to carry oxygen. Your doctor can test your blood on a regular basis and, if the cell counts are low, order the transfusion of whatever amount of blood he or she feels will reduce your fatigue. One standard is to order blood transfusions when your hematocrit falls below 30.
Because the bone marrow is not replenishing the red cells naturally, this outside replenishment may be ordered repeatedly, on a monthly or more frequent basis, as needed. When blood transfusions are required frequently, you may want to consider whether the time spent traveling to the medical center and getting the treatment is worth the benefit received. This is one of the many choices you have to make between treatment and quality of life.
Techniques for dealing with the fatigue and the breathlessness of low red blood counts are discussed in the next sections, "Fatigue and Shortness of Breath."
White blood cells cannot be transfused. Because of the increased risk of infection when white counts are low, your doctor may suggest immunizations for flu and pneumonia, or avoiding people who have contagious diseases. You will want to pay attention to health alerts aimed at people with reduced immune systems. Report any fever to your doctor for early anti- biotic therapy, if needed.
Low platelet counts may cause problems with clotting and reduce the body's ability to stop bleeding, even from minor cuts and scrapes, such as those that occur while shaving. Tell your doctor about any sign of bleeding, such as a nosebleed or blood in your urine or stool.
You may bruise more easily. If this happens, talk to your doctor about medicines, food or herbs that increase the clotting ability of blood.