Recomendation for Hematologist in Santa Monica CA

I"m newly diagnosed with ITP - seeing a doc who is probably first rate but I don't really connect with him

I'm looking for recommendations for a someone who practices in Santa Monica or Westwood CA, who is a smartest guy/gal in the room and also has good communication skills

Some pertinent info is below.

If anyone has anything to add I'd much appreciate it.

Thanks to all!

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I'm 68 years old -

Starting in late 09 my platelet count dipped into the low 100's

Starting in Autumn of 13 it dipped into the high 50's

Since then counts taken every 10 weeks or so have been 57, 46, 53, 56, 35, 44

I'm intolerant of steroids - in 03 I took Medrol for a bulging disc in my neck, and it laid me so low I had to abandon it after the 4th day.

My current doc wants me to start I think it's Rituxin - 4 treatments, 4 hours per treatment with an IV drip (Does that sound like Rituxin?)

I'd like a second opinion before I start strong meds

Some other info that may or may not mean anything to having a low platelet count

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I had two knee replacements in Dec 08, and Dec 09

Late in 09 my Platelet count dipped from normal range into the low 100's and stayed there - give or take 20 points

March 2013 I took my first trip to the far east - Hong Kong and Phuket

April 2013 I developed fierce vertigo - went to several docs but no one could diagnose the cause

The severity of the vertigo lessened gradually but never went away

Dec 2013 I got a gum infection from a teeth cleaning, took a 7 day course of amoxicillan, the infection was cured and the vertigo disappeared along with it

hi- I don't have any doctor recommendations since I live in northern CA, but yes! you should get a second opinion. When I was new to ITP I read on the Mayo clinic website that the treatment for ITP can be worse than the disorder, so I always take that into consideration.

Are you having any bleeding symptoms? Rituxin is a pretty serious drug. People can live with low counts- just depends on your symptoms and what you are comfortable with. My hemotologist sees 30K as a safe count. I personally wouldn't treat at all if I had counts in the 40s, (or even the 20s) but I've never had bleeding problems so I've grown comfortable with the lower counts.

Hi Steven,

If you would like to see one of the top hematologists, I would highly recommend Dr. Howard Liebman
from USC. It is worth traveling a few miles to see one of the top doctors. But, with your platelets at the point they are, I sure wouldn't be taking Rituxan. You are still fairly stable with your platelets. It could be some of the meds you take that changes your count. It's hard to say.

Dee Dee

I bruise easily and they subside slowly. Not good, but my paternal grandmother had the same problem her entire adult life and she lived to 85

And I've had a 2 or 3 bloody noses in the past few months, but they stopped with 60 seconds or so of pressure - nothing close to hemorrhaging.

I don't know if that qualifies as "bleeding" requiring immediate treatment.

I agree, with your counts and minimal symptoms, it seems your doctor is being overly aggressive with treatments.

It is worth keeping in mind that you don't have prednisone in your pocket as a 'rescue' treatment if needed. But still, platelets over 50 is generally considered pretty safe.

Liebman is great, I met him at conference.
Erica

Steven, I still think you are doing very well. Two or three bloody noses in the past few months isn't really that bad. I'm currently in remission and sometimes my bruises heal slowly, too.

You might want to attend this year's conference in Manhattan Beach. It's so close to you. I'm considering going, too. You can ask them questions while you are there. Liebman is always there. And, maybe you could talk to him.

Dee Dee

Dee Dee, i'm definitely interested in the conference. Where can I get information on it?

Steven,
It is at the Manhattan Beach Marriott Hotel in Manhattan Beach from Friday, July 11, through Sunday, July 13. You can look on the main PDSA site for the prices and information. Also, you can sign up for all three days; or, just for Saturday and Sunday (Friday is late afternoon). I attended the conference in Colorado and found it to be very informative--so I do plan on attending Saturday and Sunday (I live about 55 miles away.

Dee Dee