nose bleeds and bruising

[Green1988]

hello

my husband has been having some nose bleeds past couple of days and also some bruising in the past few weeks? He isn’t on any medication and he’s Calr type 1? Is this normal also he is due to start aspirin as we are flying next week?

[Mazcd Partner MPNVoice]

hello Green1988, your husband should contact his haematology nurse specialist for advice on this. Best wishes, Maz

[hunter5582]

Mazcd is correct about contacting the MPN care Team for patient-specific advice.

One of the oddities of ET is that there is increased risk of both thrombosis and hemorrhage. The hemorrhaging you describe is not uncommon. Aspirin may exacerbate this issue. However, the risk of thrombosis when on a long flight is not something to be ignored. A thrombotic event would likely be worse than a controllable nosebleed or bruises.

In this situation, after consulting with the MPN care Team, I would consider getting a nosebleed kit. That way he can fly without worrying about a nosebleed event. There are several different types. Here is one amazon.com/Be-Smart-Get-Pre...

Hope you both enjoy your trip. Happy and safe travels.

[Green1988 in reply to hunter5582]

Hello thanks for your reply I did contact the haemotologist and he said it’s not uncommon because the platelets are not working as they should be.

[hunter5582 in reply to Green1988]

The Dr. Spivak KISS explanation is that platelets are like little sponges. They suck up all the von Willebrand factors (needed for coagulation) so there is not as much left when it is actually needed. That is a bit of an oversimplification of a very complex process but it does suffice the sort of get why this happens.

The excessive bleeding/bruising is just something we deal with when managing ET. Aspirin can make it worse but that has to be balanced against the risk of thrombosis. It is bit like walking on a tightrope while juggling knives at times. 😲

I expect with a bit of preparation your trip will go fine. Happy travels.

[Green1988]

😳 thank you.

[Pte82]

Green1988, vitamin C is important for collagen biosynthesis. Liposomal vitamin C offers higher absorption and longer vitamin C activity. My wife uses liposomal C for nose bleeds, bleeding gums and bruising.

[Solyesh]

Great advice already given - with the most important one being he should seek consultation from his MPN specialist. Ironically as platelet numbers increase, hemorrhaging becomes a risk factor (while we are usually focused on clotting..). Has he recently seen an increase in his platelet count? It was bleeding at my gums (which I never had) which prompted a mid-cycle set of bloodwork and a platelet reading at 1,400..this eventually led to cytoreductive therapy (was on aspirin and monitoring previously) - would be good to just get things checked out -

[Green1988]

Hello his platelets are 580 I checked with the haemotologist and he said because the platelets don’t function normally this is not uncommon.

[TLJ-1 in reply to Green1988]

As others experienced, I started having nosebleeds as well after starting an anticoagulant, Xarelto, which is a bit more aggressive than aspirin (but then I already had a flurry of pulmonary thrombi before I was even diagnosed with PMF) . I've found that when I can't get a nosebleed to stop with tissue up the nostril and applying pressure for up to 30 minutes, I sometimes need some more help. I've found that "nose sponges" sold by Seal.On work great. I purchased these in the U.S., but I think I've seen them or an equivalent in Switzerland as well. They're also much less tiring than pressing the side of my nose for a long time too! I carry one with me everywhere I go.