A Story About Platelets

Aaron's platelet count broke 300 this week.

For reference, normal platelet count can span anywhere from 150 to 400. So he's well within the normal range, and at this point, it's quite possible he has more platelets than I do!

Before this summer, platelets were one of those things I never devoted a single thought to. If one of my kids got a cut or scraped his knee, a kiss and a bandaid was all he needed. His body took care of the rest.

But after Aaron's diagnosis, it seemed like platelets were the only thing I could think about. Instead of being in the hundreds, Aaron's were in the single digits. That's the point where doctors start to worry about spontaneously bleeding.

So of course Aaron started getting regular platelet transfusions. That would usually bump his count up to the 50's or 60's. The goal was for the transfusion to last a week, and the clinic always optimistically scheduled him for seven days out.

However, even when he got an especially rich bag of platelets, that didn't change their life span, which is only about six days. Consequently, every Sunday all of the tell tale signs of low platelets emerged: bruises, petechiae, and bleeding gums. It couldn't have been any clearer if he had been wearing a platelet meter, and it was unnerving to watch it happen week after week.

There is one weekend that stands out in my memory more than any of the others. We were at a family reunion in Hobble Creek Canyon with all of Mike's siblings and his parents. We stayed in a sprawling cabin where the 30+ grandchildren ran around to their heart's content.

At that point, we knew that Maxwell was a bone marrow match for Aaron and his transplant day was scheduled. This reunion felt like a last hurrah for him. He seemed to sense it because I watched him play with more exuberance and enthusiasm than I'd seen from him in weeks. I kept thinking he would crash, but he was blessed to draw from some untapped pool of energy I didn't know he still had. He was so happy. I felt a little apprehensive, but I just couldn't bring myself to reign in any of the fun.

On the final night, Aaron was playing murder in the dark with cousins. He took an unfortunate bump in the mouth, and his gums started bleeding immediately. In normal circumstances, a person's platelets rush to the scene and clot the blood. But Aaron didn't have enough platelets to rush anywhere or do anything. Mike and I both knew his gums probably weren't going to stop bleeding until he got more platelets.

We pulled him from the game and watched him over the next hour. As suspected, his gums continued to slowly leak. There was nothing alarming about the flow--just that we knew it wasn't going to stop.
We figured the best thing he could do was go to bed and we would take him to the hospital in the morning.

(I should probably insert here that we had no cell phone reception, and the landline at the cabin only worked for Utah County. We considered driving down the canyon so we could call the hospital, but we already knew from past experience what they would say: "Is his nose bleeding? Did he get a head injury? Then you're fine to wait.")

So that's what we did. But as I said good night to Aaron, he confessed that he was worried he was going to start bleeding more in the middle of the night. It was the first time I'd heard him admit to being worried about anything, and that kind of freaked me out. Mike and I decided we would set alarms to check on him at midnight, 2:00, and 4:00 just to make sure it wasn't getting any worse.

When I got up at 4:00, I used my flashlight to look at Aaron. He was sleeping quite peacefully, but his lips were encrusted in blood, and there were splotches of it all over his pillow and sheets. I woke up Mike, and we decided he should take Aaron to the hospital.

But an hour later, they were back. Once Mike was out of the canyon, he had called the hospital to ask if he could bring in Aaron. They said that even though he had been steadily bleeding for seven hours, as long as it wasn't a nosebleed, he should wait to come until later in the day.

So Aaron got to finish out the reunion, but all of his earlier energy had been snuffed out. He provided entertainment for his little cousins who were both scared and fascinated by his bloody mouth, but that was about it. We packed up and left as quickly as possible. On the drive home, he felt sick to his stomach from swallowing so much blood. He threw up, and it looked like he was holding a bag of blood.

Although this is the most extreme example (and sorry to those of you who are now feeling nauseous yourself!), this was Aaron's reality. His body didn't make platelets. He was alive because of transfusions.

I've thought about those scary weeks many times over the past few weeks as we've watched the steady climb of Aaron's platelets. It has been thrilling. When they crossed over 300 this week, it felt like we could resume our earlier habit of never giving them a passing thought.

Except, maybe not.

With platelets flowing in his blood again, Aaron has picked back up many of his favorite activities, including riding around on his ripstick. Earlier this week, one of the wheels hit a crack in the driveway, and Aaron flew off, skidding up his arm.

With wonder, we watched it form a scab. A big old beautiful scab. Even the younger boys commented on it.

We might not ever be able to stop marveling at a healthy, working body.