Follow Up Visit to the Hematlogist - 9/25/08

I went in for another blood test and to speak with Dr. A. There was good news regarding my white blood cell count. It finally has crept into the normal range - today it was 4.3 and the low end of normal is 4.2. He told that it was probably due to the radioactive iodine and things look good with regards to my white count.

My platelets still remain low (mine were again at a 119 and the low end of normal is 150). He said that there is no cause for alarm. He looked at all of my past records and saw that I have had a low or relatively low platelet count since 1995 (Thrombocytopenia). Since I have been living with it with no problems for many years, the low count is probably caused by an auto immune issue (A person who has a low platelet count with no known cause is said to have idiopathic thrombocytopenic purpura (ITP) - Dr. A discussed this with me). Due to the low counts, he said that I should eventually get a bone marrow test to rule out any another reason. He doesn't believe that the low platelet count has anything to do with the radiation since I was low before the RAI and have been for years before it. I scheduled one for 10/20 at 4:15PM in his office. He said that the test might leave me a little sore the next day but that is about it. Nothing to worry about.

Bottom line - white count is normal, platelets are still on the low end (probably caused by something autoimmune), get a bone marrow test just to be safe

ENT Visit - Another Swollen Salivary Gland - 9/25/08

I made a second visit to the ENT doctor today, and I was glad to find out that the swelling/enlarged gland that I felt on the left side of my neck was the salivary gland under my jaw (sub mandibular gland - number 2 in the diagram below). Big relief.

About a week and a half ago (about the time of Reach the Beach), I felt a slight enlargement of the gland on the left side of my neck but didn't really think anything of it. I thought it was probably due to the cooler weather and no sleep during the race or a cold coming on (a swollen lymph node). Over the next few days to a week, I noticed the size fluctuated but was definitely larger than the one on my right side. Then over the next few days, I started to find that the gland swelled up to the size of a marble in the morning and was firm, and then got smaller throughout the day. I was a little concerned. It wasn't solid so I didn't think it was a mass. I didn't have a fever or pain in my neck, so I didn't think it was a serious infection. Since I did not feel sick, I was thinking that it might be my salivary gland. From all of the diagrams I've seen, the main salivary glands are the parotid gland in your check and behind your ear (number 1 in the diagram above), and the sub mandibular gland below your jaw. The more I felt the gland in my neck, the more it seemed to be concentrated below by mouth, and not in the middle of my neck where you usually feel a swollen lymph node. I wanted to get it checked out just to make sure. I went to see Dr. Green, a doctor in Dr. S's practice and he confirmed the diagnosis. This makes sense. I guess I am going through the progression of salivary discomfort after RAI. The discomfort started in my cheeks, then went behind my ear (more severely on the left side), and now to the glands below my mouth. Dr. Green told me to continue hydration and sucking on sour candies. Be patient like I was before and it should get resolved.

He wanted me to come in again in a month for a follow up and I am scheduled for 10/21 at 8:30AM.

Follow Up Blood Test - 9/3/08

I went back to the NYU Clinical Care Center again this afternoon for my weekly blood test. Not much substantial news to report. My white blood cell count crept up slightly from 3.6 last week to 3.7 this week (low end of normal is 4.2). My platelets still remain low. I notified my hematologist's office that my platelets have been low on the past few tests and I have a history of lower platelet counts (and the reason that I visited a hematologist in the past). Thankfully, a platelet test was added to my blood work this week to see if there is anything that can be causing my low platelet count. Dr. A's office let me know that they received my records from my past hematologist. The nurse said that I don't need to come in for any additional blood tests right now but recommended that I come in to the doctor in a few weeks to discuss my case and see if he has any new thoughts on my low WBC and platelet counts or additional recommendations.

Some questions to ask the doctor the next time I see him:

While I am glad that my WBC is moving upward, it is still not in the normal range. Is this to be expected after radioactive iodine treatment? How long do you expect it to take before it is back in the normal range again? Although my WBC count is low, are you "fine" with what I have right now? Do I need to limit any of my activities? I looked at my physicals over the past 8 years and my WBC has usually been in the mid 4 range.

Is there anything to worry about regarding my low platelet count? Is there a reason for my low platelet count? I have had a low count for many years now - do some people just have a low count?