a diagnosis

Blake has idiopathic thromobocytopenia (ITP). ITP is the condition of having an abnormally low platelet count (thrombocytopenia) of unknown cause (idiopathic).[1] As most incidents of ITP appear to be related to the production of antibodies against platelets, immune thrombocytopenic purpura or immune thrombocytopenia are terms also used to describe this condition. Often ITP is asymptomatic (devoid of obvious symptoms) and can be discovered incidentally, but a very low platelet count can lead to an increased risk of bleeding and purpura. ITP is diagnosed with a complete blood count (a common blood test). In some situations, additional investigations (such as a bone marrow biopsy) may be necessary to ensure that the platelet count is not decreased due to other reasons. Treatment may not be necessary in mild cases, but very low counts or significant bleeding might prompt treatment with steroids, intravenous immunoglobulin, anti-D immunoglobulin, or stronger immunosuppressive drugs. Refractory ITP (ITP not responsive to conventional treatment) may require splenectomy, the surgical removal of the spleen. Platelet transfusions may be used in severe bleeding together with a very low count. Sometimes the body may compensate by making abnormally large platelets. Visible symptoms of ITP include the spontaneous formation of bruises (purpura) and petechiae (tiny bruises), especially on the extremities, bleeding from the nostrils, bleeding at the gums, and menorrhagia (excessive menstrual bleeding), any of which may occur if the platelet count is below 20,000 per μl.

When we were admitted to Kosair, his platelets had dropped to 3,000.

When the diagnosis came, it was a relief. I wanted to cry with gratitude but at that time I was so tired, beyond tired. When we were admitted to the hospital, the hematologist came and talked to us. There were two possible diagnoses. Only two. ITP or leukemia. Leukemia? Typing this now, it's all so surreal. I still feel much like an observer on that night. That it didn't happen. Not to us. I never cried that night. Not one tear. We took turns holding Blake. Neither one of us slept. We just watched the infusion of immunoglobulin drain into our son's body. Praying that it worked. With every ounce of our being, we prayed. Sometimes silently, sometimes out loud. Very loud. The immunoglobulin drug made Blake sick. He had a fever. He was sweating. He had chills. And he vomited...all night long. Yet he never cried. Merely whimpered. Letting us hold him. Inhale the scent that is Blake. Revel in the innocence that is our son. Before a simple blood test could change everything. We had to wait eight hours after the infusion was complete before they could redraw his platelets. I lost track of time. But I know that it was morning, for the sun was streaming into the room, laying its fingers upon Blake, when the doctor came in. His platelets were 17,000. It worked. It wasn't leukemia. And still I didn't cry. We were discharged late that night. We were exhausted. And Beckett? Sweet boy, he was with my mom, but so happy to see us. Oh, I missed him. I kept thinking that if the diagnosis had gone the other way how different his life would be. How I would never see him, because I would always be in the hospital with Blake. And I was full of gratitude as hugged him. As I hugged both my children. But still, I didn't cry. And now, as I write this...I am exhausted. At the end of a rope that is quickly fraying. Adjusting to this new normal is draining. Blake has to go to the doctor every other day for a blood count. We go to clinic every other week for a check up. He can not climb. He can not have playground play. He can NOT fall. If he falls, we are headed to the ER for a CAT scan. Why? To make sure that he is not bleeding in his brain. In his brain?! Currently his platelets are at 30,000. He is beginning to bruise again. All over. Once his counts drop to 20,000 we will be going back into the hospital for another infusion. This can last from six months to two years. In less than 5% of the cases....it can last a lifetime. His whole life. That would mean no contact sports. EVER. The literature states that the incidence of ITP is 50-100 per million. Per million?!And my son got it? I am beyond overwhelmed. I feel as if I can't close my eyes, turn my head, take a breath without worrying about where he is. And the guilt if he does fall? Ha. Get a shovel and bury me. And yet, and yet despite this hardship, it could be worse. Much worse. We could still be in the hospital. My baby could be receiving chemotherapy. Losing his hair and he fights for his life. But we are not there. We are here. And for some reason, my child was spared. Oh, the plans He must have for him, for me, for all of us. The lessons we are learning. The taste of humility upon our tongues. I am not saying that this is a road I want to walk down. I don't. But I acknowledge the fact that while I walk this road, I will be able to walk it with my son beside me. That we will be able to celebrate his 2nd birthday together. I just wish that the tears would come.