Typically you need to be below 9.0 hmg to get a transfusion. The fluctuation in her blood counts is common.
Mine have been known to bounce all over the place. Sometimes a simple cold of virus will cause my counts to fall. I have had the disease 18 years and the only thing that keeps my counts stable is Spring and Fall. Extreme temperatures of summer and winter cause my counts to bounce.
I have only had infrequent transfusions 1-2 per year and antibiotics as needed for infections. Don't expect the doctors to always know what is causing fluctuations. If you get copies of all blood counts and tests and your Mom keeps track of her activities and how she feels each day, you will eventually be able to know what causes her counts to fluctuate. This will just take patience and time.
Ask as many questions of the doctors that you want. That is what they get paid for. Don't fear transfusions. They can really help your Mom fight the disease and make her feel better in the meantime.
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