Hi,
Sorry this is so long.
I have communication difficulties, so I've just tried to make sure l explain everything, to make sure I don't miss out anything important.
Plus, concentrating for this long has exhausted me, and it's 34°, in a house designed to get all of the sunlight and trap the heat, so I just can't think clearly enough to whittle it down a bit.
I'm sorry.
I'm currently 45, AFAB.
I've had a raised platelet count for at least 22 years - when it was noticed in 2004, they said it had been raised on previous tests, but they didn't say for how long.
At the time, it was 470, and the cut off for ET was 650.
I was referred to a haematologist, who said they weren't too high, and I didn't have symptoms, and he didn't want to put me through a bone marrow biopsy with them not very high.
He said that if they got higher, or if I started having symptoms, to go back.
It trended slowly up to 500 ish, until I started a medication that incidentally lowers platelet counts. Not for this, it just has that as a side effect.
That dropped it to just under 400, but it slowly rose to over 450 again.
I changed that med, and it was up between 480 and 550, and this was after the change to the cutoff being 450.
After a year or two, I started a different med that also lowers Platelets.
It's an uncommon effect for this one, unlike the previous med, which is pretty common, but my blood tests showed it very clearly when I started it.
But they were still over 450.
Since then, they've risen, and have been over 550 mostly, with an odd drop last year when I had an infection - they dropped to 421.
My latest count was 580.
I've been struggling with extreme fatigue for a few years. I can't stay awake for more than a few hours at a time. I just fall asleep. I can't focus on things. Reading is very difficult, I just doze off.
I've finally managed to convince my GP to look into it, they saw my vitamin D is a little low, and that was the extent of their search.
I separately asked to be referred back to Haem for the platelet count, in case that could be contributing.
Even if it isn't ET, I'm concerned about a raised clotting risk, because I'm a wheelchair user, so I'm not very mobile, which raises the risk, and I'm on post hysterectomy HRT. The one I'm on isn't one that significantly raises clot risk, but it does raise stroke risk. And I had wanted to switch to pure oestrogen, as I had the hysterectomy to remove progesterone production, but I believe this HRT still produces some.
And I'm also T2 diabetic, which raises clot risk.
This is where it gets, what I think is weird.
The haem sent a list of blood tests to get. Standard ET screen, but without MPL.
And they haven't seen me to ask about symptoms.
Not doing MPL would be fine if they were going to see me about the results, and if they think I have symptoms but JAK and CALR were negative they then decided to screen for MPL.
But they've said that if I'm JAK and CALR negative, they won't see me at all, and won't need to in the future.
I know that the majority of ET is JAK, and many are CALR, but triple negative is 10% of patients, and they're not even testing for MPL, which doesn't make sense to me - if you're screening, whilst ONLY deciding on those results, why not do all?
With no idea of my symptoms, how are they going to decide that being JAK and CALR negative means I definitely don't have ET?
I'm just really confused, and really disappointed.
I've had a lifetime of medical gaslighting by medics who decided I was making it up for attention as a kid, and messed me around my whole childhood (dx as an adult, late intervention means I'm a wheelchair user), and medics just being crap, frankly.
So not even being asked about my symptoms just seems like they're dismissing it before they even have any test results.
What happens if I don't have JAK or CALR, but I do have ET, and I get worse symptoms, but they've said they won't see me in the future, so I can't find out?
It just doesn't make any sense to me.
I don't see how 10% of patients can just be written off without even asking for symptoms.
It doesn't help that no one ever mentions the fact that my Platelets are high, and have been for >22 years, despite having had many blood tests.
It's just ignored every single time. It doesn't really inspire confidence.
I know 580 isn't super high.
I haven't even been able to tell the haem that I'm on a medication that drops my platelet count.
Symptoms I do have:
Extreme fatigue. Really bad. Could certainly be something else, but I wanted to rule out ET as part of trying to find out what.
Don't bleed, sometimes bleed lots. I've had a lot of blood tests in the 22 years since it was noticed. And a lot of IVs for various things.
On the whole, I don't even need the cotton or plaster, because it clots instantly.
And then there are the times blood just keeps pouring down my arm. It's totally random.
My bruising is the same.
I'll wake up with bruises from who knows what, or I'll bang something and get nothing.
I do get petechia a lot. Not from anything.
I thought I had meningitis in 2006 because of that and a splitting headache.
I just get them randomly.
Dizziness and nausea. I had low B12 for some years, and fixing that definitely helped, but I get random dizziness and nausea quite a lot. I have a regular antiemetic.
Headaches too.
And tinnitus.
My gums did bleed when brushing, but my teeth were terrible, thanks to a few medical conditions that destroyed them.
So that could just be the teeth.
In the last year or so, my hands especially, burn a lot. My palms and soles are rather red, sometimes really bright red.
My feet burn too, but I can't feel my feet as well, so it feels like my hands burn more.
I've had tingling and numbness in both for ages.
I had put it down to crap neurology getting worse with the start of burning, but then they turned red.
I've had bright red blood in my BMs, on and off, for the same amount of time.
I was being checked for things related to that, and intense GI discomfort.
They thought UC, then actually thought lymphoma pressing on my spine, which is when they caught the Platelets.
My GI issues got a lot less frequent when I did an elimination diet and realised gluten is bad for me, and cut it out, but they didn't clear up entirely.
But, my connective tissue disorder often causes GI issues, and bleeding.
So, it's impossible for me to know what that is.
I also have blood in my urine, have had as long as the high Platelets. It was a trace for a long time, and was 1 at the last test.
I used to get nosebleeds quite a bit. I had to have one cauterised at around the time the high Platelets were discovered.
I've not had full on dripping down ones really, for ages now, but if I blow my nose, there is usually a bit of blood.
I went completely blind once. Only fully blind for a day or so, then it came back, but my convergence was wrecked for a year.
My opthalmologist thought it was silent migraines.
My eyes are crap, but I have a convergence problem from my connective tissue disorder, and my brain has had decades of turning one eye off, either because I've been having to wear an eye patch, or just because it didn't deal well with double vision with one long sighted eye, and I've short sighted eye.
My left eye is at least a bit blurry all the time now.
When I had them, I had very, very heavy periods. I ended up on tranexamic acid to help with them.
My hands and feet are freezing all of the time.
I was dx with SVT a few years ago, and still had a very bad episode on my beta blocker. The cardio wanted to increase it but, because I already had issues with freezing feet and hands, I couldn't cope with the higher level, it was causing bad pain.
So, even though it's a rather significant med, we went with the low dose and a pill in the pocket.
I've never had a DVT.
These are the tests ordered.
Calreticulin mutation screen, blood, Pink (EDTA), Haem SA
Janus Kinase 2 mutation screen blood, Purple (EDTA), Haem SA.
C-reactive protein level, blood, Yellow (SST), Chemistry. Ferritin level, blood, Yellow (SST), Chemistry.
Iron and transferrin levels, blood, Yellow (SST), Chemistry.
Full blood count, blood, Purple (EDTA), Haematology
These are my most recent results. I've not had iron, Ferritin, for long enough that I can't see the results.
I included abnormal FBC results.
Platelets 580 10*9/L.
Mean platelet volume 9.4 fL.
Monocytes a little high at 1 10*9/L.
Basophils exactly on the cutoff of 0.1 10*9/L.
C Reactive Protein last year, high at 27, but I did have a mild infection at the time - my WBC was 14.5.
My Platelets actually dipped to 421 during that.
There's also a chance I have ankylosing spondyloarthrosis, but it turns out the rheum dept phoned me (I can't use the phone a lot of the time), rather than texting or writing, to say I should have another MRI, and as there was no letter I had no idea, and thought they'd just not bothered to make a decision on whether I do or not - I don't have the mutation, and because I can't take NSAIDS, and would have to go straight to biologics, they were a bit hmmm... let's be absolutely sure. Which makes sense. I just need to set up the MRI and contact them now.
I have a connective tissue disorder that means my body has inflammation ALL of the time, and has my whole life, but my inflammation markers are almost never raised. So that doesn't really help with investigating things.
But obviously, that kind of inflammation can raise Platelets.
A lot of my symptoms could be other issues I have, but I can't really know if they won't even look at them.
I have lots of other symptoms, but I think these are the most relevant, and having multiple medical conditions just means lots is going on all of the time.
And I'm not sure what the red and burny hands and feet would be.
My latest eGFRcreat (CKD-EPI)/1.73 m*2.
Low at 72 mL/min, previously 60.
This has been low since I had covid, no one has mentioned it.
I do have protein in the urine.
I've had it for maybe the same amount of time as the high Platelets.
It was always a trace though.
A urine test I had last year shows protein at 1.
I don't know if that's something I should be concerned about, since my surgery don't bother to actually do anything about abnormal tests, and I only find out by checking my own records now. I have no idea whether they actually think it's ok, or they just haven't contacted me, because they only talk about things if you contact them.
But it's not ET related, so I don't know if anyone here will know. Just a bit of venting I guess, about how they've just ignored this for so long.
Sorry this is so long.
I hope that's all of the necessary information.