What is threatening bleeding?

[lc12345]

Hi, I'm in-between treatments now and need to hold on 10 more days till my doctor's back. I had IVIG which had a very short term effect it seems and I'm having a couple of new bruises (smallish really) and a bit of blood when I'm brushing my teeth. In addition, I have allergic eczematic rush so a couple of bleeding cracks on my skin because of dry eczema. I'm wondering at what point I should be worried and when I should rush to A&E. I assume my platelets are quite low now. Many thanks

[tinkerbelle77]

I have similar also bleeding from my nose when i blow it. As long as the bruises are just small and the bleeding is just a little and stops straight away i wouldnt rush to a&e. Only time i would would be heavy nose bleed or id my gums wouldnt stop or if the bruises were really big. Maybe leave a msg for your consultant and they would say whether or not they wantee ur count checked. Everyone is different. Good luck. X

[lc12345 in reply to tinkerbelle77]

thank you, indeed everyone is different

[sailor]

tinkerbelle77 is right. bruising and small bleeding is no problem. I have even had really large bruises, recently from my knee to the tips of my toes. It went in time but some lovely colours!!!!.

I would only really be concerned if you normally bleed excessively without warning i.e a nose bleed or similar, that you cannot stop. If not, then get on with your life and don't worry excessively. In over 10 years with a count of around 10 and no medication, I have only had one BAD bleed from the nose and then I only went in after a couple of hours. Good luck.

[lc12345 in reply to sailor]

thank you. Doctors for some reason always ask about mucusal bleeding, maybe it's an indicator if pre-disposition to internal bleed.

[janran in reply to lc12345]

Hi yes my consultant is the same. He is not too hung up on the count or if I am bruising but says that I should have treatment if I have blood blisters in my mouth as this can be an indicator that I may go on to have a bleed in the intestine or gut.

[lc12345 in reply to janran]

blood blisters are also tricky, I do have them if I 'bite' myself when eating. E.g. now I have two - both from biting. Maybe if I have lots of them for no reason - I should rush for help. Capillaries are so fragile that every tiny damage causes bruise/blister.

[janran in reply to lc12345]

it is so difficult to know when to go in isn't it? I think you're right in that my blood blisters were quite small but seemed to pop up for no reason. I am lucky that my count responds well to steroids but I hate them so much that I tend to ignore any symptoms for a couple of weeks. Also in Plymouth, I have open access to the ward and that helps as I know I can go in straight away if I need to rather than going through my GP or A&E. Hope all goes well with you and you can avoid rushing to A&E Janet

[lc12345 in reply to janran]

Thank you! Yes, it's so difficult to understand when to go. Open access to the ward would be fantastic but seems to be impossible dream in London...

[Wolverhampton]

Hi I think I echo what has already been said. I currently have a count of zero. It has waxed and wained at less than 5 for about a year now. My consultant is of the view that the count is not the over riding factor. It seems while there is no serious bleeding of often things are best left alone.Ivag is a good tool but tends to have short lived benefit. I was told by my consultant that he didn't want to use without a good reason because there is a likelihood that the more often it is used the less effective it will become. In other words it is a useful tool in the armoury best not over used.

[lc12345 in reply to Wolverhampton]

Thank you, I'm likely close to zero at the moment too.

[virginiabranscom]

It never ceases to amaze me how different everyone's ITP treatment is, especially in different countries...With my Boston hematologists, a count under 20 definitely means some kind of treatment. I like the idea of paying just as much or more attention to symptoms. Thank you all for enlarging my knowledge of options!

[lc12345 in reply to virginiabranscom]

My consultant also gives treatment at below 20 - it's just now she's away and I'm reluctant to go to general specialists unless in danger

[LHine]

I was told to watch for stomach pain, bloating or nausea as they can also mean internal bleeding (or a hundred other things).

[lc12345 in reply to LHine]

thank you

[Hidden]

I attend a haematologist in London and have open access to the Haematology Day Unit. I can call and go in for a blood test any time I like. And also speak to the ITP nurse. You could change doctors if you liked. I am seen at the Royal London.

[lc12345 in reply to Hidden]

I have this kind of access - can come for a blood test, but no ITP nurse and it's not easy to get a conversation with my doctor if something is going not as planned - I'd always need to wait for the next appointment.