerned that I am diabetic and on blood thinners.  He said the only complications he had after doing hundreds of orchiectomies were diabetic patients on blood thinners.  I am asking for responses from girls with a similar history before an orchiectomy and if there were any complications.

The surgeon wants to call my primary provider.  I was really lucky and scheduled an appointment with her for this Monday morning. So good chance I can talk to her before the surgeon calls her.  Your responses will better prepare me for talking with my doctor o Monday.

The surgeon kind of backed off on his concerns after he found how small all my genitals are.  So, I am optimistic.  I would appreciate any responses and information.

Thank You,
       Coral
 

[Lori Dee ✅]

Your surgeon's concerns are realistic. It's good that you can discuss this with your doctor, and hopefully everyone can agree on the best course of action.

Now I'll step back and let someone with experience take the lead.

[Sarah B ✅]

Hi Coral

I think the encouraging part is that your surgeon and primary provider are talking to each other.  There may well be a way of temporarily stopping your blood thinner but that depends very much on which drug it is and why you need it.  Stopping it reduces bleeding risk but may increase the risk of a clot or stroke so it is something the prescriber and surgeon need to plan together rather than something to stop independently.

Diabetes is another consideration because higher glucose levels around surgery can increase infection and wound-healing problems.  It might be worth asking your primary provider what your current A1C is and what glucose range they want before and after surgery.

I also would not assume that complications only happen to diabetic patients on blood thinners.  Orchiectomy is generally a relatively low-complication procedure but bleeding, hematoma, infection or abscess and wound problems can occur in other patients too.  The useful question for your surgeon may be exactly what complications he saw in those previous diabetic patients and whether they were related to bleeding, infection or healing.

Most importantly I would ask them to give you a written plan for when to stop and restart each relevant medication.  I would not change the blood thinner or diabetes medication without that plan.

Best Wishes Always
Sarah B
Global Moderator
@coral

[Devlyn ✅]

I can't address the diabetes part, but I was on daily low dose aspirin when I had my orchiectomy, which I paused ahead of the surgery. I had in internal stitch let go and the pressure from the bleeding forced the incision back open.

Most people here have no such issues, though. I agree with everyone else that it's good your team is working together.

[coral]

Sarah B,

Thank you for your very informative response.  I am consistently on top of my A1C, which is currently 6.9.  The goal for my age is 8.0 or below. So, I am considered well controlled.  Actually, my personal goal is 6.5.  I use a Glucose Monitoring system and keep it active on my phone 24/7. It just takes a glance at my phone to see my glucose level. Right now, it is 135.

Yes, stopping the blood thinner, which I believe is a relatively small dose, is a possibility.  This will be a topic when the doctors talk.  My consultation appointment on Friday was the doctor's last appointment for the day.  I was incredibly lucky and managed to get an appointment with my primary tomorrow morning.  So, hoping I can talk with her before the surgeon calls her. I have a very good relationship with my doctor.  She says I am her favorite diabetic patient.

My primary reason for the orchiectomy is to reduce the testosterone. My gender pathways doctor would never approve the testosterone blockers due to my diabetes.  They say the blockers are too hard on the kidneys, which are considered to be compromised due to diabetes.  Instead of the surgery, he suggested putting me on the blockers.  However, the way Kaiser works, it would be started at a very low dose and take some time to be effective.  I am 79 now and don't have all that many years to wait for results.

Now you have more of my story.  Yes, it is fantastic that my doctors will be talking.

Also, a note for everyone:
I always prepare a packet for all doctor's appointments.  This contains several attachments with current reportable levels, a med list, lifetime issues etc., and a summary including issues I want to discuss. If I don't bring it, she always asks where her papers are?  It takes a bit to get this together, but the all the doctor's love the information.

Coral