What should I expect from an appointment re: high platelet count?
April 2, 2016 8:13 AM   Subscribe

YANMD. One of those workplace blood screen things came back with a high platelet count, which apparently has many terrifying possible causes. I am going to my GP to ask about it on Monday, but given my many negative experiences with doctors ever believing anything, I'd like to know what I should expect from her. If you've had this, it would be super helpful to know what response you got.

The blood screen also looked for vitamin deficiencies, anemia, etc., and I don't have those things. Just the weirdly high platelet count.

The internet claims that 35%-40% of people with a high platelet count (over 500) have cancer. That's kind of terrifying! I would like to find out if I'm one of those people, but past experience (with other doctors) leads me to believe that instead, the doctor will say I'm fine, and then I will get gradually worse over the course of weeks or months until eventually I end up hospitalized.

I'm assuming the doctor will order another CBC. Assuming that comes back with similar results, what is the next step? Are there particular tests I should push for? Magic words to make doctors take you seriously?

I am working hard at not having a freak-out; any advice or experience would be helpful. Thank you!
posted by goodbyewaffles to Health & Fitness (6 answers total)
Get one opinion, then if you do not like what you hear, get a second opinion. This may be something that has many causes that are not cancer. You need to find a doctor you can trust, having a global mistrust of all doctors is not really going to help you get decent health care. Stop scaring yourself and self-diagnosing via internet. If your health insurance plan has a nurse hotline, you might call that and ask what tests might be ordered to see what is causing your high platelet count. If the doctor you are currently seeing routinely dismisses your concerns and you have ended up hospitalized because of misdiagnoses and not taking you seriously, you need another doctor. If you believe all doctors operate this way, you are the one with the problem.
posted by mermayd at 8:24 AM on April 2, 2016

I think it would be helpful to you to tell the doctor up front that you have some medical anxiety and a past history of doctors who blew you off. You can put that at the top of the list of written questions you bring with you to the appointment. You can also bring a friend or family member, if you have someone who's good at dealing with authority figures who can back you up. I think that would be the best way of making sure you get all your questions answered, and it doesn't hurt to have a witness to put a doctor on their best behavior.

A single high platelet count doesn't necessarily mean much, especially if you're a woman, especially if you were having White Coat Syndrome at the time the original blood test was done. It's definitely a reason to get you in for a second look, but don't jump straight to cancer just yet.
posted by Lyn Never at 8:47 AM on April 2, 2016 [4 favorites]

In a study of 10,000 adults (men and women), 99 of them tested initially as having a high platelet count; on follow up, only eight of those 99 still had elevated platelets. Therefore, while I understand your instinct to plan for the eventuality that "assuming that comes back with similar results," I would start by assuring you that that assumption is an unlikely one.

The next step is a complete history and physical exam, because there are many things that can cause thrombocytosis. Most of them are benign. While malignancy can certainly cause elevated platelets, the stat you found on the internet sounds insanely high to me.
posted by telegraph at 8:50 AM on April 2, 2016 [5 favorites]

I had this happen to me. I was a large donor of platelets. Then my hematocrit went down, well under the 40 you need to donate, 32 IIRC.

I went to a hematologist-oncologist (freaked me out, but that's their specialty). Tested me for EVERYTHING! I had anemia caused by a vitamin deficiency.

Told me to eat more red meat.

I'm anemic and it's worse if I eat gluten. Weird, but each person is weird.

Speak to your doctor, run the tests and be prepared to be an outlier who produces a lot of platelets. Donate them, people need them.

Don't read any more on the Internet. It freaks you out.
posted by Ruthless Bunny at 12:00 PM on April 2, 2016

I don't know about platelets in particular, but many tests used for screening are cheap but not trustworthy. A re-test may use a more expensive, but more accurate test.
posted by SemiSalt at 12:29 PM on April 2, 2016

IANYD. I have a high platelet count, and checked with my mom - it turns out, her labs always come back as showing a high platelet count and now the doctors just think she's one of those people with more platelets. I relayed the family history of a high platelet count to my doctor and this factored into his assessment of my labs.

Anecdotal but thought I'd let you know. I know it's hard, but don't freak out, not yet - it's not going to help.
posted by joseph conrad is fully awesome at 2:03 PM on April 2, 2016

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