Newsflash! My immune system is not a team player. Despite being too weakened to fight off any actual threat to my health, it is perfectly able to attack any infused platelets vigorously. Last night, my platelets were 8 and I had a fever so they attempted to give me an infusion and about half way into it, I began shaking all over and feeling short of breath. If I really concentrated, I could make the shaking less or maybe even make one limb stop, but then if I moved anything voluntarily, it would start up again. Because I could partially control it, I thought perhaps it was psychiatric and was really a panic attack. Or maybe it was a conversion reaction. Maybe I was just plain crazy. All of these really horrible, mean thoughts that I would never think about any of my patients. At any rate, they got it under control with benadryl and demerol, stopped the platelets and I woke several hours later in exactly the same position I had gone to sleep in--I am what you might call a lightweight. They sent off "transfusion reaction" labs and initially they were read as normal--not a transfusion reaction.
A few hours later, my platelets were 2 so they gave me another transfusion. This time, they pre-medicated me with benadryl and I got through the transfusion, but then had a similar episode of rigors, complete with desaturation into the 80's, pulse in the 130's and SBP 40 points higher than usual. Loves me some demerol; it works in maybe 2 or 3 minutes for rigors.
The docs came in and said that it was a transfusion reaction both times and that both times my platelets got no improvement at all from the infusion. The first plan was to collect more of my blood and try it out with all the units of platelets they had and see if they had any that might work. It turns out that there are 14 units of platelets in the hospital and my blood does not seem to have anti-bodies to 5 of them. They've set those aside for me. I'm getting one of them in a few minutes, having just taken my benadryl and tylenol. They do have a plan C and a plan D if needed and they tell me that they have seen people with 0 platelets for 3 weeks do just fine (that's plan D). In the meantime, I am developing lots of purple spots. Fortunately, not my face and only a few on my hands.
Also, because rigors and one whole body bruise aren't enough indignities for one day, my hair has chosen today to start falling out.
more to follow.