Plavix and ITP

I have not posted in a long while. My husband took NPlate for three years and it kept him at approx. 50,000, but the headaches grew worse. Last year the MD tried Danazol and he has been taking it successfully. His platelets have stayed around 50,000 and sometimes even higher.

Now he must have an aortic heart valve replacement. It will be done through a catheter since he cannot have a second open heart surgery. The treatment following the procedure is to take Plavix for three months afterwards. He does respond to prednisone, so he'll take that before the operation to make sure his count is up, but his hematologist says he can't take Plavix, but the cardiologist says he has to take it and if he can't, they may not allow him to have the needed surgery. They have asked if he can take Ticlid, but hemo says no to that too.

He's scheduled for this next week. Has anyone heard of an ITP patient successfully taking Plavix? He may also have to remain on an aspirin regimine for his heart. He hasn't taken aspirin for 30 years!

ITP becomes difficult when you have another medical issue to deal with at the same time, especially if they conflict.

There have been other people with ITP who have had to juggle blood thinners and ITP, so it can be done. You have to seriously consider the consequences if your husband does not take Plavix and aspirin. Seems that the risks of not doing it could be worse than ITP.

It would be great if the two doctors would have a conversation and come to some agreement. The conflict only makes things harder for the patient because they don't know what to do. Heart issues are nothing to play around with though.

Is there any way to keep his counts around 50k? If so, he should be able to do both Plavix and aspirin with no problems.

We were told today that the surgery will be delayed a week because one of the cardiologists can't be there. This is being done under a controlled study which makes it a little more complicated.

I feel the heart issue is the most important right now. He had quadruple bypass 13 years ago (had to be on IVIG for 5 days before it) and has had a pacemaker for 5 years. He has had ITP for 30 years, had the splenectomy, and has never had severe ITP symptoms.

This also gives us a little more time to see the hematologist and urge him to work with the heart guys. One problem is that they are at different hospitals. His count has been around 50k for the past year with taking Danazol. He'll boost it with prednisone before the surgery. All the MDs are comfortable with him being at 50k.

It's good to know it has been done. I'll keep you posted.

Yeah, let me know how it goes. I have to take aspirin too, and my hemo has told me that as long as counts are above 50k, it's fine. Luckily, my counts have been normal since I've had to take the aspirin.

There have been people here who have had to use Heparin and Coumadin with low counts. It's hard to juggle, but can be done.