Nosebleeds revisited

I thought I knew some answers regarding nosebleed prevention--keep nose moist (saline spray, mist inhalers)--and treatment--steady pressure with head bent forward, ice on nose or face, Afrin if you can spray it in, etc.--but I've had six nosebleeds since May 10, involving three trips to the ER and two nose-packings. (My right nostril is currently stuffed and distorted with the uncomfortable pressure packing.) Probably four or maybe five of those are related to a bad cold, dry conditions, and usually my platelets were below 20K.

BUT I've been diagnosed with ITP since 2000, and I've often been below 20K and almost never got nosebleeds before. Because of this, my hema thinks the nosebleeds aren't really related to low platelets and wants me to get even more advice from the ENT people (like the one scheduled to unpack my nose tomorrow).

Do any of you have experiences or advice that could help me? I am becoming terrified now of blowing my nose (even very gently) and am scared of traveling because it seems to me a nosebleed could happen at any time. Even the ones that don't require packing (which ruin two-three days) take so much time (often over two hours) to stop. I used to think I didn't really suffer much from ITP symptoms--bruises were manageable--but bloody noses are not so manageable.

I control my ITP with predisone. Doc so far has tried to keep me on lowest possible dose--but we are rethinking this now. I was on 10 mg/day at the time of yesterday's big nosebleed (15-17K platelets), and now am on 20 mg. I tolerate the pred pretty well except it wires, agitates me. I think a higher dose raises my blood pressure, which is usually low. The packing in my nose keeps me awake anyway though so I can't blame the prednisone for that right now.

Karen,
About ten years ago I began getting severe nosebleeds (I don't have ITP, my daughter was diagnosed with it. ) My nose would bleed for one to two hours, and it would just pour out like a faucet turned on full blast! My twins, who were 1 at the time, would get into all kinds of mischief, because I couldn't leave the bathroom sink--it was so much blood, the drops would just splatter out of the sink and onto the floor. This went on once or twice a day for almost two months. Finally, after passing out from loss of blood, my sister took me to the ER. After bloodwork that all came out normal except for anemia (no surprise!) and a CT scan which was normal, a doctor finally took a look up my nose. He said that I had visible polyps and needed to see an ENT. I called every ENT in town, and the soonest appointment I could get was 3 months out. There was no way I could go on losing this much blood for another 3 months!

So, I looked in one of my homeopathic books for bleeding nasal polyps that break open easily, and found Phosphorus 6C, 4 times/day was called for. I tried it. By day three, the bleeding had stopped. By day seven, I had the urge to blow my nose, and when I did, a whole string of seven polyps came out. Gross, but interesting in a sick sort of way!
After that, I've never had another nosebleed.

Homeopathic Phosphorus 6X or 6C or else Ferrum phos 6X (Iron phosphate) are both good remedies to take that will help stop bloody noses. You can find it at most any health food stores, sold OTC. Usually these will stop a nosebleed within a few minutes or less.

April

Karen,

Have you tried tranexamic acid tablets? My son rarely gets nosebleeds but when he does, he seems to get a run of them together like this. Since he has taken these tablets when he gets the first one, it seems to stop there. As I understand it, tranexamic acid does nothing for platelets, but helps clots stick better?

Ali

Thanks for suggestions, Ali and April. I hadn't seen Ali's response when I went to the ENT doc to have my nose-balloon removed today. I did ask him about he homeopathic remedies. He said he hadn't any experience or any patient experience with those, but he said I do not have polyps. I think I can email him a question about the tranexamic tablets (oh how I would like a pill that stopped nosebleeds!), but he didn't suggest them himself. He did suggest keeping the nose moist, using saline sprays, "unpetroleum" jellies, "nasal gel," steam, etc. Of course, I'd already been trying to keep my nose moist. He said room humidifiers wouldn't be great here (San Francisco Bay area)--would promote mold, but if I vacation in really dry places, a room humidifier in the bedroom would be good.

When he suctioned out my nose with a tube attached to an electric vacuum, I asked him if I could get one of those! Then I wouldn't have to be so terrified of blowing my nose. (Those little snot-suckers for babies don't work for big noses, I've discovered.) He said he didn't think I could get one, that I wouldn't know how to use it without hurting myself--but boy, would I like to try it!

I'm not 100% free of this last nosebleed distress, as the ENT doc replaced the big, painful plug with a very small gauze one covered with coagulant and anti-bacterial stuff, and told me to leave it in till Sunday. But compared to the big one, the little one is great. I'm almost fit to go out in public!

Karen,

You don't need to have polyps for the Phosphorus to be indicated. I did, and they seemed yo be the reason for my bloody noses, but both Phosphorus and Ferrum phos are great remedies for bleeding, especially recurring bleeding. They work best for this in the lower potencies (6X, 6C, 12X, 12C, 30X, 30C), which are generally the only potencies you'll find sold in health food stores OTC. These will not harm you. Most doctors don't know much if anything about homeopathy, as it is not generally in their training. Naturopaths and many chiropractors have some knowledge on homeopathy, though usually just know basic acute remedies.

Buy a bottle (around $6-$, and take 1 pill under your tongue. (ignore the label telling you to take 5--1 is enough). If bleeding hasn't stopped in 5 minutes, take one more pill. If it still hasn't stopped in 15 minutes, take one more pill. If still no result , try the Ferrum phos in the same manner. I think you'll be surprised at how quickly it can stop the bleeding.
At my Kid's school, children frequently get nosebleeds during the hot and dry Santa Ana winds. Parents have been shocked to see how nosebleeds stop within seconds, usually, when they give one of these remedies.
April

Karen,

You and I just might be long lost twins!

I had a nosebleed on May 8th, went to the ER where they packed it. Since then I have been repacked 3 times and cauterized once. In this time I have also had a few bleeds that I was able to stop on my own, I think I have had 9 nosebleeds since May 8th. Because of this I was referred to a Hemo which has done a bone marrow, coagulation work up and clotting factors assays. Other than a low platelet count of 30 - 40 (had to be done through a manual count) everything came back normal so I have now been referred to an ENT. I'm at my wits end and not really sure what to do, I live in a dry climate but I have humidifiers and am putting moisturizers in my nose constantly.

Any suggestions and help is appreciated.

Kindest regards,
Barry

Barry, I sympathize from the bottom of my heart and the top of my nose! If your ENT has any fresh suggestions, please pass them on.

I now have a nose gel as well as a gel spray, and they do seem to keep my nose more moist than the regular saline spray. I also bought, at a regular drug store, a package of little gauze rolls that have some sort of coagulating agent on them. In case of nosebleed, I am supposed to stuff these up my nostrils and press my nose firmly. I don't know how well they will work as this is what they were doing in the ER before they packed my nose last time, and it didn't stop the flow--though it might have slowed it down.

The only other hint I have is for when you get your nose packed. This last time, we asked the ER doc for the little tool that plugs into the tube. When it seemed to me that my nose was still bleeding, despite the packing (blood kept running down the back of my throat), my husband pumped it up harder. When the bleeding seemed to stop, he let out a little of the air so it wasn't quite so uncomfortable.

I am a little leery of taking tablets like phosphorous to try to stop the bleeding because those tablets seemed to be used for so many things--I guess I want some sort of assurance that they are safe and might really work for someone in our position. I'm trying to keep an open mind though.

I found a gel called Nobleed online so I ordered a tube, I'll let you know how it works for me.

All the best,
Barry