On November 15, 2004, Jo went to her OB for her 8-week pregnancy checkup. She was pretty sure she was pregnant and we were very excited to have it confirmed. As a routine part of that checkup, her blood counts were checked and, to our surprise, they came back critically low. Her platelet count was 31,000 – normal is anywhere from 150,000 to 450,000. Her red blood cell counts and white blood cell counts were also very low, but the platelets were the primary concern. Jo knew she had felt winded and tired, but she felt it was just a normal part of being pregnant.
Jo was immediately put in touch with Dr. Raul Alvarez, a hematologist in Highlands Ranch, CO. Dr. Alvarez began running tests and giving her all the normal medications for somebody that is anemic. On November 21st, Dr. Alvarez had Jo checked into Swedish Medical Center where she spent a full week over the Thanksgiving Holiday. (I did manage to sneak her in some very nice Thanksgiving deserts, compliments of our close friends, Thuy Nguyen and Huong Hoang.)
On November 24th, Jo’s platelets had dropped to 13,000 and she received her first blood transfusion. We still didn’t know what was really going on or how it would affect the pregnancy. Dr. Alvarez had requested that I come to meet with him and Jo on at least 2 or 3 different occasions. He seemed as scared as we were. He very slowly and methodically explained to us what was going on and the severity of the problem.
Aplastic Anemia is a very rare blood disorder where the bone marrow fails – usually for no known reason. We have found some very sparse data that suggests that pregnancy can cause Aplastic Anemia, but there will never be any way to know for sure if this is the case for Jo.
Jo does want me to mention that she had a bone marrow biopsy while at Swedish. Since she was admitted as a patient (and things were slow over Thanksgiving), they sedated her for the procedure (sticking a long needle into her hip bone to extract some bone marrow) and things went pretty smooth – this will be important when you hear about the next bone marrow biopsy.
The results of the biopsy were not good. Dr. Alvarez drew some diagrams for us showing how Jo’s bone marrow was working at about 5% of normal. He again emphasized how serious this was and requested that we go to Washington, D.C. to visit the specialists at the National Institutes of Health (NIH).
