Rectal bleeding

i am a chronic, refractory ITP patient and am now being treated with Promacta. Wednesday i started passing blood and had a platelet count of 24k. My Promacta dose was increased from 25 mg to 50 mg. Since the problem still was present this morning, I went for another count. My platelet count was 55k. The nurse called and said that the doctor wanted me to get a colonoscopy because he did think that my bleeding was caused by ITP, even at a count of 24k. I have several questions. Am I being self- absorbed to think that it would be nice to talk to a doctor when bleeding, even if I am not profusely bleeding? Has anyone else experienced similar difficulties at similar counts? Has anyone noticed a marked change in symptoms after a number of years? (For example, i now bruise like I did 23 years ago and have nose bleeds with low counts.)

I would go to my GP and get them to do an examination to see if there's any obvious reason for the bleeding and if not then I'd do the colonoscopy. Speaking to a heamatologist about it will not be particularly useful.

I agree with Ann, go get it checked out by your primary care dr.

Thank you for your responses. When I read my message again, I realized that I omitted the word not. Sorry.
I will schedule a colonoscopy. When I had more pronounced bleeding with a low platelet count seven years ago, I had a colonoscopy and was cleared for ten years. What confused me was the hemo's statement, via a nurse, that my platelet count was not low enough to cause bleeding. What is a low enough count? I wondered too if anyone else has had a similar experience? Also, I wondered about changing symptoms. For the first few years after dx, I would bruise badly. Then I seemed to relapse after some viral infections (not all) and exhibited only slight red streaks, with counts from 2k to 7k. I used to respond to Prednisone or Dexamethasone. For the past two year my counts have zig-zagged, I reached my limits with Prednisone, and bruising and bleeding occur at higher counts. I work full time and am busy and happy. I am treated at a major cancer center. My doctor is available on Wednesdays, but I feel that I cannot bother him and that ITP does really merit attention anyway. That is why I asked questions here. Sorry to be long-winded.

Yes, my symptoms have changed over the years. When I was first diagnosed in 2007 I was covered in bruises with counts around 40k. I've never since had bruises like that even though my counts have gone lower, down to 0.

You shouldn't feel like you are bothering the doctor, when you are having a problem you should feel free to call him, or a nurse. I am treated at a practice that treats many cancer patients too. I know what you mean about feeling that ITP doesn't rate the attention that cancer would. But, my dr doesn't make me feel that way and I do feel comfortable calling when I have a symptom of concern.

Since you had this before, did you find out what was causing the bleeding then?

Thanks, dru.
The last episode was ignored since symptoms went away with increased meds and higher counts. Plus, the doc had only my word to go on. The first and most scary time occurred while traveling. It was a couple of days before I got to see the doc who originally diagnosed my ITP. He seemed quite concerned and said I should have gone to an ER. He wanted a colonoscopy done too. I had it done when I returned home.
There is a huge difference in attitudes and treatment protocol between my hometown and city where I live now. That is confusing to me.
Enough whining. I am happy to report that I am feelin much better today. Thanks for listening.

Glad you are feeling better
It's okay the whine once in a while, this is a good place to vent.