Oral Surgery with a low count?

I need to get a wisdom tooth removed..it's only partially out, so it'll take some oral surgery.
The problem:
...my last count was 32 and the surgeon won't do anything until they're at least in the 50's.
No amount of me saying "they've been this way for years, and I only bleed slightly more than average." will convince him otherwise. It's the numbers game now. *sigh*
Seriously, I am NOT a bleeder. I've never had a nose bleed in my life..never had mouth sores... Only bruises, and only when my count first dropped (to 11K) back in 2010. I've been riding in the 30's with a few bumps up into the 60's for four years now. I don't take anything for it now (tried drugs, tried homeopathy, tried diet change. I'm on to actually fixing myself as a human being first...it's been the best thing for me thus far)

So my question here is:
Does anyone have experience with oral (or otherwise) surgery and a lower count?
Better yet... does anyone know an oral surgeon who's familiar with ITP (preferably in northern California)...or a way I could find such a surgeon?

Thanks!
~ Kate

Sorry, not much you can do to change a doc's mind once they think there is a risk to them.

I had oral surgery to remove a broken upper bicuspid last summer with a count of 15k. It was an absolute non-event.
Had a lower molar sliced out a couple of years ago and it was another non-event.


.

Because of my ITP most of my extractions have been done in hospital as a precaution.

Back in 2001, an oral surgeon, more worried than YOUR oral surgeon, Kate, wanted me to be at 100K before he removed some cysts from my mouth. I tried, with increased prednisone (from 3 mg/day to 10), but could only get a reading of 88K. I talked him into doing the surgery anyway. He had absolutely no problem, said I bled less than other people. At that time of my life, I probably could have had the same results at 25 or 30K, but maybe his nervousness would have affected the surgery more than my platelet count. I think Jack is right in that if the doctor doesn't have experience with low platelets, he's not going to want to go there.

What is interesting is that both of my oral surgeons (2 different occasions) and my hematologist did not want me taking steroids (Pred nor Dex) to boost counts prior to the extractions. They said it can interfere with the healing process. I dunno, I'm not an oral surgeon, nor do I play one on TV.
And as usual.....everyone's ITP is different.

I had similar when I had eye socket surgery with a graft. The surgeon didn't want me to be on steroids because it impairs healing and the graft might not take. I had to get my count up on steroids and then stop it a week or two before and hope. I didn't quite understand it because they then gave me dex during and the day after surgery because I'd been on steroids recently.

Hi Kate,

It seems to me that a partial extraction can be very serious in the way of getting an infection. My husband had a tooth pulled a while back (it had a "hook" at the very end) and it was a very hard extraction and very painful (I had told him to go to an oral surgeon ). He ended up a very bad infection and a lot of trips to the doctor.

There are a lot of good hematologists in the San Francisco area that could maybe help you out. Not quite sure where you live. I would think the best thing would be to get that partial tooth out right away.

Just my thoughts,
Dee Dee

Thanks everyone!!

I'm going to have a consult with a totally different surgeon, cause I was really uncomfortable with the first guy I saw (I wanted to put my hand on his shoulder and say "Calm down, man!"...He was super jittery. Yikes)

So yeah... I'll see a different guy...and just not tell him my number. And it's my responsibility if something goes wrong. But I'm not going to take drugs to "fix" a number on a piece of paper...especially when I clot just as good as someone in the 90s. As well all say: Everyone is different!


I'll let you all know it goes..

Hi - I've been having oral surgery jitters. I am scheduled to have one Tue 5/13. I have a soft tissue overgrowth on my upper gums excised. My hematologist and attending physician tell me that 50 is fine. The oral surgeon told my doctor he would feel uncomfortable with 50.
This is the strategy the attending physician developed:
1. On the day of the surgery I will have a bloodtest/platelet count done. If the count is too low the surgery will be postponed.
2. I will then arrange to stay at the hospital as on inpatient for 2 days and receive an infusion of immuno globuline. I believe they will also set up for a possible platelet transfusion. Following that I will go straight to the dental clinic for the surgery.
Since I get all of my medical care at a local hospital, this required coordination across several departments: dental, heme, and internal medicine where I had to get a 'medical clearance'.
Right now I am relived there is a plan inplace and that my surgery should be uneventful. I am not as anxious as I was -
Vega

Vega,

This sounds like a very good plan that your doctor has in place. Wishing you the best of
luck and I know you will be relieved when the procedure is over.

Dee Dee