Pity Party Post (or, I could use some support) (XP)
Jun 7, 2016 22:08:23 GMT -5
Post by littleducky on Jun 7, 2016 22:08:23 GMT -5
XP on CAR
Pity party, table for 1 please. I know I haven't been super active on this board, but I'm having a rough time this evening and I'd appreciate support from any of you who are still up this late.
This might end up being a semi-post and run, but I am really upset and need to post about it even though I am going to try to go to sleep soon.
I know I've posted about this before in some threads, but I have a chronic autoimmune disorder called ITP which causes me to have a lower than normal platelet count. Normal is 150-400. If a platelet count is low, it can cause blood to not clot normally. They will not do an epidural or spinal anesthesia if the platelet count is below 80 because of risks of bleeding in the spine leading to paralysis. There is also an increased risk of hemorrhage if the platelet count is low.
When I was pregnant with son (who is now 5), my platelets dropped to around 50 in the third trimester and I was treated with very high doses of steroids, which I responded to briefly but then stopped responding to. Then I had two days of IVIG (intravenous immunglobulin) at 38 weeks, which did work and got my count up, and I was induced a couple days later before they had a chance to drop again.
This time around, my ITP has been one thing that has NOT been a problem during this pregnancy. My platelet count has been above 100 this entire pregnancy. Still below the normal 150-400 range, but well within the safe ranges for delivery and for anesthesia. I've been getting blood drawn weekly for the past month to make sure my platelet counts stays at a good level. Also, as I've posted about, it turned out I was anemic, so I started treatment for that today with IV iron therapy. The hematologist was hoping I'd be able to get 5 iron infusions before delivery. I'm scheduled for a second one on Friday.
I just checked the patient portal and my CBC results from yesterday showed a platelet count of 64. I am so upset. The one thing that seemed to be going easier this time around is out the window. I see the OB tomorrow (not my main OB, but she will be in the office too, so I might ask to talk to her) and will talk to her about what the plan is for moving forward and will talk to the hematologist, too, but if I had to guess, I'm probably looking at doing IVIG within the next couple of days and then being induced within a few days of that. It's too risky to go into labor with my current platelet count, and the IVIG takes a couple days to work, so I doubt they'll want to wait long. And the IVIG response doesn't last for that long, so once my platelets do go up, I think they'll want me to deliver sooner rather than later, before my counts have a chance to drop again.
The extra wrinkle this time is that I'm still anemic and the sooner I deliver, the less iron infusions I'll be able to get, and the less they'll be able to try to get my hemoglobin level up, so now that is part of the puzzle, too.
I'm just so frustrated and upset. All I wanted was to go into labor on my own rather than be induced this time around, and it appears that the likelihood of that happening is getting slimmer and slimmer. And I'm worried that we won't be able to get my platelet count to a safe range and also get my hemoglobin up before I deliver. Now I have to hope that I don't go into labor before we get a chance to do something to treat my ITP and get my counts up.
I would appreciate any and all good thoughts and wishes you have to spare.
Pity party, table for 1 please. I know I haven't been super active on this board, but I'm having a rough time this evening and I'd appreciate support from any of you who are still up this late.
This might end up being a semi-post and run, but I am really upset and need to post about it even though I am going to try to go to sleep soon.
I know I've posted about this before in some threads, but I have a chronic autoimmune disorder called ITP which causes me to have a lower than normal platelet count. Normal is 150-400. If a platelet count is low, it can cause blood to not clot normally. They will not do an epidural or spinal anesthesia if the platelet count is below 80 because of risks of bleeding in the spine leading to paralysis. There is also an increased risk of hemorrhage if the platelet count is low.
When I was pregnant with son (who is now 5), my platelets dropped to around 50 in the third trimester and I was treated with very high doses of steroids, which I responded to briefly but then stopped responding to. Then I had two days of IVIG (intravenous immunglobulin) at 38 weeks, which did work and got my count up, and I was induced a couple days later before they had a chance to drop again.
This time around, my ITP has been one thing that has NOT been a problem during this pregnancy. My platelet count has been above 100 this entire pregnancy. Still below the normal 150-400 range, but well within the safe ranges for delivery and for anesthesia. I've been getting blood drawn weekly for the past month to make sure my platelet counts stays at a good level. Also, as I've posted about, it turned out I was anemic, so I started treatment for that today with IV iron therapy. The hematologist was hoping I'd be able to get 5 iron infusions before delivery. I'm scheduled for a second one on Friday.
I just checked the patient portal and my CBC results from yesterday showed a platelet count of 64. I am so upset. The one thing that seemed to be going easier this time around is out the window. I see the OB tomorrow (not my main OB, but she will be in the office too, so I might ask to talk to her) and will talk to her about what the plan is for moving forward and will talk to the hematologist, too, but if I had to guess, I'm probably looking at doing IVIG within the next couple of days and then being induced within a few days of that. It's too risky to go into labor with my current platelet count, and the IVIG takes a couple days to work, so I doubt they'll want to wait long. And the IVIG response doesn't last for that long, so once my platelets do go up, I think they'll want me to deliver sooner rather than later, before my counts have a chance to drop again.
The extra wrinkle this time is that I'm still anemic and the sooner I deliver, the less iron infusions I'll be able to get, and the less they'll be able to try to get my hemoglobin level up, so now that is part of the puzzle, too.
I'm just so frustrated and upset. All I wanted was to go into labor on my own rather than be induced this time around, and it appears that the likelihood of that happening is getting slimmer and slimmer. And I'm worried that we won't be able to get my platelet count to a safe range and also get my hemoglobin up before I deliver. Now I have to hope that I don't go into labor before we get a chance to do something to treat my ITP and get my counts up.
I would appreciate any and all good thoughts and wishes you have to spare.
