Open Heart Surgery W/ ITP

[Dahle2424]

On 11/8/2019 I had my 1st Heart Attack. Platelet Count was 3K. Stents would not be a option, because of lifetime Blood thinners. Would need open Heart surgery - 3 way bypass. This is not possible until my platelets get to 100K to perform the operation. Starting in late Dec 2019 I would start NPLATE injections

to Boost my #'s and each time taking blood counts only to slowly rise and fall. 9 visits later I only got to 8K. Am I interoperable ? Lets try IVIG and infuse over a 4 week period. 1st Infusion is on 3/2/2020. 2nd Heart Attack is on 3/4/2020. Now What? I never had a chance to get my #s higher than 11K when I went into the Hospital and I have no more time. The plan is to start IVIG in the hospital and with Platelets on stand by would continue to infuse during the operation. 7 hours latter - success. Remember they needed 100K but could work with a minimum of 80K - My # = 59K. Remarkably I did not bleed uncontrollably. The doctors had never performed this with such low Platelets. Anyway - 8 days later I check out of the Hospital with a count of 5K. No we must deal with Covid - 19.

I am 60 yrs and after 4weeks at home, I am back to work. During my many visits to the Hematologist we were able to rule out Cancers etc and concluded that this is my Normal and in fact - Do I really have ITP. I'll never be higher than 6K and I am OK with that. I Show no outwardly signs other than bruising from time to time. Anyway $450,000 later I am here and Fortunately I got out of the Hospital on 3/11/2020. Stay Safe

[BeBop2018]

I have chronic ITP and have required cardiovascular stenting on numerous occasions. To raise my platelet count I was given high doses of prednisone and responded in 1-2 days. I currently take 5 mg/d prednisone and maintain a low level of platelets. Since your platelet number increased with IvIg, you may be a candidate for other methods of modulating your immune response when needed. There may also be additional alternatives to boost your very low platelet level. Best wishes.

[sharroN42]

Dear Dahle,

So sorry to hear of your ordeal but glad your came through. I recently had emergency hernia repair surgery and was terrified because of low platelets. They infused me with dexamethasone (l believe because l was truly ‘out of it’) and l came through with flying colours. I’d had knee replacement surgery in September and evidently lost ‘a lot of blood’ in spite of an ivig and a count of 220. In hindsight l realize l had not taken the dexamethasone course for 6 days prior to surgery. Doing quite well 5weeks after surgery.

[Dahle2424 in reply to sharroN42]

Good Morning Sharro, - Glad to hear you are doing fine. I went back to my Primary Care Doctor to run some routine blood tests, and my platelets were 8K. This is "my normal"

No visits to the Hematologist, no drugs & no treatments.

[sharroN42 in reply to Dahle2424]

Wow! Why does your Primary Care Doctor feel this is the best course?

[Dahle2424 in reply to sharroN42]

This is my Choice. The Doctor continues to recommend that I follow up with a Hematologist and I refuse. I have been to 5 different Hematologists our the last 30+ years and not one can tell me what is the cause or how to correct it. I am tired of all of the testing and considering that I made it through Open Heart surgery at 59K with no complications shows that my current 8K level is "MY" normal. I have never had a nose bleed for no reason, bruising is not an issue, and if I cut my self - It just takes a little longer than most people to stop. This is why they call it ITP " idiopathic". They have no clue. During one of my last visits - I was told that I may not even have ITP.

My blood sample was sent to rule out other possible causes ie; cancer - all negative.

It appears that I may have been born with this 60+ years ago. Hence - this is my normal. Even my dentist has no concern.

[sharroN42 in reply to Dahle2424]

Great! I applaud you. I have a charming Argentinian born haematologist who never answers questions although he tells me he can keep me going til I'm 90. After my initial scare I've backed off the closely followed diet I put myself on. Other than occasional black bruising, I, too have few symptoms. I am on 20 mg of dexamethasone every 2 weeks so maybe that helps. Maybe I'll do the same thing. No point making yourself ill worrying.