November 2011 Moms

So sick of the low platelet business... :(

So, I got a call today that my labs from this week showed my platelet count dropped to 107. Last week, my doctor said if they dropped 15%, they'd induce me. Since then, they've dropped about 22%. Well, my doctor is OOTO, once again, I think for some kind of family emergency. The other nurse basically had my husband and I drop everything to come in for a "thorough exam" and talk about induction.

We get there, and the nurse took my blood pressure and checked my urine - then was like "well, the doctor may see you, she may not." WTF.

Well, she did end up coming in, talked to us briefly and then sent us on our merry way. She called 3 hours later, after consulting a high-risk doctor, to say she didn't think we needed to be induced until my numbers hit 80 or I get to 39 weeks.

Don't get me wrong, I'm glad I didn't need to be induced. I'm glad they are monitoring me, and I know it's not the doctors fault. And, I am glad there isn't any imminent danger to me or the baby - that they know of.

I'm just so sick of the stupid emotional mind game of these numbers dropping, them calling me to "come in and be checked" and not knowing when it's an emergency and when it's nothing to worry about. I hate that they don't know why this is happening, why I have upper-right side pain going with it, and that they can't be 100% certain that these things aren't going to cause complications for my delivery. I wish my body would just, for once in my life, be normal!!!!!!!!

Thanks for reading if you got this far. I guess I just needed to vent!

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Re: So sick of the low platelet business... :(

  • I am so sorry they are jerking you around. Seems like they would go by some set criteria and stick to it. I know what you mean about the mind games! I go in Weds to have a c-section, and I might have to wait one more week if amnio of her lungs show not ready. Of course I want her to be ready, but gah! The unknown back and forth of what they think is best is killing me! Hoping you get some peace of mind soon.
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  • I feel your pain girl! I was ready to get this over and done with on Tuesday but since my platelets went from 119 to 138 they couldn't do it. Now they're back down to 123 so I'm waiting to see my Dr on the 1st to see what she says, but either way I won't go past my original due date. It will either be natural or induction so I'm just dealing with it at this point.

    Good luck!

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  • I'm still confused why low platelets equals inductions.  Do you have something else going on?  Mine were at 88 this week and no induction was discussed.  Steroids below 50K is what was discussed.  Am I missing something?



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  • imageJing22:
    I'm still confused why low platelets equals inductions.  Do you have something else going on?  Mine were at 88 this week and no induction was discussed.  Steroids below 50K is what was discussed.  Am I missing something?

    It doesn't HAVE to equal induction in all cases. For me, low platelets along with the side pain I have, they are afraid may turn into HELLP. That's why they are monitoring me closely.

    But, when you get below 100, you will most likely not be allowed an epidural. It seems that different doctors have a different "low" that determines that, but mine says below 100. At that point, I would also have to go under general anesthesia if I needed a c-section.

    The main issue, it seems for my doctors, with low platelets is that they can't tell for sure what causes them. Platelets are what cause your blood to clot. If you get too low, you are at a high risk for bleeding problems. Also, low platelets often go hand-in-hand with Pre-e and hypertension. This seems to be my doctor's biggest concern.

    And, sometimes, the cause of low platelets can be that your body is effectively "attacking" your own platelets - which, in some cases, can cross over to the baby's blood stream, attacking their platelet supply, causing problems for the baby. But, I believe this is rare.

    It is not "normal" for platelets to drop more than 10% during pregnancy. According to my doctor, when they get low enough, they stop trying to figure out why it is happening and induce because the risk gets too great that something more serious could potentially happen, to the mom or the baby.

    I had ITP when I was little (which is low platelets, in the acute form) which caused me to bruise all over my legs from the waist down. It was very painful; I couldn't walk for months. It took a few months to go away. That is one of the many things that can happen when platelet count gets too low.

    I'm surprised that your doctor isn't monitoring you closely, for pre-e symptoms at least, with platelets below 100. It can be serious...but you're right, it doesn't HAVE to equal induction. Here is a pamphlet I found to be helpful when I started researching it: https://www.pdsa.org/assets/pdf/itp_preg_web1.pdf

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  • To add to my already long response, here is an excerpt from that pamphlet. This seems to be the rule of thumb your doctor is following. My doctors have just set their number at 100,000 it sounds; your doctor must be in the 50,000 camp.

    Q Is there a platelet count to maintain during
    pregnancy to protect the woman and the fetus?


    A There is a consensus that at a platelet count of 50,000
    ppm or greater, both the pregnant woman and fetus are
    safe. Most physicians will not treat ITP during pregnancy
    if the platelet count remains at or above this level. In fact
    many physicians consider a platelet count above 20,000
    ppm safe during pregnancy, but most want it above
    50,000 ppm near term and between 80,000 and 100,000
    ppm for an epidural anesthesia.

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  • I had platelet issues with my last pregnancy. They were worried at 130,000 but kept waiting. i didnt understand. It took me a while to figure it out but under 100 is bad but under 90 means you have to be put under if surgery is needed. the risk for bleeding issues is MUCH higher. I went in the day before having the twins and tested at 88,000 the morning of the surgery I tested again and this time I was at 90,000 exactly. THANKFULLY I was able to get the spinal and be awake for the surgery and I had NO complications after. It did not take long before my platelets came back up. I was just tested on tues to make sure they are in check this time. so far so good.
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  • Oh rest assured I am being monitored and have a hematologist whom I am also seeing.  Fortunately, my blood pressure is perfectly fine and I exhibit none of the signs of HELLP.  I was confused because your numbers are much higher than mine, yet your doctor is talking induction.  It makes sense if you are exhibiting signs of Pre-E etc.  Good luck!



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  • imageJing22:
    Oh rest assured I am being monitored and have a hematologist whom I am also seeing.  Fortunately, my blood pressure is perfectly fine and I exhibit none of the signs of HELLP.  I was confused because your numbers are much higher than mine, yet your doctor is talking induction.  It makes sense if you are exhibiting signs of Pre-E etc.  Good luck!

    I don't technically have any other symptom of pre-e yet. They think the side pain is unrelated; they are monitoring to make sure, but the if my bp goes up or there is protein in my urine, I will be induced.

    Right now, they are talking induction because if they drop anymore, I may not be able to have the epidural. The labor just becomes more high-risk when you get to that point of low platelets, and my doctor and I would like to avoid that.

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  • Just curious, with your platelets being at 88, did your docs tell you about the no epidural/general anesthesia for c-section?
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  • Ugh, I've just started experiencing the consequences of low platelets. My doctor told me last week that they were low (first I knew of it), but they were "over a hundred" so I was still eligible for an epi. I didn't think anything of it, assumed that meant they were 130, 140, whatever. Then a couple of days ago she told me they were 108k. It turned out to be a big deal yesterday when I went to triage for a dose of Prostin. The nurses and on-call doc took my BP, which happened to be elevated at the time, then saw that my platelet levels were 108k, and jumped to the toxemia conclusion. They were threatening to keep me and induce me, even though I was in triage getting meds for a closed cervix. A CBC yesterday showed that they'd gone up to 119k, so they let me go home, but it was still scary for a couple of hours, and super frustrating.

    *hugs*


     image

    DS: 11/8/11 | 9 lb 7 oz, 22 in
    DD: 5/22/14 | 9 lb 9 oz, 21.5 in


  • imagejenbarker99:

    Ugh, I've just started experiencing the consequences of low platelets. My doctor told me last week that they were low (first I knew of it), but they were "over a hundred" so I was still eligible for an epi. I didn't think anything of it, assumed that meant they were 130, 140, whatever. Then a couple of days ago she told me they were 108k. It turned out to be a big deal yesterday when I went to triage for a dose of Prostin. The nurses and on-call doc took my BP, which happened to be elevated at the time, then saw that my platelet levels were 108k, and jumped to the toxemia conclusion. They were threatening to keep me and induce me, even though I was in triage getting meds for a closed cervix. A CBC yesterday showed that they'd gone up to 119k, so they let me go home, but it was still scary for a couple of hours, and super frustrating.

    *hugs*

    Ugh, I'm sorry you're going through it too! I think the worst part is that the doctors have to jump to the worst conclusion (just in case it is serious) - which gets me worked up - and then they do the extra testing, and things are "fine". Sounds like that happened to you too!

    It's like I always have this induction looming over my head, and then when I think it might really happen they're like "Just kidding, fooled you!" 

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  • imagelittlewinnie15:
    imagejenbarker99:

    Ugh, I've just started experiencing the consequences of low platelets. My doctor told me last week that they were low (first I knew of it), but they were "over a hundred" so I was still eligible for an epi. I didn't think anything of it, assumed that meant they were 130, 140, whatever. Then a couple of days ago she told me they were 108k. It turned out to be a big deal yesterday when I went to triage for a dose of Prostin. The nurses and on-call doc took my BP, which happened to be elevated at the time, then saw that my platelet levels were 108k, and jumped to the toxemia conclusion. They were threatening to keep me and induce me, even though I was in triage getting meds for a closed cervix. A CBC yesterday showed that they'd gone up to 119k, so they let me go home, but it was still scary for a couple of hours, and super frustrating.

    *hugs*

    Ugh, I'm sorry you're going through it too! I think the worst part is that the doctors have to jump to the worst conclusion (just in case it is serious) - which gets me worked up - and then they do the extra testing, and things are "fine". Sounds like that happened to you too!

    It's like I always have this induction looming over my head, and then when I think it might really happen they're like "Just kidding, fooled you!" 

    I know, I felt like I had whiplash yesterday! I'm just thankful that they're higher at the moment, and hoping for the best. Good luck to you! I'll keep you in my thoughts.


     image

    DS: 11/8/11 | 9 lb 7 oz, 22 in
    DD: 5/22/14 | 9 lb 9 oz, 21.5 in


  • imagelittlewinnie15:
    Just curious, with your platelets being at 88, did your docs tell you about the no epidural/general anesthesia for c-section?

     Yes.  Fortunately my hematologist is on staff at the hospital and has been making  the calls of what goes and what does not.  I plan to go drug free anyway and I've had some progress at my last appointment: baby's head is sitting really low and doctor could feel it.  Sometimes you just have to roll with the hand you are dealt and not get all panicked.  There is not really anything you can do for this problem anyway and I've seen all the doctors I can and been prodded a billion times with needles. Plus platelet counts are not usually static.  You can be tested one day and get a low reading and have it go up 30K the next.  Mine keeps wavering along those lines: between 80K and 120K.  I hope you don't have to be induced for your sake though.  How awful to get pitocin potentially without an epi.




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  • Yep. This is ONE of the many reasons we are planning my c-section THIS Weds. Being such a bleeding risk with the previa before delivery, having to have a section where there will be more blood lost in general because they have to cut through the placenta to get to baby, low iron, etc. She is afraid with the platelets low, that if I start bleeding at home, it will be a bad situation. Especially if they keep getting lower. Then, having low iron will cause it's own problems if I bleed too much. Then, their is the fact that I do want to be awake when baby is born and no GA.  Looks like this was our low blood platelet checkin-haha!!
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  • imageJing22:

    imagelittlewinnie15:
    Just curious, with your platelets being at 88, did your docs tell you about the no epidural/general anesthesia for c-section?

     Yes.  Fortunately my hematologist is on staff at the hospital and has been making  the calls of what goes and what does not.  I plan to go drug free anyway and I've had some progress at my last appointment: baby's head is sitting really low and doctor could feel it.  Sometimes you just have to roll with the hand you are dealt and not get all panicked.  There is not really anything you can do for this problem anyway and I've seen all the doctors I can and been prodded a billion times with needles. Plus platelet counts are not usually static.  You can be tested one day and get a low reading and have it go up 30K the next.  Mine keeps wavering along those lines: between 80K and 120K.  I hope you don't have to be induced for your sake though.  How awful to get pitocin potentially without an epi.

    Yeah, I'm trying my best to roll with it! I want to go natural too, but the thought that the epi is there seems to help me mentally. The thought of general anesthesia terrifies me for a c-section! I'm keeping my fingers crossed for no induction too... hopefully when my regular doctor gets back, she'll set my mind at ease. She is much more calm about the situation!

    Good luck - I hope all of our counts stay up!! :)

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  • imagesarahjames9:
    Yep. This is ONE of the many reasons we are planning my c-section THIS Weds. Being such a bleeding risk with the previa before delivery, having to have a section where there will be more blood lost in general because they have to cut through the placenta to get to baby, low iron, etc. She is afraid with the platelets low, that if I start bleeding at home, it will be a bad situation. Especially if they keep getting lower. Then, having low iron will cause it's own problems if I bleed too much. Then, their is the fact that I do want to be awake when baby is born and no GA.  Looks like this was our low blood platelet checkin-haha!!

    Seriously, I almost did one earlier this week!! Haha. 

    It sounds like you've got the perfect storm of blood issues going on there... I hope they're able to proceed with the c-section as planned and it all works out! This Wednesday - that is SO soon!! :)

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  • I know! It seems soooo surreal!! I had my last P17 shot last week too, so she said my contractions will probably pick up even more! Gahh!! They cannot be any worse! I hope I make it until Weds honestly! I f I go in labor this weekend or Monday, I won't get my OB, just whoever is oncall! Stay in just a couple more days, LO.
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