Low Platelets

Platelets are the blood cells that help the body to form clots. This is important to prevent bleeding from cuts or other injuries. Normal platelet counts usually range between 150,000 – 400,000 per mm3 of blood. Anytime platelets drop below 50,000 per mm3, there is an increased risk for bleeding. If platelets drop below 20,000 per mm3 and there are signs of bleeding, then you may require a platelet transfusion.

There are a number of causes for low platelets. Some patients have low platelets as a result of receiving chemotherapy; others may have autoimmune diseases or blood disorders. Whatever the cause of the low platelets, there are several precautions to follow to prevent injuries that may result in bleeding.

Signs and Symptoms of low platelet counts

• Excessive bruising
• Tiny, pinpoint red spots on your skin (called petechiae)
• Bleeding gums
•  Nosebleeds that do not stop
• Excessive bleeding from an injury that will not stop even after pressure has been applied
• Dark colored urine or blood in your urine
• Blood from the rectum, blood in the bowel movement (BM), or black colored BM
• Menstrual bleeding that is heavier than usual, lasts longer than usual, or occurs between periods

What to do to avoid bleeding?

Adjust your lifestyle to prevent injuries.

• Avoid strenuous activity, contact sports, lifting heavy objects, training to cough, forceful nose blowing, or constipation.
• Avoid medications (see below) that affect blood clotting (unless approved by your doctor).
• Do not take aspirin or any product that contains aspirin. Check the labels of all drugs you are taking salicylic acid, the chemical name for aspirin. If you are not sure about a drug or can not tell by reading the label, check with your oncologist, nurse or a pharmacist. Do not take any non steroidal, anti-inflammatory medications such as Motrin® (Ibuprofen), Aleve® (Naproxen), Advil®, etc. unless approved by your oncologist. For headaches or other pain, use acetaminophen (Tylenol®).

Low Platelets Thrombocytopenia

• Avoid procedures that may cause a break in the skin. Avoid rectal exams, vaginal exams, vigorous thrusting during sexual intercourse, enemas, suppositories, douches, tampons, vaginal or rectal applicators, rectal thermometers, dental exams, surgeries, etc.
• Take special precautions with personal hygiene.
• Avoid falls in the shower or tub by using slip guard mats.
• Keep your teeth clean with a soft toothbrush. Do not use alcohol-based mouthwashes. Do not use dental floss. Keep your lips moist with lip balm to prevent cracking.
• Use an electric razor for shaving.
• Wear shoes to protect your feet.
• Avoid tight constrictive clothing or jewelry.
• Use stool softeners to avoid hard bowel movements that may cause injury to the rectum.

When to call the doctor

• Bleeding that does not stop after applying pressure for 15 minutes.
• Bleeding from the rectum, blood in the stool, or black stools.
•  Blood in the urine or dark colored urine.
• A change in your vision.
• Persistent headache, blurred vision, or a change in your level of consciousness such as decreased attention span, excessive sleepiness, confusion, or difficulty being awakened.

*If you have a major injury or start spontaneous bleeding, go immediately to the nearest emergency room.