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The "safe" level for platelets depends on what type of activities you're talking about, as well as individual tolerances. Levels below 20k (and especially below 10k) can cause petichiae and bruising even if you're not doing anything particularly risky, but the more impact you're engaged in, the higher you want those levels to be. I'm used to hearing 50k as being a safe level for most normal daily activities, but if you're in a car crash or fall off a ladder, that's not going to be enough. Internal hemorhaging as well as external bleeding is a big concern.
When Ken was first diagnosed, his plts were 8k. The ER doctor looked me straight in the eye and said "DON'T let him fall down." Like I would have been able to stop him! We celebrated when his plts finally reached 100k. As his hem/onc said "You can do brain surgery at that level!"
As for why anemia puts a strain on the heart, it's because Hgb is what carries oxygen to the tissues (including the brain), and low Hgb means the heart has to pump a lot harder to deliver the same amount of oxygen. At least that's my understanding. Somebody may have a better explanation.
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-Lisa, husband Ken age 60 dx SAA 7/04, dx hypo MDS 1/06 w/finding of trisomy 8; 2 ATGs, partial remission, still using cyclosporine
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