Cancer medical care 

Caring for side effects of chemotherapy

Insufficient platelets | Decreased platelets | Low platelets | Thrombocytopenia | Bleeding 

1. Causes of low platelets during cancer treatment | Causes of bleeding

2. Symptoms of low platelets | Symptoms of bleeding

3. Problems that may be caused by low platelets? | Problems that may be caused by bleeding?

4. Treatment of low platelets | treatment of bleeding

5. What should I do when the platelets are too low? | What should I do when bleeding?

6. Hygiene when platelets are too low | Hygiene when bleeding

7. Dietary precautions when platelets are too low | Dietary precautions when bleeding

8. Exercise moderately and regularly when platelets are too low | Exercise moderately and regularly when bleeding

1. Causes of low platelets during cancer treatment | Causes of bleeding

After the patient received chemotherapy, radiotherapy or surgical resection, the internal organs were severely damaged; the hematopoietic system mainly includes the liver, spleen, kidney, thymus, lymph nodes, bone marrow and other organs, all of which suffered varying degrees of injury and impact, and high levels of injury and impact. Inhibition of cell growth and metabolism in normal body.

Since bone marrow is the main hematopoietic tissue, almost all injuries and effects are caused after chemotherapy and radiotherapy. Causes "bone marrow suppression", causing side effects such as blood cell reduction.

The degree and time of blood cell decline vary greatly depending on the type of chemotherapeutic drugs, drug dosage, bone marrow function of the patient, and the sensitivity of the patient's hematopoietic cells to the drug.

Usually it will reach a minimum within 7-14 days after the end of treatment, and then slowly rise again. The risk of fever and infection most often occurs between the 10th and 14th days.

2. Symptoms of low platelets | Symptoms of bleeding

•Bleeding from anywhere; for example: mouth, nose or rectum

• Bleeding in the mucous membranes, such as: cornea, oral cavity, nasal mucosa, anus

• Bleeding from nostrils and gums

• Bloodshot eyes when blowing nose

• Bloody or dark brown spit or vomit

•Bright red, dark red or black stool

• Red, pink or brown urine

• Women may have a lot of vaginal bleeding every month

• Subcutaneous petechiae, petechiae

• Intravenous ecchymosis

• New unexplained bruises on the skin

• The precise red spots on the skin, usually starting from the feet and legs

• Headache, dizziness or blurred vision

• The ecchymosis becomes worse and enlarged

• Joint or muscle pain

• Hemorrhagic stroke

Low platelets and bleeding range from mild to life-threatening. It depends on your platelet count below 150,000/L and your symptoms.

If you have any of these symptoms, please tell your doctor or nurse.

Let your health care team know if you have other medical problems; such as heart or other diseases, as this may make blood platelets too low and bleeding symptoms worse.

Pay attention to the symptoms of low platelets and bleeding throughout the treatment. If you have any of the symptoms described here, please inform your healthcare team.

Be sure to mention how the symptoms affect your daily life. This will help you get the necessary treatment.

3. Problems that may be caused by low platelets | Problems that may be caused by bleeding

• The first thing a doctor needs to know is how low your platelets are and how severe your bleeding is.

• Low platelets and bleeding will affect your quality of life; low platelets and bleeding have been found to shorten the survival period of cancer patients. May be enough to threaten your life.

• Low platelets can cause internal bleeding and make the situation worse.

• Severe low platelets and bleeding may mean that you must delay cancer treatment or reduce the treatment dose. It may also cause certain cancer treatments to not work properly.

• If you have headache, vomiting, shortness of breath, bleeding, etc., it is recommended to return to the doctor and seek medical treatment.

4. Treatment of low platelets | treatment of bleeding

There are two main goals in the treatment of low platelets (bleeding):

• Causes of low platelets | Causes of bleeding

•Depends on the number of platelets in the patient and the presence or absence of bleeding symptoms

The most common treatments for low platelet (bleeding) in cancer patients include:

• Blood transfusion (injection of platelets)

• Steroids, which reduce the destruction of platelets by suppressing the immune system

•Other methods

The doctor will treat you based on your test results, symptoms, time of symptoms, cancer type, cancer treatment, and other factors. Discuss with your healthcare team the treatment that is right for you. As with any medical problem, the expected benefits of treatment should always outweigh the possible risks.

Risk of blood transfusion

• Blood transfusion reaction: The patient's immune system attacks foreign blood cells. This usually looks like an allergic reaction. Most of these reactions are mild and treatable, but sometimes they can be more severe.

• Lung injury related to blood transfusion: This is one of the more serious risks. It can cause breathing difficulties and requires treatment in the hospital.

• Exposure to certain bacteria, such as hepatitis B or C viruses.

• Risks associated with blood transfusion (TACO): This can happen if the blood supply is too fast for the heart to process.

Other treatments for low platelets (bleeding)

Splenectomy, immunoglobulin injection, Rituximab (anti-CD20 target drug), romiplostim and eltrombopag (thrombopoietin analogs).

In the research report of Japan and Italy, it was found that purpura of immune thrombocytopenia is related to Helicobacter pylori infection. After about half of the patients receive Helicobacter pylori eradication treatment, the number of platelets will rise. At present, the mechanism of this phenomenon is not very clear. However, compared with other treatments, the patient's risk and medical expenses are relatively low.

Discuss with your doctor the causes of low platelets and bleeding, appropriate treatments, and the risks of treatment.

5. What should I do when the platelets are too low? | What should I do when bleeding?

Prevention of internal hemorrhage [cranial (brain), respiratory tract, gastrointestinal tract]

•Avoid blowing your nose hard and increasing brain pressure to avoid bleeding due to rupture of blood vessels.

•Avoid coughing hard and increasing brain pressure to avoid bleeding caused by rupture of blood vessels.

• Avoid forceful defecation and increased cerebral pressure to avoid blood vessel rupture and bleeding.

• Prevent falls and hit the head

• If you have headache, lethargy, vomiting, or confusion, please seek medical attention immediately.

• Avoid taking rectal temperature, enema, or using anal suppositories.

• Prevent constipation, drink plenty of water, and use stool softeners prescribed by a doctor.

• Observe whether there is blood in the stool or black stool every day

Prevent mucosal bleeding

• Avoid flossing your teeth until the number of platelets increases.

•Avoid picking the nostril with fingers, damage the mucosa and bleeding

•Avoid digging ears and bleeding from blood vessels

• When nose bleeding occurs, you should sit up immediately; apply pressure to the nostril area under the bridge of the nose. If continuous pressure for more than 10 minutes is ineffective or there is a lot of bleeding, please return to the doctor immediately.

• Use a soft toothbrush.

• Protect and maintain the integrity of the skin and oral mucosa.

Prevent skin bleeding

• Only use an electric shaver for shaving. Instead of the blade for shaving.

• Avoid contact, intense sports, such as: wrestling, boxing, rugby. And any other activities that may cause injury or fall.

• Protect the skin from cuts, abrasions, and sharp objects.

• If your mouth bleeds, rinse it with ice water several times.

• Do not squeeze or scratch pimples and pimples.

• Use skin care lotions to protect dry skin.

Prevent falls

• Anti-slip mats and handrails in the bathroom

• Try to wear anti-slip shoes

• Appropriate lighting should be maintained indoors at night to avoid falls.

•Remove dangerous objects indoors and outdoors, such as sharp table corners, fragile glass pieces, etc.

• Avoid wearing tights.

• Do not take anti-inflammatory and painkillers by yourself, such as aspirin, which may make bleeding worse.

• Observe whether there is bleeding tendency, gastrointestinal bleeding, hematuria, bloody stools, etc.

other

• Women should pay attention to menstrual flow.

• If necessary, follow the doctor's instructions for blood transfusion.

•Return to the clinic on time to draw blood for tracking, so as to keep abreast of the situation.

• Keep your head level with or higher than the heart. Lie flat or stand upright.

• If bleeding starts, stay calm. Sit down or lie down to get help.

• If you have abnormal bleeding or any form of bleeding that has not stopped, seek medical attention immediately.

•Reduce excessive social activities and avoid aggravating physical burden.

Please seek medical treatment as soon as possible

• Bleeding does not stop

• Extensive bruises and enlarged areas.

• If you have a fever over 38 degrees Celsius, chills or tremors, you need to consult a doctor for evaluation. Do not take any anti-fever medicines.

• If you have headache or vomiting, notify the medical staff immediately.

• Redness, swelling and pain at the injection site.

• Severe stomatitis or ulcers

• Hematuria or bloody stools.

Drug contraindications; may make bleeding more serious, please seek medical treatment

• Prohibition of platelet inhibitors

•Prohibition of anticoagulant drugs

•Prohibition of Aspirin and Voltaren anti-fever drugs.

6. Hygiene for low platelets | Hygiene when bleeding

• Pay attention to the cleanliness and hygiene of the integrity of the oral cavity, skin, and anal mucosa.

•Do not pick your nose with your hands to avoid damage to the nasal mucosa.

•Should use a soft toothbrush to brush your teeth

• Keep bowel movements smooth

• Avoid bleeding in the nasal cavity, gums, and anus, which will affect the changes in the condition.

7. Precautions for diet when platelets are too low:

  • Avoid fish oil ; after ingesting fish oil EPA, EPA will replace the AA on the platelet cell membrane, thereby inhibiting platelet aggregation and reducing the formation of thrombus.

  • Avoid attributes: hot, dry food. Hot foods will make the bleeding of platelet patients more serious; therefore, it is not advisable to eat more, such as lamb, leeks, and lychees.

  • Avoid spicy food. Spicy food is easy to exacerbate bleeding, and it is not suitable for excessive consumption.

  • Avoid hard surfaces of food.

  • Avoid burning, roasting, and fried food. The skin of grilled and fried food is hard and it is easy to rub the mucous membrane of the digestive tract and cause bleeding. It is not easy to digest, which hinders the normal work of the spleen and stomach, and easily leads to intestinal digestive disorders.

  • Avoid binge drinking, overeating, and alcohol abuse. Overdrinking and overeating aggravate the burden on the digestive tract; and make a large amount of food accumulate in the gastrointestinal tract and easily cause internal organ bleeding. At the same time, alcohol should never be drunk.

  • Avoid excessive fat. Excessive fat intake will inhibit the human hematopoietic function; and cause the patient's digestion and absorption malabsorption.

  • Eat less leeks, which contain sulfides, which can inhibit platelet clotting.

  • Suitable for high-protein, high-vitamin, easy-to-digest soft food, liquid, semi-liquid diet.

  • It is advisable to eat foods with the effects of nourishing blood, stopping bleeding, cooling blood, and clearing away heat; such as peanuts, red dates, longans, walnut kernels, lentils, lotus roots, and radishes.

  • Eat a balanced diet. Enough calories and protein can provide energy and restore normal cells that have been injured.

  • Do not eat uncooked food. Such as: lettuce salad, sashimi, etc.

  •Avoid drinking commercially available beverages containing ice-cold, hand-cranked ice-cold beverages.

  • If there are no special restrictions, you should drink plenty of water every day, at least more than 2000C.C. per day.

  • Eat cooked foods and take in more vitamins and phytochemicals.

  •Comprehensive brewing of cereal powder, easy to digest, easy to absorb, and less burden

  •Juice (non-chemical blended juice)

  • Adverse reactions of bone marrow suppression after radiotherapy and chemotherapy. Red blood cells is too low , low white blood cells, platelets insufficient; in Chinese medicine is qi, kidney deficiency, liver and kidney ... and other syndromes; commonly used qi and blood, spleen and stomach to the blood first.

   • For those with reduced blood cells, the first step is to strengthen the spleen and stomach. Astragalus, longan, wolfberry, ginseng, codonopsis, red dates,... and other medicines can be used; Astragalus, wolfberry and red date drink.

   • For those with thrombocytopenia, jujube, cohosh, Ligustrum lucidum, longan meat, peanut coat... and other drugs can be used.

(1) Blood-enriching five-treasure porridge
Ingredients:15g red dates (cored), 15g longan meat, 12g medlar, 30g peanut coat, red brown rice and white rice. Appropriate
 

 function:

 Peanut coat : can stop bleeding, dispel blood stasis, reduce swelling, and be used for various bleeding symptoms and thrombocytopenia.

 Jujube : nourish blood and soothe the nerves.

 Longan Meat : Tonic the heart and spleen, replenishing qi and blood.

 Lycium barbarum : nourishing liver and kidney.

 Red brown rice : rich in vitamin B and fiber.

 Combining the above ingredients can achieve the effects of nourishing the liver and kidney, nourishing the heart and spleen, and nourishing qi and blood.

 practice:

 1.  Wash the above materials first

 2. Boil the peanut coats with 8 bowls of water + low heat for 1 hour, remove the residue and take the juice for later use.

 3. At the same time, soak the red brown rice with water for 1 hour to soften the red brown rice.

 4. Then add appropriate amount of red brown rice, white rice, red dates, longan meat, medlar, and then use peanut juice to cook the rice into porridge.

 5. The ratio of red brown rice to white rice should be adjusted according to personal taste and gastrointestinal digestibility; for those who like soft, cooked taste and poor gastrointestinal function, more white rice should be added and red brown rice reduced.

(2) 30 grams of Caulis spatholobi, 15 grams of Astragalus, 10 jujubes, boil water.

(3) 50 grams of jujube, 50 grams of peanuts, a little bit of organic corn, add a small amount of brown sugar, boiled water; after cooking, discard the corn to drink soup; patients with high blood sugar do not add sugar.

(4) Burdock 1/5 root, 4-5 large red dates, about 15 grams of peanuts, about 15 grams of sweet almonds, 1 carrot, and cook the soup.

8. Please exercise moderately and regularly when platelets are too low

Exercise can promote bone marrow blood flow and maintain normal hematopoietic function.

The bone marrow in the bones is the main hematopoietic tool of the human body, which contains a large amount of red bone marrow that can produce many hematopoietic stem cells, and provide sufficient blood supply for the human body. If there is not enough blood supply, the bones will not get adequate nutrition, and a series of diseases will appear.

Quantitative and moderate exercise, especially aerobic exercise, such as slow walking, jogging, yoga, slow breathing; inhale evenly and slowly, hold your breath, and exhale slowly; 20 seconds from the beginning, slowly Increase to 1 minute or longer; it can increase the activity of hematopoietic stem cells and achieve the purpose of enhancing bone marrow hematopoietic function; at the same time, it can also strengthen the strength of bones and make bones stronger and healthier.

If you have religious beliefs, you can chant silently; pray, confess

Christianity, Catholicism: Hallelujah, Hallelu Yah

Islam: Allahu akbar

Buddhism: Amitabha

No religious belief : I'm sorry, I love you, please forgive me, thank you

There are two main reasons leading to the decline of bone marrow hematopoietic function:

The first is the lack of exercise, which weakens the hematopoietic function of cells. Without moderate and regular exercise, it is useless to eat more nutrients; if a factory imports a lot of materials and does not have normal production operations, it will not be able to produce good products. It just hoards and consumes a lot of materials. Exercise produces blood circulation and effectively produces red blood cells, white blood cells and platelets.

The second is malnutrition and lack of hematopoietic materials. Including protein, iron, vitamin C, vitamin B complex, folic acid, amino acids, trace elements, vitamins and other nutrients. Need to develop good eating habits.

Protein is not big fish or big meat; after chemotherapy, certain parts of the gastrointestinal tract are damaged. Therefore, the work and burden of the gastrointestinal tract are reduced, and foods that are easy to digest and easy to absorb are mainly used. Such as: soy milk, tofu, plant milk, comprehensive brewed cereal flour, ... and so on.

Exercise at least 30 minutes each time, at least 3 to 5 days a week. Strenuous exercise, staying up late and overwork should be avoided. There should be adequate rest to avoid the consumption of a lot of physical strength and nutrients. If the platelets are too low and the bleeding is too severe, it is not suitable for exercise.

When changing posture, such as getting up from a chair or getting up. The action must be slowed down. You can sit on the edge of the bed for 5-10 minutes, preferably accompanied by someone. Avoid falls due to dizziness and fainting.

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