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Patient Instructions

Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and bone marrow transplants can destroy some of your platelet cells.

If you do not have enough platelet cells, you may bleed too much. Everyday activities can cause this bleeding. You need to know how to prevent bleeding and what to do if you have bleeding.

Talk with your doctor before you take any drugs, herbs, or other supplements. Do not take aspirin or ibuprofen (Motrin, Advil) unless your doctor tells you it is okay to.

Be careful not to cut yourself:

• Do not walk barefoot.
• Use only an electric razor.
• Use knives, scissors, and other tools carefully.
• Do not blow your nose hard.
• Do not cut your nails. Use an emery board instead.

Take care of your teeth:

• Use a toothbrush with soft bristles.
• Do not use dental floss.
• Talk with your doctor before getting any dental work done. You may need to delay the work or take special care if you have it.

Do not get constipated:

• Drink plenty of fluids.
• Eat plenty of fiber in your meals.
• Talk with your doctor about using stool softeners if you are straining a lot when you have bowel movements.

Other tips:

• Avoid heavy lifting or playing contact sports.
• Do not drink alcohol.
• Do not use enemas, rectal suppositories, or vaginal douches.

Woman should not use tampons. Call your doctor if your periods are heavier than normal.

If you cut yourself:

• Put pressure on the cut, with gauze, for a few minutes.
• Use ice to help slow the bleeding.
• Call your doctor if the bleeding does not stop after 10 minutes or if the bleeding is very heavy.

Know what to do if you have a nosebleed:

• Sit up and lean forward.
• Pinch your nostrils, just below the bridge of your nose (about two-thirds down).
• Use ice on your nose to help slow the bleeding.
• Call the doctor if the bleeding gets worse or if it does not stop after 30 minutes.

Call your doctor if you have any of these symptoms:

• Bleeding from your mouth or gums
• A nosebleed that does not stop
• Bruises on your arms or legs
• Very small red or purple spots on your skin
• Brown or red urine
• Black or tarry looking stools, or stools with red blood in them
• Blood in your mucus
• You are throwing up blood
• Long or heavy periods (women)
• Headache that does not go away or is very bad
• Blurry or double vision
• Belly pain

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.