It is challenging to manage a disease like ET. I was diagnosed in October, 2023. Mine was found while diagnosing colitis and Exocrine Pancreatic Insufficiency. The blood tests revealed platelets of 792,000. I was referred to a hematologist/oncologist (whom I adore!), had a bone marrow biopsy and started Hydroxyurea (HU) along with one low-dose aspirin daily. My platelets dropped quickly into the 200,000s and my HU dosing was changed to only 4 days a week with 3 days off. Yes, it's exhausting. All of my chronic diseases cause fatigue, and all the meds to manage them do so as well. At 71, I rest often, try to get enough sleep, and don't beat myself up when I am too tired to participate in an activity or event. The key is to do what you can and enjoy it, modify other activities if possible so as not to wear yourself out, and be kind to yourself.