Thrombocythemia and need neck surgery: Will surgery make it worse?

I would consult your surgeon now about this...it is my understanding that invasive surgery is not wise with a platelet count as high as yours. The surgery won't make your blood count higher but the high platelet count can cause thrombosis ( blood clot / stroke). If you do nothing now, at your pre-op appointment any surgeon with a real degree would not perform surgery on a patient with a platelet count that high. Please consult a hematologist and your neurosurgeon immediately.

What is considered a normal count?

From Google: A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. A platelet count of less than 150,000 platelets per microliter is lower than normal. When you have a low platelet count, you may have trouble stopping bleeding.

My platelets were 1094 when I was dx with Essential Thrombocythemia 4 or 5 months ago. I was immediately put on low dose aspirin by the doc, then Hydroxyurea by the specialist. My platelet count is now 608. Under 450 would be ‘normal’, as above, but obviously 608 is a hell of a lot better than over 1000. Symptoms greatly improving but I would be very reluctant to add surgery into the mix, even now. I have read about surgeries being delayed until counts come down. But I guess this decision depends on many factors. Presumably your surgeon is aware of the ET and you can consider pros and cons together.

I had surgery to remove a blood clot in my carotid artery when my count was in the 700’s. I never even thought about thrombosis….naively for sure. But the blood clot had to go before it let go on its own, or I might not be here, so I would say that you should discuss the matter with your doctor to weigh the pros and cons of the surgery with the added knowledge of your platelet count.

Re: "Symptoms greatly improving" What were your symptoms before you started treatment?

Headaches, dizziness, physical fatigue/weakness eg going up stairs, subcutaneous haemorrhages. I thought menopause was hitting me hard! Of course it all affects mood too … hard to feel competent and capable in the usual ways with these kind of symptoms. Good days and bad days. The monthly CBC’s have become very important in terms of getting some kind of picture of what is going on in me.
I started Hydroxy on 22 May this year. I guess most of the symptoms are still around but in reduced frequency and severity. Some of them are also noted as side effects of the Hydroxy medication, and for me I’m sure that stress levels impact y symptom picture as well, so it’s hard to know just what the balance of causation really is at any given time.

I was supposed to have surgery on my shoulder and was advised against it until my platelets were controlled and lower - down from 900's to 694 at the moment - to avoid a thrombotic event. Does your haemotologist know that you are about to have major surgery? If not please inform him and your neurosurgeon. I am also on Hydroxyea - If platelets do not fall below 600 this week they will increase the dosage. My shoulder surgeon is conferring with my haemo to know when it will be safe to operate.
I still get incredible fatigue and suicidal migraines - Maxalt melts is my go-to godsend. I'm still smiling and getting on with life at 67. Good luck!

I had 10/10 migraine headaches when I was just on hydrea for my ET. I added 2 baby aspirin a day and the headaches totally stopped. My oncologist at Mayo said that the headaches were caused by microvascular ischemia. That essentially means that not enough blood is getting to the tissues in your head which causes low oxygen and low nutrients to the tissues and you get pain. It is very dangerous. The physicians is Tulsa OK where I live had no idea why I had pain. I added the aspirin myself. A month laster I saw the physician at Mayo and she said I did the exact right thing. She seemed a little surprised the the physicians including my oncologist did not figure it out. I was glad my background as a Nurse Practitioner helped me to research my own problem and find a solution. When my plan for using baby aspirin was confirmed by Dr Palmer at Mayo I felt very relieved. Good luck to you.

I am on soluble aspirin 75mg per day with 500mg Hydrea but still get these debilitating headaches.
I have had a fusion with deficit in my oesophagus due to an accident during surgery when a plate had to be removed as I had difficulty swallowing some 'shrapnel' was left behind. My GP seems to think all this contributes to the migraine as nerves are being compressed and my neck has further crumbled and fused.