My shaky first experience with plasmapheresis treatment
My blood pressure dropped and I blacked out
I watched nervously as hospital staff rolled in a large machine that looked like something from “Doctor Who.” I giggled, thinking of those alien robots from the TV show that chanted “exterminate.” The machine was set up, and tubing was attached to the port catheter hanging out of my chest.
Once the machine was activated, its lights blinked on and off, and bright red blood flowed out of the port, through a tube, and back to the machine to be cleaned. The machine’s operator, who was my usual nurse, chatted with the head nurse, but their voices became more and more distant. I rubbed my eyes, which had begun to feel fuzzy, unsure of what was happening.
Swirls of colors, tiny sparkles, and flashes of light filled my vision. Was I hallucinating? One of the nurses noticed the confusion on my face and asked if I was OK.
“I don’t know, everything is moving really fast,” I responded. “There are swirls of colors.”
As the nurses exchanged worried looks, my field of vision began to shrink, and darkness crept in. The last thing I remember saying was, “I don’t feel good. I want to stop.” At that moment, a heart monitor alarm sounded and I blacked out. This was my first experience with plasmapheresis.
It occurred during my lengthy ICU stay in the fall of 2020. I’d been there for over a month, suffering from multiorgan failure caused by blood clots in my organs and the destruction of my platelets and red blood cells. Nearly every component of my blood was under attack in seemingly contradictory ways. The previous night, one of my nephrologists suspected that I was suffering from three different diseases simultaneously.
His guess was that I had immune thrombocytopenia (ITP), thrombotic thrombocytopenic purpura (TTP), and atypical hemolytic uremic syndrome (aHUS). While it would take a week to get the aHUS test results back, I’d already been diagnosed with ITP in 2018 but hadn’t experienced a severe flare since my initial treatment. TTP was evident due to the damage to my kidneys, liver, and heart.
Since we had to wait for the aHUS diagnosis and treatment, my medical team decided to treat ITP first. Corticosteroids, my previous ITP treatment, hadn’t significantly helped, so they wanted to try plasmapheresis. In ITP, the immune system mistakenly attacks the body’s healthy platelets, which are needed for proper blood clotting. Therefore, the machine I mentioned earlier would remove antibodies from my blood, and that would stop the antibodies from attacking my platelets and red blood cells.
However, a common side effect of plasmapheresis is a drop in blood pressure, which is what caused me to black out. When I woke up, the plasmapheresis machine was gone, and my room was quiet. A nurse noticed I was awake and came to check on me.
“Welcome back, sleepyhead! I bet you’re starving,” she said. She was right. I’d passed out for nearly 12 hours.
Eventually, I underwent four more plasmapheresis sessions. Removing the harmful antibodies seemed to slow down the destruction of my platelets and blood, which allowed my body to finally begin the healing process.
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