Neil what is Urgent QR and Nosebleed QR

[Sandy L]

Hi Neil,

I am concerned about my husband bleeding since his platelets are now down to 15. What is Urgent QR and Nosebleed QR that you refered to in another post. Thanks for your help.

[Laural]

Hi Sandy!
Urgent QR and Nosebleed QR are available in many drugstores in a powder form. When put onto a bleeding spot or a nosebleed, it forms a clot instantly. It is very helpful for nosebleeds that are from the frontal area of the nose, especially when platelets are low. Also works well for children when they skin a knee or elbow to keep the bleeding minimal.
Laura

[Neil]

Hi Sandy,
Keep in mind Nosebleed and Urgent QR are available over the counter. Not prescriptions.
does Mike have any visible symptoms of low platelets?
If he does not have any symptoms you might want to look ar my message to Rene on July 13, 2005—and discuss with his doc.
Neil

[Jimbob]

Neil,
thanks for telling us about this product. Some previous products to stop or slow bleeding contained some form of sulfa. I am allergic to sulfa with quick and horrible response. I intend to get the various QR products. I wonder if the extra strengh nosebleed QR would have stopped the flow from the cut veins in my upper sinus area that happened when I was in the hospital last year. What I went through was not pleasant.

[Neil]

Hi Jimbob,
Not sure how how Nosebleed QR would work in upper sinus area. Instructions caution one to keep it out of the posterior sinus area and not to breath it in.
When I have had nose bleeds I lie on the bed with my head back, over the edge and breathe through my nose attempting to get as much air flow as possible into my nose. Air seems to help the clotting process. ALso use cold compresses on the nasal area.
Also try to keep calm and avoid panic. Have been able to get under control in 45-60 min. Have not had to go to the ER yet.
Neil

[Sandy L]

Hi Neil,

I will look for your post as you suggested. He does not seem to have any visible signs at this time. Thank you for the good advice on nose bleeds. I will share them with Mike and I hope he never needs to use them but I will buy them tomorrow just in case.

[Sandy L]

Laura
You are so young to have to go thru all this. No talk about a possible SCT?

[Laural]

Sandy,
As my MDS is a secondary form due to original treatments for Acute Lymphocytic Leukemia, a SCT has not been seen as a very viable option. I have always opted for the least invasive treatment to keep the disease manageable. Currently, my docs and I are trying to keep the disease in a quiet state. I have very few effects from this disease right now, only occasional energy depletion if I try to do too much for too long. I have been stable for close to 9 months now with no transfusions and no increase in blast cells. I am real glad to see Revlimid nearing approval as this was the last drug I used, and it did a great job getting me independent of transfusions. It will be good to know it is available outside of trials if I should need it again.
Laura

[Neil]

Hi Sandy,
Have some points you may wish to discuss with Mikes hemo. It gets a little sticky, but you both should have a good grasp of a low platelet condition where there is no bleeding, bruising or petechiae.
If there are no symptoms, why get a platelet tx? At some point a patient will become refractory to plts. We want to delay that point as long as possible.
Some patients have problems with plt counts of 75,000. Others with counts of 10,000 get by without symptoms. Discussions with my hemo covered a couple points. One is the quality of plts. Typically the cells are cloning and the abnormal clones turn out a huge quantity of abnormal plts. They are identified, killed off and flushed. There are still some normal cells that produce normal plts. These are the ones that are identified and counted in a CBC. In my case the 10,000 normal plts are sufficient to handle my needs without symptoms.
Another point– There are plts in ones tissues that are not circulating in the blood stream. In the event of a trauma they go to work and help clotting. This is why when a patient goes on Prednisone or other steroids the plt count goes up—temporarily. The Pred releases the cells in the tissues and the patient sees a boost in plt count since they are now circulating. Question is: for how long.
The average body has about 5 liters of blood. Abour 2.25 liters consist of cells. The rest is plasma (93% water, 7% solids). Of the 2.25 liters of cells .037L are leukocytes, about a bartenders jigger full. About .0065L are platelets— a little over a teaspoonful. The rest are RBCs.
That small volume of NORMAL plts have a pretty big job to do.
I have had counts as low as 3000. No symptoms. The lab techs were in a panic. Get ready for a tx. But my doc reigns them in and asks for a slide. He them manually counts them and they always come out around 10,000.
The equipment used to count platelets is accurate to within 15,000 on counts between 50,000 and 500,000. When counts go low it takes a series of CBCs over time to become “comfortable” with the actual level. Every time they get a new lab tech and that person runs my sample there is a bit of panic. It takes a bit of time to calm them. I’m getting used to it.
When dx 81/2 yrs ago my count was 35,000. It slipped every 6 months till I hit the 10,000 point mid 2001.
Another anamoly. I went on Procrit in Nov 2003. Was on a weekly routine. At one point I had a CBC 3-4 days after my shot. RBC were up AND my WBC and Plt counts were also up. By the time the week was over they they were at “normal”. AM now on a 2 week Procrit interval. After a week all 3 lines peak and go back to “normal” at 14 days. My red counts have increased to an average of 3.6 and 11.9 at the 14 day point. Not only did Procrit boost my reds, it seems to have kicked my marrow into gear and helped WBC and plts. My hemo indicated there has been a very small number of patients where this occured. The Procrit customer service reps would not acknowledge this could happen and recorded my “complaint”.
When I was first dx and we got a handle on my plt condition my hemo said no more contact sports ( at 65?), watch out for any vision problems. Get an annual eye exam and get right in if there are any flashing lights in the corners of the eyes, any blood shot eyes, anything out of the norn. Drive very carefully! An accident could cause real problems. I also get my teeth cleaned every 3-4 months. Bleeding gums are common with low plts, . I wanted to be pro-active with dental hygene. It seems to work in my case. This is not true for all with low plts.
I carry a copy of my latest CBC and BMB results in the glove compartment.
Doc also prescribed Vitamin B6. Seems ther might be some benefit to plt production. I take a multi vitamin and vitamin C. Get all the exercise I can tolerate and all the rest I need. Follow a low carb, low fat diet.
Had to have some dental surgery a few yrs ago. Went in and got a six pack of plts at 11AM and had the surgery at 1PM. No problems.
Had a hernia repair last Oct. Got 2, 6 packs that got me up to 53,000. Had the surgery–no problem. My counts remained in the 30,000 range for almost 3 weeks before going back to 10,000.
At one point I was looking a Thalidomide. Was going to go to Rush Presbyterian in Chgo. When they saw my plt count they insisted I have a plt tx before getting a BMB. I refused and cancelled the appointment. Did not want what I consider an unnecessary tx. Never had a bleeding problem with any other BMB.
It takes some time to get over the apprehension. It takes a lot of effort to avoid panic when I get nicked and start to bleed. So far I have been able to handle them without going to the ER.
If Mike fits my mold, he might be able to avoid the Plt tx—as long as he does not have symptoms and his counts do not trend lower over time.
Might be worth a discussion with his hemo to evaluate his condition.
My classification is Refractory Anemia with Multilineage Dysplasia. A lot different than RAEB
Neil

[Donna]

Wow Neil! – you are a walking book of knowledge. What a great help to everyone on this forum!. You mentioned the flashing lights in the corner of the eye. That sure strikes home for me.
Yes! – rush to the emerg if that ever happens. My sister in law saw these lights, ignored it, called the dr. to make an appointment for the following week. She died 2 days before her appointment. Not something you want to ignore.

Donna

[Pauline]

Hi Neil,

Thank you for your post it is wonderful information. You mentioned some patients can get by with low platelets for years as long as there are no symptoms. Some can get by at 10,000 without significant problems while others have difficulty at 75,000.

My mother’s only symptoms are reddish spots on her arms. At times, they can be pretty big but she has never bled from her gums or nose. My mother also hit 3 once and they ran with her chart to order platelets. What is your wbc?

Our Dr. never mentioned anything about flashing lights in the corner of the eye. Does that indicate bleeding? I thought my mom was fairly safe having platelet count around 37 but I guess not. Pauline

[Donna]

Hi Pauline,
Flashing lights in the corner of the eye indicate bleeding in the brain.

Donna

[Neil]

Hi Pauline,
Flashing lights in the eye can have several sources.
The most common results for aging. The gel in the eye shrinks away from the inner lining of the eye. Bits of debris break away and drift around in the fluid. These are called floaters and are common as we get older. Annoying, but not at all unusual.
Another is from a detached retina.
In any event it is best to get to an opthamolosist —quickly. Call your hemo if you cant get an immediate appointment. Mine gets me scheduled within hours.
My WBC ranges between 1.2 and 1.7. It was 1.5 this morning
Neil

[Pauline]

Hi Neil,

Thank you for the information. I will make sure she sees an opthamologist. My mom’s wbc ranges between 1.8 and 2.2.. Pauline

[Sandy L]

THANK YOU NEIL. WE GO TOMORROW AND I WILL BE SURE TO BRING IT UP.

I agree with Donna – you are a walking book of knowledge. Please do not leave this group. We need you.

Thanks again to all

[Author]

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