jp - As an FYI - as the more I read in these (and other) posts everybody has a bit different journey and as long as you really trust your doc, at least listen, but also it is good to get 2nd opinion from an MPN specialist. Your experience with HU sounds similar - I was on it for 4-5 years with varying results going up and down. Stopped taking when it really disrupted all my blood values (RBC, PLT, WBC, etc) in a 30 day period (while not overweight I also lost 30 lbs that was not all bad). I was switched to Jakafi and overall have at least kept my PLT values in check. Still see some of the symptoms progressing; although some may just be normal aging (although I hate to admit that). Good luck with your journey.