This is my first post, and as a 29 year old survivor of stage 3 Distal Cholangiocarcinoma I get annoyed reading these forums people don't provde solutions.
Vitamin K, Bile, and FAT these three are essential for your platelet count/ coagulation (the bile and fat are needed for K absorbtion). Have your dr check your prothrombin time. When I had a blocked bile duct I was severely K difficient, even though I ate tons of vegetable (high in vitamin K) I got a vitamin K shot which lasts a while as it stores in the liver. But if your Dr is ambivulent (many are) supplement with first a bile pill, then a healthy fatty meal (almond butter rules, but peanut's good too and cheaper or fatty fish), then take the vitamin K pill. Everytime mine drops while I'm on chemo I take one (100-150% DV) a day in addition to lots of fresh veggies with some vingar and oil, just not the day before or after an infusion (conflicting data on reducing chemotherapy potentcy).
Ofcoarse the morbid diagnosis, which I hope it's not, is Metastasis to the Spleen, but that would have been indicative by the scan. In any event the spleen is NOT the main source of platelet production, it only stores it for emergency (which is clearly your case). The chemo makes the spleen work overtime due to the massive purging of blood cells. Suggest vitamin K to your Dr, and if not try it anyway, and see if after a few weeks your numbers improve (empirical evidence). Just don't overdo it, vitamin K can be toxic, but I find that difficult for people with bile flow problems, or no gall bladder.
What everyone on this board needs to remember is most people die from the extraneous complications of CC (cholangitis, other infections, malnutrition, surgical complcations, liver cirrhosis). Treat those first, that's what my doctors did (mainly due to my denial of cancer), I was near death in last June with severe cholangitis and then after I finished 3rd overall in a 112 mile bike race last September with a stent in my bile duct waiting for my Whipple in November, which was a !@#$ing success. Then I was back to racing 2 months later.
If you have more questions I may or may not respond as I don't check here as often. I read medical journals online instead, atleast they provide answers.
"If life doesn't give you what you want, grab it by the throat until it does..."