Bruising but no bleeding issues with low platelets

I am new to the site. In 2005, I told my doctor during a general visit that I bruised easily and I wondered if there was a reason for it. They tested my blood and my platelets were at 35,000. He sent me a hematologist, he ran tests, told me there was nothing he could do.

I moved around and in 2011 returned to my original GP and he asked about the platelets. I told him I hadn't been checked in years, he sent me to a different hematologist. She was determined to figure it out.

I have steroid. Hated that. We tried several things and settled on IVG. I have been sporadic with the treatments because I have no other symptoms besides bruising. I clot like a champion (if there were a clotting competition) Nothing really raises the count for any long term.

I start retuxan this week. The doctor seems to push having my spleen removed and I don't want to do that.

I am looking for anyone with symptoms similar to mine. Bruising.

I am 61 years old and other than a low platelet count, I am in good health.

I need a second opinion from someone who deals with this.

Thanks

What was your most recent platelet count?

So far, knocking on wood, my only symptom has been bruising - which is bleeding, under the skin.

You need a different doctor. This one does not seem to know much about ITP. Removing the spleen has a low success rate particularly in older people. It also raises the risk of dangerous clots.

If your counts are above 30 you may not have to treat at all especially since you have no bleeding.
Erica

Bruising can happen for a variety of reasons. Clotting disorders, hypothyroidism, micronutrient deficiencies, and connective tissue disorders are among the many possible explanations besides ITP. Have you had your prothrombin time or other clotting tests run? Is there a history of such troubles in your family? These and other issues can be addressed with your doctor(s) if appropriate, mostly through routine blood work.

I've bruised very easily for most of my life. Even at a platelet count of around 100 I still bruise readily. But in my case the cause is a connective tissue disorder known as Ehlers-Danlos. It took quite some time for my doctors to get this all sorted out.

In my experience, bruising tends not to interest doctors (unless the bruises are spectacular), especially if there are no other clinically significant signs/symptoms. So maybe start by checking your recent blood test results to see if there's anything out of the normal range.

last week count was 40,000

eklein wrote: You need a different doctor. This one does not seem to know much about ITP. Removing the spleen has a low success rate particularly in older people. It also raises the risk of dangerous clots.

If your counts are above 30 you may not have to treat at all especially since you have no bleeding.
Erica

Erica is right. There is no need to treat at this point, and you need a new doctor.

Is there a teaching hospital at a university near you? That would be a good place to start. You can also tell us where you live, and someone here might know someone in your area.
Also:
pdsa.org/resources/find-an-itp-doctor.html
Also:
pdsa.org/about-us/our-medical-advisors.html

Aoi: I have had every kind of test. Everything else is fine.

When my platelet count fall below 50,000, I get bruising.

Eklein: Thank you. I agree about the treatment. The doctor has really busted her butt trying to figure this out and she listens, which is way more than the first doctor did.

I needed support for how I was feeling about it. Thank you.

I agree also. Taking out your spleen would be like replacing a car engine when it only needs oil. Total overkill. It's nice that this doctor listens, but there is more to patient care than that.

Most people do not treat unless counts are below 20k or 30k, and some do not treat unless they have active bleeding symptoms. You always have the option to treat if symptoms start, but you also have the option of not treating at all right now. It seems that you've been living with this for a few years with no treatment and did just fine.

koanola you received good replies by all. Personally I am not comfortable with a count at 20k so I'd have to be talking with my hematologist and go from there.

Bruising is bleeding - I looked like I had been beaten in a back alley by a 2x4 when I finally went to the MD. Don't discount your bruising.

Regarding splenectomy - in 1990 I was told by a specialist "you WILL have your spleen removed", all these years later it's still where it belongs. Have you seen the Treatment page - there are a lot more options out there since I was diagnosed when there was just prednisone and/or splenectomy www.pdsa.org/treatments.html

It sounds like you like & trust your new hematologist. I think the main thing to remember is it is your body!

I second the ideas above. There is no "undo button" for surgery. Whenever one of my doctors suggests a surgery, I ask what the conservative options are. Then I do those and delay the surgery as long as I reasonably can. I also make sure to see other doctors to get perspective on my options.

Also, glad to hear that everything else checked out normally.