TOPIC:

Does anyone have any knowledge of platelet function tests or platelet aggregation tests?

Ellen's platelet count is pretty decent now at 67k, the highest it's been since she started low-dose Rituxan 1 yr 9 months ago (woo-hoo!). She has some pretty bad osteoarthritis starting up, though, and needs to be taking NSAIDS to reduce the inflammation.

Any thoughts on use of NSAIDS with counts in the 60s? Would platelet function testing help?

Here is something I found on the tests themselves:
www.ncbi.nlm.nih.gov/pmc/articles/PMC4340464/ Published online 2015 Feb 18. doi: 10.2147/VHRM.S44469
Platelet function tests: a comparative review

Based on what I've been told by my doctors, as long as I'm over 50k, I can take NSAID's. I don't think platelet function tests are necessary, but you could ask her doctor. Is Ellen symptomatic at counts around 50k?

Ellen's lowest count was 11, and then she only had ugly bruises - no bleeding gums, nosebleed, etc. Bruising starts in the 20s, so to answer your question, she is asymptomatic at 50k.

I've been doing some more reading, and ibuprofen is the shortest-acting NSAID of the ones discussed. The effect of ibuprofen on platelets lasts 6 to 11 hours depending on dose (unlike aspirin which lasts for the life of the platelet).

Congrats to Ellen on her good count

When I started taking them, my counts were in the 60's. I used Naproxen, it seems to work best for me. At the time, I didn't care what happened to my counts. I was desperate. But I also knew that Prednisone would bump counts up if need be. It's not as easy for Ellen.

Celebrex does not affect platelet function.
Naproxen, Ibuprofen, and aspirin do affect platelet function.
How could I have missed this? It is not new information, but I have not found it spelled out clearly on this website or forum.

www.medscape.com/viewarticle/411528
Study Confirms Celebrex Does Not Interfere With Platelet Function February 17, 2000
New York (MedscapeWire) Feb 16 -- A double-blind, randomized, placebo-controlled study published in the February issue of the Journal of Clinical Pharmacology concludes that the cyclooxygenase (COX)-2 -- specific inhibitor Celebrex (celecoxib capsules) does not interfere with platelet function, even at 1200 mg per day, which is 6 times the recommended daily dose for osteoarthritis. Normal platelet function is important for patients at risk of bleeding and for those who are already taking medications that increase the risk of bleeding. This is significant for the millions of Americans with arthritis who may be taking low-dose aspirin for cardiovascular disease prophylaxis.
Study authors report that "unlike celecoxib or placebo, naproxen produce statistically significant reductions in platelet aggregation...and increased bleeding time." In contrast, the study notes that even at very high doses, "celecoxib will not interfere with normal mechanisms of platelet aggregation and hemostasis, supporting the premise that celecoxib is COX-1 sparing relative to conventional [nonsteroidal anti-inflammatory drugs]."

[Ignore the strikethroughs. There seems to be a bug in the software, and I can't make the strikethroughs go away.]

Those drugs are listed in the 'foods not to eat' part, but I don't think it says why.