Remember Me     Forgot Login?   Sign up   •  Web site Help & Info

!!! DISCUSSION GROUP RULES !!!

1. You must be a registered website user in order to post and comment. Guests may read only.
2. Be kind and helpful, not rude and cynical.
3. Don't advertise or promote anything. You will be banned from the group.
4. Report problems to the moderators. THANK YOU!

16 year old daughter diagnosed with ITP in August

More
12 years 10 months ago - 12 years 10 months ago #29667 by eiepriya
My daughter who is 16, was diagnosed with ITP last August.
She's been having nosebleeds since she was about 2 years old. I also had a lot of nosebleeds as a child so I just thought it was a hereditary thing. At last year's annual check-up, her pediatrician sent her to an ENT and to a hematologist, just to rule anything out. The ENT cauterized one nostril, which he said had 4 big juicy vessels on the surface, which were causing her nosebleeds. That was last July. Only 1 small 2 minute nosebleed since. August was her appointment with the hematology clinic at our Children's Hospital. Blood tests confirmed very low platelets, and once anything more sinister was ruled out, a diagnosis of ITP was delivered.
The odd thing is, despite her low platelet counts, she is pretty much asymptomatic, other than occasional bruising. No petichiae, no gum bleeding ever, hardly any nosebleeds in the last year, normal periods, no prolonged bleeding, no fatigue, great appetite, great mood, no depression. You get the picture. With the hematologist's consent, we've pretty much taken and wait-and-see approach, that is, until this past Monday when her count was at 8. We decided to treat with ivig after having previously treated with prednisone. The prednisone acted rapidly but the effects were short-lived: about a month and she hated the side-effects: bloating, moon-face, ravenous appetite, acne on her face, chest and back and the growth of hair on her upper lip. Ivig went well yesterday until last night when a bad headache began. She had the worst headache of her life, a sore neck and nausea and all she could take was Extra-Strength Tylenol, which barely took the edge off. There was no pain management plan prior to the ivig despite the fact that bad headaches are a common side-effect. This frustrated me to no end. I asked the doctor and she told me to give Tylenol in the event of a headache. Luckily, after sleeping for most of the day today, she is finally turning the corner. Her head still aches but a lot less intensely. The sore neck is almost gone and her light sensitivity is much better. She even had pizza for dinner and watched some tv.
Of course now, she is vowing never to have ivig again. Any tips on preventing or treating the headaches with something more effective than Tylenol? She drank a lot during the procedure, which lasted about 5 hours total and she drank water and tea today. I don't know at what rate the infusion was given, but the nurse told me that they deliver it slowly, especially the first time.
I'm really frustrated and my daughter is at her wit's end with weekly trips to the hospital to have bloods done and to see the hematologist.
We recently saw our naturopath who suggested 6000 IU of Vitamin D daily. Of course, the hematologist said that it was much too high a dose and to lower it to 800-1000 IU. Have any of you seen any improvement with Vitamin D, which is supposed to be great for auto-immune diseases?
Thank for your bearing with me through my ramblings.
Looking forward to hearing from you.
  • Sandi
  • Offline
  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
More
12 years 10 months ago #29669 by Sandi
Mariew:

Hello and welcome. Did they pre-treat your daughter with any meds prior to giving her IVIG? Sometimes using Solumedrol and other steroids can be helpful to prevent the side effects. It sounds like she had aseptic meningitis and it really irks me that more doctors don't take precautions. Drinking a lot of water the day before and the day of the treatment can help too.

Vitamin D usually does not help platelet counts. I would have her levels checked before taking any though, as Vitamin D can be toxic if too much is taken. 800 IU's is the RDA, 6,000 IU"s is a therapeutic dose and should only be used if the Vitamin D level is low. Been there, so I know a bit about that.

Labs and doctor visits are common when counts are down at first, and that will slack off in time. I know it gets old fast. It's not necessary to actually see the doctor every week, so I don't really know why he'd be making you do that. You can do the CBC and if counts are low, a treatment can be arranged by phone. When you get to your breaking point, maybe you can suggest that. IVIG is a pretty temporary treatment and sometimes not worth the side effects and time, so it might be a good idea to look into something else if need be.

Symptoms do count, so if she is not having a lot of bleeding issues, you might not need to rush into treatment.

Just a bit of hope - my sister had ITP at the age of 16. The only treatments available at the time were Prednisone and splenectomy. My sister did Prednisone on and off for a year, then went into remission and has been ITP-free since. She is 46 years old now. Her doctors pushed splenectomy and my Mom, thankfully, held off. She'd have had it for nothing.
The following user(s) said Thank You: eiepriya
More
12 years 10 months ago #29701 by eiepriya
Thanks Sandy for the great advice.
My daughter is feeling much better and will be going to school today. Tomorrow is our hospital visit to check her count - fingers crossed that it worked, albeit temporarily.
More
12 years 10 months ago #29705 by Lori1220
My daughter is 14yrs old. 2yrs next month since diagnosed with ITP. Her count usually 5-10K. Have tried prednisone, winrho, rituxin (did not work for her), IVIG. IVIG bumps her counts to around 100K then back down to 5-10K in about 4 weeks. She has bleeding issues starting around 20K. We usually try and hold off treating as long as possible. She gets headaches, nausea/vomiting with IVIG. She does best if she gets benadryl and tylenol premeds before IVIG and then scheduled throughout the infusion. She also does best with a slow infusion (over 12hrs is best for her). At times she needs an antiemetic and for her, compazine works the best. Our hematologis gives her a few tabs of oxycodone and compazine to go home with as the first 24-48hrs seem to be the worst. Good luck with your daughter.
The following user(s) said Thank You: eiepriya
More
12 years 10 months ago #29706 by eiepriya
Hi Lori,
Thanks for your helpful suggestions. Although my daughter vows never to have ivig again, if she does, I will make sure there is a pain management plan in action.
Good luck with your daughter.
Best,
Marie