Falling Platelets

The blue gown didn't really fit

I finally went to the hematologist yesterday. My platelets are down to 102 from 115, unfortunately trending downwards.   For some reason he wanted to do an exam (?) which was interesting because the nurse didn’t tell me which way to put the dreaded paper blue gown on, opening facing front or facing forward?   When she left the room so I could get undressed I must have switched it back and forth at least 5 times. The little plastic “belt” that they give you to tie it shut was woefully inadequate to secure the gown closed in any fashion, not that it mattered anyway because there simply wasn’t ample paper to cover my enormous belly.  I went with the back opening and after a quick exam we sat back down in his office and the doctor (who looked about 18 years old) basically told me there was nothing they could do.

Well, he said the ONE thing we could try is a short round of steroids to see if it was my own immune system suppressing the platelet production and if so, give me more steroids to increase them further. I don’t know about that option, I tend not to trust what the medical community finds “safe” for pregnant women (DES was prescribed only as long ago as the 70s!)

When I brought up transfusion as a possible option he said well yes… if your OBs want to pursue that but I’m not sure if it’s “warranted just because you want an epidural.”  At this point I should have grabbed my medical records and slapped him across the face with them.   If it was just a matter of a SINGLE baby, I would have to make my peace with delivering without an epidural. Which wouldn’t be fun but it’s obviously possible.   But with a twin birth that is most likely going to either start or end with a c-section (or in the best case scenario a vaginal birth with a breech extraction if I should be so lucky) my platelets count may well determine if I’m conscious or unconscious for the birth of my girls. Just the THOUGHT of being under and missing the magical moment of their birth makes me want to cry.

There is just so much that is unknown at this point. What will Baby A’s head position be at birth?  How much bigger will baby B be than baby A? Who will be the OB on call when I go into labor (and will he/she do a breach extraction?) Who will be the anesthesiologist on call and how low is their threshold for platelets before they say no epidural (the hematologist said NO one will do one below 80, but between 80-100 there is a big variability between doctors.)

All this is very much on my mind as we head into the final stretch. Speaking of which, Jasper’s 4th birthday party is a week from tomorrow!!! (His birthday has always been the last “major event” in my mind before the girls come.)

Although I’ve been knee deep in party planning and telling relatives what presents he might like, we of course haven’t figured out what WE are getting him yet! Any suggestions for a 4 year old boy??


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Flo says:

I had low platelets in my 2nd pregnancy, my baby is 3.5 months old now. I did 2-3 weeks or so of the steroids (prednizone). They have you take 20 mg (4 pills) for 5 days, then 2 pills for 5 days then 1 pill for 5 days to wean you off. My platelet count did go up slightly so before I reached the 1 pill a day they bumped me up again and I was still on them when I delivered, but I had to keep taking them even after to finish the 1 pill cycle (you can’t just quit cold turkey). The steroids didn’t give me any side effects and my baby was projected to be over 9 pounds so I REALLY wanted the epidural. I was induced 4 days early… when I went in, my platelets were at 89, and they had warned me that some anesthesiologists won’t give them under 100, some will go down to about 80, it’s their call and since they’re on call different days it’s just luck of the draw who you get. LUCKILY the anesthesiologist that I got felt comfortable giving me the epidural so I got it and thank God because my son ended up being 10 pounds 8 ounces!!
I would say don’t worry too much about the steroids. Even if they don’t get your levels to increase maybe they’ll keep them from dropping too much.

Oh and the reason you can’t get an epidural is because the opening of the little tube they put in is thicker and is in there for a long time, plus where they place the tube is different than a spinal block, it’s a thin syringe that they shoot the medicine in and pull it out. I think they worry about things healing back up and clotting after the epidural, but I’m not sure. The other stuff I learned when I asked my perinatologist.

I wish you the best of luck in the rest of your pregnancy and I hope your levels stay around 100, that you’re able to get an epidural and deliver 2 healthy babies vaginally!!

Holly says:

rokenbok my boys loved them!

Jamie says:

Aw, I love hearing all the new news! Jasper is about a month older than my youngest and I am 6m preggers. I am so sorry your going through this as you remember in the end the stress almost melts away when you see them..remember that you’ll have two beauties! Don’t over think the birthday present, I’d say. Maybe a goldfish or lego’s (which I know have nothing in common with each other,lol)Or a special day out with you (to pick up what he didn’t get that you think he would like) Well wishing you wonderful weeks ahead!

E. says:

I just went through the same thing. I had my second baby 2 weeks ago and had slowly decreasing platelets since 28 weeks. I was monitored by a hematologist as well and we did try steroids the week before my scheduled c-section but unfortunately they did nothing to increase my count ( the other option I was given was IvIG infusion but I was not comfortable with that.) On the day of delivery my count was in the 60’s and I had to have general anesthesia. It was certainly not ideal but it all worked out and we have a healthy baby boy. I wish you the best for the rest of your pregnancy and birth of your babies!

Farah says:

Best of luck Ariana! Wishing you much health and happiness as you await the birth of your beautiful twins!

Amber Fox says:

I wanted to wish you the best of luck with delivering your twins. I am in my 38th week with twin boys, so I am familiar with your labor fears and discomfort levels. I pray both girls come out via one exit route and for you to have a healthy delivery. And may the transition for your son be smooth.

My platelets were in the 50s when I delivered Cole – so I was knocked out, but I was awake for Lulu’s birth; they were around 110 or so… I wanted to give you some optimism – at 34 weeks with Lulu, my platelets were falling and they considered delivering her immediately, but they rebounded on their own. Good luck!

Jenny says:

My son turns 4 on the 21st and we got him the Leap Pad. Might be a good present for the girls upcoming arrival because it can take pictures too.

GiGi says:

Be sure to take care of yourself, Ariana! Any building toys, like Legos, Lincoln Logs, and Tinker Toys are good for that age group. Logan especially liked a building toy called “Zoobs” at that age (still does, actually). Hope you find something that truly fits your little man!

Heather says:

Wow! Lots going on! Good luck with everything.
My 4-year old really likes baseball…uniform (even though he’s not on a team), mitt, batt, you name it. And, bows and arrows. He got a scooter for his b-day but hasn’t taken to it too much. Also, Zingo and Smatch.
Happy Birthday to Jasper. Hope you have fun!

Kristen says:

Thinking of you Ariana!

Jackson has already started asking for a scooter for his birthday. I’m kind of excited about that present, I have no problem with buying him things that will help his coordination and give him some exercise.

I hope you take lots of pics at his party!

Sarah says:

My platelets were really low when I delivered via C-section (although I don’t know the exact number), low enough that the epidural was out of the question. They were able to do what they called a full spinal for me, I don’t know the difference is but it meant that I was awake for the birth. But super out of it in recovery. Still, not knocked out. I wonder if that’s an option for you?

Claudia says:

Well, I can tell you what Jordan likes (he’s turning four on 8/20). Jake and the Neverland Pirates ship (he’s really into boats). He also likes those pillow pets that shine stars on the ceiling. Puzzles are always a hit and for some reason, he’s really into stuffed animals all of a sudden. Twister is also fun right now (although you can’t play…ha ha) as well as dinosaurs and construction sets. I hope these ideas helped to spark an idea of your own!