What to do?

My 15 year old was diagnosed in Dec. His counts are generally hovering between 55-65. We were very happy that he is safe and in no danger. The dr restricted his activity to almost nothing. He was a goaltender on an elite hockey team until this. He has given that up but desparately wants to play for his high school in the fall. Today the dr has pretty much squashed our hopes of spontaneous remisson. She said maybe a 20% chance but she doubts it. He is very upset about no hockey. So today she has allowed him to go back to most sports except hockey, football. She sugested a 5 day steroid treatment in the summer to see what type of response we would get. If is goes well then we could do that in the fall so that he could play hockey. It would be 60mg 2x a day for 5 days with no taper. If he crashes then we will try 5 days with a taper. If neither works then no hockey. Wondering what your thoughts are. I really dont care if he ever plays hockey again, but I want his to be happy too.

I can't say yes or no!

That said my advice is make sure you research all the possible side effects of taking prednisone. What possible side effect can occur with stopping a 120mg dose abruptly after 5 days. Are there long term effects from doing short bursts like this? What happens if he doesn't respond are there any other options.

Way the pros and cons talk talk talk between you and your son and the doctor. Discuss options like if it works and he decides to play hockey again. Can we get his counts done before each game? and how can we do this?

Personally I'd say no hockey.

His counts are decent. 120mg a day seems really high to me - how much does your son weigh? The side effects of Prednisone are awful. Never mind the possible long term damage it can do to your body - why risk it?

There are plenty of other sports your son can partake in. Weight lifting and track might be really good for him. It's unfortunate that he can't play the two sports he loves but unless he's at the level where he could become professional the risks of Prednisone don't outweigh the benefits of doing the treatment (and even if he's good enough to go pro his ITP will likely make it impossible anyways).

What if after the Prednisone his counts drop to lower levels than he's already at and the treatments become necessary? You never know how his body is going to respond.

I'm sorry you're going through this. But if it were my son I'd say find another sport.

My advice is a bit different. First of all, no one can ever predict what will happen with ITP. Although a spontaneous remission is unlikely, I've seen it happen from time to time.

With treatment, a remission is even more likely, but that depends on the treatment and how it's given. A short, high dose course of Prednisone will most likely result in a high count with a crash. That would be an average response. Side effects would likely be minimal since it would be over quick. He might experience hunger and mood swings in that time. Long term side effects are unlikely. I can understand doing that to see if there would be a response, but other than that, it might not be worth it. I've seen people do that and then they ended up with even lower counts than they started with. Of course, that is not true for everyone, so if you feel you need to give it a try, do it. Doing a longer high dose course might give you a better long term result, but again, everyone is different.

It's a tough decision whether to treat or give things up that are enjoyed. I can understand how a teenager would be upset with having to give up something that he really loves. Only you and your son can make that decision based on benefit vs. risk. There are other treatment options to look into which also have pros and cons.

@ 2Jacks,Thank you and I agree with you. The dr recomended this. She actually brought it up! She said a 5 day course would not give him any long term side effects and minimal short term. I never thought about if when he came back down that his levels could go even lower. And he is 130 pounds.

@Sandi, She wants to day 5 day with no taper and see how long it lasts. Then if needed 5 day with a taper. But now I am thinking definitely now because I dont want him lower that what we have been stable at 55-65 for about 2 months now. She also sugested IVUG, but she doesnt really want to so that.

IVIG is usually a very temporary thing. Normally, it lasts a week or two. It's sometimes not worth the time it takes to get the infusion. But again, it is an option.