Andy,
I was always sick a lot my whole life; a simple cold would take weeks to get over, etc. Then when my spleen got so huge, I couldn't walk across the room without being completely short of breath. After I had it out, I felt better, but slowly started getting sick a lot again with infections. After six years of this, I was so sick all the time, that I was on antibiotics almost all the time. I did not think I could even go back to teaching after the summer. Then I finally started on regular monthly transfusions and my health has improved dramatically. I just don't get infections like I used to do. I am much, much healthier because of the transfusions, and because the spleen is out. I think if you don't have to take antibiotics all the time, it is better, so you can use them when you really need them.
Of course there's always some crazy medical things happening with me. Two weekends ago I got sick on the morning I was going in for my transfusion. I had gone 5 weeks instead of 4, and I always seem to get into trouble if I do that. My hemoglobin was not exteremely low though, 10.4. I ended up in the emergency room getting IV fluids, while they checked me out. My hemoglobin had gone up to 10.9, and they couldn't find anything wrong with me except my usual weird blood. i was extremely weak, nauseated, and dehydrated. I drink a lot of liquids, but I get dehydrated easily. I have been told hemoglobin readings go up when a person is dehydrated. Anyway, I finally got my transfusion, and it took 3 days to get my strength back. I don't know what that was all about.
So, a long answer to a short question! I think getting a really enlarged spleen out, and starting regular blood transfusions are two important things for thal intermedias as they get older. Maybe not in all cases, but it was in my case. Take care, Jean