Saturday, November 21, 2009

ITP- what on earth's that?

Last week I had a bad fright – or maybe it was wake-up call. I was discovered to have an extremely low thrombocyte (blood platelet) count, in the order of 5,000 per cubic millimetre of blood instead of the healthy 150,000 – 450,000. At such a low level, my blood almost had no clotting ability at all, and had I fallen or been involved in a road accident, I was in serious risk of major internal bleeding, intercranial bleeding or a cerebral haemorrhage (stroke).

I’d had no symptoms, other than some strange bruising. I bruise easily, but usually remember hitting myself or bumping into something and thinking “now I’ll have a bruise”. These just appeared, almost overnight, so I mentioned them to my family doctor when I went to get some prescriptions renewed.

No big deal, I thought. Had a blood test, went off to do some shopping, carried my groceries home – a nice walk of about a kilometre through a local park - and worked at my desk all afternoon. That evening I was rushed to the ED, as soon as my disastrously low blood test results came through.

So a week later, after excellent care in one of Australia’s best teaching hospitals – Sydney’s Royal Prince Alfred (RPA) - I’m now facing the likelihood that ITP (idiopathic thrombocytopenic purpura, aka immune-mediated thrombocytopenic purpura) is going to be a part of my life. If I’m really lucky, this will be a one-off event, and when I’m weaned off the steroids in 10 weeks’ time, it will go away and never come back again. Be the idiopathic thing: “idiopathic” means “no-one knows why”.

But we won’t know. We’ll have to keep checking, every few months.

Because, given my age (61) and the fact that I’m a woman, it’s more than likely this will be chronic ITP – the auto-immune version that comes back every so often after the immuno-suppressant effect of the steroids has worn off.

I didn’t know anything about ITP before last week – had never even heard of it, so I looked it up. (It helps being a health and science writer, I’m good at finding information). Here’s the broad info from Wikipedia, and here’s the Mayo Clinic’s rundown of treatments and drugs.

I’m heartened by the link on the Mayo page to Lifestyle and Home Remedies – it looks like there will be some diet and exercise ideas I can follow up to improve my overall health while taking steroids. I already know I have to protect my liver – no alcohol, and decaff instead of regular coffee – and I will need to up my calcium intake, as prolonged use of corticosteroids can cause osteoporosis.

But first, let’s find out what my platelet count is after I see my haematologist next week. Will I hit 150,000?

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