Brief Answer: Need to be investigated. Detailed Answer: Welcome to Health care Magic, I am sure, your Doctor must be investigating and monitoring for your Low Haemoglobin. It could be due to still bleeding somewhere, or effect of chronic liver disease causing hemolysis, or affecting kidneys. Your platelet count is low as well, that also suggest, may be there is hidden bleeding somewhere. i would like to know when TIPS procedure was done, and how frequently you are doing Full blood count, and how often you are receiving transfusion? What investigations you have undergone to know the cause of gradually decrease in your Hemoglobin? What medications you are taking at present? have you been tested for Occult bleeding in stool? Have you been investigated for Prostate? How is your Diet? If you are taking diet rich in Iron and Vit C, regular Hematinics, blood transfusion, and had undergone successful TIPS procedure, and your hemoglobin is reducing on repeated test, you need to go thorough investigation. you are most welcome for your next question, if there is any. Dr H Hamdani

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Brief Answer: See the detail answer Detailed Answer: Hi, Welcome back to XXXXXXX I would not say that you had massive blood transfusion, but low platelet count could be due to blood transfusion, due to dilution of coagulation factor as a result of repeated or rapid blood transfusion. There is a possibility of defects in Absorption of Iron supplement and diet. May be your doctor can give you parenteral iron, bypass the GIT, and then see the effects on HB. This can exclude the possibility of any GIT involvement.Though at HB of 8.7 gm% , there is no need of blood transfusion, but if in case there is any need, may be you should be given Platelet concentrate, and RBC concentrate. Besides these, we should also investigate kidney function test, Liver function test, blood coagulation factors, urie test for RBC's, and occult blood test in stool, or colonoscopy. Make sure that you are not taking any pain killers, aspirin or other herbal or alternative medicines without knowledge of your Doctor. I would say also to not become impatient. Sometimes blood forming system takes sometime to restore its normal process after chronic blood loss, and surgery. I have tried to answer your question without knowing your actual clinical condition, and investigation reports. I feel , you are at best place for medical treatment, just keep patience, trust your Doctor, and definitely they will find the cause of it, and will manage the problem efficiently. Though I would be happy to assist you at any time. Dr H Hamdani

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