Spleen-o-rama

Had my annual visit with Dr. Blood yesterday, and she ordered another spleen ultrasound. I had one when I was first diagnosed with ET two years ago, but since my platelets are moving from the 600s to the 700s, she wants to check it again. If it's OK, I'll continue on wait-and-watch with aspirin only. If it's enlarged, I will join Club Hydrea.

So this seems like a good time to talk about spleens!

UPDATE 3 (December 2, 2017): Spleen ultrasound was normal, so back to wait-and-watch mode for another year unless platelets spike. But here's a fun math problem! Below are the dimensions of my spleen in 2015 and the latest dimensions. Figure the number of cubic centimeters to determine any size change. Show your work!

2015 spleen: 9.7 centimeters by 5.2 centimeters by 10.2 centimeters
2017 spleen: 10 centimeters by 4.4 centimeters by 9.8 centimeters

UPDATE 2 (November 29, 2017): Had my spleen ultrasound this morning, so hope to know the verdict about whether it's time to start the hydroxyurea by Friday.

UPDATE 1: Here's Dr. Oh explaining the spleen issue for you.

Your spleen is an organ on the left side of your abdomen. It's about the size of your fist. It's part of your lymph system, so it's important in fighting infection. But it also filters worn out red blood cells. If you have two or three times the normal number of red blood cells like most of us ET patients,  the spleen has to filter out a lot more cells, and it gets bigger.

About 30 percent of us with ET have some spleen enlargement.

You can think of the spleen like a sweeper bag that gets fatter more quickly if it has extra dust to sweep up. (That's kind of over simplification, but you get the idea.) Is it going to explode? Probably not. But an enlarged spleen might be more easily ruptured by a trauma, like a car accident.

An enlarged spleen isn't usually painful. If you feel anything at all, it might be abdominal pressure. If your spleen gets very large, it takes up space from your stomach and makes you feel full or lose your appetite. My dad had COPD and ET, and he complained of stomach pressure, and spleen enlargement made breathing more difficult.

Controlling spleen size makes your innards more comfortable and keeps your spleen healthier. In order to reduce or stabilize spleen size, doctors will reduce your platelet count. Fewer platelets to "sweep up" means the "sweeper bag" gets less full. Hydroxyurea (Hydrea) is the first choice of most doctors to reduce platelet counts.

People can live without their spleens, but, because the spleen helps fight off disease, doctors want to keep this organ healthy and intact. This may be especially important for all of us with ET because we are immuno-compromised because of our disease.

So, if your doc hasn't talked to you about your spleen, make a note to ask about it at your next visit. Meantime, you can read more about your spleen at the Mayo Clinic site.

Be well!

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