Last Tuesday when I went for the infusion, a nurse told me my platelet’s number of a blood test I had the day before was under the borderline for receiving the infusion, and I would need a blood withdrawn once again.
It was totally unexpected. A result sent by e-mail yesterday after the lab was everything normal though it didn’t include the number of the platelets. For the last six months I thought I was doing just fine with platelets despite a warning of low platelets count as one of the major side-effects of T-DM1.
The 2nd lab came back with 83,000 platelets while the 1st one was 74,000. Since the borderline was 75,000, I barely made it to have the infusion.
My oncologist hasn’t mentioned anything about the platelets, but the chart I got from the nurse showed as below.
I don’t know the numbers before 8/13, but it has been plunging constantly, and if this is a side effect, I am afraid that next time will be even less.
According to the Mayo Clinic web site, the normal range is between 150,000~450,000. If the platelets number is low, people may have anemia or bleed easily and have difficulty to stop it. No wonder I have had bleeding recently when I brush my teeth, and a bloody nose yesterday after the infusion.
In Japan, Dr. M told me that there was a report of subarachnoid bleeding among the T-DM1 patients. Indeed, the Mayo Clinic web site says it is rare, but the low platelets may cause fatal bleeding in the brain or intestine.
Have I had headaches because cancer spread to the brain or I am bleeding in the brain? If it were bleeding, probably I would have been dead or paralyzed by now. Then, is this an antecedent symptom of the bleeding?
I also learned a headache was one of side effects of T-DM1.
I need a brain MRI. I made the appointment on 11/1.