expectations . . . and thankful thursday

The following was written 5 weeks ago and will be followed by what I am ever-so-thankful for this week::


I was recently pregnant. When you are pregnant they check out all sorts of stuff: they ask for little jars of your pee quite often. They drain blood from your veins and check it all out. They push on your {big!} belly. Sometimes it seems like a bit much, but I understand why they do it all {well, I'm not doctor, but I mostly understand why they do it.}

Toward the end of my pregnancy with Sara the platelets were low in my blood. They figured it was gestational. The bummer of the whole thing was that when your platelets are low you can't get an epidural. Ok, I can live with that. Not ideal, but doable. I've had epidurals before a couple times and found them to be quite nice, but I've also delivered a few babies without them and that went ok too. This time around the labor was less "ok" than any of the other times, but still I survived. No epidural. Quite a bit more pain but still a fabulous, wonderful, healthy, miracle of a little girl in the end.

I stopped thinking about my platelets.

My 6-week check up came and went and I didn't even ask about them. They hadn't been re-checked and I wasn't concerned and didn't even think about it. The guess was that, since they became low during pregnancy and hadn't ever been before, that it was a gestational problem and would resolve itself after sweet Sara's birth.

Fast forward a bit and I was at the doctor {different doctor} for a completely different matter. She looked in my records and asked if my platelets had been re-checked. I said no and she said that before I left I should just swing into the lab and have them take some blood so we could make sure the situation had been resolved. I gave my blood donation and headed home. Later that afternoon {actually, I think it may have even been considered evening by then} the doctor called me at home and said that my platelets were lower even than they were when Sara was born. She said that I should see a hematologist to figure out what was going on. A scheduler would call me to set up the appointment. The scheduler called and said that my clinic didn't have a hematologist and I could either go to Maplewood or St. Paul. I said I'd go to Maplewood. I'd been to the Maplewood clinic and knew right where it was. Plus, I'd have to pay for parking at the St. Paul location and I'm cheap, so that sealed the deal.

The scheduler gave me the name of the doctor and told me the appointment was at their location at 1580 Beam. I almost didn't write the address down. I'd been there before and knew right where the Maplewood clinic was. And it was on Beam. But, I was writing down the time and the doctors name in my calendar anyway, so I made note of "1580 Beam" in my calendar.

Fast forward to the afternoon of January 4th. The day of my appointment. Kirb comes home from work early to watch the kids and leaves his car running so I can be on my way. I give him a little "kid handoff" speech about who has eaten what, when and how the day has gone. I grab my purse and a book {you know how doctor appointments often lead to a bit of waiting} and head out. I drive for 10 minutes or so and find myself on Beam Ave. I haven't been to the Maplewood clinic in probably almost 10 years, so I start looking at the numbers on the buildings. I'm in the 1600's, so it shouldn't be much farther. But wait, the numbers are getting bigger. Weird. So, I turn around and go the other way. But I know the building I am expecting to go to is farther up the road in the direction I was originally going. Still, I turn around. I get to 1580 Beam and as it turns out, it is not the Aspen Clinic in Maplewood. It is a building that I have had a view of 4 times in my life. Each time I delivered a precious little bundle at St. John's Hospital. A building that I'd spent 8 days of my life looking at. And thinking about. Never assuming I would need to go there. Assuming I would have no reason to ever step food inside it. Vaguely praying for the people that I saw heading in there from my maternity wing hospital room. Nursing, holding, loving and taking in sweet baby Rebekah. And Joe. And Anna. And, just recently, Sara.

Minnesota Oncology: Maplewood Cancer Center.

What? Really? Why on earth is my appointment here?

At this point I'm a little shook up. So, I head in. I check in at the front desk and sure enough, I'm at the right place. Why did the schedule lady tell me my appointment was at "our location at 1580 Beam". It would have been a nice heads up to know I was going to the "Maplewood Cancer Center".

The lady at the front desk hands me a clipboard of about 10 pages of papers to fill out and sign. Also she takes my insurance card and a picture ID {that's a new one} to photocopy. One of the first questions following name/address/birthdate/contact person was "Have you had any previous cancer treatments?" Yikes. That question sounds suspiciously like I am here for cancer treatment. Which I'm not! Clearly. I'm just here to check on a minor blood issue. Or at least that was my understanding. I fill out all the papers. How old was my grandpa Fletcher when he died? I write 70 with a question mark. How do you spell "emphysema"? I never can remember. Can you write heartbreak as the cause of death? I think that's what my grandma Carlson died of after spending 2 years without my grandmpa following his death -- which at 96 I listed as "natural causes". I debated between that and "old age", but "natural causes" seemed more "correct", more medical. And, you know me, I like to get the answers right.

I was called back by the nurse. She weighed me {always a joy! -- at least it doesn't start with a "2" anymore}, checked my height and brought me in to the room. Room 5. She took my blood pressure. Twice. Then my pulse. For a pretty long time. She said both were high and maybe it was a little anxiety about seeing a new doctor. Really? Do you think? This building says "cancer" on the outside of it. Doesn't that make everyone's blood pressure go up? Then the doctor came in. His first name was Vladimir. His voice reminded me of the Doorman/Butler/Bellhop/whatever-he-was guy from the Curious George movie {think "You are kick-ed from building." if you've seen the movie. That's totally what he sounded like.} I had a hard time not giggling. Which would have been altogether inappropriate on many levels. He tapped on my back up and down my spine. Looked at my ankles. Pushed on my {not quite as big} belly. To a non-doctor some of the things doctors check seem completely random. Anyway, he had no good thoughts on why I would have low platelets. He said he would look into Lupus, rheumatoid arthritis and other auto-immune diseases and then if that showed nothing he would investigate to see if it was something "bad".

We have a nurse friend who gets so mad when people search on the internet to find out about medical stuff. I know this and yet what did I do? Google to find out what "bad" might mean. I should have been clued in from the letters on the outside of the building, I guess. Here's what I found::

Definition By Mayo Clinic staff

Thrombocytopenia is the medical term for a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that play an important role in blood clotting. Platelets stop blood loss by clumping and forming plugs in blood vessel holes.

Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system malfunction, or as a medication side effect. Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding can occur.

Thrombocytopenia usually improves when the underlying cause is treated. Sometimes medications, surgery or a blood transfusion can help treat chronic thrombocytopenia.

Anyway, the plan was to have me come in for weekly blood draws to see how things change {or don't} from week to week and then have an appointment with Dr. Vladimir again 4 weeks later.

From my non-medical understanding of what he explained to me -- and what I learned on the internet {sorry Dan!} -- platelets have a very short life-span. Your body is constantly making them. They "live" about 8-10 days. New platelets are bigger and older ones are smaller. A normal platelet count is between 150,000 and 450,000 {but doctors disregard the 3 zeros at the end when they tell you your numbers}. I was just under 100 {the cutoff for an epidural} when Sara was born. I was down to 51 when they checked around Christmas-time. I was 58 at my first appointment at the cancer center. The majority of my platelets were big. That means that my body is making them just fine, but something is killing them earlier than normal, thus the lower count. All of that doesn't mean too much to me, but hopefully somehow soon some answers will be found!

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Thankful Thursday Update::

I had my appointment with Vlad {that's the way Kirby has referred to the hematologist the past month or so since we've "known" him} this week. My platelets are still low, but have been trending upward over the past 5 weeks of lab results that we've been monitoring. This week they were 73. Still less than halfway to the bottom range of normal, but heading in the right direction at least. So, here's what we found out {in a nutshell} at the appointment this week::Before I get too long winded, I'll just say that it's basically wonderful news. Phew! At their lowest my platelets were 51 (normal is 150-450) and at their highest, during this whole business, they were 73. That was this week. The doctor said the fact that they are trending upward is a good sign. It might take months or even a year to get back up to normal levels -- and they may not get all the way back up to that point ever, but that's ok I guess. Not ideal, obviously, but ok! He said that he ruled out everything that he suspected might be the culprit {Lupus, Rheumatoid arthritis, other auto-immune diseases} and my low platelets aren't caused by any of those systemic-type problems. So that's good . . . and a little bad, since he really has no idea what is causing the low platelets. He mentioned a few possibilities that were interesting, but in the end inconsequential. I guess maybe there might have been a compatability issue with my blood and Sara's when I was still pregnant that would cause my body to fight against my platelets and kill them off as if they were something bad to fight against. Also, sometimes after a respiratory illness your platelets can drop and although it's usually a short-lived drop, sometimes it's long-term. So, the long and short of it is that we know what it's NOT, but we still don't know what it IS. Overall, he said that I am pretty healthy with the exception of the platelet thing, which shouldn't pose too much of a problem, but is still a mystery. He wants to recheck my blood in 3 months to see what change there has been. The biggest danger to having ongoing low platelets would be if I was pregnant again; then it might cause additional problems and complications. Although we'd pretty much decided this already, that would seem to be a sign that Sara will be our last little bundle {at least of the biological sort}.

This verse has been often in my mind throughout this whole ordeal {it's one I memorized in 2009 and have come back to often since then}::

"May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit."
Romans 15.13

So today I am thankful for health. For perspective that comes only from a scare like this. Over the past 5 weeks I've had a couple days of freaking out and crying, but amazingly, overall, I've felt peace. I know this has come from the Lord and is due to all the support, encouragement, love and prayers I've felt from the smallish handful of people who knew about the whole business. I am blessed and so grateful for all of it!

So, the verse that I'm working on for the next couple weeks is so very appropriate::

"Enter his gates with thanksgiving and his courts with praise; give thanks to him and praise his name." (Psalm 100.4)

I would like to think that I would "give thanks to him and praise his name" even if the outcome had been different, but I wasn't, so that's something I won't know, I guess. For now I will give thanks for the good news and be thankful for a healthy body. I am continually amazed by our bodies and how we are made. {"fearfully and wonderfully" as it says in Psalm 139}. Praise God!