DEAR DR. DONOHUE: I was told that the platelet count should be between 150,000 and 400,000. For about 20 years, my count has been as low as 70,000. Recently it was 77,000 with a few giant-size platelets. Should I be concerned? — E.R.

ANSWER: Platelets are the smallest blood cells. Another name for platelets is thrombocytes. Their job is to keep us from bleeding profusely when a blood vessel breaks. They plug the break with a clot. Counts of less than 75,000 increase the bleeding risk due to severe trauma or surgery. Counts of 20,000 to 30,000 increase the bleeding risk in ordinary situations. Counts of 5,000 to 10,000 are a dangerous risk for bleeding.

One process that leads to diminished platelets is their destruction from antibodies, body-made grenades that are used by the immune system to ward off invaders. In this case, their use has been hijacked and directed to platelets. I think this is what you have. The attack on your platelets hasn’t ever put you in serious danger of hemorrhaging. It’s unlikely ever to do so after 20 years.

Signs of real trouble include frequent, spontaneous nosebleeds, bleeding gums, bruising at young ages (bruising at older ages is a different story), gastrointestinal tract bleeding and blood in the urine.

Treatment depends of the cause and symptoms. You need no treatment. You have no symptoms. Your count has never reached a truly dangerous level.

Should treatment be required, cortisone drugs, IVIG (immunoglobulin) and Rh-o immunoglobulin are the medicines that would be used. In emergency situations, platelet transfusions save the day.

I’m sure your doctor will continue to follow your counts. I’m equally sure they won’t drop to a dangerous level after a 20-year history of having low counts.

DEAR DR. DONOHUE: We have a friend who has a very short memory. She can’t remember names and what she did a few hours before. In one hour she might ask us the same question three or four times. She drives a car to the library and grocery store and a few other places, but when she gets there, she forgets why she came.

She takes a pill called donepezil.

We saw a book by a doctor about reviving memory. Is there any proof that it works? — D.R.

ANSWER: I don’t know the book, and I don’t know the method suggested in it. However, if there were a successful treatment for reviving memory, the news would be broadcast daily, and a huge number of people would be using it. Since that isn’t the case, I have my doubts about the method you read about.

Memory loss, especially memory loss for things in the immediate past, often is a sign of dementia, a loss of mental function. Alzheimer’s disease is the most prevalent dementia. Your friend’s medicine donepezil (Aricept) is an Alzheimer’s medicine. Your friend’s doctor must have prescribed it because he or she believes your friend has Alzheimer’s disease.

I wonder about the wisdom of this lady driving a car.

DEAR DR. DONOHUE: I’m a new diabetic. I take medicine, and I check my blood sugar daily. At what number should my blood sugar be? — R.R.

ANSWER: Diabetes is under good control if your first reading in the morning before eating is between 90 and 130 mg/dL (3.9 to 7.2 mmol/L). An acceptable level before bedtime is 110 to 150 (6.1 to 8.3).

If you are being monitored by having your hemoglobin A1C checked periodically, it should be less than 7 percent.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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