Need Help Understanding Beta Thal Minor Hematocrit Levels for Surgery

My 25 year old daughter is on the eve of major jaw surgery.  She had blood work done on 6/27 and results showed a PCV of 28, which the doctor viewed as too low for a safe surgical procedure.  He may not have remembered her thal condition.  She was retested yesterday and her level is up to 30, which is in the questionable range.  She has irregular menstrual periods and her most recent was 10 days to 2 weeks ago. 

What's a typical range for a beta thal minor female with these characteristics?  And what are the surgical issues we should be concerned about with low hematocrit levels?  are low levels for thal sufferers viewed the same way low hematocrit levels are viewed for people with normal blood?

Mark

Her PCV or hematocrit is on the low side for thal minors. This is typically in the low 30's for a woman with symptomatic thal minor.
The standard procedure for this crit level is to be prepared for transfusion if necessary. This will be dependent on how much blood loss occurs during the surgery. This is the case for anyone with anemia and a crit level this low, regardless of the cause of the anemia.Has she been taking any supplements at all? Folic acid is highly recommended, as it is essential  for building red blood cells.

I feel that she needs to look at her diet and make sure it is nutritious and that empty calories are not being consumed. Her crit is lower than it should be and diet and nutrition, including supplements should be considered to help raise her Hb level.

Thanks Andy.  Last night I looked back at as many of her blood tests as I could find.  Here is a chart I made.

         7/12  12/09  12/06  10/06  9/06   8/00    7/06   8/00      2/89     11/88
HCT    28.3     35       31        28   27.8   30.9       31     30.9       33.8         29.7

It looks to me like her norm has been a pretty low HCT number according to your inclinations.She has one outlier at a 35 which must be closer to the range we would hope for, but typically she ranges between 28 - 31.

The string of monthly tests in '06 relates to another medical condition we were trying to understand.  Turned out to be IBS.  But, along the way, Chron's disease was a consideration.  The interesting thing this provides is a string of values that show her monthly rhythms.

The peak in '09 I think relates to supplement therapy she was on.  I'm not sure what that was.

She's also gluten intolerant and vegetarian ...  doesn't make this easy does it...

She was born in '87 and we had her tested a couple times because I have thal minor.

Is this helpful?  Does this teach us something new about her particular characteristics?  Do you have any feel for how doctors think about numbers like these as they relate to surgery?  I feel like there's something to be learned here but I don't know the right question to ask.  can you help me with this?  I can provide more data if that would be helpful.  Just tell me what's needed.

Best,
Mark

Andy,

Really appreciate you helping me with these questions.  Learning to use the site in a more sophisticated way.  The attachment below  is a more complete list of Steph's blood test results.  Hopes this helps.

Best,
Mark

The key figure I see here is her RBC count. In thal minors, this should be higher than normal, and in the past she was, but currently it is normal. This may indicate that she has iron deficiency anemia in addition to thal minor, as IDA will lower the RBC. I would suggest an iron panel of tests be done to see if she is iron deficient, also. If so, iron injections can quickly reverse this and raise her Hb so she can undergo surgery. With a well balanced vegetarian diet, iron levels can be maintained (I am vegetarian and my crit is 47).

Very interesting and thanks for the POV. She has been on both Folic acid and iron supplements in prep for the surgery.  I wonder if something else has entered the picture.  We'll check with her doctors tomorrow.

Again, thank you for jumping in and helping us out.

Best,
Mark