Thank you @hopeful33250 for your response and advice. I live in Ottawa, Canada and I'm currently being seen by a physician (the Tropical Disease Specialist) from the Ottawa Hospital - which is actually a collection of 3 hospitals in the area, I believe. I've not met with the surgeon yet - the appointment is on the 18th of this month - but he or she will apparently be from the 'Liver and Pancreas' surgical unit of the hospital.

I have online access to some of my medical records from the hospital and I found a clinical note from the 18th of September where a group of 12 doctors, who I think are part of the Liver and Pancreas Surgical team, discussed my case. Their consensus, at that time anyway, was that there was not an immediate need for splenectomy unless I was symptomatic or the hematologist felt surgery would help manage my low platelets. I don't know if 'symptomatic' means something beyond the pressure, dizziness, fatigue etc. that I'm already feeling regularly (assuming those symptoms are connected to this issue, of course). This meeting was also held before my last ultrasound that apparently shows I do have an enlarged spleen - which may be the cause of my low platelets.

I probably will not get to see the results of the ultrasound until I meet with the surgeon. So, I don't know to what degree my spleen is enlarged or if this latest finding changes anything one way or the other. I do know that I'm feeling pressure in my chest in areas where I didn't before, but I'm not sure how significant this is.

So far, I haven't thought about getting a second opinion. If they decide surgery is necessary, I may then have to consider my options.