Thursday, May 28, 2015
Doctor's Perspective
What are platelets?

By Dr. Anthony Policastro I write this article as I sit in the hospital with a low platelet count. I have found over the last few days that many people do not know what platelets are. Everyone is familiar with red blood cells. They carry oxygen. People know that white blood cells fight infection. What many people do not realize is that the blood also contains cells called platelets. They are responsible for making our blood clot normally. We tend to take them for granted. There are other clotting factors in our blood stream. For example, boys with hemophilia are missing one of those clotting factors. However, those are proteins and not cells. Normally, the platelet count is between 250,000 and 400,000. When it decreases, the risk of bleeding increases. The risk of bruising after minor trauma increases. The risk of being unable to stop bleeding from an injury increases. Fortunately, the decrease must be significant for this to happen. Very few problems occur with counts above 50,000. Between 20,000 and 50,000 we start to see issues with easy bruising. Under 20,000 we can see bleeding without trauma. I recently had pneumonia. Sometimes, the body will develop a reaction to this kind of infection. The antibodies that form to fight the pneumonia will think that the platelets are pneumonia cells. Thus, they will destroy the platelets. Last week I had a minor bump to my eye. The result was a big black eye. The following day I noticed bruising on my legs and feet. My platelet count had been 135,000 after the pneumonia so I figured it might be lower than that. It was 2,000. Off to the hospital I went. When people asked me what was wrong, I told them I had a low platelet count. Many asked what a platelet was so it seemed like a good thing to write about. Now all I have to do is convince my platelets to get above 20,000 so I can head home.

Don't drink and boat on the water DNREC's Division of Fish & Wildlife Natural Resources Police is reminding boaters that drinking and boating don't mix - and that boat operators with blood alcohol levels of .08 or higher risk facing charges for operating under the influence (OUI), as well as putting themselves, their passengers and other boaters in Delaware waters at risk. "Just like driving a road vehicle, operating a boat with a blood alcohol level of 0.08 percent or higher is in violation of Delaware and federal laws," said Cpl. John McDerby of F&W Natural Resources Police. "Boat operators found at or above the legal limit will find their voyage terminated, will be arrested and may have their vessel impounded. Boat operators under the influence also can face fines and potential jail time." According to national statistics from the U.S. Coast Guard, alcohol use is a leading contributing factor to fatal boating accidents. Of the 610 boating-related fatalities reported on the nation's waterways in 2014, 21 percent were caused by alcohol or drug intoxication. Nationally in 2014, 277 accidents involved alcohol use and resulted in 108 deaths and 248 injuries. "Drinking while boating is a choice. The best way to minimize the risk of an accident is to make the wiser choice - don't drink and boat," said Cpl. McDerby. "Environmental stressors aboard a boat - such as constant motion, heat, sun glare and dehydration - all enhance the effects of any amount of alcohol. Because of this, we strongly recommend that boat operators not consume alcohol, and we encourage having a non-drinking designated boat operator." Other tips for recreational boaters include:

  • Exercise patience and courtesy at crowded boat ramps and docks.
  • Observe all "Slow No Wake" areas.
  • Maintain a lookout for other vessels and keep a safe distance from them.

  • Avoid traveling at unsafe speeds, especially in congested areas.
  • Make sure children 12 and younger are wearing life jackets while underway as required by law.
  • Wear your life jacket and encourage all your passengers 13 and older to wear them also.
  • Check navigation lights and make sure to turn them on when operating at night.
  • Carry your boating safety certificate and required safety equipment, including enough life jackets for everyone aboard; a fire extinguisher, and a whistle.
  • Paddle boards are considered vessels, and passengers are required to have a life jacket on board and carry a whistle or other sound-producing device. If out after sunset, a flashlight is also required.
For access to the online Delaware Boating Handbook and other safe boating information, visit the DNREC website and click Delaware Boating Safety, or contact Delaware Boating Safety Coordinator Cpl. John McDerby at 302-739-9913 or email

Living Beyond Cancer session Living Beyond Cancer: Stress Reduction, the fifth session of a monthly series addressing important issues for cancer survivors and their loved ones, will meet on Tuesday, June 2 at 5:30 p.m. in the Conference Room of the Nanticoke Cancer Care Center, 801 Middleford Rd., Seaford. This monthly series has covered many topics and is sponsored by the Nanticoke Cancer Care Center and Cancer Support Community Delaware. Survivors may join in at any session. In this session, Mariann Wolskee, LCSW will guide you to stress release techniques to help you cope with a cancer diagnosis and beyond. A light snack will be provided. You must register in advance by calling the Cancer Support Community Delaware office at 645-9150.

Dr. Petrera offers new approach Peninsula Orthopaedic Associates (POA) surgeon Dr. Pasquale Pertrera recently returned from Genk, Belgium where he was invited to spend a day operating with Dr. Kristoff Corten. Dr. Corten of Associatie Orthopedie is an internationally recognized expert on minimally invasive hip replacement surgery using the direct anterior approach. This advanced surgical technique can offer advantages over standard surgical procedures, including smaller incisions, shorter hospital stays, faster recovery and rehabilitation, less blood loss, and less scar tissue. To find out if you are may be a candidate for a hip replacement with the anterior approach, contact Peninsula Orthopaedic Associates at 877-749-4154.

Dr. Waked joins Nanticoke Nanticoke Health Services and the Nanticoke Physician Network welcome Tarek Waked, MD, a board certified general surgeon who performs weight loss surgery. Dr. Waked is accepting new patients at Nanticoke Physician Network General and Bariatric Surgery located at 121 S. Front St., Seaford. Dr. Waked graduated from the American University of Beirut in Beirut, Lebanon in 2006. He completed residency in General Surgery at Inova Fairfax Hospital, VCU Campus in Virginia and a fellowship in Minimally Invasive and Bariatric Surgery at the Mayo Clinic in Rochester, Minn. in 2013. Dr. Waked is a Fellow of the Association of Metabolic & Bariatric Surgeons fluent in English, Arabic and Spanish. He is also available for general surgery and is trained in advanced minimally invasive laparoscopic procedures.