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1693621 tn?1318902971

Platelets

hi, I haven't even began the meds as yet. Oct. 14. but, my platelets keep going down and down. they went to 50 and every two months have blood tests with my oncologist.and he mentioned that we don't want them at 30 or that meant a plasma transplant.. so thank the LORD.. last week they stayed the same 'adequate' as they would say.. geez, now ,maybe I won't be able to begin the meds until they do something with these platelets.... hmm... don't like this.
14 Responses
446474 tn?1446347682
Sunshine:
I guess your oncologist (why oncologist?) is only comfortable with 30.000. I have known people who have gone down into the teens with no signs of bleeding although is does get risky when it gets that low.

Streamline:
For most people platelet count will level out at a certain point and will not continue to decrease after that.

As with all blood levels they vary over time to some degree.
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From MedicineNet.com
http://www.medicinenet.com/thrombocytopenia_low_platelet_count/page3.htm#symptoms

"What are the symptoms of thrombocytopenia (low platelet count)?

In many instances, thrombocytopenia may have no symptoms, especially if mild, and it can be detected only incidentally on routine blood work done for other reasons.

If thrombocytopenia is severe, for example less than 20 per micro liter, it can potentially manifest as increase bleeding when a person is cut or injured or increased bleeding during menstrual period.

Spontaneous bleeding can also happen with severe thrombocytopenia (less than 10,000 to 20,000 platelets). This type of bleeding usually occurs under the skin or the mucus membrane (the inner lining of the oral cavity, gastrointestinal tract, or the nasal cavity).

Petechiae may be seen in patients with very low platelet counts. Petechiae are small (pin head size) red, flat spots seen under the skin on the dependent parts of the body because of increased pressure due to gravity, for example, on the lower legs. These happen because of bleeding out of the tiny blood vessels under the skin or the mucus membrane. Petechiae are generally not palpable or painful.

Other rashes or bruises seen in thrombocytopenia are called purpura, which are small, purple spots under the skin as a result of hemorrhage. These are typically greater than 3 millimeters in diameter and may represent a confluence of petechiae."
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Hector
Avatar universal
Yes 50 is very low platelet level, and not even on tx......... I would be surprised if they let one start tx at that low. I started with platelets in the low 80's and they droped to 29 during tx...... Me being cirrhotic they run low.
1693621 tn?1318902971
hi, thanks for responding.. you mentioned that  your platelets went down to 29 ?? whoa.. they didn't mention a plasma transfusion for getting that low.. glad you pulled thru that without the transfusion..on Oct 14 , is when I see my Dr. on being treated.we had spoke about it beginning of the summer, when she wanted be to begin.. was a bit disappointed that I wanted to wait for fall. but , guess,we shall see, what's gonna go on.. thanks a mint..hope your doing well.
446474 tn?1446347682
As can-do said 50,000 is a really low platelet count.
Your platelet count may be too low to start treatment I'm afraid.
Is your low platelet count only caused by your cirrhosis or do you have some other health conditions?

What does the hepatologist say? It is really up to them to care for you during treatment. So their opinion is what really matters. Most docs wouldn't even attempt treatment with the low of count. If you do treat you should be monitored very closely.
Are you on a transplant list?

Interferon will reduce your platelet count even more. If you are cirrhotic the only way to safely raise your platelets is with transfusions. But I would imagine you may need a lot of transfusions over the 48 weeks of treatment.

It is a tough situation to be in. I wish you luck.

Good luck.
Hector
Avatar universal
I started treatment with Incivek at 64,000 platelets. They were 32,000 by week 4. Two weeks ago they were 29,000. I had labs drawn yesterday but have not gotten the results. I am about to start week 12. My doc said they won't intervene until they go below 25,000 and then we would decide what option to take. I agree with Hector your hepatologist will make a reccomendation. I have noticed every doctor has a different opinion and I believe they look at patients and their cirumstances on a case-by-case basis.

Good luck, I hope all goes well.
Avatar universal
I started treatment with Incivek at 61,000.  By week 6 they had dropped to 19,000 and meds were reduced.  At week 10 still not at full dose meds again, platelets are at 31,000 now.  I have weekly CBC's and am monitored very closely by my hepatologist thru a transplant center.  I have also been on Xifaxan for close to a year, it supposedly helps with the increase of platelets although I haven't seen much of a change.  Just be sure you have a knowledgeable doctor who is familiar dealing with low platelets because really there isn't a whole lot you can do to increase them for any extended period of time.
446474 tn?1446347682
Hi ASmile.

Xifaxan (Rifaximin) is an antibiotic that treats hepatic encephalopathy (HE) by stopping the growth of bacteria that produce toxins. It is often used in combination with Lactulose. HE causes changes in thinking, behavior, and personality caused by a build-up of toxins in the brain in people who have advanced liver disease. This is because the liver is so damaged it can not full perform this function fully any more. (A healthy liver filters these toxins out of the blood.) This is why decompensated cirrhotics should not eat red meat as it is hard to digest and produces a lot of toxins such as ammonia.

Xifaxan Drug Description:
http://www.rxlist.com/xifaxan-drug.htm

Xifaxan has no effect on platelet count.

Cheers!
Hector

Avatar universal
Yes you are correct with Xifaxan's description.  However, my doctor believes it can also increase platelets. Not a substantial increase, but it was enough to allow me to start treatment.  My plateles went from 39 to 61 in the months prior to starting triple therapy. :)
1693621 tn?1318902971
hello, thank you for responding.. on my platelets being so low.. and I do have other chronic disease that I do deal with. but, anyhow... my oncologist, had mentioned to me that he didn't want to see 30 because that's when the bleeding of the nose,gums. and sometimes in the brain. could take place. so ,I do go right now every 2 months for updates, and my last one was 'adequate' as he wrote on my chart on my online reports from drs. (blood work that is) so at least it's at the 50 level ,twice in a row and did not go down.. hooray.. then I don't need a plasma transfusion.......whew... I'll tell ya, Oct. 14 is my day to talk to my hepper Dr...to see exactly what is going on... so ,,,, I shall wait,,, to see, scared as like most everyone was just in the beginning.... well, everyone I hope ,are hanging in there and honestly,,, best to all of us,, going thru 'THIS MISSION..... smile....... even when ya don't think ya can.... you can...... (((hugzz)
Avatar universal
Reading about platelets and having this platelet problem myself is it in anyone's experience that as treatment goes on this problem will resolve itself or is it always going to be an up and down problem even as we get closer to finishing our tx. which may keep us in jeopardy of not being able to finish treatment in the end.
Avatar universal
After starting tx my platelets improved to 169,000, but my recent lab came in 129,000.  Seems like a big swing in one week and hope it's not a trend.  I really don't need the third leg of anemia, I already have two.
1693621 tn?1318902971
hi, thank you for again, your reponse, I 've been seeing an oncologist for quite a few years ,do to other blood disorders that I deal with... which the pupura ,is being on ,but I see another type of Dr. for that one.. but ,on the oncologist would be the cryofibrinogenimia,,,,, and the thrombrocylopenia pupura is very very close to the cryo (also meaning cold) fibrin, our fibrin. and during the winter weather is when it worsens on my legs, I am left on my ankles and top of feet with permanent dark brusising that just does not go away... but, what baffles them is that I also get it during the summer weather sometimes as well... and this summer was my best.. yeah..... I deal with sarcoid ,raynaud's syndrome, Barr's virus,, and a few others,, isn't fun at all with to boot a painful back which is in another division ,with osteoporosis, osteosarthritis, degenative disc disorder, stenois, ahh. 8 hr back operation with two rods and a plate,,,, whew..... now , ask me how I feel.... lol .......so . oh yes ,, oouch... divirticilitis...... also had cancer insitu,,, cleared that... with a complete hysterectomy..... yrs ago... and had appendix out... had shingles when I was like 8 /9 yrs old... and suppose to be like older adults that it come out... hmmm. been a blast....so I think i shall CONQUER  this hopefully. take care and thanks
Avatar universal
I started treatment with 60 platelets. By week 4 they dropped to 25. I also needed procrit at that week. By week 8 my platelets went up to 85. That's high for me. Are you taking aspirin or any blood thinners. I would be careful not to.I think I can tell my platelet count by the help of my gums. If they don't bleed I think my platelets are OK. When they dropped to 25 they would bleed while sleeping. They dropped down to 65 by my 12th week blood work. I happy if they stabilize there. It's can all get so scary. Hang in there and if you have an aggressive doctor he/she will probably treat you. Good luck.
Avatar universal
I started treatment with platelets of 62 and hepatologist said no problem, we'll just watch it. He has me doing blood work every two weeks. I go tomorrow which sould be interesting I just started week two of treatment. We'll see. I had seen other GI's that didnt want to treat because of low platelets but the Dr. I have now is part of transplant dept.and he said he see people a whole lot worse than me. Wow, really. I guess thats good. LOL! But so far so good. Time will tell. The blood doesnt lie.....
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