David is feeling fine but had an active bleed again last night and so he got more platelets. The hematologist said he thinks this is likely idiopathic thrombocytopenic purpura (ITP) an autoimmune situation where his body is attacking and destroying the platelets. He started out at a count of 9,000 when he was admitted on Friday. Yesterday it fluctuated between 40,000, 30,000 and 40,000. If it gets up to 50,000 with no active bleeds he can come home. Normal values are 150,000 - 400,000. He was out of bed yesterday to take a walk and use the bathroom but otherwise was in bed. He is on megadoses of prednisone to combat the immune response and will be on it for six weeks if it works. If the prednisone works then the diagnosis is confirmed. If not then then next step is a bone marrow biopsy. Since his other blood cell counts seem in the normal range this is not the first step. I remember my first and only bone marrow sampling. The pain was extreme even with the local anesthetic. This was in 1973 when my pernicious anemia was diagnosed.
This ITP may just go away as mysteriously as it started. He seems to be his usual self...in a pretty good mood as long as he has his meals and meds on schedule, has the urinal in an easy to reach place and can read his Kindle and iPad email and blogs. The TV is annoying because you cannot pause your show when doctors or nurses come in to do stuff. He is terribly bruised from bleeding under the skin but says it doesn't hurt. Please keep him in your prayers.
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