Question

My 22 year old son was recently diagnosed with ITP with 2 hospitalizations in the past month. He is on 200mg of prednisone right now. My question is that his dream and goals and college degree were and are always to become a policeman. He has been testing for police departments and has made several lists so far. We are pretty sure that one of them may hire him. With this newly diagnosis, do you think the police departments will still hire him??? He would be devastated if this were to cause him from becoming a police officer and future swat member

any advice would help

I used to work for a county and had some responsibility for the testing of people who wanted to become Sheriff's Deputies. I do think it would be a problem to be hired if he had dangerously low counts. I'm not sure if there would be a problem if he is in remission or if he was diagnosed with acute rather than chronic ITP and had normal counts.

Here's what I would suggest - contact a county or city far from your own where your son would not likely apply. Ask to see a copy of the guidelines for passing the medical exam to be hired onto the police or deputy force. These should be available to you if you ask, you might have to be a little persistent or they might even be posted on the website. In fact first check the website for the force he would most like to work for.

There are many law enforcement positions that don't involve physical risk so that might be a plan B, I know he would be disappointed but it is still law enforcement.
Erica

Thank you for your response. He wont even discuss NOT getting into the PD due to this and he is hoping that this will be thing of the past soon, he wants a speenectomy thinking it will cure it all, but the doctor told him they must try other stuff first. I dont understand why they doubled his prednisone when everytime they lower it from a previous 100mg a day, his platelets went down to 3000 and 6000 the second time and now he was released and they put him on 200mg a day. Tomorrow he gets his blood drawn and my guess his platelets will be fine and then they will start lowering it again. he is tested each thursday.

The doctor hopes that if and when the police departments call him that this will be a thing of the past, a past diagnosis, but this is really getting down to the wire for him. He works out faithfully waiting for that call and is in school and he works, I am sure in his head he is getting concerned and he didnt want to go to the hospital last week he was so ticked, but he did and he got his platelets and gamma stuff again. I understand his frustration for this to be thrown at him when all is going well in his life, ugh! feel so bad for him

You might want to check if being spleen-less would be a problem for a police department. I really don't know.
Erica

ok, will do , thanks:)

I checked with the department I used to work for and the blood in the physical is apparently only tested for drugs testing. That is only for that one department - each can have different rules and tests. However I'm sure they also take a complete verbal and written medical history. And remember they also do background checks. It's a big problem if any kind of deceit is detected so it is smart to reveal everything in the written and verbal histories because they consider it deceit if it turns up in the background and you didn't disclose it.

I think that if your son gets his counts up to normal he is not likely to have problems but if his counts are at a dangerous level for physical work then he would probably to be excluded from consideration - he would be at high risk of bleeding from head injury for example.

Lots of people have enduring remissions - this might be just a small bump in his long road.
Erica

Debra:

There are remissions. Rituxan is a pretty good method of achieving that for some people - he may want to discuss that with his doctor. Right now, I think it might be his best shot as far as what he needs for his lifestyle.

I think that is the next route if I recall the doctor mentioning. I just don't understand why the higher dose of prednisone when it wasn't doing anything before and his platelets dropped so low when they lowered it before.

Personal preferrance, a way to get counts back up fast....no real rhyme or reson to treatment methods sometimes. Some doctors do a really fast taper the first time, counts drop, and they decide to go back up and go slower the second time. Sometimes that works, sometimes not.

Some protocols say that if the normal steroid dose doesn't work then try doubling it. But the success rate, as in a long remission, from steroids is extremely low. It's said to give a remission to under 20% of patients and it is said that there are the same number who have an acute ITP. So I wonder if the remissions are in fact spontaneous and would have occurred without the steroids which would mean that steroids never work with anyone. But hey, that's just my theory, no doctor seems to have thought of it!

I think splenectomy is maybe a reasonable option for someone who is young and needs a remission for their lifestyle. I don't see how he could do a police job without a remission. The number of appointments he could need would give them cause for concern if nothing else.

thats my fear also, so praying this is cleared up soon, thanks for all the responses, certainly nice to have someone to speak to:)

well, even with the 190mg a day of prednisone, his platelets dropped to 43000, so they decreased to 180mg day and he will begin treatments next thursday on rituxan and that will go on for the next 4 weeks

Rituxan will give him a good shot at remission. I truly hope it works for him. Fingers crossed!

sweet, thank you sandi for the upbeat response:) Merry Christmas!

Merry Christmas to you too!

Why such a high dose of Prednisone???? WOW!!! I have not heard of a dose that high before. At first when my counts were in the teens, 80mg was the highest dose. I would agree with the Rituxan. My first round lasted 16 months. The second round is over 2 years now. Counts rose as high as 350k+. Now counts have leveled off around 200k. I have been doing Security for 17yrs. When my counts were low I did not work due to the chances of injury. Law Enforcement is a Dangerous profession. He would need to stay on top of his counts!!! This is an issue I am going to ask one of my Law Enforcement friends.
Good Luck with the Rituxan. Be patient, Rituxan can take several weeks after last dose before he can see results.

Thanks Dean, but we were wondering the same thing about the high dose, he cant wait to get off it let me tell you:) The one doctor feels that once they get his platelets in order and if he gets that call, there should be no reason for them not hiring him since they should be leveled off, we are hoping. He is making the lists for area police departments and we are hoping this stuff will be under control by the time they call for processing. God has HIS plan and we are so thankful he did not go into the Army as planned, so thankful about that now that this ITP has come up. This all started when he started taking natural supplements for working out at the gym and getting ready for all the physical agility tests and then the bruising came which led to finding the ITP. The doctors feel the ITP was not caused by the supplements but the supplements caused them to test him which found the ITP. We pray this will be handled soon:)

What sort of supplements? Some are known to trigger autoimmune disorders.

not sure, but we do know they had creatine in them and initially that is what the doctor thought was causing the bruising and then he was told to discontinue anything with creatine in them, but he found something else, and his bruising was extreme and at that point they did the blood tests and his platelets were so low

That just sounds like an outrageously high dose in my opinion. Has he ever mentioned being Stressed out over job placement?

Throughout all of this my son has stated what is so weird is that he has never been happier, felt better and everything going for him until this came up

Dean - that is not a very common dose for ITP, but it is done occasionally. One member here was on 2,000 mg's a day. If he wasn't a regular and as reputable as he is, I would never have believed him.

Glad to hear he was doing good until this "EVIL" monster we call ITP joined his life. Staying positive goes a long way in this Immune Disorder battle.

2000mg's, now that is a major WOW!!!!
Why would such a High dose be taken?? That sounds like some major side affects!!!

Sandi - also our friend with 2000 mg has multiple and severe medical issues, and has had dangerous debilitating bleeds, and is refractory to I think ALL other treatments - so the situation is a little different than most.
Erica

Yes he does. Just wanted to point out that high doses can be given. I'm sure it wasn't easy. I probably would have ended up in jail for some reason!