Biopsy problems.. Fear of Bleeding

Question

Hi..
Wondered what people's experiences of biopsies were.. I'm due one and am worried as platelets 117, and I did bleed for a long time.. About 8 hours after I had a tooth ou!!!
Does this reflect... How much I might bleed after a biopsy.

Also if you do bleed alot internally.. What can they do??
Anyone any ideas.
I'm geno 3 hcv ... Tx failure.
Had fibroscan but because my bloods so low.. And apri score high.. Consultant thought biopsy might shed more light on the state of my liver. Otherwise I wouldn't be even considering it..

Just interested to hear others experiences.. Who may have low platelets.. If you can tell me the number.. Too.. And whether this effected any bleeding problems.. 
Thanks
Alico x

48weeks · Answer

They did some imaging of the area when I went back the next day because of the pain. They said my system would absorb the blood, and I guess it did, it just took weeks. I'm probably in the minority here in terms of biopsy stories, but the pain was no joke.

alico222 · Answer

Hi 48 weeks.. Just a question.. Apart from the pain...did anything have to be done about your bleeding and breathing .. Did you have other tests etc. ?

Thanks
Alico x

alico222 · Answer

Thanks everyone.. It does help to talk!!!
ESP. When worried!!!!
I suppose everyone has different experiences.. Thanks for all insights!!!

Love
Alico

Ekkiemom · Answer

Hey there Howie!  I told you that you were our resident Guru.
Hope ur doing well

Peace my friend
Debs

hepcandme · Answer

I had 2 recent surgeries for breast cancer and my platelets were quite low - less than 70 but I received platelets intravenously both times

Despite my low platelet count, I have never noticed a tendency towards easy bruising or spontaneous nose bleeds or cuts that bled profusely. The incision from my surgeries healed nicely

So, at least in my case, there were no problems. Your docs certainly know about your low platelet level so they will take extra precautions, I'm sure

That said, I have never had a liver biopsy and have not researched the probability of an internal bleed

Carlhcv · Answer

I just re-read your question so disregard my fibroscan suggestion. Good luck to you. :)

Carlhcv · Answer

How about a fibroscan instead? And, yes, Hector is awesome!

1bucky · Answer

Hello alico,
When I was a teenager 45 years ago, it took a day before my molar extractions quit bleeding. My last biopsy was done in a hospital under twilight guided by an ultrasound. Much better that my first one done in a surgical suite without sedation. Now that the new scans are available no more biopsies for me. I only had the last one to get the clinical evidence that my IDS needed to get me approved for my meds off label (S&O).
Bucky

AugustineMama · Answer

They tell me not to worry as I hang anywhere from 50,000 to 100,000 and have for years. My spleen is massively enlarged also. Can't help but be concerned. I do carry a copy of my medical history in my car in case I'm in an accident as we do travel quite a bit.

Dee1956 · Answer

Hi again, I was afraid of bleeding as well.  My doctor offered to go through a vein in my neck.  In hindsight I should not have done it in his surgical suite in his office building.  I should have been in a hospital

Dee1956 · Answer

Hi Hector is the most knowledgeable person on here and he always give the best answer.
I just wanted to add that my platelets were 67 when I had a liver biopsy.  I was worried just like you.  As long as you trust your doctor and are in a good hospital I would not worry.

Pulling a molar is a little different that a needle biopsy.  Many things could have affected that.  I remember my son laid down after his tooth was pulled which was the worst thing he could have done.
With his head below he heart he bled all over his pillow and he had normal platelets.  Just like a head injury will bleed very badly.

Everyones experience will be different.  Good luck, Dee

48weeks · Answer

I had a biopsy a year ago and bled internally. I was in pain immediately afterwards, and for a few weeks. It was a sharp pain and I was unable to take deep breaths for a few weeks. My platelets were lower than the normal range, but higher than yours. Biopsys have always been painful for me, but never to that extent. I hope to never have another one.

alico222 · Answer

Thanks..
The body is strange sometimes and surprises us is all I can say... Worried mum!
Thanks again
Alico x

AWorriedMom · Answer

Hector, you never disappoint. Your posts are always so thorough. Thanks for the work you continue to do. 

Alico, I have had a couple of major surgeries with platelets like yours in the 120,000 range, and never had any problem at all. The only problem I had was with a laproscopic biopsy when I was on interferon and my platelets were 60,000. I developed a painful blood clot. Ironic, since they did it witha laproscope so they could make sure I wasn't bleeding. Go figure??

alico222 · Answer

Thanks both...
I suppose I'm worried because I know I took a long time to stop bleeding after a molar tooth extraction. And other dental surgery.. Resulted in my surprised dentist commenting .. I shouldn't have bruises like I did!!!

Yes appreciate both your experiences.. Thank you for your encouragement.
Generally day to day I don't bruise but a knock always results in a bruise.
But I don't have gums bleeding or nose bleeds or the red pin pricks.

Probably other people  out there.. Had big bleeds with teeth out and bruised and had liver biopsies ok ?????
Anyone???
Just to reassure me further.

Thanks hector and worried mum.
Hope you get sorted hector.. Read some previous posts.. Know you've had a hell of a time of it..Welldone.. Helping others here,,
Thanks
Alico x

HectorSF · Answer

I agree with aworriedmom their is no reason to be concerned given your current platelet count. Only if you have other coagulation issues (high INR, low vitamin K, etc.) from advanced cirrhosis or some other cause would they be an issue. If that was the case the doctor would give you platelets before the procedure.

While 117,000 as a platelet count is below normal and technically thrombocytopenia (a low platelet count), it is not low enough to be medically worrisome. Low" is a relative term which is why the number is important. Typically it takes what is called "Moderate Thrombocytopenia", a platelet count of 50,000-75,000 cells/µL, to increase the risk of bleeding during an invasive procedures such as liver biopsy.
 
Many of us the have had cirrhosis have lived with platelet counts half your platelet count without any major bleeding issues. I had a platelet count less than 70,000 for 6 years before receiving a liver transplant. I now have a  platelet count typically of 90,000 and probably will for the rest of my life. Even with a new liver my spleen remains enlarged because of my previous portal hypertension so I have a low platelet count and even take aspirin daily with and coagulation issues.

When a low platelet count or any coagulation issue is present people bruise very easily, have recurrent nose, gum bleeds that can take a long time to stop.Often they will have pinpoint-sized, red or purple spots on your skin, etc. These are all typical signs of coagulations issues.

If you remain concerned, you should talk to the doctor who ordered the biopsy about your concern, as they are the true expert regarding your liver disease.

Please keep in mind that regardless of the biopsy result all people, even those with cirrhosis, can be cured with current treatments. So stage of liver disease is no barrier to treatment.

Good luck with your biopsy!
Hector

AWorriedMom · Answer

Your platelets are not even close to the number which causes concern. Doctors worry about surgical procedures when the platelets are below 50,000. I think you are worrying needlessly.