The Rise of the Platelets

I’m at the point where I am only meeting with the doctor once a week for a platelet check so there isn’t much to say between appointments. It’s a waiting game. With that being said, this post will serve as my update for the last week or so.

On Friday, July 29th I had two bloody noses. Saturday was even worse. I had three in total. Sunday I had another one and Monday morning, yet another. That is seven bloody noses in a four-day span. I think Saturday’s bloody noses were due in part to having a stuffy nose. Every time I blew my nose on one side, the other side started bleeding. I’m not sure if this was due to the pressure of blowing my nose or what.

This morning while I was in the shower I noticed that my right shoulder was bleeding.  I hadn’t scratched at it or scrubbed it, but there was blood running down my arm.  At first I thought maybe I had another bloody nose that was dripping, but when I washed away the blood it immediately started up again.  I could barely even see the tiny little cut/hole on my shoulder.  By the time I dried off from my shower, I didn’t even remember where on my shoulder it had been.  Regardless, between the seven bloody noses the spontaneous shoulder bleed, I was assuming the worst at today’s appointment.  I thought for sure my platelets had gone down.

Despite the symptoms and warning signs telling me otherwise, my platelets didn’t go down!  In fact, they went way up!  My count jumped from 54 to 80!  My hematologist said that the Prednisone is finally working on my platelets.  Because of that, he held off on tapering my dose again.  I protested but he said to give him one more week. Depending on my numbers next Tuesday he may finally taper it again.

I thought he’d have an update about my Sertraline today but the psychiatrist never returned his call. We tried calling him again while I was in the office today but he didn’t pick up. I gave the hematologist his email address so hopefully he can finally get a response.

In the meantime, he consulted a psychiatrist in the building and briefly explained my situation and the psychiatrist agreed that it could definitely be the Sertraline causing the easy bruising and increased bleeding. Today’s platelet count served as further proof. Since my platelets went up but the bleeding got worse, it’s definitely a problem with the Sertraline damaging the platelets. The doctor explained it to me like his – Sertraline releases seratonin and is meant to balance these levels. Platelets contain small bits of seratonin that interact with the medication. He said he found multiple studies and papers linking Sertraline to platelet problems. As for why it was never a problem before, I didn’t have ITP before. Circumstances changed, so my side effects changed.

I just get nervous because I’ve only been taken off of one long term antidepressant before and it did not go well. It felt like an out of body experience.  I felt helpless and out of control, which was terrifying.

I’m really nervous about having the same experience this time around. I almost started crying in the doctor’s office. I had to hold back tears. As I sit here writing this I’m trying to figure out what I’m really so afraid of though. I know that I’m in a much better place emotionally than I was back then and I have a strong support system, a great job, and a loving husband. What am I so afraid of?!  Perhaps I’m not afraid so much as annoyed. Annoyed the hospital didn’t immediately point out the potential interaction with my meds and ITP?  Maybe. Annoyed that I still don’t have a long term game plan or any end of the Prednisone in sight?  More likely this.

One of the worst things is waiting – waiting in any form is a trigger. It increases my anxiety and frustration and makes me feel as if I have no control over a situation. I feel like I can’t move on or go back to “normal” until this is all over. I never know what my week is going to look like. As a planner, the unpredictability of this illness and my current state is sheer terror. I hate not having a plan in place. I hate that things keep getting pushed off. Don’t get me wrong, I’m thrilled that my platelets went up and I don’t have to worry about further treatments at this time, but it’s all a false sense of security because I’m still on the Prednisone. I won’t know the real status of my AIHA or ITP until I’m completely off the steroids, so it’s hard to get excited in the meantime.

My mother says I should be celebrating the little victories, such as a rise in my platelets, but it’s hard to celebrate until/unless I know it’s over.