Low Platelets and Preventing Bleeding During Cancer Treatment

Signs and Symptoms of bleeding

• Nose bleed
• Bright red blood in stool or urine
• Coughing up blood
• Bright red blood in vomit
• Abnormal vaginal bleeding (heavier, longer or not with your regular menses (period))
• Bleeding gums or lips or blood on your toothbrush.  Blood blisters inside the mouth. 
• Sudden bloodshot eyes or whites of the eyes become bloody

• Black tarry stool
• Severe headaches which may also come with sudden vomiting
• Visible red/purple rash-like spots on any part of your body (petechiae)
• Bruising on any part of your body
• Pain in your stomach, joints and muscles
• Shortness of breath, difficulty breathing
• Dizziness, severe headache, vision changes and/or changes in your mental status

Avoid Bleeding and Bruising

• Keep all of your appointments to see your doctor and lab work checked.
• Ask when your platelet count is likely to drop.  
• Come in for a platelet transfusion if your doctor feels this is needed.
• Ask if you need to stop taking any medications that may increase your risk for bleeding.

• Keep your skin clean and dry.
• Use a moisturizing lotion on your skin and hands regularly.
• Protect your skin from cuts, scrapes and sharp objects. Use an electric razor.
• Carefully trim and cut nails.  Keep nails fairly short.
• Use lubrication during sex.  You may need to avoid sex when platelets are low to prevent bleeding

Mouth Care

• Use only a soft-bristled toothbrush.
• Use dental floss only to remove plaque or debris between teeth.  Do not go under the gum line with the dental floss.
• Do not use a dental pick.  Do not use a toothpick.
• Use alcohol-free mouthwash.

• Avoid constipation.
  • Use a stool softener and laxative as directed.
  • Drink 6-8 cups of fluid per day.
  • Get in some light exercise every day.
• Avoid straining when having a stool.
• Do NOT use suppositories or enemas.
• Do not take rectal temperatures.

• Keep your home free from clutter.
• Adjust your bead at the lowest level.
• Ask for help walking if you are weak or feel dizzy.
• Wear non-skid shoes and slippers.
• Use a night light.
• Use the stair rail when on the stairs.
• Avoid physical activity that could lead to an injury, including contact sports.

Managing Bleeding

• Apply direct pressure where you are bleeding for at least 10 minutes.
• Apply an ice pack for 10-15 minutes to stop bleeding.
• Raise your arms or legs above your heart if bleeding from a limb.
• If you are bleeding from your nose:
• Gently pack the bleeding side of your nose with gauze or tissue.
• Leave the packing in place until bleeding stops.
• If you are having abnormal vaginal bleeding, note the number of pads you are using and how often you need to change.
• Note how long the bleeding is lasting.
• Prepare to call your nurse or doctor.

When To Call

• If you develop a severe headache that causes dizziness, vomiting and/or you become confused or lose consciousness -  Call 911
• If you develop obvious or less obvious signs of bleeding (see the top section of this sheet).
• If you are unable to stop bleeding.
• If you have unusually heavy menstrual flow, it is lasting longer than normal.
• If you fall and hit your head.