Platelets at 77- see doc ASAP?

Hi Everyone,
I have been laying low, happy in the knowledge that my hubby (Rick) will be seen/treated by an excellent hepatologist in January 2009. But I recently got his bloodwork back, and his platelets have dropped to 77. Last year at around this time they were 99. He also has edema in his ankles, which seems to come and go.
  When I called the center where my Ricks hepatologist is, they said that if his PCP has any reason that he should be seen sooner than January, he needs to call and advise it. However, Rick's PCP is a moron- he has sat by year after year watching Rick's platelets fall and ASL/ALT's rise and said "everything's fine". So he will see no cause to rush the visit unless I push him to.
  Should I try to get this appointment moved closer, or are platelets at 77 still comfortable enough to wait a few months before treating? I just don't want to stand by and do nothing, and find out that it's too late. Thanks for any advice.
-Dee

[portann]

It sounds like you've answered your own question. No harm can come from seeing the hepatologist sooner than scheduled and harm may come if you don't. You can't rely on your PCP for direction.

I don't know myself if 77 is low or not but I would not take no for an answer from the PCP. He only needs to make a quick call to get you off his hands; otherwise, I'd camp out until he agrees.

[jt57]

77 is low, even if you are on treatment.  if he is not, then he really needs to get in to see the Dr.  don't wait.  call tomorrow.

Jean

[mikesimon]

I think you should definitely push to get seen by the hepatologist as soon as possible. I see no upside in waiting and instead I see a possible risk. I believe that you can get your PCP to comply if you make your case clear to him - just be a strong but reasonable advocate.

About his platelet count: My understanding is that <50,000 platelet count triggers some reservations about certain medical procedures and most doctors consider <30,000 to be a dangerous level. I believe that clotting is a multi-faceted mechanism that involves more than just platelet activation - you can have a below normal platelet count and yet still have a normal or near normal prothrombin time(clotting time). A count of 77,000 shouldn't be a problem. I would say that riding a motorcycle isn't a recklessly dangerous activity - any more so than is riding with a normal platelet count, that is. In fact, I rode with a significantly lower platelet count than your Husband's. But, I'm not considered a cautious man so that might not be a strong argument in favor of riding.
Mike