Hi Teo,
It is very common that Hgb decreases when the bone marrow function decreases in MDS patients. Your mother's Hgb is much too low at 5 plus - even if she doesn't feel tired the heart has to work very hard and she will develope heart insufficiens.
The EPO drug doesn’t have much effect - perhaps it could be combined with a drug for low white blood cells called G-CSF (Neupogen or Neulasta).
http://bloodjournal.hematologylibrar...106/3/768.full
She should have more frequent blood transfusions and 2 units every time - good that your sister insisted. Many patients (like me) have irregular antibodies and it can be very hard to find blood for us. I have to leave blood for the test one day before the transfusion because it takes hours to find blood for me.
Then they should consider iron chelation because her ferritin value will increase.
I am still not sure that your mother has MDS with dysplasia in her bone marrow. Perhaps immunophenotyping could increase the possibility for her to get a diagnose.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719025
Household work can not decrease Hgb – in fact it is important to not rest too much.
Kale is good for most persons but if the platelets are low we should avoid kale and many types of food and drugs that increase the risk for bleeding like green tee, garlic and so on.
Kind regards
Birgitta-A