Disappointed with medical team

I injured my knee at work on January 5th. Finally had MRI last week and discovered horizontal fracture on inner right knee. Prior to knee injury, my platelet count was 242,000 with 17mg of prednisone a day. After injury to knee,platelet level reduced to 3,000. Had to visit ER for platelet transfusion and prednisone. Visited hematologist office and always see physician assistant and he said there was no correlation to knee injury and lower platelet count. For some reason, I didn't believe him. Since my first hospitalization in early December/diagnosis of ITP last year, I've only seen my hematologist in his office on three occasions. All my visits have been with physician asst. When asked PA if there were certain foods to eat to increase platelet level, he just said eat a well-balanced diet. Should i insist seeing only hematologist and not physician asst.?

All doctors do things differently and all patients have different preferences. I rarely saw my doctor and had few appointments. I got counts on my lunch hour and if they were low, a nurse would call me to discuss treatments. If counts were above treatment level, we'd do nothing. I liked it that way; I worked and didn't want to miss work time. I also honestly don't know what we would have had to talk about if I saw him more often. That was my preference. Seeing him once every few months was fine with me.

I don't think there is any correlation between your knee and your platelet count either, but odd things do happen. Sometimes a stressful situation or trauma to the body can trigger an autoimmune response, so maybe that was the cause more than the injury itself. Many ITP'er have been injured without platelet drops. I've also heard stories where people have had counts go up after an injury, because platelets rush to the injury site, signaling the body to produce more. Both of these are hard to prove either way.

As for diet, there really isn't anything you can eat to raise counts. If there were, no one would need treatments. Some people have found that going gluten free helps, or eliminating some other type of food, but it can take a long time to figure out what works for you.

If you would prefer to see your Hemo more often, I'd either ask him about it or find another Hemo.

Good luck with your counts and your knee!

Thanks for the reply, Sandi. And thanks for info/ knowledge that you shared. I definitely rather see the hematologist than PA. Have a good evening.

Hi Hernas - I broke my foot last October, that did nothing to my count. I'm with Sandy when she says she doesn't think there is any correlation between your knee and count.

How long have you been on 17mg of prednisone?

If you would rather see the hematologist instead of the PA let that be known - you may just decide you like the PA better

Good luck to you with that knee - hope your recovery is easy.

I was on 17 mg of pred per day until platelets dropped to 3,000. Went to ER for platelet transfusion and increased prednisone to 60 mg per day; now reduced to 40 mg per day -platelet level 257,000 as of yesterday.

For what it's worth, I'd trust the Hemo's PA to deal with ITP much more than I'd trust any ER.

I'd liked to trust PA but not comfortable with him. I like my Hematologist; puts me at ease and makes me feel good when I leave his visit.

Hi Hernas,

I was diagnosed with ITP a month ago and since have seen my Hemo once a week. I presume when my count gets higher I will see her a lot less regularly (currently at 0). As i am beginning to learn, everyone is different and Hemo's and Doctors tend to deal with ITP differently depending on the scenario. If you are eager to see your Hemo more I would defiantly let them know. There may be a reason they feel they do not need to see you regularly?

I also agree with Sandi and Melinda in regards to the correlation.

It's brilliant to see your counts have gone up and hope they stay there for you! Good Luck with both your counts and your knee!

Hope your knee heals quickly. I was at urgent care last year for a neck injury, and my counts barely budged. My current hemo had me on B12 and folate supplements given deficiencies he found through testing, with no effect on my counts. During that time I saw docs, nurses, PAs, lab techs, and given past experiences, I tend to prefer whatever gets me in and out quickly. I have other things I'd rather be doing than having ultrasound wands rubbed over my abdomen so my spleen can be visualized.

It's hard to say what dietary or lifestyle factors improve counts, and even harder to find something that consistently does. I've kept meticulous records and done a variety of analyses on my situation, and have read a number of research articles attempting to find such connections. There just doesn't seem to be anything in diet or lifestyle that consistently helps most people most of the time.

Thanks, Katie.meloy. Have a good evening.

Thanks for your response, Aoi. Enjoy your evening.

Hi Melinda.
I was on 17 mg of pred per day for a week until platelets dropped to 3,000. Went to ER for platelet transfusion and increased prednisone to 60 mg per day; now reduced to 40 mg today. Platelet level was 257,000 yesterday.
Thanks for your kind words. Have a good evening.

Good luck with the decrease in prednisone - hope your count will stay decent as the dose goes down. Keep us posted!