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[aplasticcentral/_borders/discactive_ahdr.htm]

Re: Update on Larry

From: schmidt5@erols.com

Date: 9/28/2003

Time: 3:32:50 PM

Remote Name: 66.44.89.205

Comments

Hi Laura,

I know how overwhelming all this can be. I would highly recommend a second opinion. Your doctor should not mind. And if he does, that’s not a good sign. Be sure to take the results from his Bone Marrow Biopsy and latest CBC. BMTs, as long as there’s a match, have been the first choice for most. Age is also a factor…success rates decline with age. And, BMTs, if they take, will take care of the AA. However, you need to consider the long-term implications of a transplant. They have come a long way with other options for SAA that you need to explore. Unfortunately, there’s not one treatment that works for everyone and there is no way to predict outcomes. There are tradeoffs with each one and only you & your husband can assess which one will work best for him. Look at the immediate effects and long-term consequences of each therapy. Assess them all and talk directly to doctor(s) recommending them. Docs have a bias for their recommendation…so keep that in mind when you speak with them.

Here’s a web site with a good explanation of the blood:

http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/B/Blood.html

Here’s one on lab test:

http://www.labtestsonline.org/

As far as when to call the doctors, here are the guidelines we use:

Call if there is any bleeding from any part of the body that will not stop. We usually give nosebleeds about 15 minutes depending on the severity, same with gums. Where you can apply pressure, do so. Same rule….give it 15 minutes. Any blood in the urine or stool; unusual bruising, increased or new petecchiae; Headaches….especially if he’s not prone to them. It can signal a low hematocrit or platelets. Most AAer’s can tolerate a platelet count between 5 – 10K without any major bleeding.

Regarding infections….any fever greater than 100.5; chills; new cough, shortness of breath; burning or pain with urination; redness, swelling soreness or drainage from any part of the body; and any unusual weakness or tiredness.

Precautions: Use a soft toothbrush; don’t blow your nose too hard, use an electric razor, take care not injure yourself, don’t take asprin, motrin/advil, and don’t strain while having a bowel movement. If the white count/anc is low, stay way from large crowds and sick people; wash your hands a lot, don’t go out and do yard work. Too much mold and fungus this time of year. Avoid chemicals….cleaners, fertilizers, insecticides, etc.

Bottom line, err on the side of caution and call if you have any concerns

Hope this helps…..let us know what happens on Monday.

Marlene

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