Aplastic Anemia: The Unexpected Bump With a Friend and One Similar Case

What’s up everyone! This is Nurse JP, I am a registered nurse in the Philippines but now, technically I no longer practice as a nurse. I am already a doctor underboard. I will be sharing to you my experience as a doctor. For now the story how I unexpectedly bumped into one of my buddy way back the nursing days.

So, I was having this internship rotation as a doctor in a hospital in our place. While doing our rounds, I came a cross a very familiar name which eventually confirmed that he was my nursing buddy.

They were admitted at the pediatric emergency room that day because his kid (let’s call her Angel) had another few episodes of bleeding after being discharged for 2 days. We had a small chat prior proceeding to rounds. Eventually they were transferred to a regular room where we can visit them along with our consultant.

Later, I met another patient in the pediatric ICU, a boy who also has an aplastic anemia. He also was having episodes of bleeding in the nose and gums similar with Angel. He was already on ATG treatment for aplastic anemia, this is just one of the drugs given to patients with this condition to stop the antibodies from destroying the blood-forming bone marrow.

They easily bleed and which can happen several times in their homes or even during their hospital stay. They don’t typically grow to adulthood. Most of them die young. That is if the condition started during childhood. This condition also has an adult onset which typically as severe as the childhood aplastic anemia. This case has a high mortality, meaning the child or an adult would most likely die as the disease progresses or as the condition recurs.

As what my senior doctor said, “I’d rather treat a patient with acute lymphoblastic leukemia (ALL) than treating a patient with aplastic anemia..” This is because patients with ALL tend to respond well with chemotherapy unlike with the treatment of aplastic anemia.

What usually is the course of this blood-related disease.

If the treatment is available for all may be the patients have the chance to get better. Failure to start the treatment when condition begins will lead to a poor outcome.

The best therapy for a younger patient with aplastic anemia is bone marrow transplant and it should be from a compatible sibling donor. This will be difficult to secure because not all patient have a compatible donor. Thus most of this patient will rely to the ATG treatment which even though available will not guarantee to offer a significant improvement.

Breaking the bad news – 100% difficult and heart breaking

So, If you’re a parent or a sibling who happened to google this condition I am sorry for breaking the bad news to you. I might not have the guts to tell you personally, or may be, I will.. after I have undergone my residency training.

I do believe in miracles, and the healing power of the our Lord Jesus Christ. Just continue praying for the healing and provision for the said treatment for your patient.

Going back to my story, so eventually after the platelet had gone up to an acceptable level, praise God, Angle was discharged. I am happy that she recovered.

Remember the boy in the ICU? He also recovered and transferred to the ward. He improved but after 2 days in the ward his condition deteriorated rapidly. He developed a skin infection called necrotizing fasciitis which spreads rapidly and caused his vitals to deteriorate in the same manner.

The breaking the bad news, or others may call it priming the patient, or simply an update was a difficult task to do. This is because we know that parents will definitely cry, will mourn, will undergo an emotional crisis due to an impending death of a loved one.

As I eavesdrop, on how my senior doctor would do this it went well, and as expected the mother broke into tears. As I began to feel the tear teeming in my eyes I have to leave the place asap so that no one will catch me in case I can’t make it. Oh! heck no! haha.

That was a nerve wrecking experience that I have to learn for myself. This made me think “what if it’s my time to prime the parents”? When that time comes definitely I should have composed myself not to sympathize but to empathize with the patient.

This is your Nurse JP once again I hope you will read my next post. You can also connect with me through the following social media: YT Channel: NurseJP and FB Page.

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