LOW PLATELETS:

There are three main types of cells in your blood: white cells, red cells and platelets. Platelets help the blood to clot. When you have low platelets, you may bruise or bleed more easily.

How to know if you have low platelets:

To confirm if your platelets are low, a blood sample will be taken and the lab will do an actual count of the number of platelets. This is called a platelet count. Normally, the platelet count will be 150 (X109 /L) or higher. It may drop as low as 75 (X109 /L) to 100 (X109 /L) without serious harm during chemotherapy.

There are some signs of internal or external bleeding to watch out for, if your platelets are low, such as:

• Easy bruising.
• Tiny pinpoint red or purple dots on your skin. (May look like a rash)
• Unusual or heavy nosebleeds.
• Red or pink coloured urine.
• Black, tar-like stools (bowel movements), or blood in the stools.
• Red or brown coloured sputum or vomit.
• Dizziness, constant headache or blurred vision (this may happen with bleeding in the head)
• Bleeding from your gums, especially when brushing your teeth.
• Heavy vaginal bleeding.

If you have a very low platelet count, this is a medical emergency. You may need a platelet transfusion. Even if you feel reasonably well with these symptoms, you must contact your doctor or nurse or go the emergency department IMMEDIATELY!

Your nurse or doctor will tell you when to expect low platelet counts. This can help you to know when to watch for any of the signs of bleeding.

When your platelet count is low:

What you should do:

• Before buying any prescription or over the counter medications, tell your pharmacist that your platelet count may be low due to chemotherapy.
• Avoid strenuous exercise. You will bruise more easily.
• Use a soft bristle toothbrush, or toothettes, to clean your teeth.
• Be careful when using sharp knives, scissors, razors and other sharp items.  If you cut yourself, clean the area well and apply firm pressure with a clean cloth for at least 5 minutes.
• Check with your doctor before you have any dental check-ups or dental procedures.
• Prevent constipation. If you need a laxative or stool softener, ask your doctor, nurse or pharmacist for help. See the pamphlet on Constipation for more information.
• Use a water-based lubricant during sexual intercourse, to reduce the chance of bleeding.

What you should not do:

• You should avoid using blood thinners, or drugs that affect bleeding such as aspirin and nonsteroidal anti inflammatory drugs such as ibuprofen (Advil® ) For headache, fever, or occasional aches and pains, use acetaminophen (Tylenol®) instead. If you are taking aspirin regularly for other medical problems, it is important that you do not stop taking it before you have discussed this with your doctor.
• Do not use rectal suppositories or enemas for constipation.
• Do not take your temperature with a rectal thermometer.
• Do not shave with razor blades. Use an electric razor when platelet counts are low.
• Do not participate in contact sports or other activities which could cause bruising.
• Do not blow your nose with too much force (a nosebleed could be started).