Lithium being stopped for major surgery

[ElizabethJane]

I am to have major surgery soon. A mass was found on my kidney and I am to have a partial nephrectomy to remove itThe anaesthetist wants to stop the lithium twenty four hours. She said it was protocol for that surgery. Has anyone else experienced this ?

[panic_down_under]

The anaesthetist wants to stop the lithium twenty four hours. She said it was protocol for that surgery. Has anyone else experienced this ?

It is standard practice to stop lithium medication a day before major surgery partly because it may affect anesthesia and partly because fasting, fluid imbalances and other physiological changes may slow the rate it is metabolised and eliminated. An added factor may be that it is primarily excreted via the kidneys.

Lithium has a half-life of 24-36 hours depending on age, so a brief stoppage shouldn't impact your mental health.

[ElizabethJane]

Thank you for your reply

[panic_down_under]

When are you having the surgery, or have you already had it?

[ElizabethJane]

The op will be performed laparoscopically robotically so minimally invasive. It is for a partial nephrectomy. They have told me mid June but it could be any time.

[panic_down_under]

They have told me mid June but it could be any time.

Good. The sooner the better so you can get back to normal life.

[ElizabethJane]

Surgery is booked for the 13th June

[ElizabethJane]

I have had my surgery which went well. I did not have the lithium dose until midnight yesterday. Consequently I was very weepy today. Hopefully that will even out.

[panic_down_under]

I have had my surgery which went well.

That is great!!

I did not have the lithium dose until midnight yesterday. Consequently I was very weepy today. Hopefully that will even out.

It should do but it could take some days for the brain to adjust. There may also be some psychological impact from the surgery involved.

[ElizabethJane]

I’m still having problems with my lithium dose. I have to speak to the GP because my levels are over the limit 1.26. I know is has been very hot and maybe I haven’t drunk enough water. I don’t have any symptoms of toxicity but know how dangerous this could be. I am going to suggest to the GP that I drop the dose to 800mg from 1,000mg. I have tried finding my old psychiatrist on the internet but he has retired.