What to do about going in public when counts low?

25 years ago I had been diagnosed with ITP. I've had small set backs, but nothing like this past week brought. Counts plummeted to 3K and I was hospitalized.

I'm home now (Praise God!), but I'm feeling wiped out and not sure what I should do until my next dr. appt. With this being Easter weekend, we had lots going on. I had resigned myself that I'd have to stay home. However, my counts are up to 38K right now, so I'm thinking I can enjoy our church's Easter play and attend Easter Service.

Anyone know what our risk is with low counts (which 38K isn't that bad, I know) in being exposed to cold or flu viruses and our susceptibility in coming down with something and causing our platelets to begin to diminish again.

Any input would be greatly appreciated!
Cathy

Cathy - if you're up to it, you can go out. At 3k, I was still working and Christmas shopping.

Unless you've been on heavy duty imunosuppressants, you're no more susceptible to colds and viruses than anyone else. Some people with ITP have a drop in counts when they are sick, but some people actually have a rise in counts. Everyone is different.

Cathy, you don't mention what Rx you might be on? Nor do you mention if you still have your spleen so I'll assume yes. I'll guess the usual first Rx which is the steroid prednisone but the dose is significant to determine the risk (level of immune suppression). While it does lower the immune system the extent depends on your dose. Apparently your MD didn't provide any guidance? Regardless I don't think you need to practice isolation, just caution. I think you're likely to receive a lot of advise from people here but in general I think you'll hear prudence and watch for fevers (more a concern if you've removed your spleen).

As you said, 38 isn't a bad count (admittedly we all want to be higher and in the "normal" range) but 38 is scary none the less and below the "normal". Since you've been 25 years without a relapse, let's pray your crash is acute and perhaps caused by a bug, OTC drug or other Rx. Was there any recent illness or Rx you've used that might have been a trigger (I'm hope the MD asked that?)? DO you have any idea of how quickly your counts crashed (you would have to have had CBC's to know and after 25 years that's probably not a regular test for you).

Believe me, we all know the freight of that diagnosis but there are good (but unpredictable - will it work or not) results from the Rx available to us.

Sandi, I would find that incredibly dangerous to be at 3K. But like I said, I haven't had to really deal with this disorder for 25 years, so to have it rear it's head again scared me a bit.

Steve, You've assumed correctly - spleen is still intact.
I had IVig at the hospital (2 doses) after a platelet transfusion. Included in the regimen was high doses of prednisone intravenously.

Now home I'm on a 60 mg./per day dose of oral prednisone until I see my hemo on wed. We'll see where my counts are by then. I've been at 50K before without any ill effects and the counts would come back up. The only time I would get the CBC done was when I had excessive bruising. Leading up to this I hadn't noticed a thing until in one day I had the blood blisters in my mouth and the rash on my lower legs. wham! it was here!

Yes, the dr. did ask lots of questions to try to pinpoint what triggered it, but nothing really was revealed. But no guidance on isolation, but then again I didn't think to ask. This seemed like such an informative group, I thought I'd pose the question to see what others thought. And it seems I'm thinking I can go out.

Our family circumstances have it that I just wanted to be prudent in my actions. If I was at risk, I didn't want to pose a threat to my platelets plummeting again. while I don't live in fear of it, seriously, I also have a family to think of too.

Thanks for your caring response. I appreciate it.

It all depends on symptoms. My doctor did not get too upset with low counts, and just told me to go about my normal routine. You'll see that a lot of doctors tell patients that, but there are a few who do hospitalize. I didn't feel I was in any danger except for the times I had to drive to work in the snow. Other than that, I was fine. I found it harder to work on Prednisone, but we all feel that way!

Have you ever had Prednisone before? Do you respond to it?

yeah, I guess my symptoms scared me the most.

Yes, I've responded very well from the prednisone the first and only time I had to be treated. this time they did the ivig and the steroids. From what I've read the ivig can be temporary. So hopefully the steroids will do the trick... not that I'm looking forward the side effects. thanks for responding and helping me. I do appreciate it.

Nobody has asked the most important question - does your Easter play get rowdy? Are there egg fights, jostling for position near the stage, overly enthusiastic clapping? I'd avoid those activities at very low counts!
Erica

Leave it to Erica!

Cathy, at counts in the teens my MD advised avoiding "crowds". I too was in a "relapse" after 10years of normal counts but my anxiety and fears were hard to ignore. I skipped a couple of months of Church services and adult SS classes as my ITP doesn't respond to pred. Was that what everybody else would have done - it doesn't matter as it was what I felt I needed to do considering my situation in the short term. A count of 38 is better than 28 but not as good as 48 so who's to say when "I" should feel comfortable?

You'll find people here who live @ 38 and have established a level of confidence to live life but watch for the "signs" of a pending crash. And even if the MD were to say don't worry we don't always find it that easy (at least I didn't), if you do worry then do what's best for you. It takes time to come to grips with this disorder and get one's anxieties under a higher level of control than oftens follows the initial Dx.

I'm praying this is just an acute case that will quickly resolve itself and your life can return to "normal" - but undoubtedly with some anxiety for a while.

Well put Steve. I had a tough time last year in my first relapse. I don't do "fragile" real well, I prefer the higher risk passtimes. But you are absolutely right, it takes time to come to grips with this illness. Everyone has a different comfort level in their day to day lives, we just need to factor in another issue.