Managing Cytopenias: Platelets

 The last of the major blood lines which could be affected by MDS is Platelets. These are the cells that help your blood clot and stop bleeding. without suffecient plateltes you bleed and bruise too easily and this can lead to organ damage and even death. Here is some of my research on the risks of low platelets:

Thrombocytes or platelets are critical for maintaining homeostasis, by being able to form blood clots when needed. The normal range for platelet counts is between 150,000 and 450,00 per milliliter of blood. The term for a low platelet count is thrombocytopenia.

Symptoms of thrombocytopenia include easy bruising, bleeding longer than usual after minor cuts or scrapes, bleeding gums or nose bleeds, development of ecchymoses (large bruises) and petechiae (multiple small bruises). Sites of bleeding can include the skin, mucous membranes, gastrointestinal system, genitourinary system, respiratory system, and the brain. Chemotherapy can depress the platelet count and drugs containing acetylsalicylic acid (aspirin) or nonsteroidal anti-inflammatory agents (NSAIDS) can worsen the potential for thrombocytopenia.

If platelet counts are very low (below 10,000), or if a person with moderately low counts has greater than normal bleeding, platelet transfusions may be given. Transfused platelets last only a few days, and some people who have received multiple platelet transfusions can develop an immune reaction that destroys donor platelets. A platelet growth factor may be given to people with severe thrombocytopenia to decrease the need for platelet transfusions.

Management strategies for thrombocytopenia include:

• a. Monitoring the patient's platelet count closely.
• b. Assessing for superficial or internal signs of bleeding such as petechiae, epistaxis (nose bleeds), easy bruising, prolonged bleeding time, coffee ground emesis and hematuria.
• c. Testing the stool and urine for blood.
• d. Teaching the patient to maintain a safe environment to prevent falls or trauma.
• e. Using stool softeners to avoid straining, which can cause rectal tearing and bleeding, and eating a high fiber diet and drinking plenty of fluids to avoid constipation.
• f. Postponing, if possible, any invasive medical or surgical procedures, including dental extractions, multiple venipunctures, or injections.
• g. Avoiding using sharp instruments such as razors or scissors for grooming.
• h. Avoiding medications that may prolong or exacerbate bleeding, such as steroids or over-the-counter drugs containing aspirin.
• i. Using a soft toothbrush and avoiding flossing.
• j. Using a water-soluble lubricant for sexual activity.
• k. Giving platelet transfusions as ordered.

http://rnceus.com/chem/heme.html

Mayo clinic on Self-care

If your platelet count is low, your doctor may recommend avoiding drugs such as aspirin that may impair platelet function and avoiding excessive alcohol intake. You may also wish to avoid contact sports, which can put you at a higher risk of injury and bleeding.
http://www.mayoclinic.com/health/thrombocytopenia/DS00691/DSECTION=8