Thank you both. Staying on alternate days this week. Retest on Friday and then a dose decision after the result. 

I tried to search for what I needed, but all of the posts seem to be more than a year old and I'm wondering if there are any updates in protocol. My daughter has been in remission for 5 years after a very rocky road and treatment with prednisone, ivig, and Rituxin. She would like to pursue a phlebotomy course, but is not eager to have the required covid vaccine. She's already survived covid twice, and is concerned about the vaccine pushing her out of remission. I read about a study that showed (I think) that 12% of ITP patients in the study had a severe exacerbation of their ITP. Is the recommendation to be vaccinated still as firm, even if one might potentially have built some natural immunity?

What does your doctor say, and does he/she know what's in these products?

Margaret yes Papaya. Curious to read about your experience. I can't say for sure whether it worked for me or not, because I was taking it while on Prednisone and my platelets dropped so much I had to take Dexa + Nplate, later Revolade. So, it's possible my platelets would've dropped more quickly without Papaya, or it's possible it did nothing... for sure it didn't do enough.

I'm honestly not sure, but I was looking for current general protocol.   She's been unhappy with her doc and because we live in a rural area there just aren't a lot of choices. 

I don't know what the current protocol is - however I have had 5 covid vaccines, the recommended amount and I am now old enough to get a 6th.  I've had ITP for 34 years.    It is too bad your daughter is unhappy with her hematologist - however it might be good to get his/her opinion on the matter. 

Tomorrow a decision on the dose - I hope you get a "normal" count tomorrow mrsb, one that you are comfortable with!!

Hope you get/got good news today, mrsb!

Count now 323....too high. Missing today's dose then down to 3x a week from Monday

Oh no, mrsb!  Hope it settles in your comfort zone soon!

Oh mrsb I am so sorry - all this up & down bless your heart!!
Will you test again on Friday to see if 3x a week is better?
Take care now!!

I have blood tests booked for every Friday until the end of July.
IF everything settles down and I achieve some sort of stability I can always cancel some. 

That is good to hear.  Fingers crossed you can cancel some blood tests!

With my count at 233 this morning and my NPlate dose at a mere 10 mcgs (total dose, not mcg per kg), my MD recommended I stop taking it altogether.  So that's what I did!  The hope of being in a true remission has made me giddy.  Even if it's not "remission" per se, just maintaining a stable enough count to not need treating is a big blessing.  

Ever since Feb of this year, the count has been mostly stable despite the gradual lessening of the dose.  If anyone was to make me speculate about what happened, my guess would be the two back-to-back steroid dose-paks I had for an unrelated problem at that time perhaps "shocked" my system somehow.  Before the first pak, I was still careening from 114 to 37 in a week's time with no change in NP dose of 50.  After the second dose-pak, I haven't budged out of the mostly mid-100s, with a couple of 200s in the mix.  

I bet the office nurses will be glad they won't need to mix such an impossibly tiny dose anymore.  I will still need weekly CBCs for a while, but I'm still pretty pumped at this turn of events.  
There aren't too many people in my life who would even understand what all my fuss is about.  I know you do, so thanks for listening.  

Great news Janet. Long may it last.