Just had nose surgery and it just keeps oozing

Hi there,

I'm new to this group... My thrombocytopenia was diagnosed last year summer by a health screen which found my platelets to be at 61k (was 200+k in 2007). Been on regular followups for my plt count in th past year and it has slowly but surely been on the decline. At 40k my doctor discussed treatment options and knowing that I wanted to keep off pred for as long as possible, he prescribed colchicine 1# qd and folate, which I took for about a mOnth... But irregularly, I'm ashamed to admit. At the next blood test though my plts had gone up to 51k! Just a week ago I decided to undergo surgery for my persistently stuffed nose caused by my nasal septal deviation and grossly enlarged inferior turbinate largely due to my severe allergic rhinitis. I was excited about the procedure because for the longest time I've been breathing through my mouth and had horrible sleep quality which left me somnambulistic in the daytime with a throbbing headache. So surgery was done last Friday with the regular preop survey prep completed, and it was uneventful until I got back to the ward where I just kept oozing from my nose. The oozing finally trickled to a slight halt by the time Monday rolled along and I had to hav my packing removed. Voila, the moment they removed it hurray I was bleedi g like a fountain. Packing again! So for the past few visits for post op care I've been consistently rebled and repacked, like a nightmare that would never stop. Surgicel does a gd job of helping my clots form, though! And on one of the postop visits, my operator said u kno we didn't kno your plts were so low(35k) or we'd transfuse you with ffp prior to the op! So they didn't check my preops until I kept bleeding.. Anyhow I just hope that stable clots would form and I'd be off nasal packing for good. Just yesterday night I was tidying my desk when a fresh nosebleed started that scared the hell out of me. I compressed it and laid in bed and prayed hard that it would stop and I didn't have to visit the er. Eventually it did but I was so afraid of poppin it again that I stayed in bed after. I'm wondering though with all that bleeding in the past week if my platelets would be even more depleted by now?! Visited my haematologist and he said I can wait two weeks for the next bloodwork.. Just a little concerned about my counts now just in case they don't hold up till then!

Hi Air,

Seems a bit surprising that they didn't know of your platelet status beforehand. Isn't that normally a part of the pre-op appointment, when they have you fill out all those forms and ask lots of questions? Seems like substandard care to me, especially if you had put that on your forms. I know each doctor differs, but it seems quite a few on here say their doctors or dentists require them to be at 100k before doing surgery or major dental work.

But, I guess that's all beside the point, now, as what's done is done. One thing that I've found very helpful for when a wound keeps breaking open easily like yours is, you can get a homeopathic remedy called Phosphorus, in a low potency,
at most any health food store that has a homeopathic section. The low potencies, like a 6C, 12X, 30X or 30C, would be appropriate and safe, and are sold OTC. (The 6C, take 4 times/day--the other potencies, 3 times/day, just until you notice that the bleeding has stopped; then, take it for 3 more days, just to make sure it fully heals.) Phosphorus is an excellent remedy to stop bleeding, and is especially called for when a wound repeatedly breaks open again and again.
Who knows? It may even help your platelet counts go up. It can be a good remedy for people who bruise very easily, especially if they are 'spontaneous' bruises. But, as with any homeopathic remedy, do not take too frequently or for too long of a period. Once there is marked improvement, stop taking any further. Take it again, only if symptoms return.

april

Well, these are my thoughts. I think your doctors should have been a little more on the ball with getting counts up some for the surgery. A lot of surgeries can be performed with lower counts, but since the nose is an area that tends to bleed a lot, higher counts would have been beneficial. However, someone with normal counts may have the same amount of bleeding since the arteries in the nose can release a lot of blood. I would expect bleeding after a surgery like that and if you are getting it stopped, that is a good thing.

I doubt that the bleeding is causing your count to drop...it doesn't quite work that way unless you are losing a lot of blood. I know it seems like a lot, but unless it's pouring out for long periods of time, you should be okay. Don't let it go on for too long though without seeking help. You seem calm and in control. I think if you are leery of letting counts go for two weeks, call and ask to get one done.

I'm interested in the procedure itself...can you tell me about it? I'm supposed to have those same exact surgeries for the same problem. I've put it off for the past three years and have no plans to do it in the future because I read that it's only successful 60% of the time and it's hard to recover from. How long are you supposed to be off of work? I'd like to know, when all is said and done, if it worked for you. It is miserable to go through life like this. I do the nasal rinses and steroid sprays and they don't help all that much. I don't know anyone that's ever had the surgeries. My ENT suggested another procedure along with those two but I can't remember now what it was.

I'm very interested in this thread because of my recent experiences. As I posted (in the General dept.) last week, I had (in 11 years of ITP) my first uncontrolled nosebleed and had to get my nose packed in ER. When I had the packing removed, the head-and-neck doctor told me I have a deviated septum and he and his fellow docs "could fix it." It sounded like out-patient, simple surgery. I'm sure they would want my platelets higher than my normal (my normal is in the 20Ks) before such surgery. This doctor thought if I had a straighter septum, I would have fewer allergy congestion problems and be therefore less inclined to nosebleeds.

Like Sandi, I'd love hear from those who've had the surgery.

A very odd side-effect of my nosebleed trauma--my platelets rose astronomically--for me. I suspect the shock to my body of the bleed caused my platelets to rise to 162K on Thursday! I don't expect that to last, but it certainly is interesting!

am impresssed too the whole and i am lucky with the dentist I now have. He understand ITP! Alot in UK don't seem to be other reports.

Trouble is that I need a tooth coming out and he wont do it whilst on steroids. I hope to be off them this week. But last time he wanted to know my platelet count too. Which could get tricky seeing that I don't have a test every day.... So yes I understand concerns on here and some medics are better than others at understanding blood etc. I was quite impressed with my dentist (though inwardly minor annoyance because I can tell him the count from my last test but not on that appointment day and yes my platelets can and do seem to drop and rise on their own sometimes as such as of last weekend-judging by the signs without any testing.

You will know if you need anything more surgical doing to tell them about the platelets 'coz' whilst the docs should test before and some do. It goes to show that not all docs read the results. Or did they know how keen you were to have it done so kind of deliberately over look to help you. 35 platetlets, well they shouldn't have done it unless emergency I gather? But you may have given impression you had more than enough so kind of ignored the blood test - all to help you. Naturally, they would never say so but could it be possible?

It was nice and very interested discussion going here. I had a problem of breathing with my nose. It become so difficult for me to breathe. So I decided to have a nose surgery. It really works and I am very pleased with its result.Check out these site www.nosesurgeryguide.com/ for more information about the nose surgery.

I might have to have it done. I think I have sleep apnea and using the CPAP will not be possible since I can't breathe from my nose. I'm glad that yours went well...it gives me hope. What procedures did you have done?

Sandi,

I also know someone personally who had this done and it was VERY successful. The person was very addicted to things like afrin to keep his sinuses open. It took a solid week for him to recover and it was not easy (he had no complications), but it was painful at times. However, the end result has been he hasn't had anymore issues in 20yrs.

I have Flonase (which is not addictive) and have 43 refills. Too funny. I've heard recovery is nasty and that's why I've avoided the surgery. No time for it. But, I know I probably have to have it done and would feel so much better if I did. Maybe I can swing it next spring.

Thanks for letting me know that. I need to hear success stories.

George, what was your platelet count when you had the nose surgery? You apparently didn't have any bleeding problems related to the surgery, right? Did your doctor express any concern about your platelets?

I, too, had nose surgery years ago before I had any platelet problems. It did help some; but, my main problems seem to be seasonally allergy. My doctor has also prescribed Flonase for me to use if I need to. We just happen to live by a river-bed area and also in a horse community. So, we have a lot of dust that blows around from all the animals. I have learned to live with it--but you can end up with the nose bleed like Karen did.